[Federal Register Volume 63, Number 147 (Friday, July 31, 1998)]
[Notices]
[Pages 40882-40883]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-20421]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
Proposed Collection; Comment Request
AGENCY: Office of the Assistant Secretary of Defense Health Affairs.
ACTION: Notice.
-----------------------------------------------------------------------
In accordance with Section 3506(c)(2)(A) of the Paperwork Reduction
Act of 1995, the Office of the Assistant Secretary of Defense for
Health Affairs announces the proposed public information collection and
seeks public comment on the provisions thereof. Comments are invited
on: (a) Whether the proposed collection of information is necessary for
the proper performance of the functions of the agency, including
whether the information shall have practical utility; (b) the accuracy
of the agency's estimate of the burden of the information collection;
(c) ways to enhance the quality, utility, and clarity of the
information to be collected; and (d) ways to minimize the burden of the
information collection on respondents, including through the use of
automated collection techniques or other forms of information
technology.
DATES: Consideration will be given to all comments received by
September 29, 1998.
ADDRESSES: Written comments and recommendations on the information
collection should be sent to TRICARE Management Activity, Medical
Benefits and Reimbursement Systems, 16401 East Centretech Parkway,
ATTN: David Bennett, Aurora, CO 80011-9043.
FOR FURTHER INFORMATION CONTACT: To request more information on this
proposed information collection, please write to the above address or
call TRICARE Management Activity, Medical Benefits and Reimbursement
Systems, at (303) 676-3494.
Title; Associated Form; and OMB Number: Application for CHAMPUS-
Provider Status: CORPORATE SERVICES PROVIDER.
Needs and Uses: The information collection will allow eligible
providers to apply for Corporate Services Provider status under the
TRICARE program.
Affected Public: Businesses or other for-profit; not-for-profit
institutions.
Annual Burden Hours: 333.
Number of Respondents: 1,000.
Responses for Respondent: 1.
Average Burden per Response: 20 minutes.
Frequency: On occasion.
SUPPLEMENTARY INFORMATION:
Summary of Information Collection
TRICARE Management Activity (TMA), formerly known as OCHAMPUS, is
in the process of submitting a final rule for publication in the
Federal Register, creating a fourth class of CHAMPUS providers
consisting of freestanding corporations and foundations that render
principally professional ambulatory or in-home care and technical
diagnostic procedures. The intent of the rule is not to create
additional benefits that ordinarily would not be covered under CHAMPUS
if provided by a more traditional health care delivery system, but
rather to allow those services which would otherwise be allowed except
for an individual provider's affiliation with a freestanding corporate
facility. The addition of the corporate class will recognize the
current range of providers within today's health care delivery
structure, and give beneficiaries access to another segment of the
health care delivery industry.
Corporate services providers must be approved for Medicare payment,
or when Medicare approval status is not required, be accredited by a
qualified accreditation organization to gain provider authorization
status under CHAMPUS. Corporate services providers must also enter into
a participation agreement which will be sent out as part of the initial
authorization process. The participation agreement will ensure that
CHAMPUS determined allowable payments, combined with the cost-share/
copayment, deductible, and other health insurance amounts, will be
accepted by the provider as payment in full.
The Application for CHAMPUS-Provider Status: Corporate Services
Provider, will collect the necessary information to ensure that the
conditions are met for authorization as a CHAMPUS corporate services
provider: i.e., the provider: (1) Is a corporation or a foundation, but
not a professional corporation or professional association; (2)
provides services and related supplies of a type rendered by CHAMPUS
individual professional providers or diagnostic technical services; (3)
is approved for Medicare payment or when Medicare approval status is
not required, is accredited by a qualified accreditation organization;
and (4) has entered into a participation agreement approved by the
Director, OCHAMPUS or a designee.
The collected information will be used by CHAMPUS contractors to
process claims and verify authorized provider status. Verification
involves collecting and reviewing copies of the provider's licenses,
certificates, accreditation documents, etc. If the criteria are met,
the provider is granted CHAMPUS-authorization status. The documentation
and information are collected when: (1) A provider requests permission
to become a CHAMPUS-authorized provider; (2) a claim is filed for care
received from a provider who is not listed on the contractors' computer
listing of authorized providers; or (3) when a former CHAMPUS-
authorized provider requests reinstatement. The contractors develop the
forms used to gather information based on CHAMPUS' conditions for
participation listed above. Without the collection of this information,
contractors cannot determine if the provider meets CHAMPUS'
authorization requirements for corporate services providers. If the
contractor is unable to verify that a provider meets these
authorization requirements, the contractor may not reimburse either the
provider or the beneficiary for the provider's health care services.
To reduce the reporting burden to a minimum, CHAMPUS has carefully
selected the information requested from respondents. Only that
information which has been deemed absolutely essential is being
requested. If necessary, contractors may verify
[[Page 40883]]
credentials with Medicare, JCAHO and other national organizations by
telephone. CHAMPUS is also participating with Medicare in the
development of a National Provider System which will eliminate
duplication of provider certification data collection among federal
government agencies.
CHAMPUS contractors are required to maintain a computer listing of
all providers that have submitted the appropriate authorization
information and documentation. To avoid duplicate inquiries, the
contractors must search the computer provider listing before requesting
documentation from providers. Since the providers affected by this
information collection generally have not previously been eligible to
be authorized providers, CHAMPUS contractors will have no information
on file. The providers will have to submit the information requested on
the data collection form (Application for CHAMPUS-Provider Status:
Corporate Services Provider) in order to obtain provider authorization
status under CHAMPUS.
The information will usually be collected from each respondent only
once. It is estimated that there will be approximately 3,000 applicants
over an initial 3 year collection period or 1,000 respondents per year.
After the initial three years of collection, it is estimated that
annual number of respondents will decline to less than 100. CHAMPUS
will request the provider authorization documentation and information
when the provider asks to become CHAMPUS-authorized or when a claim is
filed for a new provider's services. If after a provider has been
authorized by a contractor, no claims are filed during a two-year
period of time, the provider's information will be placed in the
inactive file. To reactivate a file, the provider must verify that the
information is still correct, or supply new or changed information. The
total first year reporting burden is estimated to be 333\1/3\ hours.
Dated: July 20, 1998.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 98-20421 Filed 7-30-98; 8:45 am]
BILLING CODE 5000-04-U