[Federal Register Volume 62, Number 215 (Thursday, November 6, 1997)]
[Notices]
[Pages 60068-60069]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-29309]


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DEPARTMENT OF DEFENSE

Office of the Secretary


Proposed Collection; Comment Request

AGENCY: Office of the Assistant Secretary of Defense for Health 
Affairs, DOD.

ACTION: Notice.

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    In accordance with Section 3506(c)(2)(A) of the Paperwork Reduction 
Act of 1995, the Office of the Assistant Secretary of Defense for 
Health Affairs announces the proposed public information collection and 
seeks public comment on the provisions thereof. Comments are invited 
on: (a) whether the proposed collection of information is necessary for 
the proper performance of the functions of the agency, including 
whether the information shall have practical utility; (b) the accuracy 
of the agency's estimate of the burden of the information collection; 
(c) ways to enhance the quality, utility, and clarity of the 
information to be collected; and (d) ways to minimize the burden of the 
information collection on respondents, including through the use of 
automated collection techniques or other forms of information 
technology.

DATES: Consideration will be given to all comments received by January 
5, 1998.

ADDRESSES: Written comments and recommendations on the information 
collection should be sent to TRICARE Support Office, Program 
Development Branch, U.S. Army Garrison, Fitzsimons, ATTN: Tariq Shahid, 
Aurora, CO 80045-6900.

FOR FURTHER INFORMATION CONTACT:
To request more information on this proposed information collection, 
please write to the above address or call TRICARE Support Office, 
Program Development Branch, at (303) 361-1401.
    Title; Associated Form; and OMB Number: Reimbursement Information, 
Psychiatric Residential Treatment Centers Serving Children and 
Adolescents, TRICARE Form 771, OMB Number 0704-0295.
    Needs and Uses: The information collection requirement is necessary 
to obtain individual residential treatment center (RTC) data that will 
be used in calculating the prospective per diem rates for new RTCs 
seeking certifications under the TRICARE program.
    Affected Public: Business or other for-profit; non-profit 
institutions.
    Annual Burden Hours: 240.
    Number of Respondents: 20.
    Responses per Respondents: 1.
    Average Burden per Response: 12 hours.
    Frequency: On occasion.

SUPPLEMENTARY INFORMATION:

Summary of Information Collection

    Respondents are psychiatric residential treatment centers (RTCs) 
seeking certification under the TRICARE program to provide needed 
services to eligible children and adolescents. The data collection 
instrument, i.e., TRICARE Form 771, will collect the necessary 
reimbursement information that will be used in calculating prospective 
all-inclusive per diem rates for new RTCs under the TRICARE program. 
Based on current trends, it is estimated that about 20 forms will be 
completed and submitted to the TRICARE program per fiscal year for RTCs 
seeking certification under the program.
    The TRICARE Support Office (TSO), formerly known as OCHAMPUS, 
published a proposed rule on 4 December 1987, (52 FR 46098), and final 
rule on 1 August 1988, (53 FR 28873), in the Federal Register 
clarifying participation requirements and establishing a new 
reimbursement system for payment of RTCs. These amendments outlined the 
methodology used in calculating the individual RTC rates along with the 
capped amount. The amendments also described the data collection 
elements and responded to 23 distinct categories of comments.
    The TRICARE program will be responsible for: (1) sending out the 
data collection instrument (TRICARE Form 771) to all RTCs seeking 
certification under the TRICARE program; (2) answering all inquiries 
regarding the data collection; (3) compiling and analyzing the 
submitted data; (4) following up on missing or incomplete data; (5) 
calculating the individual prospective all-inclusive per diem rates; 
and (6) sending out RTC participation agreements with the calculated 
rates.
    The TRICARE's failure to collect the information will jeopardize 
fulfillment of the program requirements and would result in the 
agency's inability to collect the necessary data for establishment of 
RTC rates. The agency's inability to establish prospective per diem 
rates could also result in a reduction in availability of RTCs for 
TRICARE beneficiaries.
    The prospective payment methodology: (1) provides the potential for 
control over rapidly increasing costs for mental health care within the 
Department of Defense; (2) ensures that TRICARE beneficiaries are not 
subject to exaggerated or unjustified costs for RTC care solely because 
of the TRICARE entitlement; and (3) provides for a rate of 
reimbursement for all participating RTCs which reflects a reasonable 
amount consistent with rates charged by their peers nationally and with 
reimbursement they are accepting from other third-party payers.
    The use of improved information technology has been a consideration 
in capturing RTC charge data necessary to calculate new rates; however, 
this would create an excessive administrative burden on the agency for 
the relatively small number of providers affected by the request. RTCs 
represent less than 0.13 percent of TRICARE institutional providers and 
less than 0.04 percent of TRICARE individual professional providers. 
The agency would have to make major modifications to its payment 
records and data files in order to retrieve this information.
    In the data collection form design, we have made every effort to 
eliminate any duplication. The form consists of two major categories of 
data collection: (1) institutional per diem rates; and (2) additional 
ancillary or professional charges not included in the per diem rates. 
All data information systems have been queried to determine if there 
was any duplication of data collection elements. None of the routine 
data collection reports maintained by the agency have the information 
formatted in a way that can be used to calculate the new RTC rates.
    While TSO generates RTC reports, these reports do not include 
professional claims which are billed separately from the institutional 
component. Since the professional charges arenot married up with 
institutional charges, an all-inclusive rate cannot be determined under 
the existing reporting system. The marrying

[[Page 60069]]

up of claims would require extensive reprogramming of the current 
payment system reports and would probably result in questionable data. 
Even if TSO could modify its current reporting system, it would only 
provide one of the data components necessary for establishing the RTC 
rates. The rates for other third-party payers would remain inaccessible 
under the TSO reporting system. Other third-party information is 
critical in establishing the most favorable rate for the RTC. The RTC 
is the only one that can provide other third-party information.
    The data collection form is simplistic in design to minimize 
administrative burden on the RTCs. The requested information should 
already be maintained by the facility for normal operation. It is 
anticipated that it should take one person 8 to 10 hours to prepare the 
data, and an additional 2 to 4 hours if TRICARE should have follow-up 
inquiries regarding their data submission. TSO or the TRICARE 
contractor staff will be available to answer any questions that the 
RTCs may have regarding completion of the form.
    The issue of confidentiality has been considered. The data 
submitted by RTCs will be kept in strict confidence and will not be 
accessible to competitors. The only information accessible to the 
general public will be the TRICARE all-inclusive rates calculated for 
each RTC. These rates will appear in the TRICARE/CHAMPUS Policy Manual 
and may be released under the Freedom of Information Act.
    The information requested is financial in nature and may be 
considered private or confidential in a business sense. Specific 
knowledge of a RTC's financial position may create an unfair advantage 
for its competitors. However, the information requested is necessary 
for calculating the individual prospective all-inclusive per diem 
rates. The RTCs are only being asked to provide those data (financial) 
elements used directly in the reimbursement formula. They have also 
been assured that facility specific information will be kept 
confidential. The instruction sheet and cover letter will justify 
collection of the information and give a detailed explanation of the 
data element requirements.
    The number of one-time respondents is 20. It is estimated that a 
maximum of 12 hours will be required to complete the form since the 
requested information should already be maintained by the facility for 
normal operation. Most of the administrative burden will be associated 
with the reformatting of existing financial information. The burden of 
collecting the data will be dependent on the type of reporting system 
in use. Facilities which maintain their financial records on computers 
will be able to retrieve the requested information faster than those 
with manual systems. The use of computerized data may cut the reporting 
time in half (6 hours). Larger RTCs are more likely to have 
sophisticated reporting systems than smaller facilities. However, this 
is probably more the exception than the rule with the advent of more 
reasonably priced ADP systems for small businesses. The total one-time 
reporting burden is estimated to be 240 hours.

    Dated: October 31, 1997.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 97-29309 Filed 11-5-97; 8:45 am]
BILLING CODE 5000-04-M