Federal Register / Vol. 66, No. 247 / Wednesday, December 26, 2001 / Notices 66477

reactor coolant system parameter limits

from the Technical Specifications (TS)

and associated Bases, to the Core

Operating Limits Report. The

amendments also, add a reference to the

Refueling Boron Concentration to TS

5.6.5 to correct an omission.

Date of issuance: December 4, 2001.

Effective date: As of the date of

issuance and shall be implemented

within 30 days from the date of

issuance.

Amendment Nos.: 151 and 143.

Facility Operating License Nos. NPF–

2 and NPF–8: Amendments revise the

Technical Specifications. Date of initial notice in Federal

Register: October 31, 2001 (66 FR

55024).

The Commission’s related evaluation

of the amendments is contained in a

Safety Evaluation dated December 4,

2001.

No significant hazards consideration

comments received: No.

STP Nuclear Operating Company,

Docket Nos. 50–498 and 50–499, South

Texas Project, Units 1 and 2, Matagorda

County, Texas

Date of amendment request: February

12, 2001.

Brief description of amendments: The

amendments consist of deleting

Surveillance Requirement 4.4.6.2.2.e of

South Texas Project Technical

Specifications Section 3/4.4.6.2. Date of issuance: December 11, 2001.

Effective date: As of the date of

issuance, and shall be implemented

within 30 days from the date of

issuance.

Amendment Nos.: Unit 1—134; Unit

2—123.

Facility Operating License Nos. NPF–

76 and NPF–80: The amendments

revised the Technical Specifications. Date of initial notice in Federal

Register: June 12, 2001 (66 FR 31715). The Commission’s related evaluation

of the amendments is contained in a

Safety Evaluation dated December 11,

2001.

No significant hazards consideration

comments received: No.

Virginia Electric and Power Company,

Docket Nos. 50–338 and 50–339, North

Anna Power Station, Units 1 and 2,

Louisa County, Virginia

Date of application for amendment:

December 14, 2000.

Brief description of amendment:

These amendments revise Technical

Specifications Sections 4.7.7.1.d.1 and

4.7.7.2.a. These changes increase the

specified minimum number of

compressed bottles of air from 84 to 102,

and revise the differential pressure limit

across the Control Room Emergency

Ventilation System HEPA Filter,

demister filter, and charcoal adsorber.

Date of issuance: December 12, 2001.

Effective date: As of the date of

issuance and shall be implemented

within 30 days from the date of

issuance.

Amendment Nos.: 228 and 209.

Facility Operating License Nos. NPF–

4 and NPF–7: Amendments change the

Technical Specifications.

Date of initial notice in Federal

Register: January 24, 2001 (66 FR

7687).

The Commission’s related evaluation

of the amendments is contained in a

Safety Evaluation dated December 12,

2001.

No significant hazards consideration

comments received: No.

(Note: The publication date for this notice

will change from every other Wednesday to

every other Tuesday, effective January 8,

2002. The notice will contain the same

information and will continue to be

published biweekly.

Dated at Rockville, Maryland, this 17th day

of December, 2001.

For the Nuclear Regulatory Commission.

Ledyard B. Marsh,

Acting Director, Division of Licensing Project

Management, Office of Nuclear Reactor

Regulation.

[FR Doc. 01–31473 Filed 12–21–01; 8:45 am]

BILLING CODE 7590–01–P

OFFICE OF MANAGEMENT AND

BUDGET

Cost of Hospital and Medical Care

Treatment Furnished by the United

States; Certain Rates Regarding

Recovery From Tortiously Liable Third

Persons

By virtue of the authority vested in

the President by section 2(a) of Public

Law 87–693 (76 Stat. 593; 42 U.S.C.

2652), and delegated to the Director of

the Office of Management and Budget

by Executive Order No. 11541 of July 1,

1970 (35 FR 10737), the two sets of rates

outlined below are hereby established.

These rates are for use in connection

with the recovery, from tortiously liable

third persons, of the cost of hospital and

medical care and treatment furnished by

the United States (Part 43, Chapter I,

Title 28, Code of Federal Regulations)

through three separate Federal agencies.

The rates have been established in

accordance with the requirements of

OMB Circular A–25, requiring

reimbursement of the full cost of all

services provided and will remain in

effect until further notice. The rates for

VA that were published in the Federal

Register on October 31, 2000 remain in

effect until further notice. The rates are

as follows:

1. Department of Defense

The Department of Defense (DoD)

reimbursement rates for inpatient,

outpatient, and other services are

provided in accordance with Title 10,

United States Code, section 1095. Due to

size, the sections containing the Drug

Reimbursement Rates (section III.D.)

and the rates for Ancillary Services

Requested by Outside Providers (section

III.E.) are not included in this package.

Those rates are available from the

TRICARE Management Activity’s

Uniform Business Office web site:

http://www.tricare.osd.mil/ebc/

rm_home/imcp/ubo/ubo_01.htm. The

medical and dental service rates in this

package (including the rates for

ancillary services and other procedures

requested by outside providers) are

effective October 1, 2001. Pharmacy

rates are updated on an as needed basis.

2. Health and Human Services

The tortiously liable rates for Indian

Health Service health facilities are based

on Medicare cost reports. The

obligations for the Indian Health Service

hospitals participating in the cost report

project were identified and combined

with applicable obligations for area

offices costs and headquarters costs. The

hospital obligations were summarized

for each major cost center providing

medical services and distributed

between inpatient and outpatient. Total

inpatient costs and outpatient costs

were then divided by the relevant

workload statistic (inpatient day,

outpatient visit) to produce the

inpatient and outpatient rates. In

calculation of the rates, the

Department’s unfunded retirement

liability cost and capital and equipment

depreciation costs were incorporated to

conform to requirements set forth in

OMB Circular A–25.

In addition, the obligations for each

cost center include obligations from

certain other accounts, such as Medicare

and Medicaid collections and the

Contract Health fund, that were used to

support the inpatient and outpatient

workload. Obligations were excluded

for certain cost centers that primarily

support workloads outside of the

directly operated hospitals or clinics

(public health nursing, public health

nutrition, health education). These

obligations are not a part of the

traditional cost of hospital operations

and do not contribute directly to the

inpatient and outpatient visit workload.

Separate rates per inpatient day and

outpatient visit were computed for

Alaska and the rest of the United States.

66478 Federal Register / Vol. 66, No. 247 / Wednesday, December 26, 2001 / Notices

This gives proper weight to the higher

cost of operating medical facilities in

Alaska.

1. Department of Defense

For the Department of Defense,

effective October 1, 2001 and thereafter:

Inpatient, Outpatient and Other Rates

and Charges

I. Inpatient Rates 1 2

Per inpatient day

International

military education & training (IMET)

Interagency &

other Federal

agency sponsored patients

Other (full/third

party)

A. Burn Center ............................................................................................................................. $3,550.00 $6,156.00 $6,492.00

B. All Other Inpatient Services (Based on Diagnosis Related Groups (DRG) 3.

1. Average FY 2002 Direct Care Inpatient Reimbursement Rates

Adjusted standard amount IMET Interagency Other

(full/third party)

Large Urban ................................................................................................................................. $3,625.00 $6,170.00 $6,486.00

Other Urban/Rural ....................................................................................................................... 3,771.00 6,694.00 7,069.00

Overseas ...................................................................................................................................... 3,958.00 9,293.00 9,742.00

2. Overview

The inpatient rates are based on the

cost per DRG, which is the inpatient full

reimbursement rate per hospital

discharge weighted to reflect the

intensity of the principal diagnosis,

secondary diagnoses, procedures,

patient age, etc. involved. The average

cost per Relative Weighted Product

(RWP) for large urban, other urban/

rural, and overseas facilities will be

published annually as an inpatient

adjusted standardized amount (ASA)

(see paragraph I.B.1, above). The ASA

will be applied to the RWP for each

inpatient case, determined from the

DRG weights, outlier thresholds, and

payment rules published annually for

hospital reimbursement rates under the

Civilian Health and Medical Program of

the Uniformed Services (CHAMPUS)

pursuant to 32 CFR 199.14(a)(1),

including adjustments for length of stay

(LOS) outliers. An outlier refers to a

patient’s LOS, which is either atypically

short or long. They are determined by

short or long stay outlier thresholds.

Inliers, i.e., those patients who fall

within the bounds of the outlier

thresholds, receive DRG weights that

represent their relative resource

intensity.

Each Military Treatment Facility

(MTF) providing inpatient care has a

separate ASA rate. The MTF-specific

ASA rate is the published ASA rate

adjusted for area wage differences and

indirect medical education (IME) for the

discharging hospital (see Attachment 1).

The MTF-specific ASA rate submitted

on the claim is the rate that payers will

use for reimbursement purposes. An

example of how to apply a specific

military treatment facility’s ASA rate to

a DRG standardized weight to arrive at

the costs to be recovered is contained in

paragraph I.B.3. below.

3. Example of Adjusted Standardized

Amounts for Inpatient Stays

Figure 1 shows examples for a nonteaching hospital (Reynolds Army

Community Hospital) in Other Urban/

Rural areas.

a. The cost to be recovered is the MTF

cost for medical services provided.

Billings will be at the third party rate.

b. DRG 020: Nervous System Infection

Except Viral Meningitis. The RWP (i.e.

the DoD measure of workload credit

derived from biometrics dispositions

weighted by CHAMPUS DRG weights)

for an inlier case is the CHAMPUS

weight of 2.0860. (DRG statistics shown

are from FY 2000.)

c. The MTF-applied ASA rate is

$6,849.00 (Reynolds Army Community

Hospital’s third party rate as shown in

Attachment 1).

d. The MTF cost to be recovered is the

RWP factor (2.0860) in subparagraph

3.b., above, multiplied by the amount

($6,849.00) in subparagraph 3.c., above

which equals $14,287.00

e. Cost to be recovered is $14,287.00.

FIGURE 1.—THIRD PARTY BILLING EXAMPLES

DRG No. DRG description DRG weight Arithmetic

mean LOS

Geometric

mean LOS

Short stay

threshold

Long stay

threshold

020 ............... Nervous System Infection Except Viral Meningitis ....... 2.0860 7.7 5.5 1 29

Hospital Location Area wage

rate index

IME adjustment Group ASA MTF–Applied ASA

Reynolds Army Community Hospital .............................. Other Urban/Rural ............. .8996 1.0 $7,069.00 $6,849.00

Patient Length of stay Days above

threshold

Relative weighted product TPC

Inlier * Outlier ** Total Amount ***

#1 .................................................. 7 days ........................................... 0 2.0860 000 2.0860 $14,287.00

#2 .................................................. 21 days ......................................... 0 2.0860 000 2.0860 14,287.00

Federal Register / Vol. 66, No. 247 / Wednesday, December 26, 2001 / Notices 66479

Patient Length of stay Days above

threshold

Relative weighted product TPC

Inlier * Outlier ** Total Amount ***

#3 .................................................. 35 days ......................................... 6 2.0860 .7510 2.8370 19,431.00

* DRG Weight

** Outlier calculation = 33 percent of per diem weight X number of outlier days. The outlier must meet the criteria determined by the outlier

threshold, i.e., the number of days beyond which hospitalization LOS is considered outside the typical range. These are specific for each DRG.

=.33 (DRG Weight/Geometric Mean LOS) × (Patient LOS¥Long Stay Threshold)

=.33 (2.0860/5.5) × (35 – 29)

=.33 (.37927) × 6 (take out to five decimal places)

=.12516 X 6 (carry to five decimal places)

=.7510 (carry to four decimal places)

*** MTF-Applied ASA × Total RWP

II. Outpatient Rates

A. Per Clinic Visit 1 2

MEPRS

Code 4 Clinical service

International

military education & training (IMET)

Interagency &

other federal

agency sponsored patients

Other (full/third

party)

1. Medical Care

BAA .......... Internal Medicine ................................................................................................... $50.00 $199.00 $210.00

BAB .......... Allergy .................................................................................................................... 61.00 113.00 119.00

BAC .......... Cardiology ............................................................................................................. 107.00 199.00 209.00

BAE .......... Diabetic .................................................................................................................. 74.00 137.00 144.00

BAF .......... Endocrinology (Metabolism) .................................................................................. 124.00 231.00 243.00

BAG ......... Gastroenterology ................................................................................................... 146.00 272.00 286.00

BAH .......... Hematology ........................................................................................................... 225.00 419.00 442.00

BAI ........... Hypertension ......................................................................................................... 198.00 369.00 388.00

BAJ .......... Nephrology ............................................................................................................ 180.00 334.00 352.00

BAK .......... Neurology .............................................................................................................. 136.00 254.00 267.00

BAL .......... Outpatient Nutrition ............................................................................................... 51.00 95.00 100.00

BAM ......... Oncology ............................................................................................................... 158.00 294.00 310.00

BAN .......... Pulmonary Disease ............................................................................................... 144.00 267.00 281.00

BAO ......... Rheumatology ....................................................................................................... 116.00 216.00 228.00

BAP .......... Dermatology .......................................................................................................... 93.00 172.00 182.00

BAQ ......... Infectious Disease ................................................................................................. 151.00 282.00 297.00

BAR .......... Physical Medicine .................................................................................................. 94.00 175.00 184.00

BAS .......... Radiation Therapy ................................................................................................. 142.00 264.00 278.00

BAT .......... Bone Marrow Transplant ....................................................................................... 154.00 287.00 302.00

BAU .......... Genetic .................................................................................................................. 343.00 639.00 673.00

BAV .......... Hyperbaric ............................................................................................................. 276.00 513.00 540.00

2. Surgical Care

BBA .......... General Surgery .................................................................................................... 162.00 302.00 318.00

BBB .......... Cardiovascular and Thoracic Surgery ................................................................... 291.00 541.00 570.00

BBC .......... Neurosurgery ......................................................................................................... 169.00 314.00 331.00

BBD .......... Ophthalmology ...................................................................................................... 106.00 198.00 209.00

BBE .......... Organ Transplant .................................................................................................. 717.00 1,335.00 1,406.00

BBF .......... Otolaryngology ...................................................................................................... 117.00 217.00 229.00

BBG ......... Plastic Surgery ...................................................................................................... 134.00 249.00 262.00

BBH .......... Proctology .............................................................................................................. 95.00 177.00 186.00

BBI ........... Urology .................................................................................................................. 131.00 244.00 257.00

BBJ .......... Pediatric Surgery ................................................................................................... 72.00 133.00 140.00

BBK .......... Peripheral Vascular Surgery ................................................................................. 83.00 155.00 163.00

BBL .......... Pain Management ................................................................................................. 113.00 210.00 222.00

BBM ......... Vascular and Interventional Radiology ................................................................. 351.00 653.00 688.00

3. Obstetrical and Gynecological (OB-GYN) Care

BCA .......... Family Planning ..................................................................................................... 75.00 139.00 146.00

BCB .......... Gynecology ............................................................................................................ 98.00 182.00 191.00

BCC ......... Obstetrics .............................................................................................................. 78.00 145.00 153.00

BCD ......... Breast Cancer Clinic ............................................................................................. 147.00 274.00 289.00

4. Pediatric Care

BDA .......... Pediatric ................................................................................................................. 71.00 133.00 140.00

BDB .......... Adolescent ............................................................................................................. 75.00 139.00 146.00

BDC ......... Well Baby .............................................................................................................. 49.00 91.00 96.00

66480 Federal Register / Vol. 66, No. 247 / Wednesday, December 26, 2001 / Notices

MEPRS

Code 4 Clinical service

International

military education & training (IMET)

Interagency &

other federal

agency sponsored patients

Other (full/third

party)

5. Orthopaedic Care

BEA .......... Orthopaedic ........................................................................................................... 112.00 208.00 219.00

BEB .......... Cast ....................................................................................................................... 63.00 117.00 123.00

BEC .......... Hand Surgery ........................................................................................................ 60.00 112.00 118.00

BEE .......... Orthotic Laboratory ................................................................................................ 72.00 134.00 141.00

BEF .......... Podiatry ................................................................................................................. 63.00 117.00 124.00

BEZ .......... Chiropractic ........................................................................................................... 30.00 56.00 58.00

6. Psychiatric and/or Mental Health Care

BFA .......... Psychiatry .............................................................................................................. 121.00 226.00 238.00

BFB .......... Psychology ............................................................................................................ 75.00 140.00 148.00

BFC .......... Child Guidance ...................................................................................................... 71.00 132.00 139.00

BFD .......... Mental Health ........................................................................................................ 118.00 219.00 231.00

BFE .......... Social Work ........................................................................................................... 113.00 211.00 222.00

BFF .......... Substance Abuse .................................................................................................. 110.00 206.00 216.00

7. Family Practice/Primary Medical Care

BGA ......... Family Practice ...................................................................................................... 84.00 156.00 165.00

BHA .......... Primary Care ......................................................................................................... 82.00 152.00 160.00

BHB .......... Medical Examination ............................................................................................. 82.00 152.00 160.00

BHC ......... Optometry .............................................................................................................. 57.00 106.00 112.00

BHD ......... Audiology ............................................................................................................... 48.00 90.00 94.00

BHE .......... Speech Pathology ................................................................................................. 91.00 169.00 178.00

BHF .......... Community Health ................................................................................................. 67.00 125.00 131.00

BHG ......... Occupational Health .............................................................................................. 90.00 167.00 176.00

BHH ......... TRICARE Outpatient ............................................................................................. 58.00 108.00 114.00

BHI ........... Immediate Care ..................................................................................................... 113.00 211.00 222.00

8. Emergency Medical Care

BIA ........... Emergency Medical ............................................................................................... 142.00 264.00 278.00

9. Flight Medical Care

BJA .......... Flight Medicine ...................................................................................................... 98.00 183.00 192.00

10. Underseas Medical Care

BKA .......... Underseas Medicine .............................................................................................. 57.00 107.00 113.00

11. Rehabilitative Services 

BLA .......... Physical Therapy ................................................................................................... 43.00 81.00 85.00

BLB .......... Occupational Therapy ........................................................................................... 87.00 162.00 70.00

B. Ambulatory Procedure Visit (APV)—Per Visit 5

MEPRS

Code 4 Clinical Service

International

Military Education & Training (IMET)

Interagency &

Other Federal

Agency Sponsored Patients

Other (Full/

Third Party)

BB ............ Surgical Care ......................................................................................................... 1,068.00 1,987.00 2,093.00

BE ............ Orthopaedic Care .................................................................................................. 1,315.00 2,448.00 2,577.00

All Other B clinics other than BB and BE, to include those B clinics where:

1. There is an APU established within DoD guidelines AND ...............................

2. There is a rate established for that clinic in section IIA. Some B clinics, such

as BF, BI, BJ and BL, perform the type of services where the establishment

of an APU would not be within appropriate clinical guidelines.

297.00 553.00 582.00

Federal Register / Vol. 66, No. 247 / Wednesday, December 26, 2001 / Notices 66481

III. Other Rates and Charges 1 2

A. Per Each

MEPRS

code 4 Clinical service

International

military education & training (IMET)

Interagency &

other Federal

agency sponsored patients

Other (full/third

party)

FBI ........... Immunization ......................................................................................................... $18.00 $34.00 $36.00

B. Family Member Rate (formerly Military Dependents Rate) .............................. 11.90

C. Subsistence Rate.15

Standard Rate .................................................................................................... 8.10

Discount Rate .................................................................................................... 6.75

D. Reimbursement Rates For Drugs

Requested By Outside Providers 6

E. Ancillary Services Requested by an

Outside Provider—Per Procedure 7

MEPRS

code 4 Clinical service

International

military education & training (IMET)

Interagency &

other Federal

agency sponsored patients

Other (full/third

party)

DB ............ Laboratory procedures requested by an outside provider current procedural terminology (CPT) 2001 weight multiplier.$19.00 $28.00 $29.00

DC, DI ...... Radiology procedures requested by an outside provider CPT 2001 weight multiplier.38.00 54.00 57.00

F. Dental Rate—Per Procedure 11

MEPRS

code 4 Clinical service

International

military education & training (IMET)

Interagency &

other Federal

agency sponsored patients

Other (full/third

party)

Dental services ADA code weight multiplier ......................................................... $31.00 $73.00 $77.00

G. Ambulance Rate—Per Hour 12

MEPRS

code 4 Clinical service

International

military education & training (IMET)

Interagency &

other Federal

agency sponsored patients

Other (full/third

party)

FEA .......... Ambulance ............................................................................................................. $67.00 $124.00 $131.00

H. AirEvac Rate—Per Trip (24 hour

period) 13

MEPRS

code 4 Clinical service

International

military education & training (IMET)

Interagency &

other Federal

agency sponsored patients

Other (full/third

party)

AirEvac Services—Ambulatory ............................................................................. $257.00 $479.00 $505.00

AirEvac Services—Litter ........................................................................................ 751.00 1,397.00 1,471.00

I. Observation Rate—Per hour 14

MEPRS

code 4 Clinical service

International

military education & training (IMET)

Interagency &

other Federal

agency sponsored patients

Other (full/third

party)

Observation Services—Hour ................................................................................. $13.00 $24.00 $26.00

66482 Federal Register / Vol. 66, No. 247 / Wednesday, December 26, 2001 / Notices

IV. Elective Cosmetic Surgery

Procedures and Rates

Cosmetic surgery procedureInternational classification diseases (ICD–9)Current procedural terminology (CPT) 8 FY 2002 charge 9 Amount of

Charge

Mammaplasty—augmentation.85.50, 85.32, 85.31 ....... 19325, 19324, 19318 .... Inpatient Charge per DRG or APV ....................... (a)

(b)

Mastopexy ...................... 85.60 .............................. 19316 ............................. Inpatient Charge per DRG Or APV or applicable

Outpatient Clinic Rate.

(abc)

Facial Rhytidectomy ...... 86.82, 86.22 .................. 15824 ............................. Inpatient Charge per DRG or APV ....................... (a b)

Blepharoplasty ............... 08.70, 08.44 .................. 15820, 15821, 15822,

15823.

Inpatient Charge per DRG or APV or applicable

Outpatient Clinic Rate.

(abc)

Mentoplasty (Augmentation/Reduction).76.68, 76.67 .................. 21208, 21209 ................ Inpatient Charge per DRG or APV or applicable

Outpatient Clinic Rate.

(abc)

Abdominoplasty ............. 86.83 .............................. 15831 ............................. Inpatient Charge per DRG or APV or applicable

Outpatient Clinic Rate.

(abc)

Lipectomy Suction per

region 10.

86.83 .............................. 15876, 15877, 15878,

15879.

Inpatient Charge per DRG or APV or applicable

Outpatient Clinic Rate.

Rhinoplasty .................... 21.87, 21.86 .................. 30400, 30410 ................ Inpatient Charge per DRG Or APV or applicable

Outpatient Clinic Rate.

(abc)

Scar Revisions beyond

CHAMPUS.

86.84 .............................. 1578 ............................... Inpatient Charge per DRG or APV or applicable

Outpatient Clinic Rate.

(abc)

Mandibular or Maxillary

Repositioning.

76.41 .............................. 21194 ............................. Inpatient Charge per DRG or APV or applicable

Outpatient Clinic Rate.

(abc)

Dermabrasion ................ 86.25 .............................. 15780 ............................. Inpatient Charge per DRG or APV or applicable

Outpatient Clinic Rate.

(abc)

Hair Restoration ............. 86.64 .............................. 15775 ............................. Inpatient Charge per DRG or APV or applicable

Outpatient Clinic Rate.

(abc)

Removing Tattoos .......... 86.25 .............................. 15780 ............................. Inpatient Charge per DRG or APV or applicable

Outpatient Clinic Rate.

(abc)

Chemical peel ................ 86.24 .............................. 15790 ............................. Inpatient charge per DRG or APV or applicable

Outpatient clinic rate.

(abc)

Arm/thigh

dermolipectomy.

86.83 .............................. 15836/15832 .................. Inpatient charge per DRG or APV ........................ (a b)

Refractive surgery .......... ........................................ ........................................ APV or applicable outpatient clinic rate ................ (bce)

Radial keratotomy .......... ........................................ 65771 ............................. ................................................................................

Other procedure (if applies to laser or other

refractive surgery).

........................................ 66999 ............................. .

Otoplasty ........................ ................................... 69300 ............................. APV or applicable outpatient clinic rate ................ (b c)

Brow lift .......................... 86.3 ................................ 15839 ............................. Inpatient charge per DRG or APV or applicable

outpatient clinic rate.

(abc)

Notes on Cosmetic Surgery Charges

aCharges for Inpatient surgical care

services are based on the cost per DRG. (See

notes 8 through 10, below, for further details

on reimbursable rates.) bCharges for ambulatory procedure visits

(formerly same day surgery) are listed in

section II.B. (See notes 8 through 10, below,

for further details on reimbursable rates.) The

ambulatory procedure visit (APV) rate is used

if the elective cosmetic surgery is performed

in an ambulatory procedure unit (APU). cCharges for outpatient clinic visits are

listed in sections II.A. The outpatient clinic

rate is not used for services provided in an

APU. The APV rate should be used in these

cases. dCharge is solely determined by the

location of where the care is provided and is

not to be based on any other criteria. An APV

rate can only be billed if the location has

been established as an APU following all

required DoD guidelines and instructions. eRefer to Office of the Assistant Secretary

of Defense (Health Affairs) policy on Vision

Correction Via Laser Surgery For Non-Active

Duty Beneficiaries, April 7, 2000, for further

guidance on billing for these services. It can

be downloaded from: http://

www.tricare.osd.mil/policy/2000poli.htm.

Notes on Reimbursable Rates

1Percentages can be applied when

preparing bills for both inpatient and

outpatient services. Pursuant to the

provisions of 10 U.S.C. 1095, the inpatient

Diagnosis Related Groups and inpatient per

diem percentages are 96 percent hospital and

4 percent professional charges. The

outpatient per visit percentages are 89

percent outpatient services and 11 percent

professional charges. 2 DoD civilian employees located in

overseas areas shall be rendered a bill when

services are performed. 3The cost per Diagnosis Related Group

(DRG) is based on the inpatient full

reimbursement rate per hospital discharge,

weighted to reflect the intensity of the

principal and secondary diagnoses, surgical

procedures, and patient demographics

involved. The adjusted standardized amounts

(ASA) per Relative Weighted Product (RWP)

for use in the direct care system is

comparable to procedures used by the

Centers for Medicare and Medicaid Services

(CMS) and the Civilian Health and Medical

Program for the Uniformed Services

(CHAMPUS). These expenses include all

direct care expenses associated with direct

patient care. The average cost per RWP for

large urban, other urban/rural, and overseas

will be published annually as an adjusted

standardized amount (ASA) and will include

the cost of inpatient professional services.

The DRG rates will apply to reimbursement

from all sources, not just third party payers.

MTFs without inpatient services, whose

providers are performing inpatient care in a

civilian facility for a DoD beneficiary, can bill

payers the percentage of the charge that

represents professional services as provided

in 1 above. The ASA rate used in these cases,

based on the absence of a ASA rate for the

facility, will be based on the average ASA

rate for the type of metropolitan statistical

area the MTF resides, large urban, other

urban/rural, or overseas (see paragraph

I.B.1.). The Uniform Business Office must

receive documentation of care provided in

order to produce a bill. 4The Medical Expense and Performance

Reporting System (MEPRS) code is a three

digit code which defines the summary

account and the subaccount within a

functional category in the DoD medical

system. MEPRS codes are used to ensure that

consistent expense and operating

performance data is reported in the DoD

military medical system. An example of the

MEPRS hierarchical arrangement follows:

Federal Register / Vol. 66, No. 247 / Wednesday, December 26, 2001 / Notices 66483

Outpatient Care (Functional Category), B

(MEPRS CODE), Medical Care (Summary

Account), BA (MEPRS CODE), Internal

Medicine (Subaccount), BAA (MEPRS

CODE). 5Ambulatory procedure visit is defined in

DoD Instruction 6025.8, ‘‘Ambulatory

Procedure Visit (APV),’’ dated September 23,

1996, as immediate (day of procedure) preprocedure and immediate post-procedure

care requiring an unusual degree of intensity

and provided in an ambulatory procedure

unit (APU). An APU is a location or

organization within an MTF (or freestanding

outpatient clinic) that is specially equipped,

staffed, and designated for the purpose of

providing the intensive level of care

associated with APVs. Care is required in the

facility for less than 24 hours. All expenses

and workload are assigned to the MTFestablished APU associated with the referring

clinic. The BB and BE APV rates are to be

used only by clinics that are subaccounts

under these summary accounts (see 4 for an

explanation of MEPRS hierarchical

arrangement). The All Other APV rate is to

be used only by those clinics that are not a

subaccount under BB or BE. In addition, APV

rates may only be utilized for clinics where

there is a clinic rate established. For

example, BLC, Neuromuscular Screening, no

longer has an established rate. Therefore, an

APU cannot be defined and an APV cannot

be billed for this clinic. 6Third party payers (such as insurance

companies) shall be billed for prescription

services when beneficiaries who have

medical insurance obtain medications from

MTFs that are prescribed by providers

external to the MTF (e.g., physicians and

dentists). Eligible beneficiaries (family

members or retirees with medical insurance)

are not liable personally for this cost and

shall not be billed by the MTF. Medical

Services Account (MSA) patients, who are

not beneficiaries as defined in 10 U.S.C. 1074

and 1076, are charged at the ‘‘Other’’ rate if

they are seen by an outside provider and only

come to the MTF for prescription services.

The standard cost of medications ordered by

an outside provider includes the DoD-wide

average cost of the drug, calculated by lowest

cost for the generic drugs with the same

dosage and strength. The prescription charge

is calculated by multiplying the number of

units (e.g., tablets or capsules) by the unit

cost and adding $6.00 for the cost of

dispensing the prescription. Dispensing costs

include overhead, supplies, and labor, etc. to

fill the prescription.

The list of drug reimbursement rates is too

large to include in this document. Those

rates are available from the TRICARE

Management Activity’s Uniform Business

Office web site,

http://www.tricare.osd.mil/ebc/rm_home/

imcp/ubo/ubo_01.htm.

7The list of rates for ancillary services

requested by outside providers and obtained

at a Military Treatment Facility is too large

to include in this document. Those rates are

available from the TRICARE Management

Activity’s Uniform Business Office website,

http://www.tricare.osd.mil/ebc/rm_home/

imcp/ubo/ubo_01.htm.

Charges for ancillary services requested by

an outside provider (e.g., physicians and

dentists) are relevant to the Third Party

Collection Program. Third party payers (such

as insurance companies) shall be billed for

ancillary services when beneficiaries who

have medical insurance obtain services from

the MTF which are prescribed by providers

external to the MTF. Laboratory and

Radiology procedure costs are calculated by

multiplying the DoD-established weight for

the Physicians’ Current Procedural

Terminology (CPT) 2001 code by either the

laboratory or radiology multiplier (section

III.E.). Radiology procedures performed by

Nuclear Medicine use the same methodology

as Radiology for calculating a charge because

their workload and expenses are included in

the establishment of the Radiology

multiplier.

Eligible beneficiaries (family members or

retirees with medical insurance) are not

personally liable for this cost and shall not

be billed by the MTF. MSA patients, who are

not beneficiaries as defined by 10 U.S.C.

1074 and 1076, are charged at the ‘‘Other’’

rate if they are seen by an outside provider

and only come to the MTF for ancillary

services. 8The attending physician is to complete

the CPT 2001 code to indicate the

appropriate procedure followed during

cosmetic surgery. The appropriate rate will

be applied depending on the treatment

modality of the patient: ambulatory

procedure visit, outpatient clinic visit or

inpatient surgical care services. 9Family members of active duty personnel,

retirees and their family members, and

survivors shall be charged elective cosmetic

surgery rates. Elective cosmetic surgery

procedure information is contained in

section IV. The patient shall be charged the

rate as specified in the FY 2002 reimbursable

rates for an episode of care. The charges for

elective cosmetic surgery are at the full

reimbursement rate (designated as the

‘‘Other’’ rate) for inpatient care services

based on the cost per DRG, ambulatory

procedure visits as contained in section II.B.

or the appropriate outpatient clinic rate in

sections II.A. The patient is responsible for

the cost of the implant(s) and the prescribed

cosmetic surgery rate. (Note: The implants

and procedures used for the augmentation

mammaplasty are in compliance with

Federal Drug Administration guidelines.) 10Each regional lipectomy shall carry a

separate charge. Regions include head and

neck, abdomen, flanks, and hips.

11 Dental service rates are based on a dental

rate multiplied by the DoD established

weight for the American Dental Association

(ADA) code performed. For example, for

ADA code 00270, bite wing single film, the

weight is 0.15. The weight of 0.15 is

multiplied by the appropriate rate, IMET,

IAR, or Full/Third Party rate to obtain the

charge. If the Full/Third Party rate is used,

then the charge for this ADA code will be

$11.55 ($77 × .15 = $11.55).

The list of ADA codes and weights for

dental services is too large to include in this

document. Those rates are available from the

TRICARE Management Activity’s Uniform

Business Office web site, http://

www.tricare.osd.mil/ebc/rm_home/imcp/

ubo/ubo_01.htm. 12Ambulance charges shall be based on

hours of service in 15 minute increments.

The rates listed in section III.G. are for 60

minutes or 1 hour of service. Providers shall

calculate the charges based on the number of

hours (and/or fractions of an hour) that the

ambulance is logged out on a patient run.

Fractions of an hour shall be rounded to the

next 15 minute increment (e.g., 31 minutes

shall be charged as 45 minutes). 13Air in-flight medical care reimbursement

charges are determined by the status of the

patient (ambulatory or litter) and are per

patient during a 24-hour period. The

appropriate charges are billed only by the Air

Force Global Patient Movement Requirement

Center (GPMRC). These charges are only for

the cost of providing medical care. Flight

charges are billed by GPMRC separately. 14Observation Services are billed at the

hourly charge. Begin counting when the

patient is placed in the observation bed and

round to the nearest hour. For example, if a

patient has received 1 hour and 20 minutes

of observation, then you bill for 1 hour of

service. If the status of a patient changes to

inpatient, the charges for observation services

are added to the DRG assigned to the case

and not separately billed. If a patient is

released from observation status and is sent

to an APV, the charges for observation

services are not billed separately but are

added to the APV rate to recover all

expenses. 15Subsistence is billed under the Medical

Services Account (MSA) Program only. The

MSA office shall collect subsistence charges

from all persons, including inpatients and

transient patients not entitled to food service

at Government expense. Please refer to DoD

6010.15–M, Military Treatment Facility

Uniform Business Office (UBO) Manual,

April 1997 and the DoD 7000.14–R,

‘‘Department of Defense Financial

Management Regulation’’, Volume 12,

Chapter 19 for guidance on the the use of

these rates.

ATTACHMENT 1.—FY02 ADJUSTED STANDARDIZED AMOUNTS (ASA) BY MILITARY TREATMENT FACILITY

DMISID MTF name Serv Full cost rate Interagency

rate IMET rate TPC rate

0003 .......... Lyster AH—Ft. Rucker ....................................... A $6,703 $6,348 $3,576 $6,703

0005 .......... Bassett ACH—Ft. Wainwright ........................... A 7,241 6,856 3,863 7,241

0006 .......... 3rd Med Grp—Elmendorf AFB .......................... F 7,109 6,732 3,793 7,109

66484 Federal Register / Vol. 66, No. 247 / Wednesday, December 26, 2001 / Notices

ATTACHMENT 1.—FY02 ADJUSTED STANDARDIZED AMOUNTS (ASA) BY MILITARY TREATMENT FACILITY—Continued

DMISID MTF name Serv Full cost rate Interagency

rate IMET rate TPC rate

0009 .......... 56th Med Grp—Luke AFB ................................. F 6,474 6,159 3,618 6,474

0014 .......... 60th Med Grp—Travis AFB ............................... F 9,946 9,419 5,306 9,946

0024 .......... NH Camp Pendleton .......................................... N 8,687 8,264 4,855 8,687

0028 .......... NH Lemoore ...................................................... N 7,034 6,661 3,752 7,034

0029 .......... NH San Diego .................................................... N 10,904 10,374 6,094 10,904

0030 .......... NH Twenty Nine Palms ..................................... N 6,596 6,274 3,686 6,596

0032 .......... Evans ACH—Ft. Carson .................................... A 6,985 6,615 3,726 6,985

0033 .......... 10th Med Grp—USAF Academy ....................... F 7,062 6,687 3,767 7,062

0037 .......... Walter Reed AMC—Washington DC ................. A 10,384 9,878 5,803 10,384

0038 .......... NH Pensacola .................................................... N 8,704 8,242 4,643 8,704

0039 .......... NH Jacksonville ................................................. N 8,539 8,123 4,772 8,539

0042 .......... 96th Med Grp—Eglin AFB ................................. F 8,747 8,283 4,666 8,747

0045 .......... 6th Med Grp—MacDill AFB ............................... F 6,482 6,167 3,623 6,482

0047 .......... Eisenhower AMC—Ft. Gordon .......................... A 8,677 8,217 4,629 8,677

0048 .......... Martin ACH—Ft. Benning .................................. A 8,118 7,688 4,331 8,118

0049 .......... Winn ACH—Ft. Stewart ..................................... A 6,989 6,618 3,728 6,989

0052 .......... Tripler AMC—Ft. Shafter ................................... A 10,134 9,597 5,406 10,134

0053 .......... 366th Med Grp—Mountain Home AFB ............. F 7,056 6,682 3,764 7,056

0055 .......... 375th Med Grp—Scott AFB ............................... F 8,579 8,161 4,794 8,579

0056 .......... NH Great Lakes ................................................. N 6,538 6,220 3,654 6,538

0057 .......... Irwin AH—Ft. Riley ............................................ A 6,498 6,154 3,467 6,498

0060 .......... Blanchfield ACH—Ft Campbell ......................... A 6,577 6,228 3,509 6,577

0061 .......... Ireland ACH—Ft. Knox ...................................... A 6,467 6,124 3,450 6,467

0064 .......... Bayne-Jones ACH—Ft. Polk ............................. A 6,602 6,252 3,522 6,602

0066 .......... 89th Med Grp—Andrews AFB ........................... F 8,807 8,378 4,922 8,807

0067 .......... NNMC Bethesda ................................................ N 10,913 10,382 6,099 10,913

0073 .......... 81st Med Grp—Keesler AFB ............................. F 10,213 9,671 5,448 10,213

0075 .......... Wood ACH—Ft. Leonard Wood ........................ A 6,572 6,223 3,506 6,572

0078 .......... 55th Med Grp—Offutt AFB ................................ F 9,245 8,755 4,932 9,245

0079 .......... 99th Med Grp—Nellis AFB ................................ F 6,495 6,179 3,630 6,495

0084 .......... 49th Med Grp—Holloman AFB .......................... F 7,068 6,693 3,771 7,068

0086 .......... Keller ACH—West Point .................................... A 7,342 6,953 3,917 7,342

0089 .......... Womack AMC—Ft. Bragg ................................. A 7,586 7,184 4,047 7,586

0091 .......... NH Camp LeJeune ............................................ N 6,694 6,339 3,571 6,694

0092 .......... NH Cherry Point ................................................ N 6,809 6,448 3,632 6,809

0093 .......... 319th Med Grp—Grand Forks AFB ................... F 6,966 6,597 3,716 6,966

0094 .......... 5th Med Grp—Minot AFB .................................. F 6,965 6,595 3,715 6,965

0095 .......... 74th Med Grp—Wright-Patterson AFB .............. F 11,385 10,781 6,073 11,385

0098 .......... Reynolds ACH—Ft. Sill ..................................... A 6,849 6,486 3,654 6,849

0100 .......... NH Newport ....................................................... N 6,486 6,170 3,625 6,486

0101 .......... 20th Med Grp—Shaw AFB ................................ F 7,028 6,656 3,749 7,028

0104 .......... NH Beaufort ....................................................... N 6,940 6,572 3,702 6,940

0105 .......... Moncrief ACH—Ft. Jackson .............................. A 7,011 6,639 3,740 7,011

0106 .......... 28th Med Grp—Ellsworth AFB .......................... F 7,049 6,675 3,760 7,049

0108 .......... Wm Beaumont AMC—Ft. Bliss ......................... A 8,575 8,120 4,575 8,575

0109 .......... Brooke AMC—Ft. Sam Houston ....................... A 9,404 8,946 5,255 9,404

0110 .......... Darnall AH—Ft. Hood ........................................ A 7,904 7,485 4,216 7,904

0112 .......... 7th Med Grp— Dyess AFB ................................ F 6,999 6,628 3,734 6,999

0113 .......... 82nd Med Grp—Sheppard AFB ........................ F 6,970 6,600 3,718 6,970

0117 .......... 59th Med Wing F—Lackland AFB ..................... F 9,977 9,491 5,575 9,977

0120 .......... 1st Med Grp—Langley AFB .............................. F 6,421 6,108 3,588 6,421

0121 .......... McDonald ACH—Ft. Eustis ............................... A 6,103 5,806 3,411 6,103

0123 .......... Dewitt AH—Ft. Belvoir ....................................... A 8,131 7,735 4,544 8,131

0124 .......... NH Portsmouth .................................................. N 8,355 7,949 4,669 8,355

0125 .......... Madigan AMC—Ft. Lewis .................................. A 11,847 11,218 6,320 11,847

0126 .......... NH Bremerton .................................................... N 8,400 7,955 4,481 8,400

0127 .......... NH Oak Harbor .................................................. N 6,709 6,382 3,749 6,709

0131 .......... Weed ACH—Ft. Irwin ........................................ A 7,064 6,689 3,769 7,064

0606 .......... 95th CSH—Heidelberg ...................................... A 9,742 9,293 3,958 9,742

0607 .......... Landstuhl Rgn MC ............................................. A 9,742 9,293 3,958 9,742

0609 .......... 67th CSH—Wurzburg ........................................ A 9,742 9,293 3,958 9,742

0612 .......... 121st Gen Hosp—Seoul .................................... A 9,742 9,293 3,958 9,742

0615 .......... NH Guantanamo Bay ........................................ N 9,742 9,293 3,958 9,742

0616 .......... NH Roosevelt Roads ......................................... N 9,742 9,293 3,958 9,742

0617 .......... NH Naples ......................................................... N 9,742 9,293 3,958 9,742

0618 .......... NH Rota ............................................................. N 9,742 9,293 3,958 9,742

0620 .......... NH Guam ........................................................... N 9,742 9,293 3,958 9,742

0621 .......... NH Okinawa ....................................................... N 9,742 9,293 3,958 9,742

0622 .......... NH Yokosuka ..................................................... N 9,742 9,293 3,958 9,742

0623 .......... NH Keflavik ........................................................ N 9,742 9,293 3,958 9,742

0624 .......... BH Sigonella ...................................................... N 9,742 9,293 3,958 9,742

Federal Register / Vol. 66, No. 247 / Wednesday, December 26, 2001 / Notices 66485

1 15 U.S.C. 78s(b)(1).

2 17 CFR 240. 19b–4.

3See letter from Jeffrey P. Burns, Assistant

General Counsel, Amex, to Yvonne Fraticelli,

Special Counsel, Division of Market Regulation

(‘‘Division’’), Commission, dated November 20,

2001 (‘‘Amendment No. 1’’). In Amendment No. 1,

the Amex enclosed a draft circular that the Amex

will distribute to members. Among other things, the

circular described the Balanced Strategy Notes and

the suitability requirements applicable to the

Balanced Strategy Notes. In addition, the Amex

made the following clarifications: (1) with respect

to suitability recommendations and risks, the

Exchange will require members, member

organizations and employees thereof recommending

a transaction in the Balanced Strategy Notes to

determine that such transaction is suitable for the

customer, and to have a reasonable basis for

believing that the customer can evaluate the special

characteristics of, and is able to bear the financial

risks of, such transactions; (2) Merrill Lynch & Co.,

Inc. has designed the Balanced Strategy Notes for

investors who want to participate in the changes in

U.S. domestic equity and bond markets and who are

willing to forego market interest payments on the

Balanced Strategy Notes; (3) the Amex represents

that its surveillance procedures are adequate to

properly monitor the trading of the Balanced

Strategy Notes; and (4) the index divisor referenced

in connection with the Standard and Poor’s 500

Total Return Index keeps the index comparable

over time to its base period (1941–1943) and is the

reference point for all maintenance adjustments.

4The Amex clarified the definition of the U.S.

Bond Index by indicating that it intends to refer to

the U.S. Domestic Master Index as the U.S. Bond

Index. Telephone conversation between Jeffrey P.

Burns, Assistant General Counsel, Amex, and

Yvonne Fraticelli, Special Counsel, Division,

Commission, on December 7, 2001 )‘‘December 7

Conversation’’). As discussed more fully below, the

U.S. Bond Index, which is comprised of over 4,000

issues, is an indicator of the performance of the

investment grade U.S. domestic bond market.

5See Securities Exchange Act Release No. 27753

(March 1, 1990), 55 FR 8626 (March 8, 1990) (order

approving File No. SR–Amex–89–29) (‘‘Hybrid

Approval Order’’).

ATTACHMENT 1.—FY02 ADJUSTED STANDARDIZED AMOUNTS (ASA) BY MILITARY TREATMENT FACILITY—Continued

DMISID MTF name Serv Full cost rate Interagency

rate IMET rate TPC rate

0633 .......... 48th Med Grp—RAF Lakenheath ...................... F 9,742 9,293 3,958 9,742

0635 .......... 39th Med Grp—Incirlik AB ................................. F 9,742 9,293 3,958 9,742

0638 .......... 51st Med Grp—Osan AB ................................... F 9,742 9,293 3,958 9,742

0639 .......... 35th Med Grp—Misawa ..................................... F 9,742 9,293 3,958 9,742

0640 .......... 374th Med Grp—Yokota AB .............................. F 9,742 9,293 3,958 9,742

0805 .......... 52nd Med Grp—Spangdahlem .......................... F 9,742 9,293 3,958 9,742

0808 .......... 31st Med Grp—Aviano ...................................... F 9,742 9,293 3,958 9,742

2. Department of Health and Human

Services

For the Department of Health and

Human Services, Indian Health Service,

effective October 1, 2001 and thereafter:

Hospital Care Inpatient Day

General Medical Care.

Alaska ............................ $2,025

Rest of the United

States ......................... 1,571

Outpatient Medical

Treatment

Outpatient Visit.

Alaska ............................ 363

Rest of the United

States ......................... 196

Beginning October 1, 2001, the rates

prescribed herein superceded those

established by the Director of the Office

of Management and Budget October 31,

2000 (FR Doc. 00–27726).

Mitchell Daniels, Jr.,

Director, Office of Management and Budget.

[FR Doc. 01–31663 Filed 12–21–01; 8:45 am]

BILLING CODE 3110–01–P

SECURITIES AND EXCHANGE

COMMISSION

[Release No. 34–45160; File No. SR–Amex–

2001–91]

Self-Regulatory Organizations; Notice

of Filing and Order Granting

Accelerated Approval to a Proposed

Rule Change and Amendment No. 1 by

the American Stock Exchange LLC

Relating to the Listing and Trading of

Balanced Strategy Notes

December 17, 2001.

Pursuant to Section 19(b)(1) of the

Securities Exchange Act of 1934

(‘‘Act’’),1 and Rule 19b–4 thereunder,2

notice is hereby given that on October

29, 2001, the American Stock Exchange

LLC (‘‘Amex’’ or ‘‘Exchange’’) filed with

the Securities and Exchange

Commission (‘‘Commission’’ or (‘‘Sec’’)

a proposed rule change, as described in

Items I and II below, which Items have

been prepared by the Exchange. The

Amex amended its proposal on

November 21, 2001.3 The Commission

is publishing this notice to solicit

comments on the proposed rule change

and Amendment No. 1 from interested

persons and to approve the proposal, as

amended, on an accelerated basis.

I. Self-Regulatory Organization’s

Statement of the Terms of Substance of

the Proposed Rule Change

The Amex proposes to list and trade

Balanced Strategy Notes (‘‘Balanced

Strategy Notes’’ or ‘‘Notes’’), the return

on which is based on the Balanced

Strategy Index (‘‘Balanced Strategy

Index’’). The Balanced Strategy Index is

based upon the performance of the

Standard & Poor’s (‘‘S&P’’) 500 Total

Return Index (‘‘S&P 500 Total Return

Index’’) and the U.S. Domestic Master

Index (‘‘U.S. Bond Index’’ 4 (each, an

‘‘Underlying Index,’’ and together, the

‘‘Underlying Indexes’’) pursuant to the

methodology set forth below. Initially,

the Underlying Indexes will each have

a weighting of 50% of the Balanced

Strategy Index. The Amex will

rebalance the Balanced Strategy Index

annually to reset the weighting of the

Underlying Indexes to 50% each of the

weight of the Balanced Strategy Index.

II. Self-Regulatory Organization’s

Statement of the Purpose of, and

Statutory Basis for, the Proposed Rule

Change

In its filing with the Commission, the

Amex included statements concerning

the purpose of, and basis for, the

proposed rule change, as amended, and

discussed any comments it received on

the proposed rule change, as amended.

The text of these statements may be

examined at the places specified in Item

III below. The Amex has prepared

summaries, set forth in Sections A, B,

and C below, of the most significant

aspects of such statements.

A. Self-Regulatory Organization’s

Statement of the Purpose of, and

Statutory Basis for, the Proposed Rule

Change

(1) Purpose

Under Section 107A of the Amex

Company Guide (‘‘Company Guide’’),

the Exchange may approve for listing

and trading securities which cannot be

readily categorized under the listing

criteria for common and preferred

stocks, bonds, debentures, or warrants.5

The Amex proposes to list for trading

under Section 107A of the Company

Guide notes based on the Balanced

Strategy Index (‘‘Balance Strategy

Notes’’ or ‘‘Notes’’), as described below.

The Balanced Strategy Index will be