Notice2021-19658
Reasonable Charges for Inpatient Medical Severity-Diagnosis Related Groups and Skilled Nursing Facility Medical Services (v4.22); Fiscal Year 2022 Update
Primary source
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Published
September 13, 2021
Issuing agencies
Veterans Affairs Department
Abstract
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 (MS-DRG) for fiscal year (FY) 2022.
Full Text
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<title>Federal Register, Volume 86 Issue 174 (Monday, September 13, 2021)</title>
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[Federal Register Volume 86, Number 174 (Monday, September 13, 2021)]
[Notices]
[Page 50953]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-19658]
[[Page 50953]]
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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.
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SUMMARY: 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 (MS-DRG)
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:
<a href="/cdn-cgi/l/email-protection#27434245554609514653534f4652425567514609404851"><span class="__cf_email__" data-cfemail="e68283849487c8908792928e87938394a69087c8818990">[email protected]</span></a>; telephone: 608-821-7346 (This is not a toll-
free number.)
SUPPLEMENTARY INFORMATION: 38 CFR 17.101(a)(1) sets forth VA's
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 Veteran's employment and
covered under a worker's 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 SNF/sub-acute
inpatient facility charges.
Based on the methodologies set forth in 38 CFR 17.101(b), this
notice updates the acute inpatient facility charges that were based on
the FY 2021 MS-DRGs. 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: <a href="http://www.va.gov/communitycare/revenue_ops/payer_rates.asp">www.va.gov/communitycare/revenue_ops/payer_rates.asp</a>, 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 MS-DRGs 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
17.101(c). 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/sub-acute 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.
This notice is retaining the table designations used for acute
inpatient facility charges by MS-DRGs, 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/non-provider-based designations.
Consistent with VA's 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.
[FR Doc. 2021-19658 Filed 9-10-21; 8:45 am]
BILLING CODE 8320-01-P
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