Federal Register - September 13, 2021
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Source: Federal Register
Federal Register / Vol. 86, No. 174 / Monday, September 13, 2021 / Notices DEPARTMENT OF VETERANS
AFFAIRS
Reasonable Charges for Inpatient Medical Severity-Diagnosis Related Groups and Skilled Nursing Facility Medical Services v4.22; Fiscal Year 2022 Update AGENCY:
Department of Veterans Affairs
VA.
ACTION:
Notice.
This document updates the acute inpatient and Skilled Nursing Facility SNF/sub-acute inpatient facility charges. The updated charges are based on Medical Severity-Diagnosis Related Groups MSDRG for fiscal year FY 2022.
FOR FURTHER INFORMATION CONTACT:
Debra Vatthauer, Office of Community Care, Revenue Operations, Payer Relations and Services, Rates and Charges 13RO1, Veterans Health Administration, Department of Veterans Affairs, 128 Bingham Road, Suite 1000, Asheville, NC 28806; email:
debra.vatthauer@va.gov; telephone:
6088217346 This is not a toll-free number.
SUMMARY:
38 CFR
17.101a1 sets forth VAs collection or recovery regulations for medical care or services provided or furnished by VA to a Veteran for a nonservice-connected disability for which the Veteran is entitled to care or the payment of expenses of care under a health plan contract; for a nonservice-connected disability incurred incident to the Veterans employment and covered under a workers compensation law or plan that provides reimbursement or indemnification for such care and services; or for a nonservice-connected disability incurred as a result of a motor vehicle accident in a state that requires automobile accident reparations insurance. The methodologies for establishing billed amounts for several types of charges are found in 38 CFR
17.101; however, this notice will only address the acute inpatient and the
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SNF/sub-acute inpatient facility charges.
Based on the methodologies set forth in 38 CFR 17.101b, this notice updates the acute inpatient facility charges that were based on the FY 2021 MSDRGs.
Acute inpatient facility charges by MS
DRGs are posted on the Veterans Health Administration VHA Office of Community Care OCC website, at the following link: www.va.gov/
communitycare/revenue_ops/payer_
rates.asp, under the Reasonable Charges Data Tables section, Inpatient Data Table, as Table A v4.21. This Table A corresponds to the Table A
referenced in a notice published in the Federal Register on September 22, 2020
see 85 FR 59606. Table A v4.22
referenced in this notice provides updated charges based on the FY 2022
MSDRGs and will replace Table A
v4.21 posted on the VHA OCC website.
Also, this notice updates the SNF/
sub-acute inpatient facility all-inclusive per diem charge using the methodologies set forth in 38 CFR
17.101c. This charge is adjusted by a geographic area factor that is based on the location where the care is provided.
For the geographic area factors, see Table N, title Acute Inpatient, and Table O, title SNF, on the VHA OCC
website under the v4.215 link in the Reasonable Charges Data Tables section. Tables N and O are not being updated by this notice. The SNF/subacute inpatient facility per diem charge is posted on the VHA OCC website under the Reasonable Charges Data Tables section, Table B v4.21. This Table B corresponds to the Table B
referenced in a notice published in the Federal Register on September 22, 2020
see 85 FR 59606. Table B referenced in this notice is v4.22, which provides an update to the all-inclusive nationwide SNF/sub-acute inpatient facility per diem charge and will replace Table B
v4.21 posted on the VHA OCC website.
The charges in this notice for acute inpatient and SNF/sub-acute inpatient facility services are effective October 1, 2021.
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This notice is retaining the table designations used for acute inpatient facility charges by MSDRGs, which are posted on the VHA OCC website under Reasonable Charges Data Tables. This notice also is retaining the table designation used for SNF/sub-acute inpatient facility charges, which also are posted on the VHA OCC website.
Accordingly, the tables identified as being updated by this notice correspond to the applicable tables referenced in a notice published in the Federal Register on September 22, 2020 see 85 FR
59606.
The list of data sources presented in Supplementary Table 1 v4.22 reflects the updated data sources used to establish the updated charges described in this notice and will be posted on the VHA OCC website under the Reasonable Charges Data Sources section.
The list of VA medical facility locations is also updated. In Supplement Table 3, posted on the VHA
OCC website under the VA Medical Facility Locations section, VA set forth the list of VA medical facility locations, which includes the first three digits of their zip codes and provider-based/nonprovider-based designations.
Consistent with VAs regulations, the updated tables described in this notice will be posted on the VHA OCC website, under the Payer Rates and Charges information section.
Signing Authority Denis McDonough, Secretary of Veterans Affairs, approved this document on August 16, 2021, and authorized the undersigned to sign and submit the document to the Office of the Federal Register for publication electronically as an official document of the Department of Veterans Affairs.
Luvenia Potts, Regulation Development Coordinator, Office of Regulation Policy & Management, Office of General Counsel, Department of Veterans Affairs.
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