7846 Federal Register / Vol. 80, No. 29 / Thursday, February 12, 2015 / Notices 

G. Indirect Medical Education (IDME) 

Adjustment 

Passage of the Medical Modernization 

Act of 2003 modified the formula 

multipliers to be used in the calculation 

of IDME adjustment factor. Since the 

IDME formula used by TRICARE does 

not include disproportionate share 

hospitals (DSHs), the variables in the 

formula are different than Medicare’s, 

however; the percentage reductions that 

will be applied to Medicare’s formula 

will also be applied to the TRICARE 

IDME formula. The multiplier for the 

IDME adjustment factor for TRICARE for 

FY 2015 is 1.02. 

H. Cost to Charge Ratio 

TRICARE uses a national Medicare 

cost-to-charge ratio (CCR). For FY 2015, 

the Medicare CCR used for the TRICARE 

DRG-based payment system for acute 

care hospitals and neonates will be 

0.2726. This is based on a weighted 

average of the hospital-specific 

Medicare CCRs (weighted by the 

number of Medicare discharges) after 

excluding hospitals not subject to the 

TRICARE DRG system (Sole Community 

Hospitals, Indian Health Service 

hospitals, and hospitals in Maryland). 

The Medicare CCR is used to calculate 

cost outlier payments, except for 

children’s hospitals. The Medicare CCR 

has been increased by a factor of 1.0065 

to include an additional allowance for 

bad debt. The 1.0065 factor reflects the 

provisions of the Middle Class Tax 

Relief and Job Creation Act of 2012. For 

children’s hospital cost outliers, the 

CCR used is 0.2939. 

I. Pricing of Claims 

The final rule published on May 21, 

2014, (79 FR 29085–29088) set forth all 

final claims with discharge dates of 

October 1, 2014, or later and reimbursed 

under the TRICARE DRG-Based 

payment system, are to be priced using 

the rules, weights and rates in effect on 

as of the date of discharge. Prior to this, 

all final claims were priced using the 

rules, weights and rates in effective as 

of the date of admission. 

J. Updated Rates and Weights 

The updated rates and weights are 

accessible through the Internet at 

http://www.tricare.mil/drgrates. The 

implementing regulations for the 

TRICARE/CHAMPUS DRG-based 

payment system are in 32 CFR part 199. 

Dated: February 6, 2015. 

Aaron Siegel, 

Alternate OSD Federal Register Liaison 

Officer, Department of Defense. 

[FR Doc. 2015–02898 Filed 2–11–15; 8:45 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

TRICARE, Formerly Known as the 

Civilian Health and Medical Program of 

the Uniformed Services (CHAMPUS); 

Fiscal Year 2015 Mental Health Rate 

Updates 

AGENCY: Department of Defense. 

ACTION: Notice of updated mental health 

rates for Fiscal Year 2015. 

SUMMARY: This notice provides the 

updated regional per-diem rates for lowvolume mental health providers; the 

update factor for hospital-specific perdiems; the updated cap per-diem for 

high-volume providers; the beneficiary 

per-diem cost-share amount for lowvolume providers; and the updated perdiem rates for both full-day and half-day 

TRICARE Partial Hospitalization 

Programs for Fiscal Year 2015. 

DATES: Effective Date: The Fiscal Year 

2015 rates contained in this notice are 

effective for services on or after October 

1, 2014. 

ADDRESSES: Defense Health Agency 

(DHA), Medical Benefits and 

Reimbursement Branch, 16401 East 

Centretech Parkway, Aurora, CO 80011– 

9066. 

FOR FURTHER INFORMATION CONTACT: Elan 

Green, Medical Benefits and 

Reimbursement Office, DHA, telephone 

(303) 676–3907. 

SUPPLEMENTARY INFORMATION: The final 

rule published in the Federal Register 

(FR) on September 6, 1988 (53 FR 

34285) set forth reimbursement changes 

that were effective for all inpatient 

hospital admissions in psychiatric 

hospitals and exempt psychiatric units 

occurring on or after January 1, 1989. 

The final rule published in the Federal 

Register on July 1, 1993 (58 FR 35400) 

set forth maximum per-diem rates for all 

partial hospitalization admissions on or 

after September 29, 1993. Included in 

these final rules were provisions for 

updating reimbursement rates for each 

federal Fiscal Year. As stated in the final 

rules, each per-diem shall be updated by 

the Medicare update factor for hospitals 

and units exempt from the Medicare 

Prospective Payment System (i.e., this is 

the same update factor used for the 

inpatient prospective payment system). 

For Fiscal Year 2015, the market basket 

rate is 2.9 percent. This year, Medicare 

applied two reductions to its market 

basket amount: (1) A 0.5 percent 

reduction for economy-wide 

productivity required by section 3401(a) 

of the Patient Protection and Affordable 

Care Act (PPACA) which amended 

section 1886(b)(3)(B) of the Social 

Security Act, and (2) a 0.2 percent point 

adjustment as required by section 

1886(b)(3)(B)(xii) of the Act as added 

and amended by sections 3401 and 

10319(a) of the PPACA. These two 

reductions do not apply to TRICARE. 

Hospitals and units with hospitalspecific rates (hospitals and units with 

high TRICARE volume) and regionalspecific rates for psychiatric hospitals 

and units with low TRICARE volume 

will have their TRICARE rates for Fiscal 

Year 2015 updated by 2.9 percent. 

Partial hospitalization rates for fullday programs also will be updated by 

2.9 percent for Fiscal Year 2015. Partial 

hospitalization rates for programs of less 

than 6 hours (with a minimum of three 

hours) will be paid a per diem rate of 

75 percent of the rate for a full-day 

program. 

The cap amount for high-volume 

hospitals and units also will be updated 

by the 2.9 percent for Fiscal Year 2015. 

The beneficiary cost share for lowvolume hospitals and units also will be 

updated by the 2.9 percent for Fiscal 

Year 2015. 

Per 32 CFR 199.14, the same area 

wage indexes used for the CHAMPUS 

Diagnosis-Related Group (DRG)-based 

payment system shall be applied to the 

wage portion of the applicable regional 

per-diem for each day of the admission. 

The wage portion shall be the same as 

that used for the CHAMPUS DRG-based 

payment system. For wage index values 

greater than 1.0, the wage portion of the 

regional rate subject to the area wage 

adjustment is 69.6 percent for Fiscal 

Year 2015. For wage index values less 

than or equal to 1.0, the wage portion 

of the regional rate subject to the area 

wage adjustment is 62.0 percent. 

Additionally, 32 CFR 199.14 requires 

that hospital specific and regional perdiems shall be updated by the Medicare 

update factor for hospitals and units 

exempt from the Medicare prospective 

payment system. 

The following reflect an update of 2.9 

percent for Fiscal Year 2015. 


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Federal Register / Vol. 80, No. 29 / Thursday, February 12, 2015 / Notices 7847 

REGIONAL-SPECIFIC RATES FOR PSYCHIATRIC HOSPITALS AND UNITS WITH LOW TRICARE VOLUME FOR FISCAL YEAR

2015 

United States census region Regional rate 

Northeast: 

New England .......................................................................................................................................................................... $851 

Mid-Atlantic ............................................................................................................................................................................. 820 

Midwest: 

East North Central .................................................................................................................................................................. 709 

West North Central ................................................................................................................................................................. 669 

South: 

South Atlantic ......................................................................................................................................................................... 844 

East South Central ................................................................................................................................................................. 902 

West South Central ................................................................................................................................................................ 769 

West: 

Mountain ................................................................................................................................................................................. 768 

Pacific ..................................................................................................................................................................................... 908 

Puerto Rico ............................................................................................................................................................................. 579 

Beneficiary cost-share: Beneficiary 

cost-share (other than dependents of 

Active Duty members) for care paid on 

the basis of a regional per-diem rate is 

the lower of $224 per day or 25 percent 

of the hospital billed charges effective 

for services rendered on or after October 

1, 2014. Cap Amount: Updated cap 

amount for hospitals and units with 

high TRICARE volume is $1,070 per day 

for services on or after October 1, 2014. 

The following reflects an update of 

2.9 percent for Fiscal Year 2015 for the 

full day partial hospitalization rates. 

Partial hospitalization rates for 

programs of less than 6 hours (with a 

minimum of three hours) will be paid a 

per diem rate of 75 percent of the rate 

for a full-day program. 

PARTIAL HOSPITALIZATION RATES FOR FULL-DAY AND HALF-DAY PROGRAMS

[Fiscal year 2015] 

United States census region Full-day rate 

(6 hours or more) 

Half-day rate 

(3–5 hours) 

Northeast: 

New England (Maine, N.H., Vt., Mass., R.I., Conn.) ........................................................................... $341 $256 

Mid-Atlantic: 

(N.Y., N.J., Penn.) ................................................................................................................................ 371 278 

Midwest: 

East North Central (Ohio, Ind., Ill., Mich., Wis.) ................................................................................... 327 245 

West North Central: 

(Minn., Iowa, Mo., N.D., S.D., Neb., Kan.) ........................................................................................... 327 245 

South: 

South Atlantic (Del., Md., DC, Va., W.Va., N.C., S.C., Ga., Fla.) ....................................................... 349 262

East South Central: 

(Ky., Tenn., Ala., Miss.) ........................................................................................................................ 379 284 

West South Central: 

(Ark., La., Texas, Okla.) ....................................................................................................................... 379 284 

West: 

Mountain (Mon., Idaho, Wyo., Col., N.M., Ariz., Utah, Nev.) ............................................................... 382 287 

Pacific (Wash., Ore., Calif., Alaska, Hawaii) ........................................................................................ 376 282 

Puerto Rico .................................................................................................................................................. 244 183 

The above rates are effective for 

services rendered on or after October 1, 

2014. 

Dated: February 6, 2015. 

Aaron Siegel, 

Alternate OSD Federal Register Liaison 

Officer, Department of Defense. 

[FR Doc. 2015–02900 Filed 2–11–15; 8:45 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF DEFENSE 

Department of the Air Force 

Air University Board of Visitors Air 

Force Institute of Technology 

Subcommittee Meeting and Spring 

Committee Meeting 

ACTION: Notice of Meeting of the Air 

University Board of Visitors Air Force 

Institute of Technology Subcommittee 

Meeting and Spring Committee Meeting. 

SUMMARY: Under the provisions of the 

Federal Advisory Committee Act of 

1972 (5 U.S.C., Appendix, as amended), 

the Government in the Sunshine Act of 

1976 (5 U.S.C. 552b, as amended), and 

41 CFR 102–3.150, the Department of 

Defense announces that the Air 

University Board of Visitors’ Air Force 

Institute of Technology (AFIT) 

Subcommittee annual meeting will take 

place on Monday, March 9th, 2015, 

from 8:00 a.m. to approximately 4:30 

p.m. and Tuesday, March 10th, 2015, 

from 8:00 a.m. to approximately 3:00 

p.m. The meeting will be held at AFIT 

on Wright-Patterson Air Force Base, 

Area B, in Dayton, Ohio. The purpose of 

this meeting is to provide independent 

advice and recommendations on matters 


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