TRICARE: Changes Included in the National Defense Authorization Act for Fiscal Year 2007; Improvements to Descriptions of Cancer Screening for Women, 47460-47461 [2010-19307]
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47460
Federal Register / Vol. 75, No. 151 / Friday, August 6, 2010 / Rules and Regulations
condition: For example, educational
counseling, vocational counseling,
nutritional counseling, and counseling
for socioeconomic purposes, stress
management, lifestyle modification.
Services provided by a certified
marriage and family therapist, pastoral,
or mental health counselor in the
treatment of a mental disorder are
covered only as specifically provided in
Section 199.6. Services provided by
alcoholism rehabilitation counselors are
covered only when rendered in a
CHAMPUS-authorized treatment setting
and only when the cost of those services
is included in the facility’s CHAMPUSdetermined allowable cost rate.
*
*
*
*
*
■ 3. Section 199.6 is amended by adding
paragraphs (c)(3)(iii)(L) and (M) to read
as follows:
§ 199.6
TRICARE-authorized providers.
*
*
*
*
*
(c) * * *
(3) * * *
(iii) * * *
(L) Nutritionist. A nutritionist may
provide DSMT via an accredited DSMT
program. The nutritionist must be
licensed by the State in which the care
is provided, and must be under the
supervision of a physician who is
overseeing the DSMT program.
(M) Registered Dietitian. A dietitian
may provide DSMT via an accredited
DSMT program. The dietitian must be
licensed by the State in which the care
is provided, and must be under the
supervision of a physician who is
overseeing the DSMT program.
*
*
*
*
*
Dated: July 26, 2010.
Patricia L. Toppings,
OSD Federal Register Liaison Officer,
Department of Defense.
[FR Doc. 2010–19311 Filed 8–5–10; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
[DOD–2008–HA–0025; 0720–AB20]
erowe on DSK5CLS3C1PROD with RULES
32 CFR Part 199
TRICARE: Changes Included in the
National Defense Authorization Act for
Fiscal Year 2007; Improvements to
Descriptions of Cancer Screening for
Women
Office of the Secretary, DoD.
Final rule.
AGENCY:
ACTION:
The Department is publishing
this final rule to implement section 703
SUMMARY:
VerDate Mar<15>2010
14:05 Aug 05, 2010
Jkt 220001
of the National Defense Authorization
Act (NDAA) for Fiscal Year 2007
(FY07), Public Law 109–364.
Specifically, that legislation authorizes
breast cancer screening and cervical
cancer screening for female beneficiaries
of the Military Health System, instead of
constraining such testing to
mammograms and Papanicolaou smears.
The rule allows coverage for ‘‘breast
cancer screening’’ and ‘‘cervical cancer
screening’’ for female beneficiaries of the
Military Health System, instead of
constraining such testing to
mammograms and Papanicolaou tests.
This rule ensures new breast and
cervical cancer screening procedures
can be added to the TRICARE benefit as
such procedures are proven to be a safe,
effective, and nationally accepted
medical practice. This amends the
cancer specific recommendations for
breast and cervical cancer screenings to
be brought in line with the processes for
updating other cancer screening
recommendations. In response to public
comment on the proposed rule, this
final rule includes a clarification that
the benefit encompasses screening
based on Health and Human Services
guidelines.
DATES: Effective Date: This rule is
effective September 7, 2010.
FOR FURTHER INFORMATION CONTACT:
Commander James Ellzy, Office of the
Chief Medical Officer, TRICARE
Management Activity, telephone (703)
681–0064.
SUPPLEMENTARY INFORMATION:
A. Background
The Department of Defense updated
coverage for screening with the use of
the breast MRI for women in a
designated high risk category as advised
by the American Cancer Society. In the
process of providing this additional
coverage, it was discovered that because
of statutory wording, there was a group
of high risk women that are standard
beneficiaries under the age of 35 for
whom this coverage could not be
provided without an amendment in the
Code of Federal Regulations (CFR).
Amending the CFR will provide
coverage for breast MRI screening for all
Department of Defense beneficiaries in
the high risk category recommended by
the American Cancer Society.
B. Public Comments
The Department of Defense published
a proposed rule on July 24, 2009 (74 FR
36638–36639). A single comment was
received asking that the language be
written more clearly. The final rule
includes language in section (g)(37)(viii)
that is more precise in terms of which
PO 00000
Frm 00026
Fmt 4700
Sfmt 4700
cancers will be covered and notes that
cervical and breast cancer screenings
will be provided in accordance with the
standards based on the guidelines from
the U.S. Department of Health and
Human Services.
C. Regulatory Procedures
Executive Order (EO) 12866 and
Regulatory Flexibility Act
E.O. 12866 requires 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 each
Federal agency prepare, and make
available for public comment, a
regulatory flexibility analysis when the
agency issues a regulation that 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, although not
economically significant, is a significant
rule under E.O. 12866 and has been
reviewed by the Office of Management
and Budget. Amending the CFR will
provide coverage for breast MRI
screening for all Department of Defense
beneficiaries in the high risk category, if
necessary. It is critically important that
we eliminate any potential gaps in
coverage for high risk individuals as
quickly as possible.
Paperwork Reduction Act
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).
Unfunded Mandates Reform Act
It has been certified that this rule does
not contain a Federal mandate that may
result in the expenditure by State, local
and tribunal governments, in aggregate,
or by the private section, of $100
million or more in any one year.
Executive Order (EO) 13132
We have examined the impact(s) of
the final rule under E.O. 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
E:\FR\FM\06AUR1.SGM
06AUR1
Federal Register / Vol. 75, No. 151 / Friday, August 6, 2010 / Rules and Regulations
levels of government, therefore,
consultation with State and local
officials is not required.
DEPARTMENT OF HOMELAND
SECURITY
Coast Guard
List of Subjects in 32 CFR Part 199
33 CFR Part 117
Claims, Dental Health, Health care,
Health insurance, Individuals with
disabilities, Military personnel.
[USCG–2009–0754]
RIN 1625–AA09
Accordingly, 32 CFR, Part 199 is
amended as follows:
■
Drawbridge Operation Regulation;
Elizabeth River, Eastern Branch,
Norfolk, VA
PART 199—CIVILIAN HEALTH AND
MEDICAL PROGRAM OF THE
UNIFORMED SERVICES
ACTION:
1. The authority citation for Part 199
continues to read as follows:
■
2. Section 199.4 is amended by:
A. Revising paragraphs (g)(37)(viii)
and (ix).
■ B. Redesignating paragraphs (g)(37)(x)
through (g)(37)(xii) as (g)(37)(xi) through
(g)(37)(xiii).
■ C. Adding a new paragraph (g)(37)(x).
The revisions and additions read as
follows:
■
■
Basic program benefits.
*
*
*
*
(g) * * *
(37) * * *
(viii) Cervical and breast cancer
screenings in accordance with standards
issued by the Director, TRICARE
Management Activity, based on
guidelines from the U.S. Department of
Health and Human Services. Such
standards may establish a specific
schedule, including frequency, age
specifications, and gender of the
beneficiary, as appropriate.
(ix) Health promotion and disease
prevention visits may include all of the
services provided pursuant to
§ 199.18(b)(2) and may be provided in
connection with immunizations and
cancer screening examinations
authorized by paragraphs (g)(37)(ii) or
(g)(37)(viii) of this section.
(x) Physical examinations for
beneficiaries ages 5–11 that are required
in connection with school enrollment,
and that are provided on or after
October 30, 2000.
*
*
*
*
*
erowe on DSK5CLS3C1PROD with RULES
*
Dated: July 26, 2010.
Patricia L. Toppings,
OSD Federal Register Liaison Officer,
Department of Defense.
[FR Doc. 2010–19307 Filed 8–5–10; 8:45 am]
BILLING CODE 5001–06–P
VerDate Mar<15>2010
14:05 Aug 05, 2010
Jkt 220001
The Coast Guard is
temporarily changing the drawbridge
operation regulations of the Berkley
(I–264) Bridge, at mile 0.4, across the
Eastern Branch of the Elizabeth River,
Norfolk, VA. This change will allow the
drawbridge to operate with four opening
periods between the rush hours until
October 5, 2012, relieving increased
vehicular traffic congestion while still
providing for the reasonable needs of
navigation.
SUMMARY:
Authority: 5 U.S.C. 301; 10 U.S.C., chapter
55.
§ 199.4
Coast Guard, DHS.
Final rule.
AGENCY:
This rule is effective from 9 a.m.
on September 4, 2010, until 2:30 p.m.
on October 5, 2012.
ADDRESSES: Comments and related
materials received from the public, as
well as documents mentioned in this
preamble as being available in the
docket, are part of docket USCG–2009–
0754 and are available online by going
to https://www.regulations.gov, inserting
USCG–2009–0754 in the ‘‘Keyword’’
box, and clicking ‘‘Search.’’ This
material is also available for inspection
or copying at the Docket Management
Facility (M–30), U.S. Department of
Transportation, West Building Ground
Floor, Room W12–140, 1200 New Jersey
Avenue, SE., Washington, DC 20590,
between 9 a.m. and 5 p.m., Monday
through Friday, except Federal holidays.
FOR FURTHER INFORMATION CONTACT: If
you have questions on this rule, call
Terrance Knowles, Environmental
Protection Specialist, Fifth Coast Guard
District, at 757–398–6587. If you have
questions on viewing the docket, call
Renee V. Wright, Program Manager,
Docket Operations, telephone 202–366–
9826.
SUPPLEMENTARY INFORMATION:
DATES:
Regulatory Information
On October 9, 2009, we published a
notice of temporary deviation request
for comments entitled ‘‘Drawbridge
Operation Regulations; Elizabeth River,
Eastern Branch, Norfolk, VA’’ in the
Federal Register (74 FR 52143) and a
notice of proposed rulemaking (NPRM)
PO 00000
Frm 00027
Fmt 4700
Sfmt 4700
47461
entitled ‘‘Drawbridge Operation
Regulations; Elizabeth River, Eastern
Branch, Norfolk, VA’’ in the Federal
Register (74 FR 52158). We received 861
comments on the published deviation
and NPRM.
On March 3, 2010, we published
another notice of temporary deviation
request for comments entitled
‘‘Drawbridge Operation Regulations;
Elizabeth River, Eastern Branch,
Norfolk, VA’’ in the Federal Register (75
FR 9521) and a supplemental notice of
proposed rulemaking (SNPRM) entitled
‘‘Drawbridge Operation Regulations;
Elizabeth River, Eastern Branch,
Norfolk, VA’’ in the Federal Register (75
FR 9557). We received four comments
on the published deviation and SNPRM.
No public meeting was requested, and
none was held.
Background and Purpose
On behalf of the Cities of Chesapeake
and Norfolk Virginia, the Virginia
Department of Transportation (VDOT)
who owns and operates the lift-type
Berkley Bridge requested a temporary
change to the existing bridge
regulations. In the closed to navigation
position, the Berkley Bridge has a
vertical clearance of 48 feet above mean
high water. The current regulation set
out in Title 33 CFR Part 117.1007(b) and
(c) allows the Berkley Bridge, mile 0.4,
in Norfolk, Virginia to remain closed
one hour prior to the published start of
a scheduled marine event regulated
under § 100.501, and remain closed
until one hour following the completion
of the event unless the Patrol
Commander designated under § 100.501
allows the bridge to open for
commercial vessel traffic. In addition,
the bridge shall open on signal any time
except from 5 a.m. to 9 a.m. and from
3 p.m. to 7 p.m., Monday through
Friday, except Federal holidays, and
shall open at any time for vessels with
a draft of 18 feet or more, provided that
at least 6 hours advance notice has been
given to the Berkley Bridge Traffic
Control Room at (757) 494–2490, as
required by 33 CFR 117.1007(b) and (c).
Vessel traffic on this waterway consists
of pleasure craft, tug and barge traffic,
and ships with assist tugs seeking
repairs. There is no alternate waterway
route.
Due to a temporary closure of two
area bridges, there has been a significant
increase in vehicular traffic on the
Berkley Bridge causing back-ups,
delays, and congestion on the bridge
and its approaches. The NPRM
proposed opening the draw of the
Berkley Bridge on signal at 9 a.m.,
11 a.m., 1 p.m., and 2:30 p.m. from
October 9, 2009 to October 5, 2012, and
E:\FR\FM\06AUR1.SGM
06AUR1
]]>Agencies
[Federal Register Volume 75, Number 151 (Friday, August 6, 2010)]
[Rules and Regulations]
[Pages 47460-47461]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-19307]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
[DOD-2008-HA-0025; 0720-AB20]
32 CFR Part 199
TRICARE: Changes Included in the National Defense Authorization
Act for Fiscal Year 2007; Improvements to Descriptions of Cancer
Screening for Women
AGENCY: Office of the Secretary, DoD.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: The Department is publishing this final rule to implement
section 703 of the National Defense Authorization Act (NDAA) for Fiscal
Year 2007 (FY07), Public Law 109-364. Specifically, that legislation
authorizes breast cancer screening and cervical cancer screening for
female beneficiaries of the Military Health System, instead of
constraining such testing to mammograms and Papanicolaou smears. The
rule allows coverage for ``breast cancer screening'' and ``cervical
cancer screening'' for female beneficiaries of the Military Health
System, instead of constraining such testing to mammograms and
Papanicolaou tests. This rule ensures new breast and cervical cancer
screening procedures can be added to the TRICARE benefit as such
procedures are proven to be a safe, effective, and nationally accepted
medical practice. This amends the cancer specific recommendations for
breast and cervical cancer screenings to be brought in line with the
processes for updating other cancer screening recommendations. In
response to public comment on the proposed rule, this final rule
includes a clarification that the benefit encompasses screening based
on Health and Human Services guidelines.
DATES: Effective Date: This rule is effective September 7, 2010.
FOR FURTHER INFORMATION CONTACT: Commander James Ellzy, Office of the
Chief Medical Officer, TRICARE Management Activity, telephone (703)
681-0064.
SUPPLEMENTARY INFORMATION:
A. Background
The Department of Defense updated coverage for screening with the
use of the breast MRI for women in a designated high risk category as
advised by the American Cancer Society. In the process of providing
this additional coverage, it was discovered that because of statutory
wording, there was a group of high risk women that are standard
beneficiaries under the age of 35 for whom this coverage could not be
provided without an amendment in the Code of Federal Regulations (CFR).
Amending the CFR will provide coverage for breast MRI screening for all
Department of Defense beneficiaries in the high risk category
recommended by the American Cancer Society.
B. Public Comments
The Department of Defense published a proposed rule on July 24,
2009 (74 FR 36638-36639). A single comment was received asking that the
language be written more clearly. The final rule includes language in
section (g)(37)(viii) that is more precise in terms of which cancers
will be covered and notes that cervical and breast cancer screenings
will be provided in accordance with the standards based on the
guidelines from the U.S. Department of Health and Human Services.
C. Regulatory Procedures
Executive Order (EO) 12866 and Regulatory Flexibility Act
E.O. 12866 requires 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 each Federal agency prepare,
and make available for public comment, a regulatory flexibility
analysis when the agency issues a regulation that 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, although not economically significant,
is a significant rule under E.O. 12866 and has been reviewed by the
Office of Management and Budget. Amending the CFR will provide coverage
for breast MRI screening for all Department of Defense beneficiaries in
the high risk category, if necessary. It is critically important that
we eliminate any potential gaps in coverage for high risk individuals
as quickly as possible.
Paperwork Reduction Act
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).
Unfunded Mandates Reform Act
It has been certified that this rule does not contain a Federal
mandate that may result in the expenditure by State, local and tribunal
governments, in aggregate, or by the private section, of $100 million
or more in any one year.
Executive Order (EO) 13132
We have examined the impact(s) of the final rule under E.O. 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
[[Page 47461]]
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
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:
0
A. Revising paragraphs (g)(37)(viii) and (ix).
0
B. Redesignating paragraphs (g)(37)(x) through (g)(37)(xii) as
(g)(37)(xi) through (g)(37)(xiii).
0
C. Adding a new paragraph (g)(37)(x).
The revisions and additions read as follows:
Sec. 199.4 Basic program benefits.
* * * * *
(g) * * *
(37) * * *
(viii) Cervical and breast cancer screenings in accordance with
standards issued by the Director, TRICARE Management Activity, based on
guidelines from the U.S. Department of Health and Human Services. Such
standards may establish a specific schedule, including frequency, age
specifications, and gender of the beneficiary, as appropriate.
(ix) Health promotion and disease prevention visits may include all
of the services provided pursuant to Sec. 199.18(b)(2) and may be
provided in connection with immunizations and cancer screening
examinations authorized by paragraphs (g)(37)(ii) or (g)(37)(viii) of
this section.
(x) Physical examinations for beneficiaries ages 5-11 that are
required in connection with school enrollment, and that are provided on
or after October 30, 2000.
* * * * *
Dated: July 26, 2010.
Patricia L. Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2010-19307 Filed 8-5-10; 8:45 am]
BILLING CODE 5001-06-P
