Civilian Health and Medical Program of the Uniformed Services (CHAMPUS): Office of the Secretary, DoD. Amendment of final rule.
This amends the CHAMPUS Regulation to implement Pub. L. 96-552. This public law allows CHAMPUS to extend benefits for outpatient surgery on the basis of inpatient cost-sharing rates for dependents of members of the uniformed services serving on active duty. This amendment changes the language in the Regulation to define ambulatory surgical centers as authorized CHAMPUS providers, provides for payment on the basis of reasonable costs and amends the cost-sharing provisions to apply the inpatient rate to certain ambulatory surgical services. The intended effect of the amendment is to encourage beneficiaries to obtain their surgical services in less expensive outpatient settings when medically appropriate to do so, by providing a more favorable cost-share formula.
D000556:Ambulatory Surgical Procedures / Q000191:economics*; D006264:Health Benefit Plans, Employee / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D008889:Military Personnel; D014481:United States