Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Amendment on reimbursement methodology: Office of the Secretary. DOD. Amendment of final rule.
This amends the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) Regulation to implement The Department of Defense Authorization Act, 1982 and the Department of Defense Appropriation Act, 1982 (Pub. L. 96-86 and 97-114, respectively). These public laws require CHAMPUS to calculable prevailing charges at the 80th percentile of billed charges made for similar services in the same locality during the base period. It also allows prevailing charges (profiles) to be updated more frequently than once a year. The intent of these changes is to simplify profile development procedures, and make appropriate benefit payments, and make profiles more reflective of all providers' current charges.
D006264:Health Benefit Plans, Employee / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D008889:Military Personnel; D011907:Rate Setting and Review / Q000331:legislation & jurisprudence; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence*; D014481:United States