Purpose
To ensure that VA Medical Center is properly reimbursed at an appropriate rate for costs incurred in the performance of a research study that is considered above and beyond normal patient care activities.

Background
Both the VA Research and Development Manual and VA Headquarters have mandated that approved research and development projects that place an undue burden on Clinical Care activities must reimburse the Medical Care Appropriation at an appropriate rate. In the past, VA has not been able to properly cost account services; therefore reimbursement was unclear. In an effort to comply, the tortuously, liable rates of the MCCR were used to reimburse Clinical Care for services rendered above and beyond normal patient care activities. In 1997, with the implementation of DSS, VAMC Atlanta began implementing a cost-based approach that enabled research to request costs based on CPT codes. Beginning in 2002, the VA will provide AREF with reimbursement rates to the VA from the Foundation and will generate a bill through the Corporate Business Office (CBO).

Action
Prior to the initiation of a study, a proper budget must be negotiated with the sponsor. The CBO will utilize the billing system to generate invoices for the appropriate procedures.

Effective immediately, researchers must involve AREF when assessing and developing budgets for Clinical Care projects that are administered through the Atlanta Research and Education Foundation.

As you initiate negotiations with sponsors, please provide the Research Foundation Office with a proposed budget itemized with “above and beyond” patient care activities, as listed in the clinical impact form, so that we can negotiate with the CBO regarding the cost of these procedures. This in no way should hamper contract negotiations with the sponsor and should properly reimburse the Medical Care Appropriation for services rendered.