Beneficiary Travel Under 38 U.S.C. 111 Within the United States, 36796-36802 [E8-14722]

Agencies

• DEPARTMENT OF VETERANS AFFAIRS

[Federal Register Volume 73, Number 126 (Monday, June 30, 2008)]
[Rules and Regulations]
[Pages 36796-36802]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-14722]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Parts 17 and 70

RIN 2900-AM02


Beneficiary Travel Under 38 U.S.C. 111 Within the United States

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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SUMMARY: This document amends the beneficiary travel regulations of the 
Department of Veterans Affairs (VA) that provide a mechanism for 
payment of travel expenses within the United States under 38 U.S.C. 111 
to help veterans and other persons obtain care and services from VA's 
Veterans Health Administration (VHA). The amended regulations more 
fully implement the statutory provisions governing such payments.

DATES: Effective Date: This final rule is effective July 30, 2008.

FOR FURTHER INFORMATION CONTACT: Tony Guagliardo, Chief Business Office 
(16), Veterans Health Administration, Department of Veterans Affairs, 
810 Vermont Avenue, NW., Washington, DC 20420; (202) 254-0406. (This is 
not a toll-free number.)

SUPPLEMENTARY INFORMATION: This document revises the beneficiary travel 
regulations that were previously captioned ``Transportation of 
Claimants and Beneficiaries.'' The revised regulations, set forth at 38 
CFR part 70, provide a mechanism for payment of travel expenses within 
the United States under 38 U.S.C. 111 to help veterans and other 
persons obtain care and services from VHA, a subunit within VA.
    This final rule adopts, with changes discussed below, the 
provisions of the corresponding proposed rule published in the Federal 
Register on July 23, 2007 (72 FR 40096), based on the rationale set 
forth in the proposed rule and this document.
    The proposed rule provided for a 60-day comment period which ended 
September 21, 2007. We received comments from one commenter. We discuss 
below issues raised by the commenter.
    The commenter asserted that the revised regulations should cover 
those aspects of beneficiary travel administered by the Veterans 
Benefit Administration (VBA), one of the Administrations within VA, and 
that we should add a definition of VBA. We made no changes based on 
these comments. These regulations properly concern, insofar as they 
apply to the VBA programs discussed in this comment, the beneficiary 
travel program administered by VHA under 38 U.S.C. 111 for eligible 
beneficiaries traveling to and from a Department facility in connection 
with vocational rehabilitation or incident to a scheduled Compensation 
and Pension examination. Additional transportation benefits available 
to vocational rehabilitation participants are, however, administered by 
VBA in accordance with chapter 31 of title 38, United States Code. As 
such, they are beyond the travel benefits authorized by section 111 and 
are properly administered pursuant to separate regulations (see, e.g., 
38 CFR 21.154).
    The commenter asserted that we should add a definition of 
``beneficiary'' to read: ``Beneficiary means a person determined 
eligible for VHA benefits and who, subject to these regulations, is 
engaged in official business for the Government and authorized to 
travel at Government expense.'' We made no changes based on this 
comment. Such a definition would not be correct. A covered 
beneficiary's travel must be for the limited purpose of obtaining a 
specific VA benefit or another purpose that qualifies under this rule. 
Such travel is not undertaken in connection with the conduct of 
official business on behalf of the Government.
    The commenter asserted that we should amend the regulations to 
provide that any recipient of benefits under 38 U.S.C. chapter 18 who 
travels to or from a VA facility or VA-authorized health care facility 
for care or services is eligible to receive beneficiary travel benefits 
under section 111. We made no changes based on this comment. For 
purposes of chapter 18, the definition of ``health care'' includes, 
among other things, direct transportation costs to and from approved 
sources of health care. The authority for travel benefits under chapter 
18 is 38 U.S.C. 1803(c) and 1813(c), not section 111. These travel 
benefits are administered separately by VA's Health Administration 
Center, pursuant to 38 CFR 17.900 et seq.
    The proposed rule explained that beneficiaries of the Civilian 
Health and Medical Program of the Department of Veterans Affairs 
(CHAMPVA) had previously been included in error among the groups 
eligible for beneficiary travel benefits under section 111. The 
commenter responded that this change should enable VA to have more 
funds available for those who are in fact eligible for beneficiary 
travel benefits, permitting VA to increase its reimbursement rates. 
However, funds allocated for the payment of beneficiary travel benefits 
under 38 U.S.C. 111 have not been used to pay for CHAMPVA 
beneficiaries' travel claims. Instead, those claims have been paid with 
funds allocated to the Health Administration Center, which administers 
the CHAMPVA program. Consequently, the amendment does not adjust the 
funding amounts available for the beneficiary travel program and is for 
clarification only.
    Under the provisions of Sec.  70.30(a)(1) as proposed, the 
Secretary would be authorized to establish a per mile rate for travel 
by a privately owned vehicle. Further, proposed Sec.  70.30(a)(1)(iv) 
explained how VA would comply with the statutory provisions of 38 
U.S.C. 111(g)(1), which require the Secretary, in consultation with the 
Administrator of General Services, the Secretary of Transportation, the 
Comptroller General of the United States, and representatives of 
veterans' service organizations, to conduct periodic investigations and 
other investigations required by that section on the actual cost of 
travel incurred by VA beneficiaries traveling to and from a Department 
facility for a covered purpose. Those provisions further explained how 
VA would provide notification of current mileage reimbursement rates. 
The commenter responded that the Secretary should be bound by the costs 
identified during such investigations, when determining VA's 
reimbursement rates. The commenter further stated that any rate that is 
less than that prescribed for Federal employee travel should be 
required to be fully justified in the Federal Register. We made no 
changes based on these comments.
    Although the Secretary, when conducting investigations and 
determining rates under section 111, is required to take into 
consideration the actual cost of travel, along with other factors 
specified in the law, it is vital that the Secretary also be able to 
take into consideration the ramifications of diverting funds from 
direct medical care for the purpose of increasing mileage

[[Page 36797]]

reimbursement rates for the few categories of veterans eligible for 
beneficiary travel benefits. Indeed, in our view, by not tying the 
rates payable under section 111 to any other Federal travel program or 
otherwise mandating the reimbursement level, Congress implicitly 
recognized the need for this flexibility. Since the process and public 
notice provided for in Sec.  70.31(a)(1) are appropriate under the 
applicable statutory provisions, we believe that there is no need for 
change based on the commenter's suggestions.
    As we discuss below, this final rule makes a number of changes from 
the proposed rule in Sec.  70.31, Deductibles. The proposed rule 
provided that VA will publish a notice of any change in the rates in 
the Federal Register and make current rates available on the Internet. 
In this final rule, we provide the correct Internet address for the 
rates in Sec.  70.31(a)(2).
    Proposed Sec.  70.31(a) had stated, concerning reimbursement for 
travel to and from VA or VA-authorized health care, that VA shall 
deduct an amount established by the Secretary for each one-way trip 
from the amount otherwise payable under part 70 for such one-way trip 
except in limited circumstances, and had referred in parentheses to the 
then-current deductible. This final rule removes that parenthetical, 
which no longer is accurate, and provides a means for access to what 
the actual deductibles are. The Secretary raised the mileage 
reimbursement rate for travel under 38 U.S.C. 111 from 11 cents per 
mile to 28.5 cents per mile effective February 1, 2008, for the reasons 
stated in a Notice published in the Federal Register on February 1, 
2008 (73 FR 6291), which referred to the authority in 38 U.S.C. 111 and 
the provision in the 2008 Appropriations Act funding an increase in the 
beneficiary travel mileage reimbursement rate to 28.5 cents per mile. 
The law requires that whenever the mileage reimbursement rates are 
increased, there must be a proportionate increase in the deductible 
amount. Accordingly, that notice announced an increase in the 
deductible, which for a one-way trip is $7.77. This final rule reflects 
in Sec.  70.31(a) a Web site and offices at which the public can obtain 
this and any future change to the deductible amounts.
    The Secretary is authorized to waive the deductible requirements 
when the imposition of the deductible would cause the beneficiary 
severe financial hardship. Proposed Sec.  70.31(c) concerned 
implementation of this waiver authority. We are aware that, in general, 
deductibles and other similar cost sharing requirements constitute a 
barrier to access to care for those with limited income. Given the 
significant increase in the deductible and increasing fuel costs, many 
veterans will now experience financial hardship in meeting the 
increased deductible requirement. Therefore, the Secretary, acting 
within his discretionary authority, has concluded it is necessary to 
expand the categories of beneficiaries who are exempt from the 
deductible requirement to ensure their continued access to VA health 
care.
    Thus, Sec.  70.31 provides that the following three circumstances 
will constitute evidence of severe financial hardship for purposes of 
this section: (1) The beneficiary is in receipt of a VA pension; (2) 
the beneficiary has income for the year prior to the year of 
application made pursuant to Sec.  70.20 that does not exceed the 
household income threshold determined under 38 U.S.C. 1722(a); or (3) 
the beneficiary's projected income for the year of application does not 
exceed the household income threshold determined under 38 U.S.C. 
1722(a).
    In addition, we have added in the final rule a provision to clarify 
the length of time for which a waiver granted under this section will 
be valid and effective. While implicit in both the current provisions 
in 38 CFR part 17 and in the proposed rule, we believe it preferable 
from a notice perspective to include this in the actual text of the 
regulation. Under the provisions of Sec.  70.31(d) in this final rule, 
waivers granted under Sec.  70.31(c) will be in effect: (1) To the end 
of the calendar year of the application; or (2) until there is a change 
in the beneficiary's household income status during the calendar year 
of application that results in the beneficiary no longer meeting the 
provisions of Sec.  70.31(c) concerning severe financial hardship.
    We have also changed Sec.  70.31 by adding paragraph (e), which 
requires beneficiaries granted a waiver to promptly inform VA of any 
household income changes during the waiver period that result in their 
no longer meeting the severe financial hardship provisions of Sec.  
70.31(c). This is intended to ensure that those beneficiaries receiving 
a waiver of the deductible requirement meet eligibility criteria for 
it.
    We are, where applicable, making changes in the final rule to 
display the approved information collection control numbers that have 
been assigned by the Office of Management and Budget (OMB). This final 
rule also makes changes from the proposed rule by making a number of 
minor clarifications and punctuation corrections.
    Based on the rationale set forth in the proposed rule and in this 
document, we are adopting the provisions of the proposed rule as a 
final rule without change, except as stated above.

Executive Order 12866

    Executive Order 12866 directs agencies to assess all costs and 
benefits of 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 Executive 
Order classifies a ``significant regulatory action,'' requiring review 
by OMB unless OMB waives such review, as any regulatory action that is 
likely to result in a rule that may: (1) Have an annual effect on the 
economy of $100 million or more or adversely affect in a material way 
the economy, a sector of the economy, productivity, competition, jobs, 
the environment, public health or safety, or State, local, or tribal 
governments or communities; (2) create a serious inconsistency or 
otherwise interfere with an action taken or planned by another agency; 
(3) materially alter the budgetary impact of entitlements, grants, user 
fees, or loan programs or the rights and obligations of recipients 
thereof; or (4) raise novel legal or policy issues arising out of legal 
mandates, the President's priorities or the principles set forth in the 
Executive Order.
    The economic, interagency, budgetary, legal, and policy 
implications of this rule have been examined and it has been determined 
to be a significant regulatory action under the Executive Order because 
it is likely to result in a rule that may raise novel legal or policy 
issues arising out of legal mandates, the President's priorities, or 
the principles set forth in the Executive Order and/or materially alter 
the budgetary impact of entitlements, grants, user fees, or loan 
programs or the rights and obligations of recipients thereof.

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any given year. This rule would have no such effect on 
State, local, and tribal governments, or on the private sector.

[[Page 36798]]

Paperwork Reduction Act of 1995

    This final rule contains provisions that constitute collections of 
information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-
3521). OMB has approved those collections under control numbers 2900-
0080 and 2900-0091. (We determined that it was not necessary to obtain 
OMB approval for the proposed information collection that was 
inadvertently described in the preamble of the proposed rule as 
requiring OMB approval. We did not receive any comments concerning that 
proposed information collection.) We display the control number under 
the applicable sections of the regulations in this final rule. OMB 
assigns a control number for each collection of information it 
approves. VA may not conduct or sponsor, and a person is not required 
to respond to, a collection of information unless it displays a 
currently valid OMB control number.

Regulatory Flexibility Act

    VA hereby certifies that the provisions of the rule will not have a 
significant economic impact on a substantial number of small entities 
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
602. This rule primarily affects individuals and any effects on small 
businesses would be inconsequential. Therefore, pursuant to 5 U.S.C. 
605(b), this rule is exempt from the initial and final regulatory 
flexibility analysis requirement of sections 603 and 604.

Catalog of Federal Domestic Assistance

    The Catalog of Federal Domestic Assistance program numbers and 
titles are 64.007, Blind Rehabilitation Centers; 64.009, Veterans 
Medical Care Benefits; 64.010, Veterans Nursing Home Care; 64.011, 
Veterans Dental Care; 64.013, Veterans Prosthetic Appliances; 64.018, 
Sharing Specialized Medical Resources; 64.019, Veterans Rehabilitation 
Alcohol and Drug Dependence; and 64.022, Veterans Home Based Primary 
Care.

List of Subjects in 38 CFR Parts 17 and 70

    Administrative practice and procedure, Alcohol abuse, Alcoholism, 
Claims, Day care, Dental health, Drug abuse, Foreign relations, 
Government contracts, Grant programs--health, Grant programs--veterans, 
Health care, Health facilities, Health professions, Health records, 
Homeless, Medical and dental schools, Medical devices, Medical 
research, Mental health programs, Nursing homes, Philippines, Reporting 
and recordkeeping requirements, Scholarships and fellowships, Travel 
and transportation expenses, Veterans.

    Approved: March 31, 2008.
James B. Peake,
Secretary of Veterans Affairs.

0
For the reasons set forth in the preamble, the Department of Veterans 
Affairs amends 38 CFR chapter I as follows:

PART 17--MEDICAL

0
1. The authority citation for part 17 continues to read as follows:

    Authority: 38 U.S.C. 501, 1721, and as stated in specific 
sections.

Sec.  17.38  [Amended]

0
2. In Sec.  17.38, revise paragraph (a)(1)(xii) to read as follows:


Sec.  17.38  Medical benefits package.

    (a) * * *
    (1) * * *
    (xii) Payment of beneficiary travel as authorized under 38 CFR part 
70.
* * * * *


Sec. Sec.  17.143 through 17.145  [Removed]

0
3. Remove Sec. Sec.  17.143 through 17.145 and the undesignated center 
heading ``TRANSPORTATION OF CLAIMANTS AND BENEFICIARIES''.

0
4. Add a new part 70 to read as follows:

PART 70--VHA BENEFICIARY TRAVEL UNDER 38 U.S.C. 111

Sec.
70.1 Purpose and scope.
70.2 Definitions.
70.3 Determination of Secretary.
70.4 Criteria for approval.
70.10 Eligible persons.
70.20 Application.
70.21 Where to apply.
70.30 Payment principles.
70.31 Deductibles.
70.32 Reimbursement or prior payment.
70.40 Administrative procedures.
70.41 Recovery of payments.
70.42 False statements.
70.50 Reduced fare requests.

    Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 
1782, 1783, E.O. 11302.

Sec.  70.1  Purpose and scope.

    (a) This part provides a mechanism under 38 U.S.C. 111 for the 
Veterans Health Administration (VHA) to make payments for travel 
expenses incurred in the United States to help veterans and other 
persons obtain care or services from VHA.
    (b) This part does not cover payment for emergency transportation 
of veterans for non-service-connected conditions in non-VA facilities 
when the payment for transportation is covered by Sec. Sec.  17.1000 
through 17.1008 of this chapter, as authorized by 38 U.S.C. 1725.

(Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)

Sec.  70.2  Definitions.

    For purposes of this part:
    Attendant means an individual traveling with a beneficiary who is 
eligible for beneficiary travel and requires the aid and/or physical 
assistance of another person.
    Beneficiary means a person determined eligible for VHA benefits.
    Claimant means a veteran who received services (or his/her 
guardian) or the hospital, clinic, or community resource that provided 
the services, or the person other than the veteran who paid for the 
services.
    Clinician means a Physician, Physician Assistant (PA), Nurse 
Practitioner (NP), Psychologist, or other independent licensed 
practitioner.
    Emergency treatment means treatment for a condition of such a 
nature that a prudent layperson would have reasonably expected that 
delay in seeking immediate medical attention would have been hazardous 
to life or health (this standard would be met if there were an 
emergency medical condition manifesting itself by acute symptoms of 
sufficient severity (including severe pain) that a prudent layperson 
who possesses an average knowledge of health and medicine could 
reasonably expect the absence of immediate medical attention to result 
in placing the health of the individual in serious jeopardy, serious 
impairment to bodily functions, or serious dysfunction of any bodily 
organ or part).
    Irregular discharge means the release of a competent patient from a 
VA or VA-authorized hospital, nursing home, or domiciliary care due to: 
refusal, neglect or obstruction of examination or treatment; leaving 
without the approval of the treating health care clinician; or 
disorderly conduct and discharge is the appropriate disciplinary 
action.
    Special mode of transportation means an ambulance, ambulette, air 
ambulance, wheelchair van, or other mode of transportation specially 
designed to transport disabled persons (this would not include a mode 
of transportation not specifically designed to transport disabled 
persons, such as a bus, subway, taxi, train, or airplane). A modified, 
privately-owned vehicle, with special adaptive equipment and/or capable 
of transporting disabled persons is not a special mode of 
transportation for the purposes of this part.
    United States means each of the several States, Territories, and

[[Page 36799]]

possessions of the United States, the District of Columbia, and the 
Commonwealth of Puerto Rico.
    VA means the Department of Veterans Affairs.
    VA-authorized health care facility means a non-VA health care 
facility where VA has approved care for an eligible beneficiary at VA 
expense.
    VA facility means VA Medical Center (VAMC), VA Outpatient Clinic 
(OPC), or VA Community Based Outpatient Clinic (CBOC).
    VHA means the Veterans Health Administration, a principal unit 
within VA.

(Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)

Sec.  70.3  Determination of Secretary.

    For each fiscal year, the Secretary of Veterans Affairs will 
determine whether funds are available for paying expenses of VHA 
beneficiary travel under 38 U.S.C. 111. If the Secretary determines 
that funds are available for such purpose, VA will make payment for 
expenses of such travel in accordance with the provisions of this part.

(Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)

Sec.  70.4  Criteria for approval.

    (a) VA will approve payment for beneficiary travel under this part 
if:
    (1) The travel was made to obtain care or services for a person who 
is eligible for beneficiary travel payments under Sec.  70.10,
    (2) The travel was in connection with care or services for which 
such person was eligible under the laws administered by VA,
    (3) Application was made in accordance with Sec.  70.20,
    (4) All of the requirements of this part for payment are met, and
    (5) Any failure to obtain the care or services was due to actions 
by officials of VA or persons acting on behalf of VA.
    (b) When a claimant requests payment for beneficiary travel after 
the provision of care or services and the travel did not include a 
special mode of transportation, VA will approve round-trip payment 
under this part only if the travel was:
    (1) In connection with care or services that were scheduled with 
VHA prior to arrival at the VHA-designated facility, or
    (2) For emergency treatment.
    (c) When a claimant requests payment for beneficiary travel for 
care or services that were not scheduled with VHA prior to arrival at 
the facility and were not emergency treatment and the travel did not 
include a special mode of transportation, VA will not approve round-
trip payment under this part but will approve payment for the return 
trip if VHA actually provided care or services.
    (d) Except as provided in Sec.  70.32 concerning reimbursement or 
prior payment, when payment for beneficiary travel is requested for 
travel that includes a special mode of transportation, VA will approve 
payment under this part if:
    (1) The travel is medically required,
    (2) The beneficiary is unable to defray the cost of such 
transportation, and
    (3) VHA approved the travel prior to travel in the special mode of 
transportation or the travel was undertaken in connection with a 
medical emergency.

 (Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)

Sec.  70.10  Eligible persons.

    (a) The following listed persons are eligible for beneficiary 
travel payments under this part:
    (1) A veteran who travels to or from a VA facility or VA-authorized 
health care facility in connection with treatment or care for a 
service-connected disability (regardless of percent of disability).
    (2) A veteran with a service-connected disability rated at 30 
percent or more who travels to or from a VA facility or VA-authorized 
health care facility for examination, treatment, or care for any 
condition.
    (3) A veteran who travels to a VA facility or VA-authorized health 
care facility for a scheduled compensation and pension examination.
    (4) A veteran receiving pension under 38 U.S.C. 1521, who travels 
to or from a VA facility or VA-authorized health care facility for 
examination, treatment, or care.
    (5) A veteran whose annual income (as determined under 38 U.S.C. 
1503) does not exceed the maximum annual rate of pension that the 
veteran would receive under 38 U.S.C. 1521 (as adjusted under 38 U.S.C. 
5312) if the veteran was eligible for pension and travels to or from a 
VA facility or VA-authorized health care facility for examination, 
treatment, or care.
    (6) A veteran who travels to or from a VA facility or VA-authorized 
health care facility for examination, treatment, or care, and who is 
unable to defray the expenses of that travel as defined in paragraph 
(c) of this section.
    (7) A member of a veteran's immediate family, a veteran's legal 
guardian, or a person in whose household the veteran certifies an 
intention to live, if such person is traveling for consultation, 
professional counseling, training, or mental health services concerning 
a veteran who is receiving care for a service-connected disability; or 
a member of a veteran's immediate family, if such person is traveling 
for bereavement counseling relating to the death of such veteran in the 
active military, naval, or air service in the line of duty and under 
circumstances not due to the veteran's own misconduct.
    (8) An attendant other than a VA employee, who is accompanying and 
assisting a beneficiary eligible for beneficiary travel payments under 
this section, when such beneficiary is medically determined to require 
the presence of the attendant because of a physical or mental 
condition.
    (9) Beneficiaries of other Federal agencies, incident to medical 
services rendered upon requests of those agencies, subject to 
reimbursement agreement by those agencies.
    (10) Allied beneficiaries as defined by 38 U.S.C. 109 subject to 
reimbursement agreement by the government concerned.
    (b) For purposes of this section, the term ``examination, 
treatment, or care'' means the care services provided under the Medical 
Benefits Package in Sec.  17.38 of this chapter.
    (c) For purposes of this section, a beneficiary shall be considered 
unable to defray the expenses of travel if the beneficiary:
    (1) Has an income for the year (as defined under 38 U.S.C. 1503) 
immediately preceding the application for beneficiary travel that does 
not exceed the maximum annual rate of pension that the beneficiary 
would receive under 38 U.S.C. 1521 (as adjusted under 38 U.S.C. 5312) 
if the beneficiary were eligible for pension during that year; or
    (2) Is able to demonstrate that due to circumstances such as loss 
of employment, or incurrence of a disability, his or her income in the 
year of travel will not exceed the maximum annual rate of pension that 
the beneficiary would receive under 38 U.S.C. 1521 (as adjusted under 
38 U.S.C. 5312) if the beneficiary were eligible for pension; or
    (3) Has a service-connected disability rated at least 30 percent; 
or
    (4) Is traveling in connection with treatment of a service-
connected disability.

 (Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)

Sec.  70.20  Application.

    (a) A claimant may apply for beneficiary travel orally or in 
writing but must provide VA the receipt for each expense other than for 
mileage.

[[Page 36800]]

    (b) A claimant must apply for payment of beneficiary travel within 
30 calendar days after completing beneficiary travel that does not 
include a special mode of transportation.
    (c) For beneficiary travel that includes a special mode of 
transportation, a claimant must apply for payment of beneficiary travel 
and obtain approval from VA prior to the travel; however, if the travel 
included a special mode of transportation and the claimant without 
prior approval applies for payment of the beneficiary travel within 30 
calendar days after the travel is completed, the application will be 
considered timely submitted if the travel was for emergency treatment.
    (d) Notwithstanding other provisions of this section, for travel 
that includes meals and/or lodging, a claimant must apply for and 
receive approval prior to obtaining the meals and/or lodging in order 
to receive payment in accordance with Sec.  70.30(a)(3) for the meals 
and/or lodging.
    (e) If VA determines that additional information is needed to make 
a determination concerning an application under this part, VA will 
notify the claimant in writing of the deficiency and request additional 
information. If the claimant has not responded to the request within 30 
days, VA may decide the claim prior to the expiration of the 1-year 
submission period required by 38 U.S.C. 5103(b)(1) based on all the 
information contained in the file, including any information it has 
obtained on behalf of the claimant. If VA does so, however, and the 
claimant subsequently provides the information within 1 year of the 
date of the request, VA must readjudicate the claim.
    (f) Notwithstanding other provisions of this section, if a person 
becomes eligible for payment of beneficiary travel after the travel 
takes place, payment may be made if the person applies for travel 
benefits within 30 days of the date when the person became eligible for 
travel benefits.
    (g) The date of an application for beneficiary travel is the 
postmark date, if mailed; or the date of submission if hand delivered, 
provided by electronic means, or provided orally.

 (Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)


(The Office of Management and Budget has approved the information 
collection provisions in this section under control number 2900-
0080.)


Sec.  70.21  Where to apply.

    Claimants for beneficiary travel must submit the information 
required in Sec.  70.20 to the Chief of the Business Office or other 
designee at the VA medical facility responsible for the medical care or 
services being provided and for which travel is required.

 (Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)

Sec.  70.30  Payment principles.

    (a) Subject to the other provisions of this section and subject to 
the deductibles required under Sec.  70.31, VA will pay the following 
for beneficiary travel by an eligible beneficiary when travel expenses 
are actually incurred:
    (1) The per mile rate established by the Secretary for the period 
of travel for use of privately owned vehicle or the actual cost for use 
of the most economical common carrier (bus, train, taxi, airplane, 
etc.), for travel to and from VA or VA-authorized health care subject 
to the following:
    (i) Travel by a privately owned vehicle for a compensation and 
pension examination that is solely for the convenience of the 
Government (e.g., repeat a laboratory test, redo a poor quality x-ray) 
may have a different per mile rate if deemed appropriate by the 
Secretary.
    (ii) Per mile payment for use of privately owned vehicle may not 
exceed the cost of such travel by public transportation (even if it is 
for the convenience of the government) unless determined to be 
medically necessary.
    (iii) Payment for a common carrier may not exceed the amount 
allowed for a privately owned vehicle unless travel by a privately 
owned vehicle is not reasonably accessible or travel by a common 
carrier is determined to be medically necessary.
    (iv) As required by law, each time the Federal government makes a 
change in mileage rates payable under 5 U.S.C. 5702 and 5704 for 
Federal employee travel by privately owned vehicle, but not less 
frequently than annually, the Secretary shall conduct an investigation 
of the actual costs of travel, including lodging and subsistence. In 
conducting the investigation, the Secretary shall consult with the 
Administrator of the General Services Administration, the Secretary of 
Transportation, the Comptroller General of the United States, and 
veterans' service organizations. As part of the investigation, the 
Secretary shall review and consider various factors including vehicle 
depreciation, State and Federal vehicle taxes and the costs of 
gasoline, oil, maintenance, accessories, parts, tires, and insurance. 
However, to the extent that the Administrator of General Services has, 
within a reasonable period of time, conducted an investigation of 
travel costs that included the factors described in this paragraph, the 
Secretary may consider that investigation in lieu of conducting a 
separate investigation with respect to the findings of those individual 
factors. The Secretary is not obligated to accept or rely on any 
conclusions of the Administrator's investigation. Based on the 
investigation required by this subsection, VA shall determine whether 
there is a need to change the mileage rates payable under paragraph (a) 
of this section. If a determination is made that a change is warranted 
the new rate(s) will be published in the notices section of the Federal 
Register. Current rate(s) can be found at https://www.va.gov/
healtheligibility/Library/pubs/BeneficiaryTravel/BeneficiaryTravel.pdf 
or by contacting the Beneficiary Travel office at the closest VA health 
care facility.
    (2) The actual cost of ferry fares, bridge tolls, road tolls, and 
tunnel tolls (supported by receipts for such expenses as required by 
Sec.  70.20(a)).
    (3) The actual cost for meals, lodging, or both, not to exceed 50 
percent of the amount allowed for government employees under 5 U.S.C. 
5702, when VA determines that an overnight stay is required. Factors VA 
may consider in making that determination include, but are not limited 
to the following:
    (i) The distance the veteran must travel.
    (ii) The time of day when VA scheduled the veteran's appointment.
    (iii) The weather conditions or congestion conditions affecting the 
travel.
    (iv) The veteran's medical condition and its impact on the ability 
to travel.
    (4) The actual cost of a special mode of transportation.
    (b) Payments under this section are subject to the following:
    (1) Except as otherwise allowed under this section, payment is 
limited to travel from the beneficiary's residence to the nearest VA 
facility where the care or services could be provided and from such VA 
facility to the beneficiary's residence.
    (2) Payment may be made for travel from the beneficiary's residence 
to the nearest non-VA facility where the care or services could be 
provided and from such facility to the beneficiary's residence if VA 
determines that it is necessary to obtain the care or services at a 
non-VA facility.
    (3) Payment may be made for travel from or to a place where the 
beneficiary is staying (if the beneficiary is not staying at the 
beneficiary's residence) but the payment may not exceed the amount that 
would be payable for travel

[[Page 36801]]

under paragraph (b)(1) or (b)(2) of this section, as applicable.
    (4) If the beneficiary's residence changed while receiving care or 
services, payment for the return trip will be for travel to the new 
residence, except that payment may not exceed the amount that would be 
allowed from the facility where the care or services could have been 
provided that is nearest to the new residence (for example, if during a 
period of care or services in Baltimore, a beneficiary changed his or 
her address from Baltimore to Detroit, payment for the return trip 
would be limited to that allowed for traveling to the new residence 
from the nearest facility to the new residence in Detroit where the 
care or services could have been provided).
    (5) If the beneficiary is in a terminal condition at a VA facility 
or other facility under VA auspices and travels to a non-VA medical 
facility for the purpose of being nearer to his or her residence, 
payment may be made for travel to the medical facility receiving the 
beneficiary for such purpose.
    (6) Payment may be made for travel from a non-VA health care 
facility where the beneficiary is receiving care or services to the 
nearest VA facility where the appropriate care or services could be 
provided.
    (7) Payment will not be made for return travel for a beneficiary 
receiving an irregular discharge.
    (8) On a case-by-case basis, payment for travel may be paid for any 
distance if it is financially favorable to the government (for example, 
payment for travel could be allowed to a more distant nursing home when 
admission to that nursing home is a prerequisite to qualify for 
community assistance that would more than offset the additional travel 
payment).
    (c) Payment for travel of an attendant under this section will be 
calculated on the same basis as for the beneficiary.
    (d) For shared travel in a privately-owned vehicle, payments are 
limited to the amount for one beneficiary (for example, if a 
beneficiary and an attendant travel in the same automobile or if two 
beneficiaries travel in the same automobile, the amount for mileage 
will be limited to the amount for one beneficiary).
    (e) Beneficiary travel will not be paid under the following 
circumstances:
    (1) The payment of the travel allowance would be counterproductive 
to the therapy being provided and such determination is recorded in the 
patient's medical records, and
    (2) The chief of the service or a designee reviewed and approved 
the determination by signature in the patient's medical record.

 (Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)

Sec.  70.31  Deductibles.

    (a) VA shall deduct an amount established by the Secretary for each 
one-way trip from the amount otherwise payable under this part for such 
one-way trip, except that:
    (1) VA shall not deduct any amounts in a calendar month after the 
completion of six one-way trips for which deductions were made in such 
calendar month, and
    (2) Whenever the Secretary adjusts the mileage rates as a result of 
the investigation described in Sec.  70.30(a)(1)(iv), the Secretary 
shall, effective on the date such mileage rate change should occur, 
adjust proportionally the deductible amount in effect at the time of 
the adjustment. If a determination is made that a change is warranted, 
the new deductible(s) will be published in the notice section of the 
Federal Register. Current deductible(s) can be found at https://
www.va.gov/healtheligibility/Library/pubs/BeneficiaryTravel/
BeneficiaryTravel.pdf or by contacting the Beneficiary Travel office at 
the closest VA health care facility.
    (b) The provisions under this section for making deductions shall 
not apply to:
    (1) Travel that includes travel by a special mode of 
transportation,
    (2) Travel to a VA facility for a scheduled compensation and 
pension examination, and
    (3) Travel by a non-veteran.
    (c) VA shall waive the deductible under this section when it would 
cause the beneficiary severe financial hardship. For purposes of this 
section, severe financial hardship occurs if the beneficiary:
    (1) Is in receipt of a VA pension;
    (2) Has income for the year prior to the year in which application 
is made pursuant to Sec.  70.20 that does not exceed the household 
income threshold determined under 38 U.S.C. 1722(a) (the current income 
thresholds can be found at https://www.va.gov/healtheligibility/Library/
pubs/VAIncomeThresholds/VAIncomeThresholds.pdf); or
    (3) Has circumstances in the year the application is made pursuant 
to Sec.  70.20 that cause his or her projected income not to exceed the 
household income threshold determined under 38 U.S.C. 1722(a).
    (d) Waivers granted under this section are valid:
    (1) Through the end of the calendar year of the application made 
pursuant to Sec.  70.20; or
    (2) Until there is a change in the beneficiary's household income 
during the calendar year of the application made pursuant to Sec.  
70.20 that results in the beneficiary no longer meeting the terms of 
paragraph (c) of this section.
    (e) A beneficiary granted a waiver under this section must promptly 
inform VA of any household income status change during the waiver 
period that results in the beneficiary no longer meeting the terms of 
paragraph (c) of this section.

 (Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)


(The Office of Management and Budget has approved the information 
collection provisions in this section under control number 2900-
0091.)


Sec.  70.32  Reimbursement or prior payment.

    (a) Payment will be made on a reimbursement basis after the travel 
has occurred, except that:
    (1) Upon completion of examination, treatment, or care, payment may 
be made before the return travel has occurred, and
    (2) In the case of travel by a person to or from a VA facility by 
special mode of transportation, VA may provide payment for beneficiary 
travel to the provider of the transportation before determining 
eligibility of such person for such payment if VA determines that the 
travel is for emergency treatment and the beneficiary or other person 
made a claim that the beneficiary is eligible for payment for the 
travel.
    (b) Payment under this part will be made to the beneficiary, except 
that VA may make a beneficiary travel payment under this part to a 
person or organization other than the beneficiary upon satisfactory 
evidence that the person or organization actually provided or paid for 
the travel.

 (Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)

Sec.  70.40  Administrative procedures.

    Upon denial of an initial claim for beneficiary travel, VA will 
provide the claimant written notice of the decision and advise the 
claimant of reconsideration and appeal rights. A claimant who disagrees 
with the initial decision denying the claim for beneficiary travel, in 
whole or in part, may obtain reconsideration under Sec.  17.133 of this 
chapter and may file an appeal to the Board of Veterans' Appeals under 
parts 19 and 20 of this chapter. An appeal may be made directly to the 
Board of Veterans' Appeals without requesting reconsideration.

 (Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)


[[Page 36802]]




Sec.  70.41  Recovery of payments.

    Payments for beneficiary travel made to persons ineligible for such 
payment are subject to recapture under applicable law, including the 
provisions of Sec. Sec.  1.900 through 1.953 of this chapter.

 (Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)

Sec.  70.42  False statements.

    A person who makes a false statement for the purpose of obtaining 
payments for beneficiary travel may be prosecuted under applicable 
laws, including 18 U.S.C. 1001.

(Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)

Sec.  70.50  Reduced fare requests.

    Printed reduced-fare requests for use by eligible beneficiaries and 
their attendants when traveling at their own expense to or from any VA 
facility or VA-authorized facility for authorized VA health care are 
available from any VA medical facility. Beneficiaries may use these 
request forms to ask transportation providers, such as bus companies, 
for a reduced fare. Whether to grant a reduced fare is determined by 
the transportation provider.

(Authority: 38 U.S.C. 101, 111, 501, 1701, 1714, 1720, 1728, 1782, 
1783, E.O. 11302)


 [FR Doc. E8-14722 Filed 6-27-08; 8:45 am]
BILLING CODE 8320-01-P