61434 Federal Register / Vol. 70, No. 204 / Monday, October 24, 2005 / Notices 

a one-year interim extension of the term 

of U.S. Patent No. 4,650,787. 

FOR FURTHER INFORMATION CONTACT: 

Karin Ferriter by telephone at (571) 

272–7744; by mail marked to her 

attention and addressed to Mail Stop 

Patent Ext., Commissioner for Patents, 

P.O. Box 1450, Alexandria, VA 22313–

1450; by fax marked to her attention at 

(571) 273–7744, or by e-mail to 

Karin.Ferriter@uspto.gov. 

SUPPLEMENTARY INFORMATION: Section 

156 of Title 35, United States Code, 

generally provides that the term of a 

patent may be extended for a period of 

up to five years if the patent claims a 

product, or a method of making or using 

a product, that has been subject to 

certain defined regulatory review, and 

that the patent may be extended for 

interim periods of up to a year if the 

regulatory review is anticipated to 

extend beyond the expiration date of the 

patent. 

On April 7, 2005, H3 Pharma, Inc., an 

agent of the Administrators of the 

Tulane Educational Fund of New 

Orleans, Louisiana, the patent owner, 

timely filed an application under 35 

U.S.C. 156(d)(5) for an interim extension 

of the term of U.S. Patent No. 4,650,787. 

The patent claims the active ingredient 

vapreotide acetate in the human drug 

product Sanvar, and a method of use 

of said product. The application 

indicates that a New Drug Application 

for Sanvar (vapreotide acetate) has 

been filed and is currently undergoing 

regulatory review before the Food and 

Drug Administration for permission to 

market or use the product commercially. 

Review of the application indicates 

that except for permission to market or 

use the product commercially, the 

subject patent would be eligible for an 

extension of the patent term under 35 

U.S.C. 156, and that the patent should 

be extended for one year as required by 

35 U.S.C. 156(d)(5)(B). Since the 

regulatory review period extended 

beyond the expiration date of the patent 

April 25, 2005, interim extension of the 

patent term under 35 U.S.C. 156(d)(5) is 

appropriate. 

An interim extension under 35 U.S.C. 

156(d)(5) of the term of U.S. Patent No. 

4,650,787 is granted for a period of one 

year from the expiration date of the 

patent, i.e., until April 25, 2006. 

Dated: October 17, 2005. 

Jon W. Dudas, 

Under Secretary of Commerce for Intellectual 

Property and Director of the United States 

Patent and Trademark Office. 

[FR Doc. 05–21191 Filed 10–21–05; 8:45 am] 

BILLING CODE 3510–16–P 

COMMODITY FUTURES TRADING 

COMMISSION 

Sunshine Act Meeting 

AGENCY HOLDING THE MEETING: 

Commodity Futures Trading 

Commission 

FEDERAL REGISTER CITATION OF PREVIOUS

ANNOUNCEMENT: 70 FR 194. 

PREVIOUSLY ANNOUNCED TIME AND DATE OF

THE MEETING: 11 a.m., Wednesday, 

October 26, 2005. 

CHANGES IN THE MEETING: The Rule 

Enforcement Review has been moved to 

Friday, October 28, 2005, at 11:45 a.m. 

CONTACT PERSON FOR MORE INFORMATION: 

Jean A. Webb, (202) 418–5100. 

Jean A. Webb, 

Secretary of the Commission. 

[FR Doc. 05–21319 Filed 10–20–05; 2:24 pm] 

BILLING CODE 6351–01–M 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

TRICARE; Civilian Health and Medical 

Program of the Uniformed Services 

(CHAMPUS); Fiscal Year 2006 

Diagnosis Related Group (DRG) 

Updates 

AGENCY: Office of the Secretary, DoD. 

ACTION: Notice of DRG revised rates. 

SUMMARY: This notice describes the 

changes made to the TRICARE DRGbased payment system in order to 

conform to changes made to the 

Medicare Prospective Payment System 

(PPS). It also provides the updated fixed 

loss cost outlier threshold, cost-tocharge ratios and the Internet address 

for accessing the updated adjusted 

standardized amount and DRG relative 

weights to be used for FY 2006 under 

the TRICARE DRG-based payment 

system. 

EFFECTIVE DATES: The rates, weights and 

Medicare PPS changes which affect the 

TRICARE DRG-based payment system 

contained in this notice are effective for 

admissions occurring on or after 

October 1, 2005. 

ADDRESSES: TRICARE Management 

Activity (TMA), Medical Benefits and 

Reimbursement Systems, 16401 East 

Centretech Parkway, Aurora, CO 80011–

9066. 

FOR FURTHER INFORMATION CONTACT: 

Marty Maxey, Medical Benefits and 

Reimbursement Systems, TMA, 

telephone (303) 676–3627. Questions 

regarding payment of specific claims 

under the TRICARE DRG-based 

payment system should be addressed to 

the appropriate contractor. 

SUPPLEMENTARY INFORMATION: The final 

rule published on September 1, 1987 (52 

FR 32992) set forth the basic procedures 

used under the CHAMPUS DRG-based 

payment system. This was subsequently 

amended by final rules published 

August 31, 1988 (53 FR 33461), October 

21, 1988 (53 FR 41331), December 16, 

1988 (53 FR 50515), May 30, 1990 (55 

FR 21863), October 22, 1990 (55 FR 

42560), and September 10, 1998 (63 FR 

48439). An explicit tenet of these final 

rules, and one based on the statute 

authorizing the use of DRGs by 

TRICARE, is that the TRICARE DRGbased payment system is modeled on 

the Medicare PPS, and that, whenever 

practicable, the TRICARE system will 

follow the same rules that apply to the 

Medicare PPS. The Centers for Medicare 

and Medicaid Services (CMS) publishes 

these changes annually in the Federal 

Register and discusses in detail the 

impact of the changes. In addition, this 

notice updates the rates and weights in 

accordance with our previous final 

rules. The actual changes we are 

making, along with a description of 

their relationship to the Medicare PPS, 

are detailed below. 

I. Medicare PPS Changes Which Affect 

the TRICARE DRG-Based Payment 

System 

Following is a discussion of the 

changes CMS has made to the Medicare 

PPS that affect the TRICARE DRG-based 

payment system. 

A. DRG Classifications 

Under both the Medicare PPS and the 

TRICARE DRG-based payment system, 

cases are classified into the appropriate 

DRG by a Grouper program. The 

Grouper classifies each case into a DRG 

on the basis of the diagnosis and 

procedure codes and demographic 

information (that is, sex, age, and 

discharge status). The Grouper used for 

the TRICARE DRG-based payment 

system is the same as the current 

Medicare Grouper with two 

modifications. The TRICARE system has 

replaced Medicare DRG 435 with two 

age-based DRGs (900 and 901), and has 

implemented thirty-four (34) neonatal 

DRGs in place of Medicare DRGs 385 

through 390. For admissions occurring 

on or after October 1, 2001, DRG 435 has 

been replaced by DRG 523. The 

TRICARE system has replaced DRG 523 

with the two age-based DRGs (900 and 

901). For admissions occurring on or 

after October 1, 1995, the CHAMPUS 

grouper hierarchy logic was changed so 

the age split (age <29 days) and 

assignments to MDC 15 occur before 

Federal Register / Vol. 70, No. 204 / Monday, October 24, 2005 / Notices 61435 

assignment of the PreMDC DRGs. This 

resulted in all neonate tracheostomies 

and organ transplants to be grouped to 

MDC 15 and not to DRGs 480–483 or 

495. For admissions occurring on or 

after October 1, 1998, the CHAMPUS 

grouper hierarchy logic was changed to 

move DRG 103 to the PreMDC DRGs and 

to assign patients to PreMDC DRGs 480, 

103 and 495 before assignment to MDC 

15 DRGs and the neonatal DRGs. For 

admissions occurring on or after 

October 1, 2001, DRGs 512 and 513 

were added to the PreMDC DRGs, 

between DRGs 480 and 103 in the 

TRICARE grouper hierarchy logic. For 

admissions occurring on or after 

October 1, 2004, DRG 483 was deleted 

and replaced with DRGs 541 and 542, 

splitting the assignment of cases on the 

basis of the performance of a major 

operating room procedure. The 

description for DRG 480 was changed to 

‘‘Liver Transplant and/or Intestinal 

Transplant’’, and the description for 

DRG 103 was changed to ‘‘Heart/Heart 

Lung Transplant or Implant of Heart 

Assist System’’. For FY 2006, CMS will 

implement classification changes, 

including surgical hierarchy changes. 

The TRICARE Grouper will incorporate 

all changes made to the Medicare 

Grouper. 

B. Wage Index and Medicare 

Geographic Classification Review Board 

Guidelines 

TRICARE will continue to use the 

same wage index amounts used for the 

Medicare PPS. TRICARE will also 

duplicate all changes with regard to the 

wage index for specific hospitals that 

are redesignated by the Medicare 

Geographic Classification Review Board. 

In addition, TRICARE will continue to 

utilize the out commuting wage index 

adjustment. 

C. Revision of the Labor-Related Share 

of the Wage Index 

TRICARE is adopting CMS’

percentage of labor related share of the 

standardized amount. For wage index 

values greater than 1.0, the labor-related 

portion of the ASA shall equal 69.7 

percent. For wage index values less than 

or equal to 1.0 the labor-related portion 

of the ASA shall continue to equal 62 

percent. 

D. Hospital Market Basket 

TRICARE will update the adjusted 

standardized amounts according to the 

final updated hospital market basket 

used for the Medicare PPS for all 

hospitals subject to the TRICARE DRGbased payment system according to 

CMS’s August 12, 2005, final rule. 

E. Outlier Payments 

Since TRICARE does not include 

capital payments in our DRG-based 

payments (TRICARE reimburses 

hospitals for their capital costs as 

reported annually to the contractor on a 

pass through basis), we will use the 

fixed loss cost outlier threshold 

calculated by CMS for paying cost 

outliers in the absence of capital 

prospective payments. For FY 2006, the 

fixed loss cost outlier threshold is based 

on the sum of the applicable DRG-based 

payment rate plus any amounts payable 

for IDME plus a fixed dollar amount. 

Thus, for FY 2006, in order for a case 

to qualify for cost outlier payments, the 

costs must exceed the TRICARE DRG 

base payment rate (wage adjusted) for 

the DRG plus the IDME payment plus 

$21,783 (wage adjusted). The marginal 

cost factor for cost outliers continues to 

be 80 percent. 

F. National Operating Standard Cost as 

a Share of Total Costs 

The FY 2006 TRICARE National 

Operating Standard Cost as a Share of 

Total Costs (NOSCASTC) used in 

calculating the cost outlier threshold is 

0.923. TRICARE uses the same 

methodology as CMS for calculating the 

NOSCASTC however, the variables are 

different because TRICARE uses 

national cost to charge ratios while CMS 

uses hospital specific cost to charge 

ratios. 

G. Indirect Medical Education (IDME) 

Adjustment 

Passage of the MMA of 2003 modified 

the formula multipliers to be used in the 

calculation of the indirect medical 

education 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 new multiplier for the 

IDME adjustment factor for TRICARE for 

FY 2006 is 1.04. 

H. Expansion of the Post Acute Care 

Transfer Policy 

For FY 2006 TRICARE is adopting 

CMS’ expanded post acute care transfer 

policy according to CMS’ final rule 

published August 12, 2005. 

I. Blood Clotting Factor 

For FY 2006, TRICARE is adopting 

CMS’ payment methodology for blood 

clotting factor according to CMS’ final 

rule published August 12, 2005. 

II. Cost to Charge Ratio 

While CMS uses hospital-specific cost 

to charge ratios, TRICARE uses a 

national cost to charge ratio. For FY 

2006, the cost-to-charge ratio used for 

the TRICARE DRG-based payment 

system will be 0.4060, which is 

increased to 0.4130 to account for bad 

debts. This shall be used to calculate the 

adjusted standardized amounts and to 

calculate cost outlier payments, except 

for children’s hospitals. For children’s 

hospital cost outliers, the cost-to-charge 

ratio used is 0.4468. For FY 2006, the 

neonatal cost-to-charge ratio of .64 is 

being reduced to the same cost-to-charge 

ratio of .4130 for acute care hospitals. 

III. Updated Rates and Weights 

The updated rates and weights are 

accessible through the Internet at http:// 

www.tricare.osd.mil under the 

sequential headings TRICARE Provider 

Information, Rates and Reimbursements, 

and DRG Information. Table 1 provides 

the ASA rates and Table 2 provides the 

DRG weights to be used under the 

TRICARE DRG-based payment system 

during FY 2006 and which is a result of 

the changes described above. The 

implementing regulations for the 

TRICARE/CHAMPUS DRG-based 

payment system are in 32 CFR Part 199. 

Dated: October 18, 2005. 

L.M. Bynum, 

Alternate OSD Federal Register Liaison 

Officer, Department of Defense. 

[FR Doc. 05–21184 Filed 10–21–05; 8:45 am] 

BILLING CODE 5001–06–M 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

Senior Executive Service Performance 

Review Board 

AGENCY: Department of Defense Office 

of the Inspector General. 

ACTION: Notice. 

SUMMARY: This notice announces the 

appointment of the members of the 

Senior Executive Service (SES) 

Performance Review Board (PRB) for the 

Department of Defense Office of the 

Inspector General (DoD OIG), as 

required by 5 U.S.C. 4314(c)(4). The 

PRB provides fair and impartial review 

of SES performance appraisals and 

makes recommendations regarding 

performance ratings and performance 

awards to the Inspector General. 

DATES: October 20, 2005. 

FOR FURTHER INFORMATION CONTACT: Mr. 

Michael Peterson, Director, Human 

Capital Management Directorate, Office