Federal Register / Vol. 78, No. 31 / Thursday, February 14, 2013 / Proposed Rules 10579 

1The proposed rulemaking would also codify, 

with one modification, the existing procedure for 

pulling and refiling an HSR notification without 

payment of an additional filing fee. I have no 

objections to this proposal. 

the Agencies and also Form 8–Ks with 

the SEC announcing they have entered 

into an agreement to merge. Subsequent 

findings in the course of due diligence 

cause A and B to terminate the merger 

agreement and A files an additional 

Form 8–K announcing the termination 

of an agreement. A states that it may 

seek to enter into a new or amended 

merger agreement with B. A’s premerger 

notification filing is deemed to have 

been withdrawn on the date of the filing 

of the Form 8–K announcing the 

termination of the merger agreement. A 

can, however, refile within two business 

days on a new merger agreement, 

commencing a new waiting period, 

without paying an additional filing fee, 

if it meets the requirements of 

§ 803.12(c). 

6. A and B enter into a merger 

agreement and file premerger 

notification filings with the Agencies 

and Form 8–Ks with the SEC. Second 

requests are issued. A and B 

subsequently certify compliance with 

the second request, starting the 

extended waiting period. Prior to the 

expiration of the extended waiting 

period, the parties enter into an 

agreement with the agency conducting 

the investigation to delay closing of the 

transaction, allowing the consummation 

of the acquisition only after 30-days’ 

notice (a ‘‘timing agreement’’), and the 

extended waiting period expires. During 

the pendency of the timing agreement, 

A and B terminate the merger agreement 

and A files a Form 8–K with the SEC 

announcing the termination of an 

agreement. A’s premerger notification 

filing is deemed withdrawn on the date 

of the SEC filing as a result of that filing, 

even though the extended waiting 

period has expired and the parties are 

still within the one year period 

following that expiration under 

§ 803.7(a). Note that had the extended 

waiting period expired and no timing 

agreement had been entered into, a 

filing with the SEC announcing the 

termination of the agreement would not 

result in the withdrawal of A’s 

premerger notification filing. 

7. A and B enter into a merger 

agreement and file premerger 

notification filings with the Agencies 

and Form 8–Ks with the SEC. The 

agencies complete their review and 

early termination of the initial 30-day 

waiting period is granted. Prior to the 

expiration of the one year period 

following the grant of early termination, 

A and B terminate the merger agreement 

and A files a Form 8–K with the SEC 

announcing the termination of an 

agreement. A’s premerger notification 

filing is not deemed withdrawn as a 

result of the SEC filing because the 

initial 30-day premerger notification 

waiting period had been granted early 

termination. Therefore, the parties still 

have the full one year period prior to the 

expiration of the notification under 

§ 803.7(a) to consummate the 

transaction should it be recommenced. 

By direction of the Commission. 

Donald S. Clark, 

Secretary. 

Note: The following appendix will not 

appear in the Code of Federal Regulations. 

Concurring Statement of Commissioner 

Joshua D. Wright Regarding Proposed 

Amendments to Hart-Scott-Rodino 

Rules 

FTC Matter No. P859910 

February 1, 2013. 

The Commission has voted today to 

publish a notice of proposed rulemaking 

seeking comment on amendments to the 

Hart-Scott-Rodino (HSR) rules. Under 

the proposed amendments, HSR filings 

would be automatically withdrawn 

upon the submission of an SEC filing 

that the notified transaction had been 

terminated.1 I wish to thank staff in the 

Premerger Notification Office for their 

efforts in crafting this proposed rule and 

their diligent administration of the 

premerger notification program. 

I concur in the Commission’s decision 

because I believe the Commission 

would benefit from the public’s input 

into this proposed rulemaking. 

Nevertheless, I am concerned that the 

proposed rules may impose costs in 

excess of any potential benefits. 

The proposed rulemaking appears to 

be a solution in search of a problem. 

The Federal Register notice states that 

the proposed rules are necessary to 

prevent the FTC and DOJ from 

‘‘expend[ing] scarce resources on 

hypothetical transactions.’’ Yet, I have 

not to date been presented with 

evidence that any of the over 68,000 

transactions notified under the HSR 

rules have required Commission 

resources to be allocated to a truly 

hypothetical transaction. Indeed, it 

would be surprising to see firms 

incurring the costs and devoting the 

time and effort associated with antitrust 

review in the absence of a good faith 

intent to proceed with their transaction. 

The proposed rules, if adopted, could 

increase the costs of corporate takeovers 

and thus distort the market for corporate 

control. Some companies that had 

complied with or were attempting to 

comply with a Second Request, for 

example, could be forced to restart their 

antitrust review, leading to significant 

delays and added expenses. The 

proposed rules could also create 

incentives for firms to structure their 

transactions less efficiently and 

discourage the use of tender offers. 

Finally, the proposed new rules will 

disproportionately burden U.S. public 

companies; the Federal Register notice 

acknowledges that the new rules will 

not apply to tender offers for many nonpublic and foreign companies. 

Given these concerns, I hope that 

interested parties will avail themselves 

of the opportunity to submit public 

comments so that the Commission can 

make an informed decision at the 

conclusion of this process. 

[FR Doc. 2013–02821 Filed 2–13–13; 8:45 am] 

BILLING CODE 6750–01–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[Docket ID DOD–2012–HA–0105] 

RIN 0720–AB58 

TRICARE Revision to CHAMPUS DRGBased Payment System, Pricing of 

Hospital Claims 

AGENCY: Office of the Secretary, 

Department of Defense. 

ACTION: Proposed rule. 

SUMMARY: This rule proposes to change 

TRICARE’s current regulatory provision 

for hospital claims priced under the 

DRG-based payment system. Claims are 

currently priced by using the rates and 

weights that are in effect on a 

beneficiary’s date of admission. This 

rule proposes to change that provision 

to price such claims by using the rates 

and weights that are in effect on a 

beneficiary’s date of discharge. 

DATES: Written comments received at 

the address indicated below by April 15, 

2013 will be accepted. 

ADDRESSES: You may submit comments, 

identified by docket number and or 

Regulatory Information Number (RIN) 

number and title, by either of the 

following methods: 

• Federal eRulemaking Portal: 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Mail: Federal Docket Management 

System Office, 4800 Mark Center Drive, 

East Tower, Suite 02G09, Alexandria, 

VA 22350–3100. 

Instructions: All submissions received 

must include the agency name and 

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10580 Federal Register / Vol. 78, No. 31 / Thursday, February 14, 2013 / Proposed Rules 

docket number or RIN for this Federal 

Register document. The general policy 

for comments and other submissions 

from members of the public is to make 

these submissions available for public 

viewing on the Internet at http:// 

www.regulations.gov as they are 

received without change, including any 

personal identifiers or contact 

information. 

FOR FURTHER INFORMATION CONTACT: Ms. 

Amber Butterfield, TRICARE 

Management Activity, Medical Benefits 

and Reimbursement Systems, telephone 

(303) 676–3565. 

SUPPLEMENTARY INFORMATION: 

Executive Summary and Overview 

I. Purpose of the Regulatory Action 

This rule proposes to amend the 

TRICARE/CHAMPUS regulatory 

provision of pricing hospital claims that 

are reimbursed under the DRG-based 

payment system from the beneficiary’s 

date of admission, to pricing such 

claims based on the beneficiary’s date of 

discharge. 

The TRICARE/CHAMPUS DRG-based 

payment system applies to hospitals, 

unless such hospital is exempt by 

regulation from the payment system. 

Under the TRICARE DRG-based 

payment system, payment for the 

operating costs of inpatient hospital 

services subject to the payment system 

are made on the basis of prospectively 

determined rates. 

The TRICARE DRG-based payment 

system is modeled on the Medicare 

Inpatient Prospective Payment System 

(IPPS). Although many of the 

procedures in the TRICARE DRG-based 

payment system are similar or identical 

to the procedures in the Medicare IPPS, 

the actual payment amounts, DRG 

weights, and certain procedures are 

different. This is necessary because of 

the differences in the two programs, 

especially in the beneficiary population. 

Since the inception of the DRG-based 

payment system in 1987, claims have 

been priced following the beneficiary’s 

discharge by the hospital, but using the 

rules, weights, and rates that were in 

effect on the beneficiary’s date of 

admission. That is, claims submitted for 

the beneficiary’s inpatient stay are 

grouped to a specific DRG, and the 

pricing (i.e., payment rate) is 

determined by using the rules, weights 

and rates that were in effect on the date 

of the beneficiary’s admission to the 

hospital. The August 31, 1988, Final 

Rule (53 FR 33461) published in the 

Federal Register explains TRICARE’s 

decision to utilize the date of admission 

to price claims. Using the date of 

admission to price claims allowed 

hospitals to be reimbursed for inpatient 

services under the same payment 

methodology they expected to be used 

when the patient was admitted. Prior to 

implementation of the DRG-based 

payment system, the hospital could 

expect to be reimbursed at the billed 

charge rate since that was the method 

TRICARE used to reimburse hospitals at 

that time. For patients admitted after 

implementation of the DRG-based 

payment system, the hospital could 

expect to be reimbursed using the DRGbased payment system. The Final Rule 

continues by stating that since certain 

services were previously excluded from 

the DRG-based system, but may have 

already involved an interim bill prior to 

the effective date of the Final Rule, it 

would be administratively difficult and 

fiscally unfair to hospitals, to attempt to 

reconcile the total payments with the 

DRG-based allowed amounts. As a result 

of the analysis at the time, the provision 

stated, ‘‘except for interim claims 

submitted for qualifying outlier cases, 

all claims reimbursed under the 

CHAMPUS DRG-based payment system 

are to be priced as of the date of 

admission, regardless of when the claim 

is submitted.’’ 

II. Summary of the Major Provisions of 

the Regulatory Action 

The major provision of this proposed 

rule is to revise TRICARE’s regulation 

on the pricing of claims paid under the 

DRG-based payment system. Claims are 

currently priced by using the rates and 

weights that are in effect on a 

beneficiary’s date of admission. This 

rule proposes to change that provision 

to price such claims by using the rates 

and weights that are in effect on a 

beneficiary’s date of discharge. 

In the early stages of the DRG-based 

payment system, the approach of 

pricing claims based on the date of the 

beneficiary’s admission to the hospital 

was an effective operational policy for 

TRICARE. It is now time, however, to 

revise this policy to be consistent with 

industry standards. Medicare and other 

payers have an operational policy of 

pricing all claims, to include interim 

claims, based on the date of discharge. 

While pricing using the date of 

discharge applies to all claims, it 

becomes an issue only for those 

relatively few claims that span Fiscal 

Years (FY). That is, if an admission 

occurs on September 29, 2013, (FY 

2013) and the discharge occurs on 

October 2, 2013, (FY2014) the payment 

rate is currently based upon the DRG 

rates and weights in effect on September 

29, 2013, (FY2013) rather than on 

October 2, 2013, (FY2014). Using this 

same example, if the provisions of this 

proposed rule are made final and the 

date of discharge is used to price the 

claim, the claim will be priced using the 

rates and weights in place on October 2, 

2013, (FY2014). The rates and weights 

for the DRG-based payment system are 

updated every FY, and are based on the 

previous year’s TRICARE claims data. 

III. Costs and Benefits 

The benefits of this change include, 

aligning TRICARE pricing of hospital 

claims practices with industry standards 

and enhancing provider satisfaction 

because we are following Medicare and 

industry standards. 

There are known cost impacts 

associated with this change: 

1. One-time information technology 

costs associated with changes to 

Managed Care Support Contractors’ 

claims processing systems and one time 

administrative costs associated with the 

review change order and the assessment 

of the impact on Claims Operations, 

Customer Service, Provider 

Administration and Contracts 

Maintenance. The total one time 

information technology and 

administrative costs is estimated at 

$88,208. 

2. An annual cost of reprocessing 

interim claims of $2,500. 

3. An increase in health care costs to 

account for using the weights and rates 

in place on the date of discharge. Using 

2009 claims data, it is estimated about 

1,200 inpatient claims will span FYs. 

Consequently, reimbursing using the 

updated weights and rates in place for 

the new FYs date of discharge is 

expected to increase the payment for 

approximately 1,200 claims with 

estimated additional cost of $500,000 

annually. 

4. Total costs for this change equal 

approximately $600,000. 

IV. Regulatory Procedures 

Executive Order 12866, ‘‘Regulatory 

Planning and Review’’ and Executive 

Order 13563, ‘‘Improving Regulation 

and Regulatory Review’’ 

Section 801 of title 5, United States 

Code, and Executive Orders 12866 and 

13563 require certain regulatory 

assessments and procedures for any 

major rule or significant regulatory 

action, defined as one that would result 

in an annual effect of $100 million or 

more on the national economy or which 

would have other substantial impacts. It 

has been certified that this rule is not 

economically significant, and has been 

reviewed by the Office of Management 

and Budget as required under the 

provisions of E.O. 12866. 

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Federal Register / Vol. 78, No. 31 / Thursday, February 14, 2013 / Proposed Rules 10581 

Public Law 104–4, Section 202, 

‘‘Unfunded Mandates Reform Act’’ 

Section 202 of Public Law 104–4, 

‘‘Unfunded Mandates Reform Act,’’ 

requires that an analysis be performed 

to determine whether any federal 

mandate may result in the expenditure 

by State, local and tribal governments, 

in the aggregate, or by the private sector 

of $100 million in any one year. It has 

been certified that this proposed rule 

does not contain a Federal mandate that 

may result in the expenditure by State, 

local and tribal governments, in 

aggregate, or by the private sector, of 

$100 million or more in any one year, 

and thus this proposed rule is not 

subject to this requirement. 

Public Law 96–354, ‘‘Regulatory 

Flexibility Act’’ (RFA) (5 U.S.C. 601) 

Public Law 96–354, ‘‘Regulatory 

Flexibility Act’’ (RFA) (5 U.S.C. 601), 

requires that each Federal agency 

prepare a regulatory flexibility analysis 

when the agency issues a regulation 

which would have a significant impact 

on a substantial number of small 

entities. This proposed rule is not an 

economically significant regulatory 

action, and it has been certified that it 

will not have a significant impact on a 

substantial number of small entities. 

Therefore, this proposed rule is not 

subject to the requirements of the RFA. 

Public Law 96–511, ‘‘Paperwork 

Reduction Act’’ (44 U.S.C. Chapter 35) 

This rule does not contain a 

‘‘collection of information’’ 

requirement, and will not impose 

additional information collection 

requirements on the public under Public 

Law 96–511, ‘‘Paperwork Reduction 

Act’’ (44 U.S.C. Chapter 35). 

Executive Order 13132, ‘‘Federalism’’ 

E.O. 13132, ‘‘Federalism,’’ requires 

that an impact analysis be performed to 

determine whether the rule has 

federalism implications that would have 

substantial direct effects on the States, 

on the relationship between the national 

government and the States, or on the 

distribution of power and 

responsibilities among the various 

levels of government. It has been 

certified that this proposed rule does 

not have federalism implications, as set 

forth in E.O. 13132. 

List of Subjects in 32 CFR part 199 

Claims, Dental health, Health care, 

Health insurance, Individuals with 

disabilities, Military personnel. 

Accordingly, 32 CFR Part 199 is 

amended as follows: 

PART 199—[AMENDED] 

■ 1. The authority citation for Part 199 

continues to read as follows: 

Authority: 5 U.S.C. 301; 10 U.S.C. chapter 

55. 

■ 2. Section 199.14 is amended by 

revising paragraph (a)(1)(i)(C)(3) to read 

as follows: 

§ 199.14 Provider Reimbursement 

Methods 

(a) * * * 

(1) * * * 

(i) * * * 

(C) * * * 

(3) Pricing of claims. All claims 

reimbursed under the CHAMPUS DRGbased payment system are to be priced 

as of the date of discharge, regardless of 

when the claim is submitted. 

* * * * * 

Dated: February 1, 2013. 

Patricia L. Toppings, 

OSD Federal Register Liaison Officer, 

Department of Defense. 

[FR Doc. 2013–03419 Filed 2–13–13; 8:45 am] 

BILLING CODE 5001–06–P 

ARCHITECTURAL AND 

TRANSPORTATION BARRIERS 

COMPLIANCE BOARD 

36 CFR Part 1192 

RIN 3014–AA42 

Rail Vehicles Access Advisory 

Committee 

AGENCY: Architectural and 

Transportation Barriers Compliance 

Board. 

ACTION: Notice of intent to establish 

advisory committee. 

SUMMARY: We, the Architectural and 

Transportation Barriers Compliance 

Board (Access Board), plan to revise and 

update our accessibility guidelines 

issued pursuant to the Americans with 

Disabilities Act for transportation 

vehicles that operate on fixed guideway 

systems (e.g., rapid rail, light rail, 

commuter rail, and intercity rail). We 

are establishing a Rail Vehicles Access 

Advisory Committee (Committee) to 

make recommendations for revisions 

and updates to the accessibility 

guidelines. We request applications 

from interested organizations for 

representatives to serve on the 

Committee. 

DATES: Submit applications by April 1, 

2013. 

ADDRESSES: Submit applications by any 

of the following methods: 

• Mail or Hand Delivery/Courier: Paul 

Beatty, Access Board, 1331 F Street 

NW., Suite 1000, Washington, DC 

20004–1111. 

• Fax: 202–272–0081. 

• Email: rvaac@access-board.gov. 

FOR FURTHER INFORMATION CONTACT: Paul 

Beatty, Access Board, 1331 F Street 

NW., Suite 1000, Washington, DC 

20004–1111. Telephone: (202) 272–0012 

(Voice) or (202) 272–0072 (TTY). Email 

address: rvaac@access-board.gov. 

SUPPLEMENTARY INFORMATION: In this 

notice, ‘‘we,’’ ‘‘us’’ and ‘‘our’’ refer to 

the Architectural and Transportation 

Barriers Compliance Board (Access 

Board). 

The Americans with Disabilities Act 

requires us to issue guidelines to ensure 

that transportation vehicles covered by 

the statute are accessible to individuals 

with disabilities. 42 U.S.C. 12204. Our 

accessibility guidelines for 

transportation vehicles form the basis 

for legally enforceable accessibility 

standards issued by the U.S. Department 

of Transportation (DOT). Our 

accessibility guidelines for 

transportation vehicles are codified at 

36 CFR part 1192; the DOT accessibility 

standards for transportation vehicles are 

codified at 49 CFR part 38. 

We issued a notice of proposed 

rulemaking (NPRM) in 2010 to revise 

and update our accessibility guidelines 

for buses, over-the-road buses, and vans. 

75 FR 43748 (July 26, 2010). The NPRM 

noted that we would revise and update 

our accessibility guidelines for 

transportation vehicles that operate on 

fixed guideway systems (e.g., rapid rail, 

light rail, commuter rail, and intercity 

rail) at a future date. To begin the 

process of revising and updating our 

accessibility guidelines for 

transportation vehicles that operate on 

fixed guideway systems, we are 

establishing a Rail Vehicles Access 

Advisory Committee (Committee) to 

make recommendations for revisions 

and updates to the guidelines. We 

request applications from 

representatives of the following interests 

for membership on the Committee: 

• Manufacturers of transportation 

vehicles that operate on fixed guideway 

systems; 

• Transportation providers that 

operate fixed guideway systems; 

• Organizations representing 

individuals with disabilities; and 

• Other entities whose interests may 

be affected by the accessibility 

guidelines. 

Federal agencies may serve as exofficio members on the advisory 

committee. 

The number of Committee members 

will be limited so that the Committee’s 

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