Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); FY96 DRG updates--DoD. Notice of DRG revised rates

This notice provides the updated adjusted standardized amounts, DRG relative weights, outlier thresholds, and beneficiary cost-share per diem rates to be used for FY 1996 under the CHAMPUS DRG-based payment system. It also describes the changes made to the CHAMPUS DRG-based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS).     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); FY95 DRG updates--DoD. Notice of DRG revised rates

This notice provides the updated adjusted standardized amounts, DRG relative weights, outlier thresholds, and beneficiary cost-share per diem rates to be used for FY 1995 under the CHAMPUS DRG-based payment system. It also describes the non-regulatory changes made to the CHAMPUS DRG-based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS).     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); FY 96 updates--DoD. Amendment to notice

On October 3, 1995, 60 FR 51779, the Department of Defense published the "Notice of DRG Revised Rates" without Tables 1 and 2. These tables provide the rates and weights to be used under the CHAMPUS DRG-based payment system during FY 1996. This amendment is to display the updated rates and weights for Tables 1 and 2.     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)--DoD. Notice of revised rates

This notice provides the updated adjusted standardized amounts, DRG relative weights, outlier thresholds, and beneficiary cost-share per diem rates to be used for FY 1993 under the CHAMPUS DRG-based payment system. It also describes the non-regulatory changes made to the CHAMPUS DRG-based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS).     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); fiscal year 1994 updates--DoD. Notice of updated partial hospitalization per diem rates

This notice provides for the updating of per diem rates for both full-day and half-day CHAMPUS Partial Hospitalization Programs for fiscal year 1994.     

TRICARE/CHAMPUS: FY99 DRG updates--DoD. Notice of DRG revised rates

This notice describes the changes made to the TRICARE/CHAMPUS DRG-based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS). It also provides the updated fixed loss cost outlier threshold, cost-to-charge ratios and the Internet address for accessing the updated adjusted standardized amounts, DRG relative weights, and beneficiary cost-share per diem rates to be used for FY 1999 under the TRICARE/CHAMPUS DRG-based payment system.     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); fiscal year 1993 updates--DoD. Notice of updated mental health per diem rates

This notice provides for the updating of hospital-specific per diem rates for high volume providers and regional per diem rates for low volume providers; the updated cap per diem for high volume providers; and the beneficiary per diem cost-share amount for low volume providers to be used for FY 1993 under the CHAMPUS Mental Health Per Diem Payment System.     

TRICARE/CHAMPUS; FY98 DRG updates--DoD. Notice of DRG revised rates

This notice provides the updated adjusted standardized amounts, DRG relative weights, outlier thresholds, and beneficiary cost-share per diem rates to be used for FY98 under the TRICARE/CHAMPUS DRG-based payment system. It also describes the changes made to the TRICARE/ CHAMPUS DRG-based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS).     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)--Department of Defense. Notice of revised rates

This notice provides the updated adjusted standardized amounts, DRG relative weights, outlier thresholds, and beneficiary cost-share per diem rates to be used for FY 1992 under the CHAMPUS DRG-based payment system. It also describes the non-regulatory changes made to the CHAMPUS DRG-based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS).     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); corrections to the CHAMPUS Diagnosis Related Group (DRG) payment system rates and weights--DoD. Corrections to notice of revised rates

This document corrects an error that appeared in the notice of revised rates which was published on January 27, 1993, (58 FR 6254) and which revised the rates and weights to be used in the CHAMPUS DRG-based payment system effective for admissions occurring on or after October 1, 1992. It also clarifies the rates and weights to be used for two DRGs for which no rates and weights were calculated.     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); partial hospitalization--DoD. Final rule

This final rule establishes a CHAMPUS benefit for partial hospitalization and makes corrections and clarifications on other mental health issues resulting from implementation of recent legislative changes. The partial hospitalization benefit is being added at the request of Congress to improve the availability of mental health services under CHAMPUS. The intent is to provide a needed service at a lower cost than the full hospitalization rate, and allow more efficient use of resources for needed mental health care. Facilities must be certified and enter into a participation agreement with CHAMPUS and obtain the required preauthorization prior to admitting CHAMPUS patients. Applications for facility approval may be obtained from the Director, OCHAMPUS, or a designee.     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); establishment of national differentials for children's hospitals--DoD. Notice

The Office of the Civilian Health and Medical Program of the Uniformed Services (OCHAMPUS) is announcing the national differential rates for children's hospitals which go into effect April 1, 1995. This notice is issued as required in 32 CFR 199.14 in which OCHAMPUS announced that a notice would be published setting forth the national differential and eliminating the hospital-specific differentials.     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); corrections to the CHAMPUS diagnosis related group (DRG) payment system rates and weights--Department of Defense. Corrections to notice of revised rates

This document corrects errors that appeared in the notice of revised rates which was published on October 30, 1991, (56 FR 55895) and which revised the rates and weights to be used in the CHAMPUS DRG-based payment system effective for admissions occurring on or after October 1, 1991.     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Program; reimbursement--DoD. Final rule

This final rule revises certain requirements and procedures for reimbursement under the CHAMPUS program, the purpose of which is to implement a comprehensive managed health care delivery system composed of military medical treatment facilities and CHAMPUS. Issues addressed in this rule include: implementation of changes made to the Medicare Prospective Payment System (PPS) upon which the CHAMPUS DRG-based payment system is modeled and required by law to follow wherever practicable, along with changes to make our DRG-based payment system operate better; clarification of payment reduction for noncompliance with required utilization of publication of list of ambulatory surgery procedures; limitation on ambulatory surgery group payment rates; extension of the balance billing limitations currently in place for individual and professional providers to non-institutional, non-professional providers; adjustment of the CHAMPUS maximum allowable charge (CMAC) rate in the small number of cases where the CMAC rate is less than the Medicare rate; implementation of the government-wide debarment rule where any provider excluded or suspended from CHAMPUS shall be excluded from all other programs and activities involving Federal financial assistance, such as Medicare or Medicaid; elimination of the requirement for non-participating providers to file claims; and revision of the ambulatory surgery cost-share information to enable the cost-share to be assessed against the facility claim instead of the primary surgeon's claim.     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); five separate changes--DoD. Final rule

This final rule addresses five separate changes to comply with provisions affecting CHAMPUS. These changes will update this part to include as a benefit, a screen to check for the level of lead in the blood of an infant; to eliminate the implied statement that ambulance services are covered only to, from, and between hospitals; to include other forms of prescribed contraceptives by eliminating the reference that limits prescribed contraceptives only to those taken orally; to identify three additional Gulf Conflict groups eligible for the delay in the increased deductible; and to establish lower limits on the fiscal year catastrophic cap from $10,000 to $7,500 for all eligibles except dependents of active duty personnel, whose limit remains at $1,000.     

TRICARE formerly known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); fiscal year 1998 mental health rate updates--DoD. Notice of updated mental health per diem rates

This notice provides for the updating of hospital-specific per diem rates for high volume providers and regional per diem rates for low volume providers; the updated cap per diem for high volume providers; the beneficiary per diem cost-share amount for low volume providers for FY 1998 under the TRICARE Mental Health Per Diem Payment System; and the updated per diem rates for both full-day and half-day TRICARE Partial Hospitalization Programs for fiscal year 1998.     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); mental health services--DoD. Final rule

This final rule is to reform CHAMPUS quality of care standards and reimbursement methods for inpatient mental health services. The rule updates existing standards for residential treatment centers (RTCs) and establishes new standards for approval as CHAMPUS-authorized providers for substance use disorder rehabilitation facilities (SUDRFs) and partial hospitalization programs (PHPs); implements recommendations of the Comptroller General of the United States that DoD establish cost-based reimbursement methods for psychiatric hospitals and residential treatment facilities; adopts another Comptroller General recommendation that DoD remove the current incentive for the use of inpatient mental health care; and eliminates payments to residential treatment centers for days in which the patient is on a leave of absence.     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE prime enrollment procedures--DOD. Proposed rule

This proposed rule modifies the TRICARE Prime enrollment for active duty families by specifying that the enrollment period is continuous rather than a 12 month enrollment period and it allows monthly installment payments of enrollment fees for those beneficiaries required to pay an annual fee in order to enroll in TRICARE Prime. These modifications are being made because TRICARE will soon be available wordwide for active duty family members.