Federal Register / Vol. 60, No. 82 / Friday, April 28, 1995 / Notices 20973

1989, we published revised relative

weights based on CHAMPUS claims

data. As a result, the weights, and

therefore, the payments, nearly doubled

on average. At that time OCHAMPUS

retroactively adjusted all claims which

had been processed using the previous

lower weights. We have continued to

refine the PM–DRG weights and

classifications involving complications

during subsequent annual updates.

In addition, at the time we adopted

the PM–DRGs, we examined the

possible application of additional DRGs

to children who are older than

newborns. We contracted with the

RAND Corporation to investigate the use

of PM–DRGs for this pediatric

population. RAND’s results showed that

almost no difference in payments would

occur, so we elected not to make any

changes for the pediatric age groups.

To recognize the higher costs of

pediatric patients and hospitals with

more than their share of high-cost

patients, CHAMPUS included a

generous provision for calculating the

cost outlier for children’s hospitals and

for neonatal services. Any discharge for

services in a children’s hospital or for

neonatal services which has

standardized costs that exceed a

threshold of the greater of two times the

DRG-based amount or $13,500 qualifies

as a cost outlier, resulting in

reimbursement of the DRG-based

amount plus the differential, plus a

percentage of all costs exceeding the

threshold. Since the threshold is so low,

a considerable number of cases receive

this additional payment consideration.

As an added safeguard, CHAMPUS

will continue for an interim period to

exempt certain high-cost conditions

from payment under the DRG-based

payment system to protect acute care

and children’s hospitals from incurring

unexpectedly high costs for care related

to children under 18 years of age who

are HIV seropositive, for all services

related to pediatric bone marrow

transplants and for all services related to

pediatric cystic fibrosis.

In 1990, New York adopted some very

minor classification changes to their

neonatal DRGs which resulted in some

reductions in payments; CHAMPUS

reviewed the classification changes but

elected not to make similar changes. We

have continually consulted with

NACHRI.

Since we have implemented all of the

special measures Congress identified

and since the Congressional intent was

that the hospital-specific differential be

used only ‘‘for a transitional period of

3 years,’’ it is appropriate that a national

differential for children’s hospitals be

implemented at this time. During the

three-year transition, children’s

hospitals were held harmless via a

reconciliation calculation that ensured

payments that recognized hospitalspecific costs for high-volume hospitals.

The transition period for using the

‘‘hold harmless’’ hospital-specific and

low-volume differentials ended March

31, 1992. Reconciliations after the ‘‘hold

harmless’’ period will be calculated

applying the national differential rate in

accordance with Congressional

direction. Under the national

differential, eighteen hospitals will

receive a higher differential, and fifteen

hospitals will receive a lower

differential. Although a small number of

high-volume hospitals will experience a

reduction in CHAMPUS payments, we

remain convinced that our payments,

especially in light of the differential and

other special considerations outlined

above, will fairly compensate children’s

hospitals for their services. Even with a

national differential, our payments will

be significantly higher for all children’s

hospitals than for all other hospitals

subject to DRG-based payments. The

national differential is expected to

encourage efficiency, and comply with

Congressional intent and direction in

controlling future CHAMPUS costs.

CHAMPUS recognizes that on

average, children’s hospitals have a

more costly mix of pediatric patients

than nonexempt hospitals. CHAMPUS

is also aware that pediatric patients in

general may be more expensive than

adults because of the requirement for

more nursing care and specialized

services. Because of these higher costs,

CHAMPUS has proceeded slowly and

built in safeguards to protect children’s

hospitals against untoward financial

repercussions. We believe all of these

safeguards, as well as the numerous

refinements we have outlined, will

result in a fair and equitable payment to

the children’s hospitals. We feel

confident that sufficient time has been

allotted to identify and implement any

classification changes which were found

necessary. Of course, CHAMPUS will

continue to refine PM–DRGs on an

ongoing basis, just as we currently do

for adult DRGs.

Following are the national

differentials:

Area All hospitals

Large Urban:

Labor ..................................... $1,945.99

Non-labor .............................. 689.42

2,635.41

Other Urban:

Labor ..................................... 1,483.21

Area All hospitals

Non-labor .............................. 525.47

2,008.68

Dated: April 24, 1995.

L.M. Bynum,

Alternate OSD Federal Register Liaison

Officer, Department of Defense.

[FR Doc. 95–10426 Filed 4–27–95; 8:45 am]

BILLING CODE 5000–04–M

Record of Decision for the Final

Programmatic Environmental Impact

Statement (FPEIS) for the Ballistic

Missile Defense (BMD) Program

AGENCY: Ballistic Missile Defense

Organization (BMDO).

SUMMARY: On April 23, 1995, the

Ballistic Missile Defense Organization

(BMDO) signed the Record of Decision

(ROD) on research, development, and

testing of Ballistic Missile Defense

(BMD) capability. The decision

included in this ROD has been made in

consideration of, but not limited to, the

information contained in the Ballistic

Missile Defense Final Programmatic

Environmental Impact Statement (Final

PEIS) filed with the U.S. Environmental

Protection Agency on November 18,

1994. Other factors considered in this

decision include the present and

projected threat, cost, and

administrative and congressional

directives.

The BMD programmatic alternatives

arose from existing and potential

national security needs. The need for

further research and development of

BMD capability comes from the threat

posed by the global proliferation of

missile technology, and the

accompanying production and

development of weapons of mass

destruction. This threat is compounded

by improvements to missile

performance and weapon design by

other nations, as well as increases in the

number of missile-armed nations. The

ROD documents the BMDO decision

between the programmatic alternatives.

The BMD program includes both

National Missile Defense (NMD) and

Theater Missile Defense (TMD)

segments under the direction of BMDO.

The NMD segment of the program

considers developing ground and spacebased elements, including GroundBased Sensor (GBS), Ground-Based

Interceptor (GBI), Space-Based Sensor

(SBS), and Battle Management/

Command, Control, and

Communications (BM/C3) elements, to

defend the United States against longrange missiles. The TMD segment
20974 Federal Register / Vol. 60, No. 82 / Friday, April 28, 1995 / Notices

considers developing transportable

systems to defend elements of the armed

forces of the United States deployed

abroad, and United States’ allies, against

short- and medium-range missiles. The

TMD segment was analyzed separately

in the TMD Programmatic EIS, due to

the distinct functions and independent

utility of the TMD and NMD segments.

The decision conveyed by the ROD is

to continue research, development, and

testing of NMD capabilities. The

decision includes continuing the NMD

Technology Readiness Program but does

not include the procurement or

acquisition of an operational NMD

system. Only limited NMD research,

development, and testing is to continue.

The acquisition of TMD system

capabilities will continue as described

in the TMD ROD published in the

Federal Register on August 11, 1994 (59

FR 41277).

The specific decision with respect to

NMD is to continue a focused approach

to technology development in the form

of the Technology Readiness Program

(the Preferred Action in the Final PEIS).

The program involves the development

of existing and new technologies and

test systems for BM/C3, GBS, GBI, and

SBS elements. Research is to be focused

to ensure the capability to deploy a

limited NMD system in the next decade.

Basic technology efforts will continue to

infuse new advances as the program

proceeds. Contingency planning and

options development will continue to be

conducted to meet unexpected threats.

Three NMD System Acquisition

Alternatives were also evaluated. These

alternatives consisted of proceeding

with system acquisition and design of

NMD elements through the Engineering

and Manufacturing Development (EMD)

phase of the DoD System Acquisition

Life-cycle. Activities included in the

EMD phase involve development and

testing of elements up to, but not

including, element and/or system

production and basing. The System

Acquisition Alternatives evaluated

were:

1. Ground- and Space-Based Sensors

and Ground- and Space-Based

Interceptors System Acquisition

Alternative (which consists of

Engineering and Manufacturing

Development of GBS, SBS, GBI, SBI,

and BM/C3);

2. All Ground-Based System

Acquisition Alternative (which consists

of Engineering and Manufacturing

Development of GBS, GBI, and BM/C3);

and

3. Ground- and Space-Based Sensors

and Ground-Based Interceptors System

Acquisition Alternative (which consists

of Engineering and Manufacturing

Development of GBS, SBS, GBI, and

BM/C3).

The Final PEIS analyses determined

that environmental impacts for the

Preferred Action (No Action

Alternative) or any of the three System

Acquisition Alternatives would be

minimal. The Final PEIS analyses found

no significant and unavoidable

environmental impacts for the Preferred

Action or any of the three alternatives.

The Preferred Action would be termed

the environmentally preferred

alternative since there would be fewer

activities associated with its

implementation, and therefore fewer

impacts. The other alternatives would

generally create greater areas of

disturbance, require more resources,

and create more and greater hazards

than the Preferred Action although the

environmental impact of all options

would be minimal.

Therefore, the implementation of

BMD research, development, and testing

activities and associated mitigation

measures will proceed with minimal

adverse impact to the environment.

BMDO Deputies and Program Executive

Officers are tasked to monitor these

activities to ensure that the required

environmental standards and controls

described in the Final PEIS are

followed. BMDO activities will conform

with all applicable Federal, state, and

local statutes and regulations.

Additionally, all reasonable and

practical efforts and appropriate

safeguards will be implemented to

minimize harm to the public and the

environment.

FOR FURTHER INFORMATION CONTACT: Mr.

Richard Lehner, BMDO/SRE,

Washington, DC 20301–7100, (703) 695–

8743.

Dated: April 25, 1995.

Patricia L. Toppings,

Alternate OSD Federal Register Liaison

Officer, Department of Defense.

[FR Doc. 95–10459 Filed 4–27–95; 8:45 am]

BILLING CODE 5000–04–M

Defense Base Closure and

Realignment Commission Investigative

Hearings

AGENCY: Defense Base Closure and

Realignment Commission (a

Presidentially appointed commission

separate from and independent of DoD).

ACTION: Notice of a public, deliberative

hearing.

SUMMARY: Pursuant to Public Law 101–

510, as amended, the Defense Base

Closure and Realignment Commission

announces a day-long investigative

hearing to be held in Washington, D.C.

The purpose of this hearing is for the

Commission to consider additional and/

or alternative bases to those

recommended for closure and

realignment by the Secretary of Defense

on March 1, 1995.

The specific date, location, and

general topics follow:

May 10 (Location: Hart Senate Office

Building, Room 216)

—Chairpersons and representatives

from each of the Commission staff’s

five review-and-analysis panels

(Army, Navy, Air Force, InterAgency,

and Joint-CrossService) present

information concerning options for

additional and/or alternative baseclosure recommendations.

—Commission formally votes on

additional and/or alternative bases as

options for consideration.

The May 10 hearing will begin at 9

a.m. The building and room number are

noted in parentheses following the date

of the hearing. However, hearing

location, date, and time are subject to

change based upon availability of

facilities.

FOR FURTHER INFORMATION CONTACT: Mr.

Wade Nelson, Director of

Communications, at (703) 696–0504.

SUPPLEMENTARY INFORMATION: Changes

to the above schedule will be published

in the Federal Register by the

Commission. Please call the

Commission to confirm dates, times,

and locations prior to each event.

Individuals needing special assistance

should contact the Commission in

advance of each event to facilitate their

requirements.

Dated: April 24, 1995.

Patricia L. Toppings,

Alternate OSD Federal Register Liaison

Officer, Department of Defense.

[FR Doc. 95–10419 Filed 4–27–95; 8:45 am]

BILLING CODE 5000–04–M

Defense Science Board Task Force on

Combat Identification; Meeting

SUMMARY: The Defense Science Board

Task Force on Combat Identification

will meet in closed session on July 11–

12, 1995 at the MITRE Corporation,

Bedford, Massachusetts.

The mission of the Defense Science

Board is to advise the Secretary of

Defense through the Under Secretary of

Defense (Acquisition and Technology)

on scientific and technical matters as

they affect the perceived needs of the

Department of Defense. At this meeting

the Task Force will evaluate the DoD

long term strategy and plan for

development and fielding of a