Federal Register / Vol. 73, No. 191 / Wednesday, October 1, 2008 / Notices 57219 

Affected Public: Businesses or other 

for-profit. 

Estimated Number of Respondents: 

65. 

Estimated Number of Responses: 65. 

Estimated Frequency of Response: 

Other; Once, on becoming an S & L 

holding company. 

Estimated Total Burden: 520 hours. 

Clearance Officer: Ira L. Mills, (202) 

906–6531, Office of Thrift Supervision, 

1700 G Street, NW., Washington, DC 

20552. 

Dated: September 25, 2008. 

Deborah Dakin, 

Senior Deputy Chief Counsel, Regulations and 

Legislation Division. 

[FR Doc. E8–22984 Filed 9–30–08; 8:45 am] 

BILLING CODE 6720–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

Reasonable Charges for Inpatient DRG 

and SNF Medical Services; 2009; Fiscal 

Year Update 

AGENCY: Department of Veterans Affairs. 

ACTION: Notice. 

SUMMARY: Section 17.101 of Title 38 of 

the Code of Federal Regulations sets 

forth the Department of Veterans Affairs 

(VA) medical regulations concerning 

‘‘reasonable charges’’ 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 regulations include 

methodologies for establishing billed 

amounts for the following types of 

charges: Acute inpatient facility charges; 

skilled nursing facility/sub-acute 

inpatient facility (SNF) charges; partial 

hospitalization facility charges; 

outpatient facility charges; physician 

and other professional charges, 

including professional charges for 

anesthesia services and dental services; 

pathology and laboratory charges; 

observation care facility charges; 

ambulance and other emergency 

transportation charges; and charges for 

durable medical equipment, drugs, 

injectables, and other medical services, 

items, and supplies identified by 

Healthcare Common Procedure Coding 

System (HCPCS) Level II codes. The 

regulations also provide that data for 

calculating actual charge amounts at 

individual VA facilities based on these 

methodologies will either be published 

in a notice in the Federal Register or 

will be posted on the Internet site of the 

Veterans Health Administration Chief 

Business Office, currently at http:// 

www1.va.gov/CBO/apps/rates/ 

index.asp, under ‘‘Charge Data.’’ Certain 

of these charges are hereby updated as 

described in the Supplementary 

Information section of this notice. These 

changes are effective October 1, 2008. 

When charges for medical care or 

services provided or furnished at VA 

expense by either VA or non-VA 

providers have not been established 

under other provisions of the 

regulations, the method for determining 

VA’s charges is set forth at 38 CFR 

17.101(a)(8). 

FOR FURTHER INFORMATION CONTACT: 

Romona Greene, Chief Business Office 

(168), Veterans Health Administration, 

Department of Veterans Affairs, 810 

Vermont Avenue, NW., Washington, DC 

20420, (202) 254–0361. (This is not a 

toll free number.) 

SUPPLEMENTARY INFORMATION: Of the 

charge types listed in the Summary 

section of this notice, only the acute 

inpatient facility charges and skilled 

nursing facility/sub-acute inpatient 

facility charges are being changed. 

Charges for the following charge types: 

partial hospitalization facility charges; 

outpatient facility charges; physician 

and other professional charges, 

including professional charges for 

anesthesia services and dental services; 

pathology and laboratory charges; 

observation care facility charges; 

ambulance and other emergency 

transportation charges; and charges for 

durable medical equipment, drugs, 

injectables, and other medical services, 

items, and supplies identified by 

HCPCS Level II codes are not being 

changed. These Outpatient facility 

charges and Professional charges remain 

the same as set forth in a notice 

published in the Federal Register on 

December 26, 2007 (72 FR 246). 

Based on the methodologies set forth 

in 38 CFR 17.101(b), this document 

provides an update to acute inpatient 

charges that were based on 2008 

diagnosis related group (DRG). Acute 

inpatient facility charges by DRG are set 

forth in Table A in the September 28, 

2007, Federal Register notice (72 FR 

188). Table A in this notice provides 

updated charges based on 2009 DRGs 

and will replace Table A in the 

September 28, 2007, notice. 

Also, this document provides for an 

updated all-inclusive per diem charge 

for skilled nursing facility/sub-acute 

inpatient facility charge using the 

methodologies set forth in 38 CFR 

17.101(c) and it is adjusted by a 

geographic area factor based on the 

location where the care is provided. The 

skilled nursing facility/sub-acute 

inpatient facility per diem charge is set 

forth in Table B in the September 28, 

2007, Federal Register notice. Table B 

in this notice provides the updated allinclusive nationwide skilled nursing 

facility/sub-acute inpatient facility per 

diem charge and will replace Table B in 

the September 28, 2007, notice. 

The charges in this update for acute 

inpatient facility and skilled nursing 

facility/sub-acute inpatient facility 

services are effective October 1, 2008. 

In this update, we are retaining the 

table designations used for acute 

inpatient facility charges by DRGs in the 

notice published in the Federal Register 

on September 28, 2007. We also are 

retaining the table designation used for 

skilled nursing facility/sub-acute 

inpatient facility charges in the notice 

published in the Federal Register on 

September 28, 2007. Accordingly, the 

tables identified as being updated by 

this notice correspond to the applicable 

tables published in the September 28, 

2007, notice, beginning with Table A 

through Table B. 

We have updated the list of data 

sources presented in Supplementary 

Table 1 to reflect the updated data 

sources used to establish the updated 

charges described in this notice. 

We have also updated the list of VA 

medical facility locations. As a 

reminder, in Supplementary Table 3 

posted on the internet site of the 

Veterans Health Administration Chief 

Business Office, currently at http:// 

www1.va.gov/CBO/apps/rates/ 

index.asp, we 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 data tables and supplementary 

tables containing the changes described 

in this notice will be posted on the 

Internet site of the Veterans Health 

Administration Chief Business Office, 

currently at http://www1.va.gov/CBO/ 

apps/rates/index.asp, under ‘‘Charge 

Data.’’ 


jlentini on PROD1PC65 with NOTICES
57220 Federal Register / Vol. 73, No. 191 / Wednesday, October 1, 2008 / Notices 

Approved: August 28, 2008. 

Gordon H. Mansfield, 

Deputy Secretary of Veterans Affairs. 

[FR Doc. E8–22787 Filed 9–30–08; 8:45 am] 

BILLING CODE 8320–01–P 


jlentini on PROD1PC65 with NOTICES