FR 2021-03633

Summary of the Document

The document is a notice from the Office of Management and Budget within the Executive Office of the President. It outlines new rates established for the recovery of costs from third parties who are deemed tortiously liable for inpatient medical services provided at military treatment facilities. These rates align with those previously set on October 1, 2019, for billing medical insurers, but a distinct approval authority is now required specifically for tort liability billing. These rates are immediately effective upon publication in the Federal Register and will remain active until further notice. Further details and a full disclosure of these rates can be accessed via the Defense Health Agency's website, Health.mil.

Significant Issues or Concerns

One of the critical concerns surrounding this notice is the lack of detailed information regarding the actual rates. The document does not specify what the inpatient medical service rates are, leaving stakeholders unclear about the financial ramifications. Additionally, there is no explanation of how the initial rates, set on October 1, 2019, were determined. This lack of transparency may raise questions about the fairness of these rates and whether the process involved any potential bias.

Another point of concern is the periodic update of pharmacy rates, which the notice states but does not elaborate on how often or through what process these updates occur. The vague reference to the OMB Circular A-25 and the Health.mil website without summaries further complicates understanding, as readers must independently seek these documents to comprehend the context fully.

Impact on the Public

The broader public impact is relatively limited, as this document primarily affects third parties who might be financially responsible for medical services due to tort liability. However, individuals who interact with military treatment facilities or are connected to service members may have an interest in understanding how these rates could indirectly affect the cost of medical services.

Impact on Specific Stakeholders

For stakeholders directly involved, such as insurers and potentially liable third parties, this document has significant financial implications. They are now subject to a set of rates they must comply with when faced with tortious liability for inpatient services provided by Department of Defense medical treatment facilities. The lack of transparency and detail might lead to challenges in financial planning and disputes regarding the fairness or reasonableness of these costs.

Healthcare administrators within the Department of Defense might view this clarity in establishing a separate approval authority for tort recovery as a positive step, potentially streamlining billing processes and ensuring compliance with directive requirements. However, without comprehensive rate details, administering these billing processes might become operationally complex.

Overall, while the issuance of such rates serves a necessary regulatory function, the execution in this specific document leaves room for improvement in transparency and accessibility of information.