TRICARE; Certain Survivors of Deceased Active Duty Members; and Adoption Intermediaries, 2444-2448 [E7-709]
Download as PDF
2444
Federal Register / Vol. 72, No. 12 / Friday, January 19, 2007 / Rules and Regulations
American Animal Hospital Association, 39,
pp. 311 to 320, May/June 2003.
18. Mudarri, D. H., ‘‘The Costs and Benefits
of Smoking Restrictions: An Assessment of
the Smoke-Free Environment Act of 1993,’’
(H.R. 3434) (p. 14), Washington, DC, U.S.
Environmental Protection Agency, April
1994.
frosa on PROD1PC71 with RULES
19. Mudarri, D. H., ‘‘The Costs and Benefits
of Smoking Restrictions: An Assessment of
the Smoke-Free Environment Act of 1993,’’
(H.R. 3434) (Appendix A–1), Washington,
DC, U.S. Environmental Protection Agency;
Kaplan, R. M., J. W. Bush, & C. C. Berry,
Health Status: Types of Validity and the
Index of Well-Being, Health Services
Research Journal, pp. 478–507, winter 1976.
20. Kaplan, R. M., J. W. Bush, C. C. Berry,
(1976, Winter), ‘‘Health Status: Types of
Validity and the Index of Well-Being,’’
Health Services Research Journal, pp. 478–
507; M. M. Chen, J. W. Bush, D. L. Patrick,
(1975), ‘‘Social Indicators for Health Planning
and Policy Analysis,’’ Policy Sciences
Journal, 6, pp. 71–89; R. M. Kaplan, J. W.
Bush, (1982), ‘‘Health Related Quality of Life
Measurement for Evaluation Research and
Policy Analysis,’’ Health Psychology, 1(1),
pp. 61–80.
21. R. M. Kaplan, J. W. Bush, C. C. Berry,
‘‘Health Status: Types of Validity and the
Index of Well-Being,’’ Health Services
Research Journal, pp. 478–507, winter 1976.
22. Tufts—New England Medical Center.
The CEA Registry: Catalog of Preference
Scores, https://www.tufts-nemc.org/
cearegistry/data/
phaseIIpreferenceweights.pdf, April 5, 2006.
23. U.S. Census Bureau, Statistical
Abstract of the United States: 2002, https://
www.census.gov/prod/2003pubs/02statab/
vitstat.pdf, 2002, December.
24. Tufts—New England Medical Center,
The CEA Registry: Catalog of Preference
Scores, https://www.tufts-nemc.org/
cearegistry/data/
phaseIIpreferenceweights.pdf, April 5, 2006.
25. Id.
26. M. G. Marin, J. Van Lieu, A. Yee, et al.,
‘‘Cost-Effectiveness of a Post-Exposure HIV
Chemoprophylaxis Program for Blood
Exposures in Health Care Workers,’’ Journal
of Occupational and Environmental
Medicine, 41(9), pp. 754–760, September
1999.
27. ‘‘Time to Top Off Your Tank?: The Red
Cross Says Blood Safety Costs Are Pumping
Up Prices,’’ The Washington Post, p. T07,
June 12, 2001.
28. Lerman, C., Schwartz, & Schwartz,
Marc, ‘‘Adherence and Psychological
Adjustment Among Women at High Risk for
Breast Cancer,’’ Breast Cancer Research and
Treatment, 28, pp. 145–155, 1993.
29. Shrout, P. E., ‘‘Scaling of Stressful Life
Events,’’ (in) Dohrenwend, B. Snell, B. P.
Dohrenwend (Eds.), Stressful Life Events &
Their Contexts (pp. 29–47), New Brunswick,
NJ, Rutgers University Press, 1984.
30. Kaplan, R. M., J. W. Bush, C. C. Berry,
‘‘ Health Status: Types of Validity and the
Index of Well-Being,’’ Health Services
Research Journal, pp. 478–507, winter 1976.
31. E. Alderete, T. C. Juarbe, C. P. Kaplan,
et al., ‘‘Depressive Symptoms Among Women
VerDate Aug<31>2005
17:42 Jan 18, 2007
Jkt 211001
With an Abnormal Mammogram,’’ PsychoOncology, 15, pp. 66–78, 2006.’’
Dated: January 11, 2007.
Jeffrey Shuren,
Assistant Commissioner for Policy.
[FR Doc. E7–682 Filed 1–18–07; 8:45 am]
BILLING CODE 4160–01–S
DEPARTMENT OF DEFENSE
Office of the Secretary
32 CFR Part 199
[DOD–2006–HA–0194; RIN 0720–AB07]
TRICARE; Certain Survivors of
Deceased Active Duty Members; and
Adoption Intermediaries
Office of the Secretary, DoD.
Interim Final Rule.
AGENCY:
ACTION:
SUMMARY: This interim final rule
implements two provisions of the
National Defense Authorization Act for
Fiscal Year 2006 (NDAA FY06), Public
Law 109–163. First, Section 715 of the
NDAA FY06 extends the time frame
certain dependents of Active Duty
Service Members (ADSM) who die
while on active duty for more than 30
days shall receive TRICARE medical
benefits at active duty dependent
payment rates. Second, Section 592 of
the NDAA FY06 modifies the
requirement for those intermediaries
who provide adoption placements.
Additionally, this interim final rule
makes an administrative clarification to
the following two eligibility provisions:
those placed in the legal custody of a
member or former member; and those
placed in the home of a member or
former member in anticipation of
adoption. This clarification makes a
distinction between the two groups and
specifies that for placement into legal
custody by court order, the court order
must be for a period of 12 consecutive
months.
Public comments are invited and will
be considered for possible revisions to
the final rule.
DATES: This rule is effective March 20,
2007.
Comments: Written comments
received at the address indicated below
by March 20, 2007 will be accepted.
ADDRESSES: You may submit comments,
identified by docket number and or RIN
number and title, by any of the
following methods:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Federal Docket Management
System Office, 1160 Defense Pentagon,
Washington, DC 20301–1160.
PO 00000
Frm 00024
Fmt 4700
Sfmt 4700
Instructions: All submissions received
must include the agency name and
docket number or Regulatory
Information Number (RIN) for this
Federal Register document. The general
policy for comments and other
submissions from members of the public
is to make these submissions available
for public viewing on the Internet at
https://regulations.gov as they are
received without change, including any
personal identifiers or contact
information.
FOR FURTHER INFORMATION CONTACT: Ms.
Ann N. Fazzini, (303) 676–3803 for
questions regarding Section 715 as it
relates to the TRICARE Basic Program;
and also questions regarding Section
592.
Mr. Michael Kottyan, (303) 676–3520
for questions regarding Section 715 as it
relates to the Extended Health Care
Option (ECHO).
Mr. John Leininger, (303) 676–3613,
for questions regarding TRICARE Prime
Remote.
Questions regarding payment of
specific claims should be addressed to
the appropriate TRICARE contractor.
SUPPLEMENTARY INFORMATION: The
Department is publishing this rule as an
interim final rule in order to meet
statutorily required effective dates. The
Department is not exercising any
discretion in implementing these
provisions. In accordance with Section
715(b), the effective date for Section 715
is October 7, 2001 and shall apply with
respect to deaths occurring on or after
that date. The Department has no
discretion concerning the benefits
available to surviving dependents, the
effective date, nor the time periods
benefits are available to surviving
spouses and children respectively. The
effective date for Section 592 is January
6, 2006. Prior to the NDAAFY06, a child
placed in the home by a placement
agency recognized by the Secretary of
Defense in anticipation of the legal
adoption of the person was eligible for
TRICARE. Section 592 of the NDAA
FY06 expands those intermediaries who
perform adoption placement to include
placement by any source authorized by
State or local law to provide adoption
placement. The Department is not
exercising any discretion in defining
who are intermediaries who can
perform adoption placement. In
accordance with Public Law 103–160,
section 702(b), the effective date for
placement by a court is July 1, 1994. In
accordance with Public Law 103–337,
section 701, the effective date for
placement by a recognized adoption
agency October 5, 1994. These last two
changes are administrative corrections
E:\FR\FM\19JAR1.SGM
19JAR1
Federal Register / Vol. 72, No. 12 / Friday, January 19, 2007 / Rules and Regulations
only. Public comments are invited and
will be considered for possible revisions
to the final rule.
The effective date for Section 715 is
October 7, 2001 and shall apply with
respect to deaths occurring on or after
that date. The effective date for Section
592 is January 6, 2006. In accordance
with Public Law 103–160, section
702(b), the effective date for placement
by a court is July 1, 1994. In accordance
with Public Law 103–337, section 701,
the effective date for placement by a
recognized adoption agency October 5,
1994.
I. Payment Rates for Dependents of
Deceased Active Duty Service Members
Introduction and Background
Dependents of active-duty members
who died while on active duty have
been always eligible for TRICARE;
however, their payment rates/costsharing provisions have changed over
time. Initially, their cost-sharing
provisions were at the retiree payment
rate for all care received. This was
amended by Section 707(c) of the
National Defense Authorization Act for
Fiscal Year 1995, Public Law 103–337,
which provided for two changes. First,
effective October 1, 1993, care was to be
cost-shared at the active duty dependent
payment rate for a one-year period.
Second, for dependents of active duty
members who died while on active duty
between January 1, 1993, and October 1,
1993, only care for pre-existing
conditions was cost-shared at the active
duty dependent payment rate.
An additional amendment to the time
period for the payment rate for
dependents of deceased active duty
members was found in Section 704 of
the Floyd D. Spence National Defense
Authorization Act for Fiscal Year 2001.
Section 704 added a two-year extension
of the active-duty dependent costsharing provision which allowed
survivors of deceased active duty
members to remain eligible for
TRICARE at the active duty dependent
payment rate for a total of three years
from the date of death. After three years,
survivors remained eligible for
TRICARE at the retiree payment rate.
frosa on PROD1PC71 with RULES
Section 715 of the NDAA–FY06
General
Section 715 of the NDAA FY06
further modified the cost-sharing
provision for certain dependents of
deceased active duty members by
adding the following subparagraph
1079(g)(2) to title 10, United States
Code:
(2) In addition to any continuation of
eligibility for benefits under paragraph (1),
VerDate Aug<31>2005
17:42 Jan 18, 2007
Jkt 211001
when a member dies while on active duty for
a period of more than 30 days, the member’s
dependents who are receiving benefits under
a plan covered by subsection (a) shall
continue to be eligible for benefits under
TRICARE Prime during the three-year period
beginning on the date of the member’s death,
except that, in the case of such a dependent
of the deceased who is described by
subparagraph (D) or (I) of section 1072(2) of
this title, the period of continued eligibility
shall be the longer of the following periods
beginning on such date:
(A) Three years.
(B) The period ending on the date on
which such dependent attains 21 years of
age.
(C) In the case of such a dependent who,
at 21 years of age, is enrolled in a full-time
course of study in a secondary school or in
a full-time course of study in an institution
of higher education approved by the
administering Secretary and was, at the time
of the member’s death, in fact dependent on
the member for over one-half of such
dependent’s support, the period ending on
the earlier of the following dates:
(i) The date on which such dependent
ceases to pursue such a course of study, as
determined by the administering Secretary.
(ii) The date on which such dependent
attains 23 years of age.
(3) For the purposes of paragraph (2)(C), a
dependent shall be treated as being enrolled
in a full-time course of study in an institution
of higher education during any reasonable
period of transition between the dependent’s
completion of a full-time course of study in
a secondary school and the commencement
of an enrollment in a full-time course of
study in an institution of higher education,
as determined by the administering
Secretary.
(4) The terms and conditions under which
health benefits are provided under this
chapter to a dependent of a deceased member
under paragraph (2) shall be the same as
those that would apply to the dependent
under this chapter if the member were living
and serving on active duty for a period of
more than 30 days.
(5) In this subsection, the term ‘‘TRICARE
Prime’’ means the managed care option of the
TRICARE program.
Certain Dependents
Section 715 of the NDAA FY06
changed the time frame that certain
dependents shall continue to retain
eligibility to enroll in TRICARE Prime at
the active duty dependent payment rate
and receive the same health benefits
that would apply to them if the member
were still living and serving on active
duty. Section 715 applies to those
dependents defined in 10 U.S.C.
Chapter 55, subparagraph (D) or (I) of
section 1072(2). In the supplementary
section of this Interim Final Rule, those
dependents in subparagraphs (D) and (I)
are referred to as ‘‘certain dependents’’
and the specific legislative language for
these two subparagraphs is outlined
below.
PO 00000
Frm 00025
Fmt 4700
Sfmt 4700
2445
Subparagraph (D) of 1072(2) addresses
a child who—
(i) has not attained the age of 21;
(ii) has not attained the age of 23, is
enrolled in a full-time course of study
at an institution of higher learning
approved by the administering Secretary
and is, or was at the time of the
member’s or former member’s death, in
fact dependent on the member or former
member for over one-half of the child’s
support; or
(iii) is incapable of self-support
because of a mental or physical
incapacity that occurs while a
dependent of a member or former
member under clause (i) or (ii) and is,
or was at the time of the member’s or
former member’s death, in fact
dependent on the member or former
member for over one-half of the child’s
support.
Subparagraph (I) addresses an
unmarried person who—
(i) is placed in the legal custody of the
member or former member as a result of
an order of a court of competent
jurisdiction in the United States (or
possession of the United States) for a
period of at least 12 consecutive
months;
(ii) either—
(I) has not attained the age of 21;
(II) has not attained the age of 23 and
is enrolled in a full time course of study
at an institution of higher learning
approved by the administering
Secretary; or
(III) is incapable of self support
because of a mental or physical
incapacity that occurred while the
person was considered a dependent of
the member or former member under
this subparagraph pursuant to subclause
(I) or (II);
(iii) is dependent on the member or
former member for over one-half of the
person’s support;
(iv) resides with the member or
former member unless separated by the
necessity of military service or to
receive institutional care as a result of
disability or incapacitation or under
such other circumstances as the
administering Secretary may by
regulation prescribe; and
(v) is not a dependent of a member or
a former member under any other
subparagraph.
These certain dependents may avail
themselves of the active duty dependent
payment rates available under TRICARE
Standard, Extra, or Prime and enjoy
medical benefits at the active duty
dependent payment rate in accordance
with the time frames listed in Section
715. Of significance is the cost saving
opportunity Section 715 presents for
those certain dependents that choose to
E:\FR\FM\19JAR1.SGM
19JAR1
2446
Federal Register / Vol. 72, No. 12 / Friday, January 19, 2007 / Rules and Regulations
enroll in TRICARE Prime. Currently,
there is no TRICARE Prime enrollment
fee and no TRICARE Prime copayment
for an active duty dependent Prime
enrollee so those certain dependents
who are enrolled in Prime also would
have no Prime enrollment fee and no
Prime copayment.
Those certain dependents that choose
TRICARE Standard or Extra would be
responsible for the active duty payment
rate (cost-share) applicable under those
two programs. The active duty
dependent payment rates for TRICARE
Standard and Extra vary by type of
service (inpatient, outpatient, etc.) and
can be found in 32 CFR 199.4(f).
TRICARE Prime Remote
Because Section 715 references
TRICARE Prime, the Department is
interpreting this section to also include
the TRICARE ‘‘Prime-like’’ benefit
known as TRICARE Prime Remote
(TPR). As a result, TPR will be available
to surviving spouses and certain
dependents whose sponsor died while
on active duty for a period of more than
30 days. Surviving spouses will be
eligible to enroll in TPR for a three-year
period. Certain dependents will be
eligible to enroll in TPR as long as they
meet the criteria for being a dependent
as described in 10 U.S.C. Chapter 55,
subparagraph (D) or (I) of section
1072(2).
For additional information on the TPR
program, the reader should refer to the
interim final rules that were published
in the Federal Register on February 6,
2002, (67 FR 5477) and July 31, 2003 (68
FR 44883).
frosa on PROD1PC71 with RULES
Extended Care Health Option (ECHO)
Based on the Department’s
interpretation of Section 715 of the
NDAA FY06, the ECHO is also available
to surviving spouses and certain
dependents of deceased active duty
members because these surviving
spouses and certain dependents are
treated as if the sponsoring member
were still living and serving on active
duty.
For additional information on the
ECHO program, the reader should refer
to the final rules that were published in
the Federal Register on July 28, 2004,
(69 FR 44942) and August 20, 2004, (69
FR 51559).
Surviving Spouse
We note that Section 715 of the
NDAA FY 06 provision makes no
change to the time frame that the
surviving spouse shall receive care at
the active duty dependent payment rate.
Surviving spouses retain the three year
period of TRICARE Prime, TPR,
VerDate Aug<31>2005
17:42 Jan 18, 2007
Jkt 211001
TRICARE Extra or TRICARE Standard at
the active duty dependent payment rate.
At the end of the three year period,
surviving spouses continue eligibility
for TRICARE benefits at the retiree
payment rate.
The provisions found in Section 715
are effective with respect to deaths
occurring on or after October 7, 2001.
II. Eligibility Determinations
Section 715 of the NDAA FY06
authorizes the time frame that certain
dependents shall retain active duty
dependent payment rates for medical
benefits available under TRICARE. The
provision has no impact on eligibility
rules. Consequently, this provision does
not preclude loss of eligibility as a result
of any condition which routinely results
in loss of TRICARE eligibility such as
reaching age limits, marriage,
remarriage, etc.
Although the TRICARE Management
Activity is tasked with publishing
legislatively mandated eligibility
changes to Title 10 U.S.C.,
determination of dependent eligibility is
the primary responsibility of the
Uniformed Services. TRICARE relies
primarily on the Defense Enrollment
Eligibility Reporting System (DEERS) for
eligibility verification. However, a
determination by the Uniformed
Services that a person is eligible does
not automatically entitle such a person
to TRICARE payments. Before any
TRICARE benefits may be extended,
additional requirements of 32 CFR Part
199 must be met. In accordance with 10
U.S.C. 1084, as implemented by
§ 199.3(h), disputes regarding eligibility
as a dependent or dates of beginning
eligibility for benefits under TRICARE
can only be resolved by the appropriate
Uniformed Service Secretary.
III. Modification of Requirement for
Certain Intermediaries Under Certain
Authorities Relating to Adoptions
Section 592 of the NDAA FY06 states
that:
(a) Reimbursement for Adoption
Expenses—Section 1052(g)(1) of title 10,
United States Code, is amended by inserting
‘or other source authorized to place children
for adoption under State or local law’ after
‘qualified adoption agency’.
(b) Treatment as Children for Medical and
Dental Care Purposes—Section 1072(6)(D)(i)
of such title is amended by inserting ‘, or by
any other source authorized by State or local
law to provide adoption placement,’ after
‘(recognized by the Secretary of Defense)’.
Prior to the NDAA FY06, a child
placed in the home by a placement
agency recognized by the Secretary of
Defense in anticipation of the legal
adoption of the person was eligible for
PO 00000
Frm 00026
Fmt 4700
Sfmt 4700
TRICARE. Section 592 of the NDAA
FY06 expands those intermediaries who
perform adoption placement to include
placement by any source authorized by
State or local law to provide adoption
placement. This expanded language
mirrors the language found in Title 10,
Subpart A, Part II, Chapter 53, Section
1052, reimbursement for adoption
expenses, and provides consistency
between personnel benefit policies in
chapter 53 of Title 10, United States
Code, and eligibility for TRICARE under
chapter 55 of Title 10, United States
Code. Effective date of the NDAA FY06
(and this provision) is January 6, 2006.
IV. Administrative Change—Court
Order/Adoption Placement
During the course of amending the
regulation to incorporate the NDAA
FY06 provisions, we identified the need
for an administrative clarification to 32
CFR Part 199 Section 3. This interim
final rule clarifies the eligibility
provisions for an unmarried person who
is placed in the legal custody of the
member or former member as a result of
an order of a court of competent
jurisdiction in the United States (or
possession of the United States) by
stating that the court order must be for
a period of at least 12 consecutive
months. We currently address a child
who is placed in legal custody of a
member or former member, but the
language unintentionally omitted the 12
consecutive month period required by
10 U.S.C. 1072(I)(i).
Additionally, this rule clarifies that an
unmarried person placed in legal
custody of a member or former member
is a category that is separate and distinct
from those placed for adoption. We
accomplish this by providing separate
regulatory paragraphs for each group.
For further information on these two
groups, we refer the reader to the final
rule that established these groups, 64 FR
46133, August 24, 1999.
V. Regulatory Procedures
We have examined the impact of the
interim rule under Executive Order (EO)
13132 and it does not have policies that
have federalism implications that would
have substantial direct effects on the
States, on the relationship between the
national government and the States, or
on the distribution of power and
responsibilities among the various
levels of government, therefore,
consultation with State and local
officials is not required.
Section 801 of title 5, United States
Code, and Executive Order 12866
requires certain regulatory assessments
and procedures for any major rule or
significant regulatory action, defined as
E:\FR\FM\19JAR1.SGM
19JAR1
Federal Register / Vol. 72, No. 12 / Friday, January 19, 2007 / Rules and Regulations
one that would result in an annual effect
of $100 million or more on the national
economy or which would have other
substantial impacts.
The Regulatory Flexibility Act (RFA)
requires that each Federal agency
prepare, and make available for public
comment, a regulatory flexibility
analysis when the agency issues a
regulation which would have a
significant impact on a substantial
number of small entities.
This is not a major rule under 5 U.S.C.
801. It is a significant regulatory action
but not economically significant, and
has been reviewed by the Office of
Management and Budget as required
under the provisions of E. O. 12866. In
addition, we certify that this proposed
rule will not significantly affect a
substantial number of small entities.
This final rule will not impose
additional information collection
requirements on the public under the
Paperwork Reduction Act of 1995 (44
U.S.C. Chapter 55).
List of Subjects in 32 CFR Part 199
Claims, Dental health, Health care,
Health insurance, Individuals with
disabilities, Military personnel.
I Accordingly, 32 CFR Part 199 is
amended as follows:
PART 199—[AMENDED]
1. The authority citation for Part 199
continues to read as follows:
I
Authority: 5 U.S.C. 301; 10 U.S.C. chapter
55.
2. Section 199.3 is amended by
revising paragraph (b)(2)(ii)(H)(4) and by
adding new paragraphs (b)(2)(iv), and
(c)(9)(iii) to read as follows:
I
§ 199.3
Eligibility.
frosa on PROD1PC71 with RULES
*
*
*
*
*
(b) * * *
(2) * * *
(ii) * * *
(H) * * *
(4) An unmarried person. An
unmarried person placed in the home of
a member or former member prior to
adoption. To be a dependent child, the
unmarried person must not have
reached the age of 21 (or otherwise
meets the requirements of a student or
incapacitated child set out in
paragraphs (b)(2)((ii)(H)(1) or
(b)(2)(ii)(H)(2) of this section) and has
been placed in the home of the member
or former member by a recognized
placement agency or by any other
source authorized by State or local law
to provide adoption placement, in
anticipation of legal adoption by the
member or former member.
*
*
*
*
*
VerDate Aug<31>2005
17:42 Jan 18, 2007
Jkt 211001
(iv) An unmarried person who is
placed in the legal custody of a member
or former member by a court of
competent jurisdiction in the United
States (or possession of the United
States) for a period of at least 12
consecutive months. The unmarried
person shall be considered a dependent
of the member or former member under
this section provided he or she
otherwise meets the following
qualifications:
(A) Has not reached the age of 21
unless he or she otherwise meets the
requirements of a student set out in
paragraph (b)(2)(ii)(H)(1) of this section
or the requirements for being
incapacitated as set out in paragraph
(b)(2)(ii)(H)(2) of this section and the
incapacitation occurred while he or she
was a dependent of the member or
former member through court ordered
legal custody;
(B) Is dependent on the member or
former member for over one-half of the
person’s support;
(C) Resides with the member or
former member unless separated by the
necessity of military service or to
receive institutional care as a result of
disability or incapacitation or under
such other authorized circumstances;
and,
(D) Is not a dependent of a member or
former member under any other
provision of law or regulation.
*
*
*
*
*
(c) * * *
(9) * * *
(iii) Has been placed in the home of
a member by a placement agency or by
any other source authorized by State or
local law to provide adoption
placement, in anticipation of the legal
adoption of the member:
(A) All benefits for which entitled,
January 6, 2006.
(B) Extended Care Health Option
benefits limited to children of members
only, January 6, 2006.
*
*
*
*
*
I 3. Section 199.5 is amended by
revising paragraphs (a)(2), (b)(1), and
(f)(3)(i) to read as follows:
§ 199.5 TRICARE Extended Care Health
Care Option (ECHO).
(a) * * *
(2) The purpose of the ECHO is to
provide an additional financial resource
for an integrated set of services and
supplies designed to assist in the
reduction of the disabling effects of the
ECHO-eligible dependent’s qualifying
condition. Services include those
necessary to maintain, minimize or
prevent deterioration of function of an
ECHO-eligible dependent.
PO 00000
Frm 00027
Fmt 4700
Sfmt 4700
2447
(b) * * *
(1) The following categories of
TRICARE/CHAMPUS beneficiaries with
a qualifying condition are ECHO-eligible
dependents:
(i) A spouse, child, or unmarried
person (as described in § 199.3(b)(2)(i),
(b)(2)(ii), or (b)(2)(iv)) of a member of
the Uniformed Services on active duty
for a period of more than 30 days.
(ii) An abused dependent as described
in § 199.3(b)(2)(iii).
(iii) A spouse, child, or unmarried
person (as described in § 199.3(b)(2)(i),
(b)(2)(ii), or (b)(2)(iv)), of a member of
the Uniformed Services who dies while
on active duty for a period of more than
30 days and whose death occurs on or
after October 7, 2001. In such case, an
eligible surviving spouse remains
eligible for benefits under the ECHO for
a period of 3 years from the date the
active duty sponsor dies. Any other
eligible surviving dependent remains
eligible for benefits under the ECHO for
a period of three years from the date the
active duty sponsor dies or until the
surviving eligible dependent:
(A) Attains 21 years of age, or
(B) Attains 23 years of age or ceases
to pursue a full-time course of study
prior to attaining 23 years of age, if, at
21 years of age, the eligible surviving
dependent is enrolled in a full-time
course of study in a secondary school or
in a full-time course of study in an
institution of higher education approved
by Secretary of Defense and was, at the
time of the sponsor’s death, in fact
dependent on the member for over onehalf of such dependent’s support.
(iv) A spouse, child, or unmarried
person (as defined in paragraphs
§ 199.3(b)(2)(i), (b)(2)(ii), or (b)(2)(iv)) of
a deceased member of the Uniformed
Services who, at the time of the
member’s death was receiving benefits
under ECHO, and the member at the
time of death was eligible for receipt of
hostile-fire pay, or died as a result of a
disease or injury incurred while eligible
for such pay. In such a case, the
surviving dependent remains eligible for
benefits under ECHO through midnight
of the dependent’s twenty-first birthday.
*
*
*
*
*
(f) * * *
(3) * * *
(i) ECHO. The total Government share
of the cost of all ECHO benefits, except
ECHO Home Health Care (EHHC) and
EHHC respite care, provided in a given
month to a beneficiary may not exceed
$2,500 after application of the allowable
payment methodology.
*
*
*
*
*
I 4. Section 199.17 is amended by:
E:\FR\FM\19JAR1.SGM
19JAR1
2448
Federal Register / Vol. 72, No. 12 / Friday, January 19, 2007 / Rules and Regulations
a. Redesignating paragraphs (c)(3) and
(c)(4) as paragraphs (c)(4) and (c)(5)
respectively.
I b. Adding new paragraph (c)(3).
I c. Revising paragraphs (g)(2) and
(g)(3)(i) introductory text.
I d. Adding new paragraphs (g)(3)(i)(D)
and (g)(3)(i)(E) to read as follows:
I
§ 199.17
TRICARE Program.
frosa on PROD1PC71 with RULES
*
*
*
*
*
*
(c) * * *
(3) Survivors of Deceased Members. (i)
The spouse of a member who dies while
on active duty for a period of more than
30 days is eligible to enroll in Prime for
a 3 year period beginning on the date of
the member’s death. For the three year
period, surviving spouses of a member
who dies while on active duty for a
period of more than 30 days are subject
to the same rules and provisions as
dependents of active duty members.
(ii) A dependent child or unmarried
person (as described in § 199.3(b)(2)(ii),
or (b)(2)(iv)) of a member who dies
while on active duty for a period of
more than 30 days whose death
occurred on or after October 7, 2001, is
eligible to enroll in Prime and is subject
to the same rules and provisions as
dependents of active duty members for
a period of three years from the date the
active duty sponsor dies or until the
surviving eligible dependent:
(A) Attains 21 years of age, or
(B) Attains 23 years of age or ceases
to pursue a full-time course of study
prior to attaining 23 years of age, if, at
21 years of age, the eligible surviving
dependent is enrolled in a full-time
course of study in a secondary school or
in a full-time course of study in an
institution of higher education approved
by the Secretary of Defense and was, at
the time of the sponsor’s death, in fact
dependent on the member for over onehalf of such dependent’s support.
*
*
*
*
*
(g) * * *
(2) Active duty family member. For
purposes of this paragraph (g), the term
‘‘active duty family member’’ means one
of the following dependents of an active
duty member of the Uniformed Services:
(i) Spouse, child, or unmarried
person, as defined in paragraphs § 199.3
(b)(2)(i), (b)(2)(ii) or (b)(2)(iv);
(ii) For a 3-year period, the surviving
spouse of a member who dies while on
active duty for a period of more than 30
days whose death occurred on or after
October 7, 2001; and
(iii) The surviving dependent child or
unmarried person, as defined in
paragraphs § 199.3 (b)(2)(ii) or (b)(2)(iv),
of a member who dies while on active
duty for a period of more than 30 days
VerDate Aug<31>2005
17:42 Jan 18, 2007
Jkt 211001
whose death occurred on or after
October 7, 2001. Active duty family
member status is for a period of 3 years
from the date the active duty sponsor
dies or until the surviving eligible
dependent:
(A) Attains 21 years of age, or
(B) Attains 23 years of age or ceases
to pursue a full-time course of study
prior to attaining 23 years of age, if, at
21 years of age, the eligible surviving
dependent is enrolled in a full-time
course of study in a secondary school or
in a full-time course of study in an
institution of higher education approved
by the Secretary of Defense and was, at
the time of the sponsor’s death, in fact
dependent on the member for over onehalf of such dependent’s support.
(3) Eligibility. (i) An active duty
family member is eligible for TRICARE
Prime Remote for Active Duty Family
Members if he or she is eligible for
CHAMPUS and, on or after December 2,
2003, meets the criteria of (g)(3)(i)(A)
and (g)(3)(i)(B) or (g)(3)(i)(C) of this
section or on or after October 7, 2001,
meets the criteria of (g)(3)(i)(D) or
(g)(3)(i)(E) of this section:
*
*
*
*
*
(D) For a 3 year period, the surviving
spouse of a member who dies while on
active duty for a period of more than 30
days whose death occurred on or after
October 7, 2001.
(E) The surviving dependent child or
unmarried person as defined in
paragraphs § 199.3 (b)(2)(ii) or (b)(2)(iv),
of a member who dies while on active
duty for a period of more than 30 days
whose death occurred on or after
October 7, 2001, for three years from the
date the active duty sponsor dies or
until the surviving eligible dependent:
(1) Attains 21 years of age, or
(2) Attains 23 years of age or ceases
to pursue a full-time course of study
prior to attaining 23 years of age, if, at
21 years of age, the eligible surviving
dependent is enrolled in a full-time
course of study in a secondary school or
in a full-time course of study in an
institution of higher education approved
by the Secretary of Defense and was, at
the time of the sponsor’s death, in fact
dependent on the member for over onehalf of such dependent’s support.
*
*
*
*
*
Dated: January 10, 2007.
L. M. Bynum,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. E7–709 Filed 1–18–07; 8:45 am]
BILLING CODE 5001–06–P
PO 00000
Frm 00028
Fmt 4700
Sfmt 4700
DEPARTMENT OF HOMELAND
SECURITY
Coast Guard
33 CFR Part 165
[CGD07–05–138]
RIN 1625–AA11
Regulated Navigation Area: Savannah
River, Savannah, GA
Coast Guard, DHS.
Interim rule with request for
comments.
AGENCY:
ACTION:
SUMMARY: On January 23, 2006, the
Coast Guard published a notice of
proposed rulemaking (NPRM) to revise
the regulated navigation area in
Savannah, Georgia, to address changes
in Liquefied Natural Gas (LNG) tankship
mooring locations following the creation
of two new berths within a slip at the
Southern LNG facility on the Savannah
River. The previous rule only addressed
facility and vessel requirements when
an LNG vessel was underway or was
moored parallel to the navigational
channel outside of the slip. This interim
rule describes requirements for three
different potential mooring situations
following the expansion: an LNG
tankship moored outside of the slip, one
or more LNG tankships moored inside
the slip, and LNG tankships moored
both inside and outside of the slip. This
interim rule will become effective on
February 20, 2007. However, we still
encourage you to participate in this
rulemaking by submitting comments
and related material to the docket. We
will accept comments for 60 days from
the date this rule is published in the
Federal Register, after which we intend
to publish a final rule. Any comments
received will be considered in the final
rule. This interim rule is necessary to
ensure safe navigation of the Savannah
River and the safe transfer of LNG in the
Port of Savannah.
DATES: This interim rule is effective
February 20, 2007. Comments and
related material must reach the Coast
Guard on or before March 20, 2007.
ADDRESSES: Comments and material
received from the public, as well as
documents indicated in this preamble as
being available in the docket [CGD07–
05–138], will become part of this docket
and will be available for inspection or
copying at Marine Safety Unit
Savannah, Gordon Low Federal
Building, Suite 1017, 100 W.
Oglethorpe, Savannah, Georgia 31401,
between 7:30 a.m. and 4:30 p.m.,
Monday through Friday, except Federal
holidays.
E:\FR\FM\19JAR1.SGM
19JAR1
Agencies
[Federal Register Volume 72, Number 12 (Friday, January 19, 2007)]
[Rules and Regulations]
[Pages 2444-2448]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-709]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
32 CFR Part 199
[DOD-2006-HA-0194; RIN 0720-AB07]
TRICARE; Certain Survivors of Deceased Active Duty Members; and
Adoption Intermediaries
AGENCY: Office of the Secretary, DoD.
ACTION: Interim Final Rule.
-----------------------------------------------------------------------
SUMMARY: This interim final rule implements two provisions of the
National Defense Authorization Act for Fiscal Year 2006 (NDAA FY06),
Public Law 109-163. First, Section 715 of the NDAA FY06 extends the
time frame certain dependents of Active Duty Service Members (ADSM) who
die while on active duty for more than 30 days shall receive TRICARE
medical benefits at active duty dependent payment rates. Second,
Section 592 of the NDAA FY06 modifies the requirement for those
intermediaries who provide adoption placements.
Additionally, this interim final rule makes an administrative
clarification to the following two eligibility provisions: those placed
in the legal custody of a member or former member; and those placed in
the home of a member or former member in anticipation of adoption. This
clarification makes a distinction between the two groups and specifies
that for placement into legal custody by court order, the court order
must be for a period of 12 consecutive months.
Public comments are invited and will be considered for possible
revisions to the final rule.
DATES: This rule is effective March 20, 2007.
Comments: Written comments received at the address indicated below
by March 20, 2007 will be accepted.
ADDRESSES: You may submit comments, identified by docket number and or
RIN number and title, by any of the following methods:
Federal eRulemaking Portal: https://www.regulations.gov.
Follow the instructions for submitting comments.
Mail: Federal Docket Management System Office, 1160
Defense Pentagon, Washington, DC 20301-1160.
Instructions: All submissions received must include the agency name
and docket number or Regulatory Information Number (RIN) for this
Federal Register document. The general policy for comments and other
submissions from members of the public is to make these submissions
available for public viewing on the Internet at https://regulations.gov
as they are received without change, including any personal identifiers
or contact information.
FOR FURTHER INFORMATION CONTACT: Ms. Ann N. Fazzini, (303) 676-3803 for
questions regarding Section 715 as it relates to the TRICARE Basic
Program; and also questions regarding Section 592.
Mr. Michael Kottyan, (303) 676-3520 for questions regarding Section
715 as it relates to the Extended Health Care Option (ECHO).
Mr. John Leininger, (303) 676-3613, for questions regarding TRICARE
Prime Remote.
Questions regarding payment of specific claims should be addressed
to the appropriate TRICARE contractor.
SUPPLEMENTARY INFORMATION: The Department is publishing this rule as an
interim final rule in order to meet statutorily required effective
dates. The Department is not exercising any discretion in implementing
these provisions. In accordance with Section 715(b), the effective date
for Section 715 is October 7, 2001 and shall apply with respect to
deaths occurring on or after that date. The Department has no
discretion concerning the benefits available to surviving dependents,
the effective date, nor the time periods benefits are available to
surviving spouses and children respectively. The effective date for
Section 592 is January 6, 2006. Prior to the NDAAFY06, a child placed
in the home by a placement agency recognized by the Secretary of
Defense in anticipation of the legal adoption of the person was
eligible for TRICARE. Section 592 of the NDAA FY06 expands those
intermediaries who perform adoption placement to include placement by
any source authorized by State or local law to provide adoption
placement. The Department is not exercising any discretion in defining
who are intermediaries who can perform adoption placement. In
accordance with Public Law 103-160, section 702(b), the effective date
for placement by a court is July 1, 1994. In accordance with Public Law
103-337, section 701, the effective date for placement by a recognized
adoption agency October 5, 1994. These last two changes are
administrative corrections
[[Page 2445]]
only. Public comments are invited and will be considered for possible
revisions to the final rule.
The effective date for Section 715 is October 7, 2001 and shall
apply with respect to deaths occurring on or after that date. The
effective date for Section 592 is January 6, 2006. In accordance with
Public Law 103-160, section 702(b), the effective date for placement by
a court is July 1, 1994. In accordance with Public Law 103-337, section
701, the effective date for placement by a recognized adoption agency
October 5, 1994.
I. Payment Rates for Dependents of Deceased Active Duty Service Members
Introduction and Background
Dependents of active-duty members who died while on active duty
have been always eligible for TRICARE; however, their payment rates/
cost-sharing provisions have changed over time. Initially, their cost-
sharing provisions were at the retiree payment rate for all care
received. This was amended by Section 707(c) of the National Defense
Authorization Act for Fiscal Year 1995, Public Law 103-337, which
provided for two changes. First, effective October 1, 1993, care was to
be cost-shared at the active duty dependent payment rate for a one-year
period. Second, for dependents of active duty members who died while on
active duty between January 1, 1993, and October 1, 1993, only care for
pre-existing conditions was cost-shared at the active duty dependent
payment rate.
An additional amendment to the time period for the payment rate for
dependents of deceased active duty members was found in Section 704 of
the Floyd D. Spence National Defense Authorization Act for Fiscal Year
2001. Section 704 added a two-year extension of the active-duty
dependent cost-sharing provision which allowed survivors of deceased
active duty members to remain eligible for TRICARE at the active duty
dependent payment rate for a total of three years from the date of
death. After three years, survivors remained eligible for TRICARE at
the retiree payment rate.
Section 715 of the NDAA-FY06
General
Section 715 of the NDAA FY06 further modified the cost-sharing
provision for certain dependents of deceased active duty members by
adding the following subparagraph 1079(g)(2) to title 10, United States
Code:
(2) In addition to any continuation of eligibility for benefits
under paragraph (1), when a member dies while on active duty for a
period of more than 30 days, the member's dependents who are
receiving benefits under a plan covered by subsection (a) shall
continue to be eligible for benefits under TRICARE Prime during the
three-year period beginning on the date of the member's death,
except that, in the case of such a dependent of the deceased who is
described by subparagraph (D) or (I) of section 1072(2) of this
title, the period of continued eligibility shall be the longer of
the following periods beginning on such date:
(A) Three years.
(B) The period ending on the date on which such dependent
attains 21 years of age.
(C) In the case of such a dependent who, at 21 years of age, is
enrolled in a full-time course of study in a secondary school or in
a full-time course of study in an institution of higher education
approved by the administering Secretary and was, at the time of the
member's death, in fact dependent on the member for over one-half of
such dependent's support, the period ending on the earlier of the
following dates:
(i) The date on which such dependent ceases to pursue such a
course of study, as determined by the administering Secretary.
(ii) The date on which such dependent attains 23 years of age.
(3) For the purposes of paragraph (2)(C), a dependent shall be
treated as being enrolled in a full-time course of study in an
institution of higher education during any reasonable period of
transition between the dependent's completion of a full-time course
of study in a secondary school and the commencement of an enrollment
in a full-time course of study in an institution of higher
education, as determined by the administering Secretary.
(4) The terms and conditions under which health benefits are
provided under this chapter to a dependent of a deceased member
under paragraph (2) shall be the same as those that would apply to
the dependent under this chapter if the member were living and
serving on active duty for a period of more than 30 days.
(5) In this subsection, the term ``TRICARE Prime'' means the
managed care option of the TRICARE program.
Certain Dependents
Section 715 of the NDAA FY06 changed the time frame that certain
dependents shall continue to retain eligibility to enroll in TRICARE
Prime at the active duty dependent payment rate and receive the same
health benefits that would apply to them if the member were still
living and serving on active duty. Section 715 applies to those
dependents defined in 10 U.S.C. Chapter 55, subparagraph (D) or (I) of
section 1072(2). In the supplementary section of this Interim Final
Rule, those dependents in subparagraphs (D) and (I) are referred to as
``certain dependents'' and the specific legislative language for these
two subparagraphs is outlined below.
Subparagraph (D) of 1072(2) addresses a child who--
(i) has not attained the age of 21;
(ii) has not attained the age of 23, is enrolled in a full-time
course of study at an institution of higher learning approved by the
administering Secretary and is, or was at the time of the member's or
former member's death, in fact dependent on the member or former member
for over one-half of the child's support; or
(iii) is incapable of self-support because of a mental or physical
incapacity that occurs while a dependent of a member or former member
under clause (i) or (ii) and is, or was at the time of the member's or
former member's death, in fact dependent on the member or former member
for over one-half of the child's support.
Subparagraph (I) addresses an unmarried person who--
(i) is placed in the legal custody of the member or former member
as a result of an order of a court of competent jurisdiction in the
United States (or possession of the United States) for a period of at
least 12 consecutive months;
(ii) either--
(I) has not attained the age of 21;
(II) has not attained the age of 23 and is enrolled in a full time
course of study at an institution of higher learning approved by the
administering Secretary; or
(III) is incapable of self support because of a mental or physical
incapacity that occurred while the person was considered a dependent of
the member or former member under this subparagraph pursuant to
subclause (I) or (II);
(iii) is dependent on the member or former member for over one-half
of the person's support;
(iv) resides with the member or former member unless separated by
the necessity of military service or to receive institutional care as a
result of disability or incapacitation or under such other
circumstances as the administering Secretary may by regulation
prescribe; and
(v) is not a dependent of a member or a former member under any
other subparagraph.
These certain dependents may avail themselves of the active duty
dependent payment rates available under TRICARE Standard, Extra, or
Prime and enjoy medical benefits at the active duty dependent payment
rate in accordance with the time frames listed in Section 715. Of
significance is the cost saving opportunity Section 715 presents for
those certain dependents that choose to
[[Page 2446]]
enroll in TRICARE Prime. Currently, there is no TRICARE Prime
enrollment fee and no TRICARE Prime copayment for an active duty
dependent Prime enrollee so those certain dependents who are enrolled
in Prime also would have no Prime enrollment fee and no Prime
copayment.
Those certain dependents that choose TRICARE Standard or Extra
would be responsible for the active duty payment rate (cost-share)
applicable under those two programs. The active duty dependent payment
rates for TRICARE Standard and Extra vary by type of service
(inpatient, outpatient, etc.) and can be found in 32 CFR 199.4(f).
TRICARE Prime Remote
Because Section 715 references TRICARE Prime, the Department is
interpreting this section to also include the TRICARE ``Prime-like''
benefit known as TRICARE Prime Remote (TPR). As a result, TPR will be
available to surviving spouses and certain dependents whose sponsor
died while on active duty for a period of more than 30 days. Surviving
spouses will be eligible to enroll in TPR for a three-year period.
Certain dependents will be eligible to enroll in TPR as long as they
meet the criteria for being a dependent as described in 10 U.S.C.
Chapter 55, subparagraph (D) or (I) of section 1072(2).
For additional information on the TPR program, the reader should
refer to the interim final rules that were published in the Federal
Register on February 6, 2002, (67 FR 5477) and July 31, 2003 (68 FR
44883).
Extended Care Health Option (ECHO)
Based on the Department's interpretation of Section 715 of the NDAA
FY06, the ECHO is also available to surviving spouses and certain
dependents of deceased active duty members because these surviving
spouses and certain dependents are treated as if the sponsoring member
were still living and serving on active duty.
For additional information on the ECHO program, the reader should
refer to the final rules that were published in the Federal Register on
July 28, 2004, (69 FR 44942) and August 20, 2004, (69 FR 51559).
Surviving Spouse
We note that Section 715 of the NDAA FY 06 provision makes no
change to the time frame that the surviving spouse shall receive care
at the active duty dependent payment rate. Surviving spouses retain the
three year period of TRICARE Prime, TPR, TRICARE Extra or TRICARE
Standard at the active duty dependent payment rate. At the end of the
three year period, surviving spouses continue eligibility for TRICARE
benefits at the retiree payment rate.
The provisions found in Section 715 are effective with respect to
deaths occurring on or after October 7, 2001.
II. Eligibility Determinations
Section 715 of the NDAA FY06 authorizes the time frame that certain
dependents shall retain active duty dependent payment rates for medical
benefits available under TRICARE. The provision has no impact on
eligibility rules. Consequently, this provision does not preclude loss
of eligibility as a result of any condition which routinely results in
loss of TRICARE eligibility such as reaching age limits, marriage,
remarriage, etc.
Although the TRICARE Management Activity is tasked with publishing
legislatively mandated eligibility changes to Title 10 U.S.C.,
determination of dependent eligibility is the primary responsibility of
the Uniformed Services. TRICARE relies primarily on the Defense
Enrollment Eligibility Reporting System (DEERS) for eligibility
verification. However, a determination by the Uniformed Services that a
person is eligible does not automatically entitle such a person to
TRICARE payments. Before any TRICARE benefits may be extended,
additional requirements of 32 CFR Part 199 must be met. In accordance
with 10 U.S.C. 1084, as implemented by Sec. 199.3(h), disputes
regarding eligibility as a dependent or dates of beginning eligibility
for benefits under TRICARE can only be resolved by the appropriate
Uniformed Service Secretary.
III. Modification of Requirement for Certain Intermediaries Under
Certain Authorities Relating to Adoptions
Section 592 of the NDAA FY06 states that:
(a) Reimbursement for Adoption Expenses--Section 1052(g)(1) of
title 10, United States Code, is amended by inserting `or other
source authorized to place children for adoption under State or
local law' after `qualified adoption agency'.
(b) Treatment as Children for Medical and Dental Care Purposes--
Section 1072(6)(D)(i) of such title is amended by inserting `, or by
any other source authorized by State or local law to provide
adoption placement,' after `(recognized by the Secretary of
Defense)'.
Prior to the NDAA FY06, a child placed in the home by a placement
agency recognized by the Secretary of Defense in anticipation of the
legal adoption of the person was eligible for TRICARE. Section 592 of
the NDAA FY06 expands those intermediaries who perform adoption
placement to include placement by any source authorized by State or
local law to provide adoption placement. This expanded language mirrors
the language found in Title 10, Subpart A, Part II, Chapter 53, Section
1052, reimbursement for adoption expenses, and provides consistency
between personnel benefit policies in chapter 53 of Title 10, United
States Code, and eligibility for TRICARE under chapter 55 of Title 10,
United States Code. Effective date of the NDAA FY06 (and this
provision) is January 6, 2006.
IV. Administrative Change--Court Order/Adoption Placement
During the course of amending the regulation to incorporate the
NDAA FY06 provisions, we identified the need for an administrative
clarification to 32 CFR Part 199 Section 3. This interim final rule
clarifies the eligibility provisions for an unmarried person who is
placed in the legal custody of the member or former member as a result
of an order of a court of competent jurisdiction in the United States
(or possession of the United States) by stating that the court order
must be for a period of at least 12 consecutive months. We currently
address a child who is placed in legal custody of a member or former
member, but the language unintentionally omitted the 12 consecutive
month period required by 10 U.S.C. 1072(I)(i).
Additionally, this rule clarifies that an unmarried person placed
in legal custody of a member or former member is a category that is
separate and distinct from those placed for adoption. We accomplish
this by providing separate regulatory paragraphs for each group.
For further information on these two groups, we refer the reader to
the final rule that established these groups, 64 FR 46133, August 24,
1999.
V. Regulatory Procedures
We have examined the impact of the interim rule under Executive
Order (EO) 13132 and it does not have policies that have federalism
implications that would have substantial direct effects on the States,
on the relationship between the national government and the States, or
on the distribution of power and responsibilities among the various
levels of government, therefore, consultation with State and local
officials is not required.
Section 801 of title 5, United States Code, and Executive Order
12866 requires certain regulatory assessments and procedures for any
major rule or significant regulatory action, defined as
[[Page 2447]]
one that would result in an annual effect of $100 million or more on
the national economy or which would have other substantial impacts.
The Regulatory Flexibility Act (RFA) requires that each Federal
agency prepare, and make available for public comment, a regulatory
flexibility analysis when the agency issues a regulation which would
have a significant impact on a substantial number of small entities.
This is not a major rule under 5 U.S.C. 801. It is a significant
regulatory action but not economically significant, and has been
reviewed by the Office of Management and Budget as required under the
provisions of E. O. 12866. In addition, we certify that this proposed
rule will not significantly affect a substantial number of small
entities.
This final rule will not impose additional information collection
requirements on the public under the Paperwork Reduction Act of 1995
(44 U.S.C. Chapter 55).
List of Subjects in 32 CFR Part 199
Claims, Dental health, Health care, Health insurance, Individuals
with disabilities, Military personnel.
0
Accordingly, 32 CFR Part 199 is amended as follows:
PART 199--[AMENDED]
0
1. The authority citation for Part 199 continues to read as follows:
Authority: 5 U.S.C. 301; 10 U.S.C. chapter 55.
0
2. Section 199.3 is amended by revising paragraph (b)(2)(ii)(H)(4) and
by adding new paragraphs (b)(2)(iv), and (c)(9)(iii) to read as
follows:
Sec. 199.3 Eligibility.
* * * * *
(b) * * *
(2) * * *
(ii) * * *
(H) * * *
(4) An unmarried person. An unmarried person placed in the home of
a member or former member prior to adoption. To be a dependent child,
the unmarried person must not have reached the age of 21 (or otherwise
meets the requirements of a student or incapacitated child set out in
paragraphs (b)(2)((ii)(H)(1) or (b)(2)(ii)(H)(2) of this section) and
has been placed in the home of the member or former member by a
recognized placement agency or by any other source authorized by State
or local law to provide adoption placement, in anticipation of legal
adoption by the member or former member.
* * * * *
(iv) An unmarried person who is placed in the legal custody of a
member or former member by a court of competent jurisdiction in the
United States (or possession of the United States) for a period of at
least 12 consecutive months. The unmarried person shall be considered a
dependent of the member or former member under this section provided he
or she otherwise meets the following qualifications:
(A) Has not reached the age of 21 unless he or she otherwise meets
the requirements of a student set out in paragraph (b)(2)(ii)(H)(1) of
this section or the requirements for being incapacitated as set out in
paragraph (b)(2)(ii)(H)(2) of this section and the incapacitation
occurred while he or she was a dependent of the member or former member
through court ordered legal custody;
(B) Is dependent on the member or former member for over one-half
of the person's support;
(C) Resides with the member or former member unless separated by
the necessity of military service or to receive institutional care as a
result of disability or incapacitation or under such other authorized
circumstances; and,
(D) Is not a dependent of a member or former member under any other
provision of law or regulation.
* * * * *
(c) * * *
(9) * * *
(iii) Has been placed in the home of a member by a placement agency
or by any other source authorized by State or local law to provide
adoption placement, in anticipation of the legal adoption of the
member:
(A) All benefits for which entitled, January 6, 2006.
(B) Extended Care Health Option benefits limited to children of
members only, January 6, 2006.
* * * * *
0
3. Section 199.5 is amended by revising paragraphs (a)(2), (b)(1), and
(f)(3)(i) to read as follows:
Sec. 199.5 TRICARE Extended Care Health Care Option (ECHO).
(a) * * *
(2) The purpose of the ECHO is to provide an additional financial
resource for an integrated set of services and supplies designed to
assist in the reduction of the disabling effects of the ECHO-eligible
dependent's qualifying condition. Services include those necessary to
maintain, minimize or prevent deterioration of function of an ECHO-
eligible dependent.
(b) * * *
(1) The following categories of TRICARE/CHAMPUS beneficiaries with
a qualifying condition are ECHO-eligible dependents:
(i) A spouse, child, or unmarried person (as described in Sec.
199.3(b)(2)(i), (b)(2)(ii), or (b)(2)(iv)) of a member of the Uniformed
Services on active duty for a period of more than 30 days.
(ii) An abused dependent as described in Sec. 199.3(b)(2)(iii).
(iii) A spouse, child, or unmarried person (as described in Sec.
199.3(b)(2)(i), (b)(2)(ii), or (b)(2)(iv)), of a member of the
Uniformed Services who dies while on active duty for a period of more
than 30 days and whose death occurs on or after October 7, 2001. In
such case, an eligible surviving spouse remains eligible for benefits
under the ECHO for a period of 3 years from the date the active duty
sponsor dies. Any other eligible surviving dependent remains eligible
for benefits under the ECHO for a period of three years from the date
the active duty sponsor dies or until the surviving eligible dependent:
(A) Attains 21 years of age, or
(B) Attains 23 years of age or ceases to pursue a full-time course
of study prior to attaining 23 years of age, if, at 21 years of age,
the eligible surviving dependent is enrolled in a full-time course of
study in a secondary school or in a full-time course of study in an
institution of higher education approved by Secretary of Defense and
was, at the time of the sponsor's death, in fact dependent on the
member for over one-half of such dependent's support.
(iv) A spouse, child, or unmarried person (as defined in paragraphs
Sec. 199.3(b)(2)(i), (b)(2)(ii), or (b)(2)(iv)) of a deceased member
of the Uniformed Services who, at the time of the member's death was
receiving benefits under ECHO, and the member at the time of death was
eligible for receipt of hostile-fire pay, or died as a result of a
disease or injury incurred while eligible for such pay. In such a case,
the surviving dependent remains eligible for benefits under ECHO
through midnight of the dependent's twenty-first birthday.
* * * * *
(f) * * *
(3) * * *
(i) ECHO. The total Government share of the cost of all ECHO
benefits, except ECHO Home Health Care (EHHC) and EHHC respite care,
provided in a given month to a beneficiary may not exceed $2,500 after
application of the allowable payment methodology.
* * * * *
0
4. Section 199.17 is amended by:
[[Page 2448]]
0
a. Redesignating paragraphs (c)(3) and (c)(4) as paragraphs (c)(4) and
(c)(5) respectively.
0
b. Adding new paragraph (c)(3).
0
c. Revising paragraphs (g)(2) and (g)(3)(i) introductory text.
0
d. Adding new paragraphs (g)(3)(i)(D) and (g)(3)(i)(E) to read as
follows:
Sec. 199.17 TRICARE Program.
* * * * * *
(c) * * *
(3) Survivors of Deceased Members. (i) The spouse of a member who
dies while on active duty for a period of more than 30 days is eligible
to enroll in Prime for a 3 year period beginning on the date of the
member's death. For the three year period, surviving spouses of a
member who dies while on active duty for a period of more than 30 days
are subject to the same rules and provisions as dependents of active
duty members.
(ii) A dependent child or unmarried person (as described in Sec.
199.3(b)(2)(ii), or (b)(2)(iv)) of a member who dies while on active
duty for a period of more than 30 days whose death occurred on or after
October 7, 2001, is eligible to enroll in Prime and is subject to the
same rules and provisions as dependents of active duty members for a
period of three years from the date the active duty sponsor dies or
until the surviving eligible dependent:
(A) Attains 21 years of age, or
(B) Attains 23 years of age or ceases to pursue a full-time course
of study prior to attaining 23 years of age, if, at 21 years of age,
the eligible surviving dependent is enrolled in a full-time course of
study in a secondary school or in a full-time course of study in an
institution of higher education approved by the Secretary of Defense
and was, at the time of the sponsor's death, in fact dependent on the
member for over one-half of such dependent's support.
* * * * *
(g) * * *
(2) Active duty family member. For purposes of this paragraph (g),
the term ``active duty family member'' means one of the following
dependents of an active duty member of the Uniformed Services:
(i) Spouse, child, or unmarried person, as defined in paragraphs
Sec. 199.3 (b)(2)(i), (b)(2)(ii) or (b)(2)(iv);
(ii) For a 3-year period, the surviving spouse of a member who dies
while on active duty for a period of more than 30 days whose death
occurred on or after October 7, 2001; and
(iii) The surviving dependent child or unmarried person, as defined
in paragraphs Sec. 199.3 (b)(2)(ii) or (b)(2)(iv), of a member who
dies while on active duty for a period of more than 30 days whose death
occurred on or after October 7, 2001. Active duty family member status
is for a period of 3 years from the date the active duty sponsor dies
or until the surviving eligible dependent:
(A) Attains 21 years of age, or
(B) Attains 23 years of age or ceases to pursue a full-time course
of study prior to attaining 23 years of age, if, at 21 years of age,
the eligible surviving dependent is enrolled in a full-time course of
study in a secondary school or in a full-time course of study in an
institution of higher education approved by the Secretary of Defense
and was, at the time of the sponsor's death, in fact dependent on the
member for over one-half of such dependent's support.
(3) Eligibility. (i) An active duty family member is eligible for
TRICARE Prime Remote for Active Duty Family Members if he or she is
eligible for CHAMPUS and, on or after December 2, 2003, meets the
criteria of (g)(3)(i)(A) and (g)(3)(i)(B) or (g)(3)(i)(C) of this
section or on or after October 7, 2001, meets the criteria of
(g)(3)(i)(D) or (g)(3)(i)(E) of this section:
* * * * *
(D) For a 3 year period, the surviving spouse of a member who dies
while on active duty for a period of more than 30 days whose death
occurred on or after October 7, 2001.
(E) The surviving dependent child or unmarried person as defined in
paragraphs Sec. 199.3 (b)(2)(ii) or (b)(2)(iv), of a member who dies
while on active duty for a period of more than 30 days whose death
occurred on or after October 7, 2001, for three years from the date the
active duty sponsor dies or until the surviving eligible dependent:
(1) Attains 21 years of age, or
(2) Attains 23 years of age or ceases to pursue a full-time course
of study prior to attaining 23 years of age, if, at 21 years of age,
the eligible surviving dependent is enrolled in a full-time course of
study in a secondary school or in a full-time course of study in an
institution of higher education approved by the Secretary of Defense
and was, at the time of the sponsor's death, in fact dependent on the
member for over one-half of such dependent's support.
* * * * *
Dated: January 10, 2007.
L. M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. E7-709 Filed 1-18-07; 8:45 am]
BILLING CODE 5001-06-P