TRICARE; Changes Included in the John Warner National Defense Authorization Act for Fiscal Year 2007; Authorization of Anesthesia and Other Costs for Dental Care for Children and Certain Other Patients, 54353-54355 [07-4655]
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54353
yshivers on PROD1PC62 with RULES
Federal Register / Vol. 72, No. 185 / Tuesday, September 25, 2007 / Rules and Regulations
The (j)(2) exemption was initially
applied to this system which was the
database used for all Inspection (now
the Treasury Inspector General for Tax
Administration [TIGTA]) investigations.
TIGTA is not a part of IRS and no
Inspection investigations are maintained
in this system, with the exception of
personnel security investigations. Under
5 U.S.C. 552a(k)(5), the head of any
agency may promulgate rules to exempt
any system of records within the agency
from certain provisions of the Privacy
Act of 1974 if the system is investigatory
material compiled solely for the purpose
of determining suitability, eligibility, or
qualifications for Federal civilian
employment, military service, Federal
contracts, or access to classified
information. This is applicable only to
the extent that the disclosure of such
material would reveal the identity of a
source who furnished information to the
Government under an express promise
that the identity of the source would be
held in confidence, or, prior to
September 27, 1975, under an implied
promise that the identity of the source
would be held in confidence. Thus to
the extent that the records in this system
can be disclosed without revealing the
identity of a confidential source, they
are not within the scope of this
exemption and are subject to all the
requirements of the Privacy Act.
The sections of 5 U.S.C. 552a from
which the systems of records are exempt
include in general those providing for
individuals’ access to or amendment of
records. When such access or
amendment would cause the identity of
a confidential source to be revealed, it
would impair the future ability of the
Department to compile investigatory
material for the purpose of determining
suitability, eligibility, or qualifications
for Federal civilian employment,
Federal contracts, or access to classified
information. In addition, the systems
should be exempt from 5 U.S.C.
552a(e)(1) which requires that an agency
maintain in its records only such
information about an individual as is
relevant and necessary to accomplish a
purpose of the agency required to be
accomplished by statute or executive
order. The Department believes that to
fulfill the requirements of 5 U.S.C.
552a(e)(1) would unduly restrict the
agency in its information gathering
inasmuch as it is often not until well
after the investigation that it is possible
to determine the relevance and
necessity of particular information.
A separate notice revising the system
of records entitled ‘‘IRS 34.022—
National Background Investigations
Center Management Information
System’’ was published in the Federal
VerDate Aug<31>2005
15:17 Sep 24, 2007
Jkt 211001
Register on November 28, 2005, at 70
FR 71376. Among other changes, the
name of the system of records was
changed to ‘‘Automated Background
Investigations System (ABIS).’’
As required by Executive Order
12866, it has been determined that this
final rule is not a significant regulatory
action, and therefore, does not require a
regulatory impact analysis.
The regulation will not have a
substantial direct effect on the States, on
the relationship between the Federal
Government and the States, or on the
distribution of power and
responsibilities among the various
levels of government. Therefore, it is
determined that this rule does not have
federalism implications under Executive
Order 13132.
Pursuant to the requirements of the
Regulatory Flexibility Act, 5 U.S.C. 601–
612, it is hereby certified that these
regulations will not significantly affect a
substantial number of small entities.
The final rule imposes no duties or
obligations on small entities.
In accordance with the provisions of
the Paperwork Reduction Act of 1995,
the Department of the Treasury has
determined that this final rule would
not impose new record keeping,
application, reporting, or other types of
information collection requirements.
List of Subjects in 31 CFR Part 1
Privacy.
I Part 1 subpart C of Title 31 of the
Code of Federal Regulations amended as
follows:
PART 1—[AMENDED]
1. The authority citation for part 1
continues to read as follows:
I
Authority: 5 U.S.C. 301, 31 U.S.C. 321,
subpart A also issued under 5 U.S.C. 552, as
amended. Subpart C also issued under 5
U.S.C. 552a.
2. Section 1.36 of subpart C is
amended as follows:
I a. Paragraph (c)(1)(viii) is amended by
removing ‘‘IRS 34.022—National
Background Investigations Center
Management Information System’’ from
the table.
I b. Paragraph (m)(1)(viii) is amended
by adding the following text to the table
in numerical order:
I
§ 1.36 Systems exempt in whole or in part
from provisions of 5 U.S.C. 522a and this
part.
*
*
*
(m) * * *
(1) * * *
(viii) * * *
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*
Fmt 4700
*
Sfmt 4700
Number
Name of system
*
*
*
*
*
IRS 34.022 ................ Automated Background Investigations System
(ABIS)
*
*
*
*
*
*
*
*
*
*
Dated: September 18, 2007.
Peter B. McCarthy,
Assistant Secretary for Management and
Chief Financial Officer.
[FR Doc. E7–18859 Filed 9–24–07; 8:45 am]
BILLING CODE 4830–01–P
DEPARTMENT OF DEFENSE
Office of the Secretary
32 CFR Part 199
[DoD–2007–HA–0026]
RIN 0720–AB14
TRICARE; Changes Included in the
John Warner National Defense
Authorization Act for Fiscal Year 2007;
Authorization of Anesthesia and Other
Costs for Dental Care for Children and
Certain Other Patients
Office of the Secretary,
Department of Defense.
ACTION: Final rule.
AGENCY:
SUMMARY: This final rule implements
section 702 of the John Warner National
Defense Authorization Act for Fiscal
Year 2007, Public Law 109–364. The
rule provides coverage of contracted
medical care with respect to dental care
beyond that care required as a necessary
adjunct to medical or surgical treatment.
The entitlement of institutional and
anesthesia services is authorized in
conjunction with non-covered dental
treatment for patients with
developmental, mental, or physical
disabilities or for pediatric patients age
5 or under. This final rule does not
eliminate any contracted medical care
that is currently covered for spouses and
children. The entitlement of anesthesia
services includes general anesthesia
services only. Institutional services
include institutional benefits associated
with both hospital and in-out surgery
settings. Patients with developmental,
mental, or physical disabilities are those
patients with conditions that prohibit
dental treatment in a safe and effective
manner. Therefore, it is medically or
psychologically necessary for these
patients to require general anesthesia for
dental treatment.
E:\FR\FM\25SER1.SGM
25SER1
54354
Federal Register / Vol. 72, No. 185 / Tuesday, September 25, 2007 / Rules and Regulations
This is rule is effective
September 25, 2007.
ADDRESSES: TRICARE Management
Activity, Skyline 5, Suite 810, 5111
Leesburg Pike, Falls Church, VA 22041.
FOR FURTHER INFORMATION CONTACT: Col.
Gary C. Martin, Office of the Assistant
Secretary of Defense (Health Affairs),
TRICARE Management Activity,
telephone (703) 681–0039.
SUPPLEMENTARY INFORMATION:
yshivers on PROD1PC62 with RULES
EFFECTIVE DATE:
I. Summary of Final Rule Provisions
This final rule amends the coverage of
contracted medical care with respect to
dental care beyond that care required as
a necessary adjunct to medical or
surgical treatment. The entitlement of
institutional and anesthesia services is
authorized in conjunction with noncovered dental treatment for patients
with developmental, mental, or physical
disabilities or for pediatric patients age
5 or under. This final rule does not
eliminate any contracted medical care
that is currently covered for spouses and
children. The entitlement of anesthesia
services includes general anesthesia
services only. Institutional services
includes institutional benefits
associated with both hospital and in-out
surgery settings. Patients with
developmental, mental, or physical
disabilities are those patients with
conditions that prohibit dental
treatment in a safe and effective manner.
Therefore, it is medically or
psychologically necessary for these
patients to require general anesthesia for
dental treatment.
Prior to section 702 of the John
Warner National Defense Authorization
Act for Fiscal Year 2007, general
anesthesia and institutional services
were not covered in conjunction with
dental treatment for patients with
developmental, mental, or physical
disabilities or for pediatric patients of
any age through TRICARE medical plan
contracts unless it qualified as
adjunctive dental care. For military
families who have children that require
extensive dental treatment under
general anesthesia, the two options
available were to have the care provided
locally at a Department of Defense (DoD)
facility or a civilian facility. If the care
was provided in a DoD facility, the total
costs to the family are minimal.This
option remains available. There are,
however, locations where this care is
not available from a DoD facility due to
facility constraints (no operating room)
and/or lack of dental specialists. For
dental care provided in a civilian
facility, families currently enrolled in
the TRICARE Dental Program (TDP) or
TRICARE Retiree Dental Program
VerDate Aug<31>2005
15:17 Sep 24, 2007
Jkt 211001
(TRDP) are provided with coverage for
dental care with applicable cost-shares.
These include a 40-percent cost-share
for general anesthesia and varying costshares for dental procedures (fillings,
crowns, root canals) completed in the
operating room setting. There is an
annual maximum benefit for the TDP
and TRDP of $1,200 per enrollee. This
means that the total payments covered
services for each enrolled member will
not exceed $1,200 in any contract year.
In addition, the TRDP has a deductible
of $50 per patient per year, not to
exceed $150 per family per year.
Frequently, the annual maximum is
reached for those pediatric patients who
require extensive dental treatment
under general anesthesia. Once the
annual maximum is reached, the
remainder of the billed charges is the
enrollee’s responsibility. The hospital
costs (institutional services) are covered
by neither the TDP nor the TRDP. For
families with dental insurance other the
TDP or TRDP, their plan structure may
have defrayed some costs but out-ofpocket costs remained significant.
Families without any dental insurance
incurred the total costs of dental,
anesthesia, and institutional services.
II. Review of Public Comments
We provided a 60-day comment
period on the proposed rule which was
published in the Federal Register on
March 23, 2007 (72 FR 13721). We
received one document with joint
comments from the American Dental
Association (ADA) and the American
Academy of Pediatric Dentists (AAPD).
All comments were in support of the
proposed rule. The ADA and AAPD
concurred that the proposed rule
accurately interpreted section 702 of the
John Warner National Defense
Authorization Act for Fiscal Year 2007,
Public Law 109–364. They also
concurred with the definitions and
requirements as stated in the proposed
rule. A waiver of the preauthorization
requirement will be provided for
beneficiaries receiving care in the
transition period between October 17,
2006, the effective date of the change in
the law upon which this final rule is
based, and the implementation date, by
applying the same criteria in a postauthorization. The ADA and AAPD
recommended that post-authorization
reviews utilize the same criteria as
preauthorization reviews, and that this
transition plan be referenced in the final
rule. Post authorization review
procedures will utilize the same criteria
as preauthorization reviews; however,
post authorization procedures will be
addressed and outlined in detail in the
PO 00000
Frm 00014
Fmt 4700
Sfmt 4700
TRICARE Manuals and are not included
in this final rule.
III. Regulatory Procedures
Executive Order 12866 requires that a
comprehensive regulatory impact
analysis be performed on any
economically significant regulatory
action, defined as 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 rule is
not an economically significant
regulatory action and will not have a
significant impact on a substantial
number of small entities for purposes of
the RFA, thus this final rule is not
subject to any of these requirements.
This rule will not impose additional
information collection requirements on
the public under the Paperwork
Reduction Act of 1995 (44 U.S.C. 3501–
3511). We have examined the impact(s)
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.
List of Subjects in 32 CFR Part 199
Claims, Dental health, Health care,
Health insurance, Individuals with
disabilities, Military personnel.
Accordingly, 32 CFR part 199 is
amended as follows:
I
PART 199—CIVILIAN HEALTH AND
MEDICAL PROGRAM OF THE
UNIFORMED SERVICES (CHAMPUS)
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 199.4 is amended by
removing the first sentence of paragraph
(e)(10) introductory text and adding two
sentences in its place; revising the first
sentence of paragraph (e)(10)(iii); and
adding paragraph (e)(10)(vi) to read as
follows:
I
§ 199.4
*
E:\FR\FM\25SER1.SGM
Basic Program Benefits.
*
*
25SER1
*
*
Federal Register / Vol. 72, No. 185 / Tuesday, September 25, 2007 / Rules and Regulations
yshivers on PROD1PC62 with RULES
(e)* * *
(10) Dental. TRICARE/CHAMPUS
does not include a dental benefit.
However, in connection with dental
treatment for patients with
developmental, mental, or physical
disabilities or for pediatric patients age
5 or under, only institutional and
anesthesia services may be provided as
a benefit.* * *
*
*
*
*
*
(iii) Preauthorization required. In
order to be covered, adjunctive dental
care requires preauthorization from the
Director, TRICARE Management
Activity, or a designee, in accordance
with paragraph (a)(12) of this
section.* * *
*
*
*
*
*
(vi) Anesthesia and institutional costs
for dental care for children and certain
other patients. Institutional benefits
specified in paragraph (b) of this section
may be extended for hospital and in-out
surgery settings related to noncovered,
nonadjunctive dental care when such
outpatient care or inpatient stay is in
conjunction with dental treatment for
patients with developmental, mental, or
physical disabilities or for pediatric
patients age 5 or under. For these
patients, anesthesia services will be
limited to the administration of general
anesthesia only. Patients with
developmental, mental, or physical
disabilities are those patients with
conditions that prohibit dental
treatment in a safe and effective manner.
Therefore, it is medically or
psychologically necessary for these
patients to require general anesthesia for
dental treatment. Patients with physical
disabilities include those patients
having disabilities as defined in § 199.2
as a serious physical disability.
Preauthorization by the Director,
TRICARE Management Activity, or a
designee, is required for such outpatient
care or inpatient stays to be covered in
the same manner as required for
adjunctive dental care described in
paragraph (e)(10)(iii) of this section.
Regardless of whether or not the
preauthorization request for outpatient
care or hospital admission is approved
and thus qualifies for institutional
benefits, the professional service related
to the nonadjunctive dental care is not
covered, with the exception of coverage
for anesthesia services.
*
*
*
*
*
Dated: September 13, 2007.
L.M. Bynum,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 07–4655 Filed 9–24–07; 8:45 am]
BILLING CODE 5001–06–M
VerDate Aug<31>2005
15:17 Sep 24, 2007
Jkt 211001
DEPARTMENT OF HOMELAND
SECURITY
Coast Guard
33 CFR Part 100
[Docket No. CGD05–07–045]
RIN 1625–AA08
Special Local Regulations for Marine
Events; John H. Kerr Reservoir,
Clarksville, VA
Coast Guard, DHS.
Temporary final rule.
AGENCY:
ACTION:
SUMMARY: The Coast Guard is
establishing temporary special local
regulations for the ‘‘Clarksville
Hydroplane Challenge’’, a power boat
race to be held on the waters of the John
H. Kerr Reservoir adjacent to
Clarksville, Virginia. These special local
regulations are necessary to provide for
the safety of life on navigable waters
during the event. This action is
intended to restrict vessel traffic in
portions of the John H. Kerr Reservoir
adjacent to Clarksville, Virginia during
the power boat race.
DATES: This rule is effective from 7:30
a.m. on October 6, 2007 to 6:30 p.m. on
October 7, 2007.
ADDRESSES: Comments and material
received from the public, as well as
documents indicated in this preamble as
being available in the docket, are part of
docket CGD05–07–045 and are available
for inspection or copying at Commander
(dpi), Fifth Coast Guard District, 431
Crawford Street, Portsmouth, Virginia
23704–5004 between 9 a.m. and 2 p.m.,
Monday through Friday, except Federal
holidays.
FOR FURTHER INFORMATION CONTACT:
Dennis Sens, Project Manager,
Inspections and Investigations Branch,
at (757) 398–6204.
SUPPLEMENTARY INFORMATION:
Regulatory Information
On July 16, 2007, we published a
notice of proposed rulemaking (NPRM)
entitled Special Local Regulations for
Marine Events; John H. Kerr Reservoir,
Clarksville, VA, in the Federal Register
(72 FR 38808). We received no letters
commenting on the proposed rule. No
public meeting was requested, and none
was held.
Under 5 U.S.C. 553(d)(3), the Coast
Guard finds that good cause exists for
making this rule effective less than 30
days after publication in the Federal
Register. Delaying the effective date
would be contrary to the public interest,
since immediate action is needed to
ensure the safety of the event
PO 00000
Frm 00015
Fmt 4700
Sfmt 4700
54355
participants, support vessels, spectator
craft and other vessels transiting the
event area. However, advance
notifications will be made to users of
John H. Kerr Reservoir via, local notice
to mariners, commercial radio stations,
and area newspapers.
Background and Purpose
On October 6 and 7, 2007, the
Virginia Boat Racing Association will
sponsor the ‘‘Clarksville Hydroplane
Challenge’’, on the waters of the John H.
Kerr Reservoir. The event will consist of
approximately 70 inboard hydroplanes
racing in heats counter-clockwise
around an oval racecourse. A fleet of
spectator vessels is anticipated to gather
nearby to view the competition. Due to
the need for vessel control during the
event, vessel traffic will be temporarily
restricted to provide for the safety of
participants, spectators and transiting
vessels.
Discussion of Comments and Changes
The Coast Guard did not receive
comments in response to the notice of
proposed rulemaking (NPRM) published
in the Federal Register. Accordingly,
the Coast Guard is establishing
temporary special local regulations on
specified waters of the John H. Kerr
Reservoir, Clarksville, Virginia.
Regulatory Evaluation
This rule is not a ‘‘significant
regulatory action’’ under section 3(f) of
Executive Order 12866, Regulatory
Planning and Review, and does not
require an assessment of potential costs
and benefits under section 6(a)(3) of that
Order. The Office of Management and
Budget has not reviewed it under that
Order.
We expect the economic impact of
this rule to be so minimal that a full
Regulatory Evaluation is unnecessary.
Although this regulation will prevent
traffic from transiting a portion of the
John H. Kerr Reservoir adjacent to
Clarksville, Virginia, during the event,
the effect of this regulation will not be
significant due to the limited duration
that the regulated area will be in effect.
Extensive advance notifications will be
made to the maritime community via
Local Notice to Mariners, marine
information broadcasts, area
newspapers, and local radio stations, so
mariners can adjust their plans
accordingly. Vessel traffic will be able to
transit the regulated area between heats,
when the Coast Guard Patrol
Commander deems it is safe to do so.
Small Entities
Under the Regulatory Flexibility Act
(5 U.S.C. 601–612), we have considered
E:\FR\FM\25SER1.SGM
25SER1
]]>Agencies
[Federal Register Volume 72, Number 185 (Tuesday, September 25, 2007)]
[Rules and Regulations]
[Pages 54353-54355]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 07-4655]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
32 CFR Part 199
[DoD-2007-HA-0026]
RIN 0720-AB14
TRICARE; Changes Included in the John Warner National Defense
Authorization Act for Fiscal Year 2007; Authorization of Anesthesia and
Other Costs for Dental Care for Children and Certain Other Patients
AGENCY: Office of the Secretary, Department of Defense.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: This final rule implements section 702 of the John Warner
National Defense Authorization Act for Fiscal Year 2007, Public Law
109-364. The rule provides coverage of contracted medical care with
respect to dental care beyond that care required as a necessary adjunct
to medical or surgical treatment. The entitlement of institutional and
anesthesia services is authorized in conjunction with non-covered
dental treatment for patients with developmental, mental, or physical
disabilities or for pediatric patients age 5 or under. This final rule
does not eliminate any contracted medical care that is currently
covered for spouses and children. The entitlement of anesthesia
services includes general anesthesia services only. Institutional
services include institutional benefits associated with both hospital
and in-out surgery settings. Patients with developmental, mental, or
physical disabilities are those patients with conditions that prohibit
dental treatment in a safe and effective manner. Therefore, it is
medically or psychologically necessary for these patients to require
general anesthesia for dental treatment.
[[Page 54354]]
EFFECTIVE DATE: This is rule is effective September 25, 2007.
ADDRESSES: TRICARE Management Activity, Skyline 5, Suite 810, 5111
Leesburg Pike, Falls Church, VA 22041.
FOR FURTHER INFORMATION CONTACT: Col. Gary C. Martin, Office of the
Assistant Secretary of Defense (Health Affairs), TRICARE Management
Activity, telephone (703) 681-0039.
SUPPLEMENTARY INFORMATION:
I. Summary of Final Rule Provisions
This final rule amends the coverage of contracted medical care with
respect to dental care beyond that care required as a necessary adjunct
to medical or surgical treatment. The entitlement of institutional and
anesthesia services is authorized in conjunction with non-covered
dental treatment for patients with developmental, mental, or physical
disabilities or for pediatric patients age 5 or under. This final rule
does not eliminate any contracted medical care that is currently
covered for spouses and children. The entitlement of anesthesia
services includes general anesthesia services only. Institutional
services includes institutional benefits associated with both hospital
and in-out surgery settings. Patients with developmental, mental, or
physical disabilities are those patients with conditions that prohibit
dental treatment in a safe and effective manner. Therefore, it is
medically or psychologically necessary for these patients to require
general anesthesia for dental treatment.
Prior to section 702 of the John Warner National Defense
Authorization Act for Fiscal Year 2007, general anesthesia and
institutional services were not covered in conjunction with dental
treatment for patients with developmental, mental, or physical
disabilities or for pediatric patients of any age through TRICARE
medical plan contracts unless it qualified as adjunctive dental care.
For military families who have children that require extensive dental
treatment under general anesthesia, the two options available were to
have the care provided locally at a Department of Defense (DoD)
facility or a civilian facility. If the care was provided in a DoD
facility, the total costs to the family are minimal.This option remains
available. There are, however, locations where this care is not
available from a DoD facility due to facility constraints (no operating
room) and/or lack of dental specialists. For dental care provided in a
civilian facility, families currently enrolled in the TRICARE Dental
Program (TDP) or TRICARE Retiree Dental Program (TRDP) are provided
with coverage for dental care with applicable cost-shares. These
include a 40-percent cost-share for general anesthesia and varying
cost-shares for dental procedures (fillings, crowns, root canals)
completed in the operating room setting. There is an annual maximum
benefit for the TDP and TRDP of $1,200 per enrollee. This means that
the total payments covered services for each enrolled member will not
exceed $1,200 in any contract year. In addition, the TRDP has a
deductible of $50 per patient per year, not to exceed $150 per family
per year. Frequently, the annual maximum is reached for those pediatric
patients who require extensive dental treatment under general
anesthesia. Once the annual maximum is reached, the remainder of the
billed charges is the enrollee's responsibility. The hospital costs
(institutional services) are covered by neither the TDP nor the TRDP.
For families with dental insurance other the TDP or TRDP, their plan
structure may have defrayed some costs but out-of-pocket costs remained
significant. Families without any dental insurance incurred the total
costs of dental, anesthesia, and institutional services.
II. Review of Public Comments
We provided a 60-day comment period on the proposed rule which was
published in the Federal Register on March 23, 2007 (72 FR 13721). We
received one document with joint comments from the American Dental
Association (ADA) and the American Academy of Pediatric Dentists
(AAPD). All comments were in support of the proposed rule. The ADA and
AAPD concurred that the proposed rule accurately interpreted section
702 of the John Warner National Defense Authorization Act for Fiscal
Year 2007, Public Law 109-364. They also concurred with the definitions
and requirements as stated in the proposed rule. A waiver of the
preauthorization requirement will be provided for beneficiaries
receiving care in the transition period between October 17, 2006, the
effective date of the change in the law upon which this final rule is
based, and the implementation date, by applying the same criteria in a
post-authorization. The ADA and AAPD recommended that post-
authorization reviews utilize the same criteria as preauthorization
reviews, and that this transition plan be referenced in the final rule.
Post authorization review procedures will utilize the same criteria as
preauthorization reviews; however, post authorization procedures will
be addressed and outlined in detail in the TRICARE Manuals and are not
included in this final rule.
III. Regulatory Procedures
Executive Order 12866 requires that a comprehensive regulatory
impact analysis be performed on any economically significant regulatory
action, defined as 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 rule is not an economically significant regulatory
action and will not have a significant impact on a substantial number
of small entities for purposes of the RFA, thus this final rule is not
subject to any of these requirements.
This rule will not impose additional information collection
requirements on the public under the Paperwork Reduction Act of 1995
(44 U.S.C. 3501-3511). We have examined the impact(s) 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.
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--CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED
SERVICES (CHAMPUS)
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 199.4 is amended by removing the first sentence of paragraph
(e)(10) introductory text and adding two sentences in its place;
revising the first sentence of paragraph (e)(10)(iii); and adding
paragraph (e)(10)(vi) to read as follows:
Sec. 199.4 Basic Program Benefits.
* * * * *
[[Page 54355]]
(e)* * *
(10) Dental. TRICARE/CHAMPUS does not include a dental benefit.
However, in connection with dental treatment for patients with
developmental, mental, or physical disabilities or for pediatric
patients age 5 or under, only institutional and anesthesia services may
be provided as a benefit.* * *
* * * * *
(iii) Preauthorization required. In order to be covered, adjunctive
dental care requires preauthorization from the Director, TRICARE
Management Activity, or a designee, in accordance with paragraph
(a)(12) of this section.* * *
* * * * *
(vi) Anesthesia and institutional costs for dental care for
children and certain other patients. Institutional benefits specified
in paragraph (b) of this section may be extended for hospital and in-
out surgery settings related to noncovered, nonadjunctive dental care
when such outpatient care or inpatient stay is in conjunction with
dental treatment for patients with developmental, mental, or physical
disabilities or for pediatric patients age 5 or under. For these
patients, anesthesia services will be limited to the administration of
general anesthesia only. Patients with developmental, mental, or
physical disabilities are those patients with conditions that prohibit
dental treatment in a safe and effective manner. Therefore, it is
medically or psychologically necessary for these patients to require
general anesthesia for dental treatment. Patients with physical
disabilities include those patients having disabilities as defined in
Sec. 199.2 as a serious physical disability. Preauthorization by the
Director, TRICARE Management Activity, or a designee, is required for
such outpatient care or inpatient stays to be covered in the same
manner as required for adjunctive dental care described in paragraph
(e)(10)(iii) of this section. Regardless of whether or not the
preauthorization request for outpatient care or hospital admission is
approved and thus qualifies for institutional benefits, the
professional service related to the nonadjunctive dental care is not
covered, with the exception of coverage for anesthesia services.
* * * * *
Dated: September 13, 2007.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 07-4655 Filed 9-24-07; 8:45 am]
BILLING CODE 5001-06-M
