Authorization for Non-VA Medical Services, 70967-70969 [2012-28776]
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Federal Register / Vol. 77, No. 229 / Wednesday, November 28, 2012 / Proposed Rules
not consider the use of voluntary
consensus standards.
14. Environment
We have analyzed this proposed rule
under Department of Homeland
Security Management Directive 023–01
and Commandant Instruction
M16475.lD, which guide the Coast
Guard in complying with the National
Environmental Policy Act of 1969
(NEPA) (42 U.S.C. 4321–4370f), and
have made a preliminary determination
that this action is one of a category of
actions that do not individually or
cumulatively have a significant effect on
the human environment. This proposed
rule involves establishing a temporary
security zone. This rule is categorically
excluded from further review under
paragraph 34(g) of Figure 2–1 of the
Commandant Instruction. A preliminary
environmental analysis checklist
supporting this determination and a
Categorical Exclusion Determination are
available in the docket where indicated
under ADDRESSES. We seek any
comments or information that may lead
to the discovery of a significant
environmental impact from this
proposed rule.
List of Subjects in 33 CFR Part 165
Harbors, Marine safety, Navigation
(water), Reporting and recordkeeping
requirements, Security measures,
Waterways.
For the reasons discussed in the
preamble, the Coast Guard proposes to
amend 33 CFR part 165 as follows:
PART 165—REGULATED NAVIGATION
AREAS AND LIMITED ACCESS AREAS
1. The authority citation for part 165
continues to read as follows:
Authority: 33 U.S.C. 1231; 46 U.S.C.
Chapter 701, 3306, 3703; 50 U.S.C. 191, 195;
33 CFR 1.05–1, 6.04–1, 6.04–6, and 160.5;
Pub. L. 107–295, 116 Stat. 2064; Department
of Homeland Security Delegation No. 0170.1.
2. Add § 165.T05–0938 to read as
follows:
erowe on DSK2VPTVN1PROD with
§ 165.0938 Security Zone, Potomac and
Anacostia Rivers; Washington, DC.
(a) Location. The following area is a
security zone:
(1) All waters of the Potomac River,
from shoreline to shoreline, bounded on
the north by the Francis Scott Key (U.S.
Route 29) Bridge at mile 113.0,
downstream to and bounded on the
south between the Virginia shoreline
and the District of Columbia shoreline
along latitude 38°50′00″ N, including
the waters of the Georgetown Channel
Tidal Basin; and
(2) All waters of the Anacostia River,
from shoreline to shoreline, bounded on
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the north by the 11th Street (I–295)
Bridge at mile 2.1, downstream to and
bounded on the south by its confluence
with the Potomac River. All coordinates
refer to datum NAD 1983.
(b) Regulations. The general security
zone regulations found in 33 CFR
165.33 apply to the security zone
created by this temporary section,
§ 165.T05.0938.
(1) All persons are required to comply
with the general regulations governing
security zones found in 33 CFR 165.33.
(2) Entry into or remaining in this
zone is prohibited unless authorized by
the Coast Guard Captain of the Port
Baltimore. Vessels already at berth,
mooring, or anchor at the time the
security zone is implemented do not
have to depart the security zone. All
vessels underway within this security
zone at the time it is implemented are
to depart the zone.
(3) Persons desiring to transit the area
of the security zone must first obtain
authorization from the Captain of the
Port Baltimore or his designated
representative. Permission may be
requested prior to activation of the zone.
To seek permission to transit the area,
the Captain of the Port Baltimore and
his designated representatives can be
contacted at telephone number 410–
576–2693 or on Marine Band Radio
VHF–FM channel 16 (156.8 MHz). The
Coast Guard vessels enforcing this
section can be contacted on Marine
Band Radio VHF–FM channel 16 (156.8
MHz). Upon being hailed by a U.S.
Coast Guard vessel, or other Federal,
State, or local agency vessel, by siren,
radio, flashing light, or other means, the
operator of a vessel shall proceed as
directed. If permission is granted, all
persons and vessels must comply with
the instructions of the Captain of the
Port Baltimore or his designated
representative and proceed at the
minimum speed necessary to maintain a
safe course while within the zone.
(4) Enforcement. The U.S. Coast
Guard may be assisted in the patrol and
enforcement of the zone by Federal,
State, and local agencies.
(c) Definitions. As used in this
section:
Captain of the Port Baltimore means
the Commander, U.S. Coast Guard
Sector Baltimore, Maryland.
Designated representative means any
Coast Guard commissioned, warrant, or
petty officer who has been authorized
by the Captain of the Port Baltimore to
assist in enforcing the security zone
described in paragraph (a) of this
section.
(d) Effective period. This section will
be enforced from 8 a.m. on January 15,
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70967
2013 through 10 p.m. on January 24,
2013.
Dated: November 15, 2012.
Brian W. Roche,
Commander, U.S. Coast Guard, Acting
Captain of the Port Baltimore.
[FR Doc. 2012–28790 Filed 11–27–12; 8:45 am]
BILLING CODE 9110–04–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 17
RIN 2900–AO46
Authorization for Non-VA Medical
Services
Department of Veterans Affairs.
Proposed rule.
AGENCY:
ACTION:
The Department of Veterans
Affairs (VA) proposes to amend its
regulation governing payment by VA for
non-VA outpatient care under VA’s
statutory authority to provide non-VA
care. Under this authority, VA may
contract for certain hospital care
(inpatient care) and medical services
(outpatient care) for eligible veterans
when VA facilities are not capable of
providing such services due to
geographical inaccessibility or are not
capable of providing the services
needed. This proposed amendment
would revise VA’s existing regulation in
accordance with statutory authority to
remove a limitation on which veterans
are eligible for medical services under
this authority.
DATES: VA must receive comments on or
before December 28, 2012.
ADDRESSES: Written comments may be
submitted through
www.Regulations.gov; by mail or handdelivery to the Director, Regulation
Policy and Management (02REG),
Department of Veterans Affairs, 810
Vermont Ave. NW., Room 1068,
Washington, DC 20420; or by fax to
(202) 273–9026. This is not a toll-free
number. Comments should indicate that
they are submitted in response to ‘‘RIN
2900–AO46—Authorization for Non-VA
Medical Services.’’ Copies of comments
received will be available for public
inspection in the Office of Regulation
Policy and Management, Room 1068,
between the hours of 8:00 a.m. and 4:30
p.m., Monday through Friday (except
holidays). Please call (202) 461–4902 for
an appointment. This is not a toll-free
number. In addition, during the
comment period, comments may be
viewed online through the Federal
Docket Management System (FDMS) at
www.Regulations.gov.
SUMMARY:
E:\FR\FM\28NOP1.SGM
28NOP1
70968
Federal Register / Vol. 77, No. 229 / Wednesday, November 28, 2012 / Proposed Rules
Lisa
Brown, Chief, Policy Management
Department, Department of Veterans
Affairs, Chief Business Office,
Purchased Care, 3773 Cherry Creek
North Drive, Suite 450, Denver, CO
80209 at (303) 331–7829. This is not a
toll-free number.
SUPPLEMENTARY INFORMATION: Over the
past two decades, the healthcare
industry has increasingly emphasized
providing care in the least restrictive
environment. Care that was provided in
hospitals is now provided with a full
range of outpatient and ambulatory care
options previously unavailable. VA has
adopted this trend toward outpatient
and ambulatory care and, whenever
possible, provides treatment options to
veterans in these less restrictive modes
of healthcare delivery. Although VA has
made great strides to expand the
delivery of healthcare to veterans, VA is,
like the rest of the healthcare industry,
economically unable to provide all
possible services at all VA-operated
venues of care. VA addresses this in part
by authorizing non-VA care when
necessary to meet the veteran’s plan of
care.
VA uses the authority in 38 U.S.C.
1703 to provide certain hospital care
and medical services to eligible veterans
when VA facilities are not capable of
providing such services due to
geographical inaccessibility or are not
capable of providing the services
needed, ensuring the continuity of care
for the patient and the maximization of
healthcare resources. VA may use this
authority to provide needed non-VA
care using community resources, such
as private physicians or community
hospitals. Care provided under VA’s
authority in 38 U.S.C. 1703 is usually
referred to as the Non-VA Care program.
Non-VA care enables VA to maximize
resources and available options for
patient care at the local level, providing
care in the least restrictive mode
possible and closer to the patient’s
home.
Public Law 104–262, 104(b)(2)(B)
amended 38 U.S.C. 1703(a)(2)(B) to
expand VA’s authority to provide nonVA medical services under the non-VA
care authority. As amended, the law
authorizes VA to provide such medical
services for a veteran who has been
furnished hospital care, nursing home
care, domiciliary care, or medical
services and who requires medical
services to complete treatment incident
to such care or services.
At present, 38 CFR 17.52(a)(2)(ii)
provides that ‘‘[a] veteran who has
received VA inpatient care for treatment
of nonservice-connected conditions for
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FOR FURTHER INFORMATION CONTACT:
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which treatment was begun during the
period of inpatient care’’ is eligible for
non-VA medical services under the nonVA care authority. The existing VA
regulation does not reflect the
amendment made by Public Law 104–
262 to 38 U.S.C. 1703(a)(2)(B). This VA
regulation thus does not permit VA to
complete a veteran’s treatment through
non-VA providers under the non-VA
care authority unless the VA treatment
was begun during a period of
hospitalization.
VA proposes to amend 38 CFR
17.52(a)(2)(ii) to reflect the current
statutory authority found at 38 U.S.C.
1703(a)(2)(B). In doing so, VA would
increase the availability of care in areas
where VA cannot directly provide the
care. Proposed paragraph (a)(2)(ii) of
this revised regulation would provide
that veterans who have been furnished
hospital care, nursing home care,
domiciliary care, or medical services,
and who require medical services to
complete treatment incident to such
care or services, would be eligible for
non-VA medical services under the nonVA care authority. By expanding
veterans’ eligibility for non-VA care, VA
would be able to better utilize resources
and enhance patient care at the local
level. This regulation would give VA
greater flexibility to refer patients for
care in the least restrictive and most
convenient setting.
This revision to § 17.52(a)(2)(ii) would
clarify the time period during which
veterans are eligible to receive non-VA
care to complete their treatments.
Currently, § 17.52(a)(2)(ii) states that the
non-VA care treatment period, which
includes ‘‘care furnished in both
facilities of VA and non-VA facilities or
any combination of such modes of
care,’’ is limited to no more than 12
months after the veteran is discharged
from the hospital, unless VA determines
that the veteran requires continued nonVA care ‘‘by virtue of the disabilities
being treated.’’ This revision would
clarify that each authorization for nonVA care needed to complete treatment
may continue for up to 12 months, and
that VA may issue new authorizations
as needed. The requirement to issue a
new authorization would give VA an
opportunity to determine whether nonVA care continues to be the appropriate
means of providing the veteran’s
treatment.
We note that this proposed
amendment would only affect the
eligibility of certain veterans for medical
services provided by a non-VA provider
under the non-VA care authority in 38
U.S.C. 1703; this proposed amendment
would not require providers outside of
VA to accept VA patients. We also note
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that this proposed amendment would
not affect other provisions in this
regulation that specify veterans’
eligibility for non-VA care.
Administrative Procedure Act
Concurrent with this proposed rule,
we also are publishing a separate,
substantively identical direct final rule
in the ‘‘Rules and Regulations’’ section
of this Federal Register. (See RIN 2900–
AO47.) The simultaneous publication of
these documents will speed notice and
comment rulemaking under section 553
of the Administrative Procedure Act
should we have to withdraw the direct
final rule due to receipt of any
significant adverse comment.
For purposes of the direct final
rulemaking, a significant adverse
comment is one that explains why the
rule would be inappropriate, including
challenges to the rule’s underlying
premise or approach, or why it would
be ineffective or unacceptable without
change. If VA receives a significant
adverse comment, VA will publish a
notice of receipt of a significant adverse
comment in the Federal Register and
withdraw the direct final rule.
Under direct final rule procedures, if
no significant adverse comment is
received within the comment period,
the direct final rule will become
effective on the date specified in RIN
2900–AO47. After the close of the
comment period, VA will publish a
document in the Federal Register
indicating that VA received no
significant adverse comment and
restating the date on which the final
rule will become effective. VA will also
publish a notice withdrawing this
proposed rule.
In the event that VA withdraws the
direct final rule because of receipt of
any significant adverse comment, VA
will proceed with this rulemaking by
addressing the comments received and
publishing a final rule. The comment
period for this proposed rule runs
concurrently with that of the direct final
rule. VA will treat any comments
received in response to the direct final
rule as comments regarding this
proposed rule. VA will consider such
comments in developing a subsequent
final rule. Likewise, VA will consider
any significant adverse comment
received in response to the proposed
rule as a comment regarding the direct
final rule. VA has determined that it is
not necessary to provide a 60-day
comment period for this rulemaking that
would merely align a current regulation
with existing statutory authority and
make a minor modification concerning
determination of the time period during
which veterans are eligible to receive
E:\FR\FM\28NOP1.SGM
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Federal Register / Vol. 77, No. 229 / Wednesday, November 28, 2012 / Proposed Rules
non-VA care to complete their
treatments. VA has instead specified
that comments must be received within
30 days of publication in the Federal
Register.
Effect of Rulemaking
Title 38 of the Code of Federal
Regulations, as proposed to be revised
by this rulemaking, represents VA’s
implementation of its legal authority on
this subject. Other than future
amendments to this regulation or
governing statutes, no contrary guidance
or procedures are authorized. All
existing or subsequent VA guidance
must be read to conform with this
rulemaking if possible or, if not
possible, such guidance is superseded
by this rulemaking.
Paperwork Reduction Act
This proposed rule contains no
provisions constituting a collection of
information under the Paperwork
Reduction Act of 1995 (44 U.S.C. 3501–
3521).
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Regulatory Flexibility Act
The Secretary hereby certifies that
this proposed rule would not have a
significant economic impact on a
substantial number of small entities as
defined in the Regulatory Flexibility
Act, 5 U.S.C. 601–612. This proposed
rule would affect only VA beneficiaries
and does not affect a substantial number
of small entities. Because this proposed
rule would update an existing
regulation to make it consistent with
existing statutory authority and reflect
current and long-standing VA practices,
VA anticipates no additional
expenditures or actions as a result of
this rule. Therefore, under 5 U.S.C.
605(b), this proposed amendment is
exempt from the initial and final
regulatory flexibility analysis
requirements of sections 603 and 604.
Executive Orders 12866 and 13563
Executive Orders 12866 and 13563
direct agencies to assess the 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
effects, and other advantages;
distributive impacts; and equity).
Executive Order 13563 (Improving
Regulation and Regulatory Review)
emphasizes the importance of
quantifying both costs and benefits,
reducing costs, harmonizing rules, and
promoting flexibility. Executive Order
12866 (Regulatory Planning and
Review) defines a ‘‘significant
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regulatory action’’ requiring review by
the Office of Management and Budget
(OMB) 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 this Executive
Order.’’
The economic, interagency,
budgetary, legal, and policy
implications of this regulatory action
have been examined, and it has been
determined not to be a significant
regulatory action under Executive Order
12866.
70969
authorized the undersigned to sign and
submit the document to the Office of the
Federal Register for publication
electronically as an official document of
the Department of Veterans Affairs. John
R. Gingrich, Chief of Staff, Department
of Veterans Affairs, approved this
document on November 20, 2012, for
publication.
List of Subjects in 38 CFR Part 17
Administrative practice and
procedure, Alcohol abuse, Alcoholism,
Claims, Day care, Dental health, Drug
abuse, Government contracts, Grant
programs—health, Government
programs—veterans, Health care, Health
facilities, Health professions, Health
records, Homeless, Mental health
programs, Nursing homes, Reporting
and recordkeeping requirements,
Veterans.
Dated: November 21, 2012.
Robert C. McFetridge,
Director, Regulation Policy and Management,
Office of the General Counsel, Department
of Veterans Affairs.
Unfunded Mandates Reform Act
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
expenditures 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
one year. This proposed rule would
have no such effect on State, local, and
tribal governments, or on the private
sector.
For the reasons stated in the
preamble, the Department of Veterans
Affairs proposes to amend 38 CFR part
17 as follows:
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic
Assistance numbers and titles for the
programs affected by this document are
64.007, Blind Rehabilitation Centers;
64.008, Veterans Domiciliary Care;
64.009, Veterans Medical Care Benefits;
64.010, Veterans Nursing Home Care;
64.011, Veterans Dental Care; 64.012,
Veterans Prescription Service; 64.013,
Veterans Prosthetic Appliances; 64.014,
Veterans State Domiciliary Care; 64.015,
Veterans State Nursing Home Care;
64.018, Sharing Specialized Medical
Resources; 64.019, Veterans
Rehabilitation Alcohol and Drug
Dependence; 64.022, Veterans Home
Based Primary Care; and 64.024, VA
Homeless Providers Grant and Per Diem
Program.
§ 17.52 Hospital care and medical services
in non-VA facilities.
PART 17—MEDICAL
1. The authority citation for part 17
continues to read as follows:
Authority: 38 U.S.C. 501, and as noted in
specific sections.
2. Revise § 17.52(a)(2)(ii) to read as
follows:
(a) * * *
(2) * * *
(ii) A veteran who has been furnished
hospital care, nursing home care,
domiciliary care, or medical services,
and requires medical services to
complete treatment incident to such
care or services (each authorization for
non-VA treatment needed to complete
treatment may continue for up to 12
months, and new authorizations may be
issued by VA as needed), and
*
*
*
*
*
[FR Doc. 2012–28776 Filed 11–27–12; 8:45 am]
BILLING CODE 8320–01–P
Signing Authority
The Secretary of Veterans Affairs, or
designee, approved this document and
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28NOP1
]]>Agencies
[Federal Register Volume 77, Number 229 (Wednesday, November 28, 2012)]
[Proposed Rules]
[Pages 70967-70969]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-28776]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 17
RIN 2900-AO46
Authorization for Non-VA Medical Services
AGENCY: Department of Veterans Affairs.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) proposes to amend its
regulation governing payment by VA for non-VA outpatient care under
VA's statutory authority to provide non-VA care. Under this authority,
VA may contract for certain hospital care (inpatient care) and medical
services (outpatient care) for eligible veterans when VA facilities are
not capable of providing such services due to geographical
inaccessibility or are not capable of providing the services needed.
This proposed amendment would revise VA's existing regulation in
accordance with statutory authority to remove a limitation on which
veterans are eligible for medical services under this authority.
DATES: VA must receive comments on or before December 28, 2012.
ADDRESSES: Written comments may be submitted through
www.Regulations.gov; by mail or hand-delivery to the Director,
Regulation Policy and Management (02REG), Department of Veterans
Affairs, 810 Vermont Ave. NW., Room 1068, Washington, DC 20420; or by
fax to (202) 273-9026. This is not a toll-free number. Comments should
indicate that they are submitted in response to ``RIN 2900-AO46--
Authorization for Non-VA Medical Services.'' Copies of comments
received will be available for public inspection in the Office of
Regulation Policy and Management, Room 1068, between the hours of 8:00
a.m. and 4:30 p.m., Monday through Friday (except holidays). Please
call (202) 461-4902 for an appointment. This is not a toll-free number.
In addition, during the comment period, comments may be viewed online
through the Federal Docket Management System (FDMS) at
www.Regulations.gov.
[[Page 70968]]
FOR FURTHER INFORMATION CONTACT: Lisa Brown, Chief, Policy Management
Department, Department of Veterans Affairs, Chief Business Office,
Purchased Care, 3773 Cherry Creek North Drive, Suite 450, Denver, CO
80209 at (303) 331-7829. This is not a toll-free number.
SUPPLEMENTARY INFORMATION: Over the past two decades, the healthcare
industry has increasingly emphasized providing care in the least
restrictive environment. Care that was provided in hospitals is now
provided with a full range of outpatient and ambulatory care options
previously unavailable. VA has adopted this trend toward outpatient and
ambulatory care and, whenever possible, provides treatment options to
veterans in these less restrictive modes of healthcare delivery.
Although VA has made great strides to expand the delivery of healthcare
to veterans, VA is, like the rest of the healthcare industry,
economically unable to provide all possible services at all VA-operated
venues of care. VA addresses this in part by authorizing non-VA care
when necessary to meet the veteran's plan of care.
VA uses the authority in 38 U.S.C. 1703 to provide certain hospital
care and medical services to eligible veterans when VA facilities are
not capable of providing such services due to geographical
inaccessibility or are not capable of providing the services needed,
ensuring the continuity of care for the patient and the maximization of
healthcare resources. VA may use this authority to provide needed non-
VA care using community resources, such as private physicians or
community hospitals. Care provided under VA's authority in 38 U.S.C.
1703 is usually referred to as the Non-VA Care program. Non-VA care
enables VA to maximize resources and available options for patient care
at the local level, providing care in the least restrictive mode
possible and closer to the patient's home.
Public Law 104-262, 104(b)(2)(B) amended 38 U.S.C. 1703(a)(2)(B) to
expand VA's authority to provide non-VA medical services under the non-
VA care authority. As amended, the law authorizes VA to provide such
medical services for a veteran who has been furnished hospital care,
nursing home care, domiciliary care, or medical services and who
requires medical services to complete treatment incident to such care
or services.
At present, 38 CFR 17.52(a)(2)(ii) provides that ``[a] veteran who
has received VA inpatient care for treatment of nonservice-connected
conditions for which treatment was begun during the period of inpatient
care'' is eligible for non-VA medical services under the non-VA care
authority. The existing VA regulation does not reflect the amendment
made by Public Law 104-262 to 38 U.S.C. 1703(a)(2)(B). This VA
regulation thus does not permit VA to complete a veteran's treatment
through non-VA providers under the non-VA care authority unless the VA
treatment was begun during a period of hospitalization.
VA proposes to amend 38 CFR 17.52(a)(2)(ii) to reflect the current
statutory authority found at 38 U.S.C. 1703(a)(2)(B). In doing so, VA
would increase the availability of care in areas where VA cannot
directly provide the care. Proposed paragraph (a)(2)(ii) of this
revised regulation would provide that veterans who have been furnished
hospital care, nursing home care, domiciliary care, or medical
services, and who require medical services to complete treatment
incident to such care or services, would be eligible for non-VA medical
services under the non-VA care authority. By expanding veterans'
eligibility for non-VA care, VA would be able to better utilize
resources and enhance patient care at the local level. This regulation
would give VA greater flexibility to refer patients for care in the
least restrictive and most convenient setting.
This revision to Sec. 17.52(a)(2)(ii) would clarify the time
period during which veterans are eligible to receive non-VA care to
complete their treatments. Currently, Sec. 17.52(a)(2)(ii) states that
the non-VA care treatment period, which includes ``care furnished in
both facilities of VA and non-VA facilities or any combination of such
modes of care,'' is limited to no more than 12 months after the veteran
is discharged from the hospital, unless VA determines that the veteran
requires continued non-VA care ``by virtue of the disabilities being
treated.'' This revision would clarify that each authorization for non-
VA care needed to complete treatment may continue for up to 12 months,
and that VA may issue new authorizations as needed. The requirement to
issue a new authorization would give VA an opportunity to determine
whether non-VA care continues to be the appropriate means of providing
the veteran's treatment.
We note that this proposed amendment would only affect the
eligibility of certain veterans for medical services provided by a non-
VA provider under the non-VA care authority in 38 U.S.C. 1703; this
proposed amendment would not require providers outside of VA to accept
VA patients. We also note that this proposed amendment would not affect
other provisions in this regulation that specify veterans' eligibility
for non-VA care.
Administrative Procedure Act
Concurrent with this proposed rule, we also are publishing a
separate, substantively identical direct final rule in the ``Rules and
Regulations'' section of this Federal Register. (See RIN 2900-AO47.)
The simultaneous publication of these documents will speed notice and
comment rulemaking under section 553 of the Administrative Procedure
Act should we have to withdraw the direct final rule due to receipt of
any significant adverse comment.
For purposes of the direct final rulemaking, a significant adverse
comment is one that explains why the rule would be inappropriate,
including challenges to the rule's underlying premise or approach, or
why it would be ineffective or unacceptable without change. If VA
receives a significant adverse comment, VA will publish a notice of
receipt of a significant adverse comment in the Federal Register and
withdraw the direct final rule.
Under direct final rule procedures, if no significant adverse
comment is received within the comment period, the direct final rule
will become effective on the date specified in RIN 2900-AO47. After the
close of the comment period, VA will publish a document in the Federal
Register indicating that VA received no significant adverse comment and
restating the date on which the final rule will become effective. VA
will also publish a notice withdrawing this proposed rule.
In the event that VA withdraws the direct final rule because of
receipt of any significant adverse comment, VA will proceed with this
rulemaking by addressing the comments received and publishing a final
rule. The comment period for this proposed rule runs concurrently with
that of the direct final rule. VA will treat any comments received in
response to the direct final rule as comments regarding this proposed
rule. VA will consider such comments in developing a subsequent final
rule. Likewise, VA will consider any significant adverse comment
received in response to the proposed rule as a comment regarding the
direct final rule. VA has determined that it is not necessary to
provide a 60-day comment period for this rulemaking that would merely
align a current regulation with existing statutory authority and make a
minor modification concerning determination of the time period during
which veterans are eligible to receive
[[Page 70969]]
non-VA care to complete their treatments. VA has instead specified that
comments must be received within 30 days of publication in the Federal
Register.
Effect of Rulemaking
Title 38 of the Code of Federal Regulations, as proposed to be
revised by this rulemaking, represents VA's implementation of its legal
authority on this subject. Other than future amendments to this
regulation or governing statutes, no contrary guidance or procedures
are authorized. All existing or subsequent VA guidance must be read to
conform with this rulemaking if possible or, if not possible, such
guidance is superseded by this rulemaking.
Paperwork Reduction Act
This proposed rule contains no provisions constituting a collection
of information under the Paperwork Reduction Act of 1995 (44 U.S.C.
3501-3521).
Regulatory Flexibility Act
The Secretary hereby certifies that this proposed rule would not
have a significant economic impact on a substantial number of small
entities as defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. This proposed rule would affect only VA beneficiaries and does not
affect a substantial number of small entities. Because this proposed
rule would update an existing regulation to make it consistent with
existing statutory authority and reflect current and long-standing VA
practices, VA anticipates no additional expenditures or actions as a
result of this rule. Therefore, under 5 U.S.C. 605(b), this proposed
amendment is exempt from the initial and final regulatory flexibility
analysis requirements of sections 603 and 604.
Executive Orders 12866 and 13563
Executive Orders 12866 and 13563 direct agencies to assess the
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 effects, and other advantages; distributive impacts;
and equity). Executive Order 13563 (Improving Regulation and Regulatory
Review) emphasizes the importance of quantifying both costs and
benefits, reducing costs, harmonizing rules, and promoting flexibility.
Executive Order 12866 (Regulatory Planning and Review) defines a
``significant regulatory action'' requiring review by the Office of
Management and Budget (OMB) 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
this Executive Order.''
The economic, interagency, budgetary, legal, and policy
implications of this regulatory action have been examined, and it has
been determined not to be a significant regulatory action under
Executive Order 12866.
Unfunded Mandates Reform Act
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 expenditures 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 one year. This proposed rule would have no such
effect on State, local, and tribal governments, or on the private
sector.
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic Assistance numbers and titles for
the programs affected by this document are 64.007, Blind Rehabilitation
Centers; 64.008, Veterans Domiciliary Care; 64.009, Veterans Medical
Care Benefits; 64.010, Veterans Nursing Home Care; 64.011, Veterans
Dental Care; 64.012, Veterans Prescription Service; 64.013, Veterans
Prosthetic Appliances; 64.014, Veterans State Domiciliary Care; 64.015,
Veterans State Nursing Home Care; 64.018, Sharing Specialized Medical
Resources; 64.019, Veterans Rehabilitation Alcohol and Drug Dependence;
64.022, Veterans Home Based Primary Care; and 64.024, VA Homeless
Providers Grant and Per Diem Program.
Signing Authority
The Secretary of Veterans Affairs, or designee, approved this
document and authorized the undersigned to sign and submit the document
to the Office of the Federal Register for publication electronically as
an official document of the Department of Veterans Affairs. John R.
Gingrich, Chief of Staff, Department of Veterans Affairs, approved this
document on November 20, 2012, for publication.
List of Subjects in 38 CFR Part 17
Administrative practice and procedure, Alcohol abuse, Alcoholism,
Claims, Day care, Dental health, Drug abuse, Government contracts,
Grant programs--health, Government programs--veterans, Health care,
Health facilities, Health professions, Health records, Homeless, Mental
health programs, Nursing homes, Reporting and recordkeeping
requirements, Veterans.
Dated: November 21, 2012.
Robert C. McFetridge,
Director, Regulation Policy and Management, Office of the General
Counsel, Department of Veterans Affairs.
For the reasons stated in the preamble, the Department of Veterans
Affairs proposes to amend 38 CFR part 17 as follows:
PART 17--MEDICAL
1. The authority citation for part 17 continues to read as follows:
Authority: 38 U.S.C. 501, and as noted in specific sections.
2. Revise Sec. 17.52(a)(2)(ii) to read as follows:
Sec. 17.52 Hospital care and medical services in non-VA facilities.
(a) * * *
(2) * * *
(ii) A veteran who has been furnished hospital care, nursing home
care, domiciliary care, or medical services, and requires medical
services to complete treatment incident to such care or services (each
authorization for non-VA treatment needed to complete treatment may
continue for up to 12 months, and new authorizations may be issued by
VA as needed), and
* * * * *
[FR Doc. 2012-28776 Filed 11-27-12; 8:45 am]
BILLING CODE 8320-01-P
