Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA): Expansion of Benefit Coverage for Prostheses and Enuretic (Bed-Wetting) Devices; Miscellaneous Provisions, 65552-65553 [E8-26245]
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dwashington3 on PRODPC61 with RULES
65552
Federal Register / Vol. 73, No. 214 / Tuesday, November 4, 2008 / Rules and Regulations
highest percentage of products the
purchaser intends to produce or have
produced from the sale. Purchasers
seeking a change of index at time of
award must substantiate the need for an
alternative index by providing the
Contracting Officer with a written
request that includes a list of products
by volume the purchaser intends to
produce or expects will be produced
from the timber on that sale. In the
event a mutual agreement to modify a
contract to include an alternative index
is not reached at time of contract
execution, the index specified in the
sample contract shall apply.
(3) A market-related contract term
addition provision shall not be included
in contracts where the primary
management objective requires prompt
removal of the timber, such as, timber
is subject to rapid deterioration, timber
is in a wildland-urban interface area, or
hazard trees adjacent to developed sites.
*
*
*
*
*
(c) * * *
(1) Additional contract time may not
be granted for those portions of the
contract:
(i) With a required completion date;
(ii) Where the Forest Service
determines that the timber is in need of
urgent removal;
(iii) Where timber deterioration or
resource damage may result from delay;
or
(iv) Where included timber is
designated by diameter and delay may
change the treatment as a result of trees
growing into or out of the specified
diameter range(s).
(2) For each additional consecutive
quarter in which a contract qualifies for
market-related contract term addition,
the Forest Service will, upon the
purchaser’s written request, add an
additional 3 months during the normal
operating season to the contract, except
that no single 3-month addition shall
extend the term of a contract by more
than 1 year.
(3) No more than 3 years shall be
added to a contract’s term by marketrelated contract term addition unless the
following conditions are met:
(i) The sale was awarded after
December 31, 2006;
(ii) A drastic reduction in wood
product prices occurred in at least ten
of twelve consecutive quarters during
the contract term, but not including the
quarter in which the contract was
awarded; and
(4) For each qualifying quarter
meeting the criteria in paragraph
(c)(3)(ii) of this section, the Forest
Service will, upon the purchaser’s
written request, add an additional 3
VerDate Aug<31>2005
15:01 Nov 03, 2008
Jkt 217001
months during the normal operating
season to the contract, except no single
3-month addition shall extend the term
of a contract by more than 1 year.
(5) In no event shall a revised contract
term exceed 10 years as a result of
market-related contract term addition.
*
*
*
*
*
Dated: October 24, 2008.
Mark Rey,
Under Secretary, Natural Resources and
Environment.
[FR Doc. E8–26203 Filed 11–3–08; 8:45 am]
BILLING CODE 3410–11–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 17
RIN 2900–AM22
Civilian Health and Medical Program of
the Department of Veterans Affairs
(CHAMPVA): Expansion of Benefit
Coverage for Prostheses and Enuretic
(Bed-Wetting) Devices; Miscellaneous
Provisions
Department of Veterans Affairs.
Final rule.
AGENCY:
ACTION:
SUMMARY: This document adopts a final
rule amending the Department of
Veterans Affairs (VA) medical
regulations for the Civilian Health and
Medical Program of the Department of
Veterans Affairs (CHAMPVA) to expand
benefits by covering any non-dental
prostheses determined medically
necessary for the treatment of certain
medical conditions and by removing the
exclusion from coverage of enuretic
(bed-wetting) devices. In addition, this
final rule makes changes in delegations
of authority, technical changes, and
nonsubstantive changes for purposes of
clarity in VA’s regulations governing
CHAMPVA.
Effective Date: This final rule is
effective December 4, 2008.
FOR FURTHER INFORMATION CONTACT:
Richard M. Trabert, Policy Management
Division, VA Health Administration
Center, P.O. Box 65020, Denver, CO
80206–9020; (303) 331–7549. (This is
not a toll-free number.)
SUPPLEMENTARY INFORMATION: In a
document published in the Federal
Register on February 19, 2008 (73 FR
9068), VA proposed to amend its
medical regulations at 38 CFR part 17
concerning CHAMPVA benefits.
Specifically, it proposed to extend
prosthetic coverage to any prostheses
(other than dental prostheses)
considered medically necessary because
DATES:
PO 00000
Frm 00058
Fmt 4700
Sfmt 4700
of significant conditions resulting from
trauma, congenital anomalies, or
disease. Also, it proposed to remove the
exclusion of enuretic (bed-wetting)
devices (alarms) but would continue to
exclude enuretic conditioning programs.
Additionally, the document proposed to
amend the delegations of authority in 38
CFR 17.275, Claim filing deadline, and
38 CFR 17.276, Appeal/review process.
Finally, the document proposed to make
technical and other nonsubstantive
changes for purposes of clarity,
including to conform with Public Law
107–135, which redesignated the
statutory section authorizing the
CHAMPVA program as 38 U.S.C. 1781
(formerly 38 U.S.C. 1713). VA provided
a 60-day comment period that ended
April 19, 2008. VA received no
comments. 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 for a
technical change regarding the authority
citation for 38 CFR part 17.
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
year. This final rule would have no such
effect on State, local, and tribal
governments, or on the private sector.
Paperwork Reduction Act of 1995
This document contains no provisions
constituting a new collection of
information under the Paperwork
Reduction Act of 1995 (44 U.S.C. 3501–
3521).
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 rule as a
‘‘significant regulatory action’’ requiring
review by Office of Management and
Budget (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,
E:\FR\FM\04NOR1.SGM
04NOR1
Federal Register / Vol. 73, No. 214 / Tuesday, November 4, 2008 / Rules and Regulations
competition, jobs, the environment,
public health or safety, or State, local,
or tribal government 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 final rule have been
examined and it has been determined
not to be a significant regulatory action
under Executive Order 12866.
The Secretary of Veterans Affairs
hereby certifies that this final 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. 601–612.
Individuals eligible for CHAMPVA
benefits are widely dispersed
geographically and thus services
provided to them would not have a
significant impact on any small entity.
Therefore, pursuant to 5 U.S.C. 605(b),
this final rule is exempt from the initial
and final regulatory flexibility analysis
requirements of sections 603 and 604.
Catalog of Federal Domestic Assistance
This final rule affects the Civilian
Health and Medical Program of the
Department of Veterans Affairs
(CHAMPVA), for which there is no
Catalog of Federal Domestic Assistance
program number.
dwashington3 on PRODPC61 with RULES
■
1. Revise the authority citation for part
17 to read as follows:
■
Authority: 38 U.S.C. 501, 1721, and as
noted in specific sections.
§ 17.274
2. Amend § 17.270 by:
a. In paragraph (a), removing ‘‘1713’’
and adding, in its place, ‘‘1781’’.
■ b. In paragraph (b), removing ‘‘this
section’’ and adding, in its place,
‘‘§§ 17.270 through 17.278’’, removing
‘‘fiscal’’ year refers to October 1’’, and
adding, in its place, ‘‘fiscal year’’ refers
to October 1’’.
■ c. Revising the authority citation.
The revision reads as follows:
■
■
§ 17.270
*
*
General provisions.
*
*
*
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
facilities, Health professionals, Health
records, Homeless, Medical and dental
schools, Medical devices, Medical
research, Mental health programs,
Nursing homes, Philippines, Reporting
and recordkeeping requirements, Travel
and transportation expenses, and
Veterans.
Approved: October 28, 2008.
Gordon H. Mansfield,
Deputy Secretary of Veterans Affairs.
For the reasons stated above, VA
amends 38 CFR part 17 as follows:
■
Jkt 217001
6. Amend § 17.274 by revising the
authority citation to read as follows:
*
*
Cost sharing.
*
*
*
(Authority: 38 U.S.C. 501, 1781)
7. Amend § 17.275 by:
a. In paragraph (b), removing ‘‘Center
Director’’ and adding, in its place,
‘‘Director, Health Administration
Center, or his or her designee’’; and
removing ‘‘paragraph (a) if’’ and adding,
in its place, ‘‘paragraph (a) of this
section if’’.
■ b. Adding an authority citation at the
end of the section.
The addition reads as follows:
■
■
3. Amend § 17.271 by revising the
authority citations after paragraph (a)
and at the end of the section to read as
follows:
§ 17.275
§ 17.271
■
■
*
*
Claim filing deadline.
*
*
*
(Authority: 38 U.S.C. 501, 1781)
(Authority: 38 U.S.C. 501, 1781)
4. Amend § 17.272 by:
a. Redesignating paragraphs (a)(44)(i)
through (a)(44)(iv) as paragraphs
(a)(44)(ii)(A) through (D), respectively.
■ b. Redesignating paragraph (a)(44)(v)
as new paragraph (a)(44)(i).
■ c. Adding paragraphs (a)(44)(ii)
introductory text and (a)(44)(ii)(E).
■ d. Revising paragraph (a)(52) and the
authority citation.
The additions and revisions read as
follows:
8. Amend § 17.276 by:
a. Removing ‘‘Center Director’’ and
‘‘Director’’ each time they appear and
adding, in their place, ‘‘Director, Health
Administration Center, or his or her
designee’’.
■ b. Revising the authority citation.
■ c. In the Note, removing ‘‘20 CFR’’ and
adding, in its place ‘‘38 CFR’’.
The revision reads as follows:
§ 17.276
Eligibility.
(a) * * *
■
(Authority: 38 U.S.C. 501, 1781)
*
*
*
*
*
■
■
§ 17.272
List of Subjects in 38 CFR Part 17
15:01 Nov 03, 2008
(Authority: 38 U.S.C. 501, 1781)
(Authority: 38 U.S.C. 501, 1781)
Regulatory Flexibility Act
VerDate Aug<31>2005
PART 17—MEDICAL
65553
Benefits limitations/exclusions.
(a) * * *
(44) * * *
(ii) Any prostheses, other than dental
prostheses, determined to be medically
necessary because of significant
conditions resulting from trauma,
congenital anomalies, or disease,
including, but not limited to:
*
*
*
*
*
(E) Ears, noses, and fingers.
*
*
*
*
*
(52) Enuretic (bed-wetting)
conditioning programs.
*
*
*
*
*
*
*
Appeal/review process.
*
*
*
(Authority: 38 U.S.C. 501, 1781)
*
*
*
*
*
9. Amend § 17.277 by adding an
authority citation to read as follows:
■
§ 17.277 Third-party liability/medical care
cost recovery.
*
*
*
*
*
(Authority: 28 U.S.C. 2651; 38 U.S.C. 501,
1781)
10. Amend § 17.278 by adding an
authority citation to read as follows:
■
§ 17.278
*
*
Confidentiality of records.
*
*
*
(Authority: 5 U.S.C. 552, 552a; 38 U.S.C. 501,
1781, 5701, 7332)
(Authority: 38 U.S.C. 501, 1781)
[FR Doc. E8–26245 Filed 11–3–08; 8:45 am]
5. Amend § 17.273 by revising the
authority citation to read as follows:
BILLING CODE 8320–01–P
■
§ 17.273
*
PO 00000
*
Preauthorization.
*
Frm 00059
*
Fmt 4700
*
Sfmt 4700
E:\FR\FM\04NOR1.SGM
04NOR1
]]>Agencies
[Federal Register Volume 73, Number 214 (Tuesday, November 4, 2008)]
[Rules and Regulations]
[Pages 65552-65553]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-26245]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 17
RIN 2900-AM22
Civilian Health and Medical Program of the Department of Veterans
Affairs (CHAMPVA): Expansion of Benefit Coverage for Prostheses and
Enuretic (Bed-Wetting) Devices; Miscellaneous Provisions
AGENCY: Department of Veterans Affairs.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: This document adopts a final rule amending the Department of
Veterans Affairs (VA) medical regulations for the Civilian Health and
Medical Program of the Department of Veterans Affairs (CHAMPVA) to
expand benefits by covering any non-dental prostheses determined
medically necessary for the treatment of certain medical conditions and
by removing the exclusion from coverage of enuretic (bed-wetting)
devices. In addition, this final rule makes changes in delegations of
authority, technical changes, and nonsubstantive changes for purposes
of clarity in VA's regulations governing CHAMPVA.
DATES: Effective Date: This final rule is effective December 4, 2008.
FOR FURTHER INFORMATION CONTACT: Richard M. Trabert, Policy Management
Division, VA Health Administration Center, P.O. Box 65020, Denver, CO
80206-9020; (303) 331-7549. (This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: In a document published in the Federal
Register on February 19, 2008 (73 FR 9068), VA proposed to amend its
medical regulations at 38 CFR part 17 concerning CHAMPVA benefits.
Specifically, it proposed to extend prosthetic coverage to any
prostheses (other than dental prostheses) considered medically
necessary because of significant conditions resulting from trauma,
congenital anomalies, or disease. Also, it proposed to remove the
exclusion of enuretic (bed-wetting) devices (alarms) but would continue
to exclude enuretic conditioning programs. Additionally, the document
proposed to amend the delegations of authority in 38 CFR 17.275, Claim
filing deadline, and 38 CFR 17.276, Appeal/review process. Finally, the
document proposed to make technical and other nonsubstantive changes
for purposes of clarity, including to conform with Public Law 107-135,
which redesignated the statutory section authorizing the CHAMPVA
program as 38 U.S.C. 1781 (formerly 38 U.S.C. 1713). VA provided a 60-
day comment period that ended April 19, 2008. VA received no comments.
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 for a technical change regarding the
authority citation for 38 CFR part 17.
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 year. This final rule would have no such effect on
State, local, and tribal governments, or on the private sector.
Paperwork Reduction Act of 1995
This document contains no provisions constituting a new collection
of information under the Paperwork Reduction Act of 1995 (44 U.S.C.
3501-3521).
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 rule as a ``significant regulatory action''
requiring review by Office of Management and Budget (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,
[[Page 65553]]
competition, jobs, the environment, public health or safety, or State,
local, or tribal government 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 final rule have been examined and it has been
determined not to be a significant regulatory action under Executive
Order 12866.
Regulatory Flexibility Act
The Secretary of Veterans Affairs hereby certifies that this final
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. 601-612. Individuals eligible for CHAMPVA
benefits are widely dispersed geographically and thus services provided
to them would not have a significant impact on any small entity.
Therefore, pursuant to 5 U.S.C. 605(b), this final rule is exempt from
the initial and final regulatory flexibility analysis requirements of
sections 603 and 604.
Catalog of Federal Domestic Assistance
This final rule affects the Civilian Health and Medical Program of
the Department of Veterans Affairs (CHAMPVA), for which there is no
Catalog of Federal Domestic Assistance program number.
List of Subjects in 38 CFR Part 17
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 facilities, Health professionals, Health records, Homeless,
Medical and dental schools, Medical devices, Medical research, Mental
health programs, Nursing homes, Philippines, Reporting and
recordkeeping requirements, Travel and transportation expenses, and
Veterans.
Approved: October 28, 2008.
Gordon H. Mansfield,
Deputy Secretary of Veterans Affairs.
0
For the reasons stated above, VA amends 38 CFR part 17 as follows:
PART 17--MEDICAL
0
1. Revise the authority citation for part 17 to read as follows:
Authority: 38 U.S.C. 501, 1721, and as noted in specific
sections.
0
2. Amend Sec. 17.270 by:
0
a. In paragraph (a), removing ``1713'' and adding, in its place,
``1781''.
0
b. In paragraph (b), removing ``this section'' and adding, in its
place, ``Sec. Sec. 17.270 through 17.278'', removing ``fiscal'' year
refers to October 1'', and adding, in its place, ``fiscal year'' refers
to October 1''.
0
c. Revising the authority citation.
The revision reads as follows:
Sec. 17.270 General provisions.
* * * * *
(Authority: 38 U.S.C. 501, 1781)
0
3. Amend Sec. 17.271 by revising the authority citations after
paragraph (a) and at the end of the section to read as follows:
Sec. 17.271 Eligibility.
(a) * * *
(Authority: 38 U.S.C. 501, 1781)
* * * * *
(Authority: 38 U.S.C. 501, 1781)
0
4. Amend Sec. 17.272 by:
0
a. Redesignating paragraphs (a)(44)(i) through (a)(44)(iv) as
paragraphs (a)(44)(ii)(A) through (D), respectively.
0
b. Redesignating paragraph (a)(44)(v) as new paragraph (a)(44)(i).
0
c. Adding paragraphs (a)(44)(ii) introductory text and (a)(44)(ii)(E).
0
d. Revising paragraph (a)(52) and the authority citation.
The additions and revisions read as follows:
Sec. 17.272 Benefits limitations/exclusions.
(a) * * *
(44) * * *
(ii) Any prostheses, other than dental prostheses, determined to be
medically necessary because of significant conditions resulting from
trauma, congenital anomalies, or disease, including, but not limited
to:
* * * * *
(E) Ears, noses, and fingers.
* * * * *
(52) Enuretic (bed-wetting) conditioning programs.
* * * * *
(Authority: 38 U.S.C. 501, 1781)
0
5. Amend Sec. 17.273 by revising the authority citation to read as
follows:
Sec. 17.273 Preauthorization.
* * * * *
(Authority: 38 U.S.C. 501, 1781)
0
6. Amend Sec. 17.274 by revising the authority citation to read as
follows:
Sec. 17.274 Cost sharing.
* * * * *
(Authority: 38 U.S.C. 501, 1781)
0
7. Amend Sec. 17.275 by:
0
a. In paragraph (b), removing ``Center Director'' and adding, in its
place, ``Director, Health Administration Center, or his or her
designee''; and removing ``paragraph (a) if'' and adding, in its place,
``paragraph (a) of this section if''.
0
b. Adding an authority citation at the end of the section.
The addition reads as follows:
Sec. 17.275 Claim filing deadline.
* * * * *
(Authority: 38 U.S.C. 501, 1781)
0
8. Amend Sec. 17.276 by:
0
a. Removing ``Center Director'' and ``Director'' each time they appear
and adding, in their place, ``Director, Health Administration Center,
or his or her designee''.
0
b. Revising the authority citation.
0
c. In the Note, removing ``20 CFR'' and adding, in its place ``38
CFR''.
The revision reads as follows:
Sec. 17.276 Appeal/review process.
* * * * *
(Authority: 38 U.S.C. 501, 1781)
* * * * *
0
9. Amend Sec. 17.277 by adding an authority citation to read as
follows:
Sec. 17.277 Third-party liability/medical care cost recovery.
* * * * *
(Authority: 28 U.S.C. 2651; 38 U.S.C. 501, 1781)
0
10. Amend Sec. 17.278 by adding an authority citation to read as
follows:
Sec. 17.278 Confidentiality of records.
* * * * *
(Authority: 5 U.S.C. 552, 552a; 38 U.S.C. 501, 1781, 5701, 7332)
[FR Doc. E8-26245 Filed 11-3-08; 8:45 am]
BILLING CODE 8320-01-P
