Federal Register / Vol. 86, No. 174 / Monday, September 13, 2021 / Notices 50953 

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. 

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: 

debra.vatthauer@va.gov; 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: www.va.gov/ 

communitycare/revenue_ops/payer_

rates.asp, 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/subacute 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/nonprovider-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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