TRICARE; TRICARE Retiree Dental Program (TRDP) Basic Benefit Descriptions and Administrative Corrections, 54212-54214 [07-4658]

Download as PDF 54212 Federal Register / Vol. 72, No. 184 / Monday, September 24, 2007 / Rules and Regulations Issued on: August 6, 2007. J. Richard Capka, Federal Highway Administrator. In consideration of the foregoing, the FHWA amends title 23, Code of Federal Regulations, part 637, as set forth below: I PART 637—CONSTRUCTION INSPECTION AND APPROVAL 1. The authority citation for part 637 continues to read as follows: I Authority: Sec. 1307, Pub. L. 105–178, 112 Stat. 107; 23 U.S.C. 109, 114, and 315; 49 CFR 1.48(b). 2. In § 637.209, add paragraph (a)(5) to read as follows: I § 637.209 Laboratory and sampling and testing personnel qualifications. * * * * * (a) * * * (5) After September 24, 2009, laboratories that perform crash testing for acceptance of roadside hardware by the FHWA shall be accredited by a laboratory accreditation body that is recognized by the National Cooperation for Laboratory Accreditation (NACLA), is a signatory to the Asia Pacific Laboratory Accreditation Cooperation (APLAC) Mutual Recognition Arrangement (MRA), is a signatory to the International Laboratory Accreditation Cooperation (ILAC) Mutual Recognition Arrangement (MRA), or another accreditation body acceptable to FHWA. * * * * * [FR Doc. E7–18725 Filed 9–21–07; 8:45 am] BILLING CODE 4910–22–P DEPARTMENT OF DEFENSE Office of the Secretary [DOD–2006–HA–0210] RIN 0720–AB12 32 CFR Part 199 TRICARE; TRICARE Retiree Dental Program (TRDP) Basic Benefit Descriptions and Administrative Corrections Office of the Secretary, DoD. Final rule. AGENCY: rfrederick on PROD1PC67 with RULES ACTION: SUMMARY: This final rule amends TRICARE Retiree Dental Program (TRDP) Basic benefit descriptions by replacing specific American Dental Association (ADA) dental procedure codes and nomenclature with general benefit categories and descriptions. This revision is necessary to keep the VerDate Aug<31>2005 12:22 Sep 21, 2007 Jkt 211001 regulation current, since dental procedure codes are added, revised, and deleted on a regular basis. This final rule does not change or eliminate any benefits that are currently available under the TRDP program. This final rule also revises several incorrect, obsolete, or historical terms pertaining to the TRICARE program, and removes an inaccurate statement regarding appeals and grievances. DATES: Effective Date: October 24, 2007. ADDRESSES: TRICARE Management Activity, 16401 East Centretech Parkway, Aurora, CO 80011–9066. FOR FURTHER INFORMATION CONTACT: Debra Hatzel, Program Requirements Division, TRICARE Management Activity, telephone (303) 676–3572. SUPPLEMENTARY INFORMATION: 1. Introduction and Background A. Provisions of the Rule Regarding Dental Procedure Codes and Nomenclature. This final rule amends TRICARE Retiree Dental Program (TRDP) Basic benefit descriptions by removing specific American Dental Association (ADA) dental procedure codes and nomenclature, and replacing them with general benefit categories and descriptions from the most recent Current Dental Terminology (CDT) Manual (CDT–2005). This action is required because dental procedure codes and nomenclature are added, revised, and deleted by the ADA every two years; when this occurs, the regulation must also be revised to reflect the new codes and nomenclature. Maintaining specific procedure codes and nomenclature in the regulation is unnecessary, since the TRDP contract and TRDP marketing materials (available at https://www.tricare.osd.mil/ dental/dm2.cfm) already contain detailed benefit descriptions. Also, the TRDP contractor and enrollees are notified when the Government directs any changes to TRDP benefits, limits, or exclusions. The TRDP contract and TRDP marketing materials will continue to be the primary vehicles for communicating specific benefit information to the TRDP contractor and beneficiaries. Removal of specific procedure codes and nomenclature from this section does not change or eliminate any benefits that are currently available under the TRDP. The general categories of benefits that are listed in this final rule will be adjusted periodically to conform to the current CDT Manual. Although there are many similarities between the TRDP and the TRICARE Dental Program (TDP), the benefits are not identical. Also, there are different PO 00000 Frm 00006 Fmt 4700 Sfmt 4700 dental benefits available under the TRDP Basic program and the TRDP Enhanced program. The general benefit categories in this TRDP final rule differ from the TDP benefit categories listed in 32 CFR Part 199.13. This variance exists because some of the benefits offered under the TDP are not benefits under the TRDP Basic program (e.g., prosthodontic and orthodontic services), and because the TDP benefit categories were derived from an earlier version of the CDT Manual. B. Provisions of the Rule Regarding the Administrative Correction of Incorrect, Obsolete, or Historical Terms and Inaccurate Information. The proposed rule addressed the revision of several incorrect, obsolete or historical terms that appear in the regulation. Specifically, ‘‘Director, OCHAMPUS’’ was proposed to be amended to ‘‘Director, TRICARE Management Activity’’; ‘‘Assistant Secretary of Defense (Human Affairs)’’ was proposed to be amended to ‘‘Assistant Secretary of Defense (Health Affairs)’’; ‘‘Active Duty Dependents Dental Program’’ was proposed to be amended to ‘‘TRICARE Dental Program’’; ‘‘CHAMPUS’’ was proposed to be amended to ‘‘TRICARE/ CHAMPUS’’; and ‘‘OCHAMPUS’’ was proposed to be amended to ‘‘TRICARE Management Activity.’’ Subsequent to the publication of the proposed rule, TRICARE Management Activity identified a long-standing error in the regulation regarding appeals and grievances. Specifically, 32 CFR 199.22(k)(1) currently states, ‘‘Appeal and hearing procedures. All levels of appeals and grievances established by the Contractor for internal review shall be exhausted prior to forwarding to OCHAMPUS for a final review. Procedures comparable to those established under Sec. 199.13(h) of this part shall apply.’’ The first sentence in this paragraph is inaccurate. TRDP grievances are written complaints regarding non-appealable issues involving a perceived failure of a provider or contractor staff to furnish the expected level or quality of care (e.g., demeanor or behavior of providers or their staff). The TRDP contractor is responsible for the investigation and resolution of grievances; since they are not forwarded to TMA for ‘‘final review’’, the current CFR language is incorrect. Appeals involve decisions related to TRICARE benefits (e.g., denial of preauthorization for requested services, or denial of TRICARE payment for services received). Appeals are initially sent to the TRDP contractor for reconsideration. If the original denial is upheld (and the amount in dispute is $50 or more), the beneficiary may E:\FR\FM\24SER1.SGM 24SER1 Federal Register / Vol. 72, No. 184 / Monday, September 24, 2007 / Rules and Regulations request a formal review by the TRICARE Management Activity. If the beneficiary is dissatisfied with the formal review decision (and the amount in dispute is $300 or more, the beneficiary may request that the TRICARE Management Activity schedule an independent hearing. Since there are two possible levels of action for appeals that are forwarded to the TRICARE Management Activity (not a single ‘‘final review’’), the current CFR language is incorrect. Therefore, the inaccurate sentence has been deleted in this final rule as an administrative correction. The current TRDP appeal and hearing procedures are comparable to those established under Sec. 199.13(h) as required by the regulation, and are unchanged by this rule. rfrederick on PROD1PC67 with RULES II. Public Comments The proposed rule was published in the Federal Register on November 27, 2006. We received no public comments. III. Regulatory Procedures Executive Order 12866 directs agencies to assess all costs and benefits available, regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety, and other advantages; distributive impacts; and equity). The Order classifies a rule as a significant regulatory action requiring review by the Office of Management and Budget if it meets any one of a number of specified conditions, including having an annual effect on the national economy of $100 million or more, creating a serious inconsistency or interfering with an action of another agency, materially altering the budgetary impact of entitlements or the right of entitlement recipients, or raising novel legal or policy issues. DoD has examined the economic, legal, and policy implications of this final rule and has concluded that is not a significant regulatory action. The changes set forth in the final rule are minor administrative revisions to the existing regulation which do not change the basic TRDP benefit structure. This is neither a significant regulatory action under Executive Order 12866, nor would it have a significant impact on small entities. 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. VerDate Aug<31>2005 13:14 Sep 21, 2007 Jkt 211001 This final rule is not a major rule under the Congressional Review Act because its economic impact will be less than $100 million. Executive Order 13132 requires that each Federal Agency shall consult with State and local officials and obtain their input if a rule has federalism implications which 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. We have examined the impact of the final rule under Executive Order 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. In addition, this final rule does not impose new information collection requirements for purposes of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501–3511). 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 199.22 is amended by revising the last sentence of paragraph (b)(1), paragraph (b)(4), paragraph (c), paragraph (d)(1)(v), the first sentence of paragraph (d)(4)(ii), paragraph (f) introductory text, paragraph (f)(1) introductory text, paragraphs (f)(1)(i) through (f)(1)(vii), the first sentence of paragraph (f)(3), and paragraph (g); and by removing paragraph (f)(1)(viii), paragraph (f)(1)(ix), and the first sentence of paragraph (k) to read as follows: I §199.22 TRICARE Retiree Dental Program (TRDP). * * * * * (b) * * * (1) * * * Additional services comparable to those contained in paragraph (e)(2) of §199.13 may be covered pursuant to benefit policy decisions made by the Director, PO 00000 Frm 00007 Fmt 4700 Sfmt 4700 54213 TRICARE Management Activity, or designee. * * * * * (4) Except as otherwise provided in this section or by the Assistant Secretary of Defense (Health Affairs) or designee, the TRDP is administered in a manner similar to the TRICARE Dental Program under §199.13 of this part. * * * * * (c) Except as may be specifically provided in this section, to the extent terms defined in §199.2 and §199.13(b) are relevant to the administration of the TRICARE Retiree Dental Program, the definitions contained in §199.2 and §199.13(b) shall apply to the TRDP as they do to TRICARE/CHAMPUS and the TRICARE Dental Program. (d) * * * (1) * * * (v) The unremarried surviving spouse and eligible child dependents of a deceased member who died while in status described in paragraph (d)(1)(i) or paragraph (d)(1)(ii) of this section; the unremarried surviving spouse and eligible child dependents who receive a surviving spouse annuity; or the unremarried surviving spouse and eligible child dependents of a deceased member who died while on active duty for a period of more than 30 days and whose eligible dependents are not eligible or no longer for the TRICARE Dental Program. * * * * * (4) * * * (ii) Enrollment period for enhanced benefits. The initial enrollment period for enhanced benefit coverage described in paragraph (f)(2) of this section shall be established by the Director, TRICARE Management Activity, or designee, when such coverage is offered, to be a period of not less than 12 months and not more than 24 months. * * * * * * * * (f) Plan benefits. The Director, TRICARE Management Activity, or designee, may modify the services covered by the TRDP to the extent determined appropriate based on developments in common dental care practices and standard dental programs. In addition, the Director, TRICARE Management Activity, or designee, may establish such exclusions and limitations as are consistent with those established by dental insurance and prepayment plans to control utilization and quality of care for the services and items covered by the TRDP. (1) The minimum TRDP benefit is basic dental care to include diagnostic services, preventive services, restorative services, endodontic services, periodontic services, oral surgery E:\FR\FM\24SER1.SGM 24SER1 rfrederick on PROD1PC67 with RULES 54214 Federal Register / Vol. 72, No. 184 / Monday, September 24, 2007 / Rules and Regulations services, and other general services. The following is the minimum TRDP covered dental benefit: (i) Diagnostic services. (A) Clinical oral examinations. (B) Radiographs and diagnostic imaging. (C) Tests and laboratory examinations. (ii) Preventive services. (A) Dental prophylaxis. (B) Topical fluoride treatment (office procedure). (C) Sealants. (D) Other preventive services. (E) Space maintenance. (iii) Restorative services. (A) Amalgam restorations. (B) Resin-based composite restorations. (C) Other restorative services. (iv) Endodontic services. (A) Pulp capping. (B) Pulpotomy and pulpectomy. (C) Root canal therapy. (D) Apexification and recalcification procedures. (E) Apicoectomy and periradicular services. (F) Other endodontic procedures. (v) Periodontic Services. (A) Surgical services. (B) Periodontal services. (vi) Oral surgery. (A) Extractions. (B) Surgical extractions. (C) Alveoloplasty. (D) Biopsy. (E) Other surgical procedures. (vii) Other general services. (A) Palliative (emergenery) treatment of dental pain. (B) Therapeutic drug injection. (C) Other drugs and/or medicaments. (D) Treatment of postsurgical complications. * * * * * (3) Alternative course of treatment policy. The Director, TRICARE Management Activity, or designee, may establish, in accordance with generally accepted dental benefit practices, an alternative course of treatment policy which provides reimbursement in instances where the dentist and TRDP enrollee select a more expensive service, procedure, or course of treatement than in customarily provided. * * * * * * * * (g) Maximum coverage amounts. Each enrollee is subject to an annual maximum coverage amount for nonorthodontic dental benefits and, if an orthodontic benefit is offered, a lifetime maximum coverage amount for orthodontics as established by the Director, TRICARE Management Activity, or designee. * * * * * VerDate Aug<31>2005 12:22 Sep 21, 2007 Jkt 211001 Dated: September 14, 2007. L.M. Bynum, Alternate OSD Federal Register Liaison Officer, Department of Defense. [FR Doc. 07–4658 Filed 9–21–07; 8:45 am] BILLING CODE 5001–06–M DEPARTMENT OF HOMELAND SECURITY Coast Guard Correction Instructions In rule FR Doc. 07–4357 published on September 5, 2007 (72 FR 50877), make the following corrections: 1. On page 50877, in the first column, in line 17, remove the words ‘‘Waapa Road’’ and add, in their place, the words ‘‘the jetty access road (commonly known as Jetty Road)’’. 2. On page 50877, in the second column, in line 21, remove ‘‘533’’ and add, in its place, ‘‘553’’. § 165.T14–160 33 CFR Part 165 3. On page 50879, in the first line of the second column, in § 165.T14–160(a), remove the words ‘‘Waapa Road’’ and add, in their place, the words ‘‘the jetty access road (commonly known as Jetty Road)’’. I [Docket No. USCG–2007–29153] RIN 1625–AA87 Security Zone; Hawaii Superferry Arrival/Departure, Nawiliwili Harbor, Kauai, HI Coast Guard, DHS. Temporary final rule; additional correction. AGENCY: ACTION: SUMMARY: This document corrects a typographical error in a U.S. Code section number and corrects a reference to an access road on the jetty south of Nawiliwili Park in a temporary final rule entitled ‘‘Security Zone; Hawaii Super Ferry Arrival/Departure, Nawiliwili Harbor, Kauai, Hawaii’’ that was published September 5, 2007, in the Federal Register. These corrections are effective September 24, 2007. DATES: FOR FURTHER INFORMATION CONTACT: Lieutenant (Junior Grade) Jasmin Parker, U.S. Coast Guard Sector Honolulu at 808–842–2673. On September 5, 2007, the Coast Guard published a temporary final rule entitled ‘‘Security Zone; Hawaii Super Ferry Arrival/Departure, Nawiliwili Harbor, Kauai, Hawaii’’ in the Federal Register (72 FR 50877). In that document references were made to Waapa Road being included in the security zone covering land on the jetty south of Nawiliwili Park. The road in the zone is not named ‘‘Waapa Road’’; instead, that jetty access road is commonly known as ‘‘Jetty Road.’’ Also, when citing to the authority for making the rule effective less than 30 days after publication, instead of citing to 5 U.S.C. 553(d)(3), because of a typographic error, that section was cited as ‘‘533.’’ This document corrects those errors. A previous correction document for this rule was published September 13, 2007 (72 FR 52282). SUPPLEMENTARY INFORMATION: PO 00000 Frm 00008 Fmt 4700 [Corrected] Sfmt 4700 Dated: September 19, 2007. Stefan G. Venckus, Chief, Office of Regulations and Administrative Law, United States Coast Guard. [FR Doc. E7–18783 Filed 9–21–07; 8:45 am] BILLING CODE 4910–15–P FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 54 [WC Docket No. 05–195, CC Docket No. 96– 45, CC Docket No. 02–6, WC Docket No. 02–60, WC Docket No. 03–109, CC Docket No. 97–21; FCC 07–150] Measures To Safeguard the Universal Service Fund From Waste, Fraud, and Abuse as Well as Measures To Improve the Management, Administration, and Oversight of the Universal Service Fund Federal Communications Commission. ACTION: Final rule. AGENCY: SUMMARY: In the Report and Order, the Commission adopted measures to safeguard the Universal Service Fund (‘‘USF’’) from waste, fraud, and abuse. The intended effect of the measures adopted is to improve the management, administration, and oversight of the USF. Effective October 24, 2007 except for the amendments to §§ 54.202, 54.417, 54.619, and 54.706, which contain information collection requirements that are not effective until approved by the Office of Management and Budget. The FCC will publish a document in the Federal Register announcing the effective date for those sections. Additionally, the Commission will send, as a minor rule, a copy of this DATES: E:\FR\FM\24SER1.SGM 24SER1

Agencies

[Federal Register Volume 72, Number 184 (Monday, September 24, 2007)]
[Rules and Regulations]
[Pages 54212-54214]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 07-4658]


=======================================================================
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DEPARTMENT OF DEFENSE

Office of the Secretary

[DOD-2006-HA-0210]
RIN 0720-AB12

32 CFR Part 199


TRICARE; TRICARE Retiree Dental Program (TRDP) Basic Benefit 
Descriptions and Administrative Corrections

AGENCY: Office of the Secretary, DoD.

ACTION: Final rule.

-----------------------------------------------------------------------

SUMMARY: This final rule amends TRICARE Retiree Dental Program (TRDP) 
Basic benefit descriptions by replacing specific American Dental 
Association (ADA) dental procedure codes and nomenclature with general 
benefit categories and descriptions. This revision is necessary to keep 
the regulation current, since dental procedure codes are added, 
revised, and deleted on a regular basis. This final rule does not 
change or eliminate any benefits that are currently available under the 
TRDP program. This final rule also revises several incorrect, obsolete, 
or historical terms pertaining to the TRICARE program, and removes an 
inaccurate statement regarding appeals and grievances.

DATES: Effective Date: October 24, 2007.

ADDRESSES: TRICARE Management Activity, 16401 East Centretech Parkway, 
Aurora, CO 80011-9066.

FOR FURTHER INFORMATION CONTACT: Debra Hatzel, Program Requirements 
Division, TRICARE Management Activity, telephone (303) 676-3572.

SUPPLEMENTARY INFORMATION: 

1. Introduction and Background

    A. Provisions of the Rule Regarding Dental Procedure Codes and 
Nomenclature. This final rule amends TRICARE Retiree Dental Program 
(TRDP) Basic benefit descriptions by removing specific American Dental 
Association (ADA) dental procedure codes and nomenclature, and 
replacing them with general benefit categories and descriptions from 
the most recent Current Dental Terminology (CDT) Manual (CDT-2005). 
This action is required because dental procedure codes and nomenclature 
are added, revised, and deleted by the ADA every two years; when this 
occurs, the regulation must also be revised to reflect the new codes 
and nomenclature. Maintaining specific procedure codes and nomenclature 
in the regulation is unnecessary, since the TRDP contract and TRDP 
marketing materials (available at https://www.tricare.osd.mil/dental/
dm2.cfm) already contain detailed benefit descriptions. Also, the TRDP 
contractor and enrollees are notified when the Government directs any 
changes to TRDP benefits, limits, or exclusions. The TRDP contract and 
TRDP marketing materials will continue to be the primary vehicles for 
communicating specific benefit information to the TRDP contractor and 
beneficiaries. Removal of specific procedure codes and nomenclature 
from this section does not change or eliminate any benefits that are 
currently available under the TRDP. The general categories of benefits 
that are listed in this final rule will be adjusted periodically to 
conform to the current CDT Manual.
    Although there are many similarities between the TRDP and the 
TRICARE Dental Program (TDP), the benefits are not identical. Also, 
there are different dental benefits available under the TRDP Basic 
program and the TRDP Enhanced program. The general benefit categories 
in this TRDP final rule differ from the TDP benefit categories listed 
in 32 CFR Part 199.13. This variance exists because some of the 
benefits offered under the TDP are not benefits under the TRDP Basic 
program (e.g., prosthodontic and orthodontic services), and because the 
TDP benefit categories were derived from an earlier version of the CDT 
Manual.
    B. Provisions of the Rule Regarding the Administrative Correction 
of Incorrect, Obsolete, or Historical Terms and Inaccurate Information. 
The proposed rule addressed the revision of several incorrect, obsolete 
or historical terms that appear in the regulation. Specifically, 
``Director, OCHAMPUS'' was proposed to be amended to ``Director, 
TRICARE Management Activity''; ``Assistant Secretary of Defense (Human 
Affairs)'' was proposed to be amended to ``Assistant Secretary of 
Defense (Health Affairs)''; ``Active Duty Dependents Dental Program'' 
was proposed to be amended to ``TRICARE Dental Program''; ``CHAMPUS'' 
was proposed to be amended to ``TRICARE/CHAMPUS''; and ``OCHAMPUS'' was 
proposed to be amended to ``TRICARE Management Activity.''
    Subsequent to the publication of the proposed rule, TRICARE 
Management Activity identified a long-standing error in the regulation 
regarding appeals and grievances. Specifically, 32 CFR 199.22(k)(1) 
currently states, ``Appeal and hearing procedures. All levels of 
appeals and grievances established by the Contractor for internal 
review shall be exhausted prior to forwarding to OCHAMPUS for a final 
review. Procedures comparable to those established under Sec. 199.13(h) 
of this part shall apply.'' The first sentence in this paragraph is 
inaccurate. TRDP grievances are written complaints regarding non-
appealable issues involving a perceived failure of a provider or 
contractor staff to furnish the expected level or quality of care 
(e.g., demeanor or behavior of providers or their staff). The TRDP 
contractor is responsible for the investigation and resolution of 
grievances; since they are not forwarded to TMA for ``final review'', 
the current CFR language is incorrect. Appeals involve decisions 
related to TRICARE benefits (e.g., denial of preauthorization for 
requested services, or denial of TRICARE payment for services 
received). Appeals are initially sent to the TRDP contractor for 
reconsideration. If the original denial is upheld (and the amount in 
dispute is $50 or more), the beneficiary may

[[Page 54213]]

request a formal review by the TRICARE Management Activity. If the 
beneficiary is dissatisfied with the formal review decision (and the 
amount in dispute is $300 or more, the beneficiary may request that the 
TRICARE Management Activity schedule an independent hearing. Since 
there are two possible levels of action for appeals that are forwarded 
to the TRICARE Management Activity (not a single ``final review''), the 
current CFR language is incorrect. Therefore, the inaccurate sentence 
has been deleted in this final rule as an administrative correction. 
The current TRDP appeal and hearing procedures are comparable to those 
established under Sec. 199.13(h) as required by the regulation, and are 
unchanged by this rule.

II. Public Comments

    The proposed rule was published in the Federal Register on November 
27, 2006. We received no public comments.

III. Regulatory Procedures

    Executive Order 12866 directs agencies to assess all costs and 
benefits available, regulatory alternatives and, when regulation is 
necessary, to select regulatory approaches that maximize net benefits 
(including potential economic, environmental, public health and safety, 
and other advantages; distributive impacts; and equity). The Order 
classifies a rule as a significant regulatory action requiring review 
by the Office of Management and Budget if it meets any one of a number 
of specified conditions, including having an annual effect on the 
national economy of $100 million or more, creating a serious 
inconsistency or interfering with an action of another agency, 
materially altering the budgetary impact of entitlements or the right 
of entitlement recipients, or raising novel legal or policy issues. DoD 
has examined the economic, legal, and policy implications of this final 
rule and has concluded that is not a significant regulatory action. The 
changes set forth in the final rule are minor administrative revisions 
to the existing regulation which do not change the basic TRDP benefit 
structure. This is neither a significant regulatory action under 
Executive Order 12866, nor would it have a significant impact on small 
entities.
    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 final rule is not a major rule under the Congressional Review 
Act because its economic impact will be less than $100 million.
    Executive Order 13132 requires that each Federal Agency shall 
consult with State and local officials and obtain their input if a rule 
has federalism implications which 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. We have examined the impact of the final 
rule under Executive Order 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. In addition, this final rule does 
not impose new information collection requirements for purposes of the 
Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3511).

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 199.22 is amended by revising the last sentence of paragraph 
(b)(1), paragraph (b)(4), paragraph (c), paragraph (d)(1)(v), the first 
sentence of paragraph (d)(4)(ii), paragraph (f) introductory text, 
paragraph (f)(1) introductory text, paragraphs (f)(1)(i) through 
(f)(1)(vii), the first sentence of paragraph (f)(3), and paragraph (g); 
and by removing paragraph (f)(1)(viii), paragraph (f)(1)(ix), and the 
first sentence of paragraph (k) to read as follows:


Sec. 199.22  TRICARE Retiree Dental Program (TRDP).

* * * * *
    (b) * * *
    (1) * * * Additional services comparable to those contained in 
paragraph (e)(2) of Sec. 199.13 may be covered pursuant to benefit 
policy decisions made by the Director, TRICARE Management Activity, or 
designee.
* * * * *
    (4) Except as otherwise provided in this section or by the 
Assistant Secretary of Defense (Health Affairs) or designee, the TRDP 
is administered in a manner similar to the TRICARE Dental Program under 
Sec. 199.13 of this part.
* * * * *
    (c) Except as may be specifically provided in this section, to the 
extent terms defined in Sec. 199.2 and Sec. 199.13(b) are relevant to 
the administration of the TRICARE Retiree Dental Program, the 
definitions contained in Sec. 199.2 and Sec. 199.13(b) shall apply to 
the TRDP as they do to TRICARE/CHAMPUS and the TRICARE Dental Program.
    (d) * * *
    (1) * * *
    (v) The unremarried surviving spouse and eligible child dependents 
of a deceased member who died while in status described in paragraph 
(d)(1)(i) or paragraph (d)(1)(ii) of this section; the unremarried 
surviving spouse and eligible child dependents who receive a surviving 
spouse annuity; or the unremarried surviving spouse and eligible child 
dependents of a deceased member who died while on active duty for a 
period of more than 30 days and whose eligible dependents are not 
eligible or no longer for the TRICARE Dental Program.
* * * * *
    (4) * * *
    (ii) Enrollment period for enhanced benefits. The initial 
enrollment period for enhanced benefit coverage described in paragraph 
(f)(2) of this section shall be established by the Director, TRICARE 
Management Activity, or designee, when such coverage is offered, to be 
a period of not less than 12 months and not more than 24 months. * * *
* * * * *
    (f) Plan benefits. The Director, TRICARE Management Activity, or 
designee, may modify the services covered by the TRDP to the extent 
determined appropriate based on developments in common dental care 
practices and standard dental programs. In addition, the Director, 
TRICARE Management Activity, or designee, may establish such exclusions 
and limitations as are consistent with those established by dental 
insurance and prepayment plans to control utilization and quality of 
care for the services and items covered by the TRDP.
    (1) The minimum TRDP benefit is basic dental care to include 
diagnostic services, preventive services, restorative services, 
endodontic services, periodontic services, oral surgery

[[Page 54214]]

services, and other general services. The following is the minimum TRDP 
covered dental benefit:
    (i) Diagnostic services.
    (A) Clinical oral examinations.
    (B) Radiographs and diagnostic imaging.
    (C) Tests and laboratory examinations.
    (ii) Preventive services.
    (A) Dental prophylaxis.
    (B) Topical fluoride treatment (office procedure).
    (C) Sealants.
    (D) Other preventive services.
    (E) Space maintenance.
    (iii) Restorative services.
    (A) Amalgam restorations.
    (B) Resin-based composite restorations.
    (C) Other restorative services.
    (iv) Endodontic services.
    (A) Pulp capping.
    (B) Pulpotomy and pulpectomy.
    (C) Root canal therapy.
    (D) Apexification and recalcification procedures.
    (E) Apicoectomy and periradicular services.
    (F) Other endodontic procedures.
    (v) Periodontic Services.
    (A) Surgical services.
    (B) Periodontal services.
    (vi) Oral surgery.
    (A) Extractions.
    (B) Surgical extractions.
    (C) Alveoloplasty.
    (D) Biopsy.
    (E) Other surgical procedures.
    (vii) Other general services.
    (A) Palliative (emergenery) treatment of dental pain.
    (B) Therapeutic drug injection.
    (C) Other drugs and/or medicaments.
    (D) Treatment of postsurgical complications.
* * * * *
    (3) Alternative course of treatment policy. The Director, TRICARE 
Management Activity, or designee, may establish, in accordance with 
generally accepted dental benefit practices, an alternative course of 
treatment policy which provides reimbursement in instances where the 
dentist and TRDP enrollee select a more expensive service, procedure, 
or course of treatement than in customarily provided. * * *
* * * * *
    (g) Maximum coverage amounts. Each enrollee is subject to an annual 
maximum coverage amount for non-orthodontic dental benefits and, if an 
orthodontic benefit is offered, a lifetime maximum coverage amount for 
orthodontics as established by the Director, TRICARE Management 
Activity, or designee.
* * * * *

    Dated: September 14, 2007.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 07-4658 Filed 9-21-07; 8:45 am]
BILLING CODE 5001-06-M
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