[Federal Register: January 29, 2003 (Volume 68, Number 19)]
[Notices]
[Page 4451-4452]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr29ja03-40]
[[Page 4451]]
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DEPARTMENT OF DEFENSE
Office of the Secretary
Proposed Collection; Comment Request
AGENCY: Office of the Assistant Secretary of Defense Health Affairs,
DoD.
ACTION: Notice.
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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 March
31, 2003.
ADDRESSES: Written comments and recommendations on the information
collection should be sent to TRICARE Management Activity, Medical
Benefits and Reimbursement Systems, 16401 East Centretch 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 TRICARE-
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
On March 10, 1999, TRICARE Management Activity (TMA), formerly
known as OCHAMPUS, published a finale rule in the Federal Register (64
FR 11765), creating a fourth class of TRICARE 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 was not to create additional
benefits that ordinarily would not be covered under TRICARE 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 TRICARE. 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 TRICARE 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 TRICARE-Provider Status: Corporate Services
Provider, will collect the necessary information to ensure that the
conditions are met for authorization as a TRICARE 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 TRICARE
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
Executive Director, TMA or a designee.
The collected information will be used by TRICARE 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 TRICARE-authorization status. The documentation
and information are collected when: (1) A provider requests permission
to become a TRICARE-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 TRICARE-
authorized provider requests reinstatement.
The contractors develop the forms used to gather information based
on TRICARE conditions for participation listed above. Without the
collection of this information, contractors cannot determine if the
provider meets TRICARE 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, TRICARE 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 credentials with
Medicare, JCAHO and other national organizations by telephone. TRICARE
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.
TRICARE 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, TRICARE contractors will have no information
on file. The providers will have to submit the information requested on
the data collection form (Application for TRICARE-Providers Status:
Corporate Services Provider) in order to obtain provider authorization
status under TRICARE.
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
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that annual number of respondents will decline to less than 100.
TRICARE will request the provider authorization documentation and
information when the provider asks to become TRICARE-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: January 21, 2003.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 03-1947 Filed 1-28-03; 8:45 am]
BILLING CODE 5001-08-M