Removal of Penalty for Breaking Appointments, 22219-22221 [2013-08794]

Download as PDF Federal Register / Vol. 78, No. 72 / Monday, April 15, 2013 / Proposed Rules mstockstill on DSK4VPTVN1PROD with PROPOSALS regulated by the Coast Guard to use electronic readers designed to work with the Transportation Worker Identification Credential (TWIC) as an access control measure. The NPRM also proposed additional requirements associated with electronic TWIC readers, including recordkeeping requirements for those owners and operators required to use an electronic TWIC reader, and security plan amendments to incorporate TWIC reader requirements. The TWIC program, including the TWIC reader requirements proposed in the NPRM, is an important component of the Coast Guard’s multi-layered system of access control requirements and other measures designed to enhance maritime security. As authorized by the Maritime Transportation Security Act of 2002 1 (MTSA), the Transportation Security Administration (TSA) established the TWIC program to address identity management shortcomings and vulnerabilities identified in the nation’s transportation system and to comply with the MTSA statutory requirements. On January 25, 2007, the Department of Homeland Security (DHS), through the Coast Guard and TSA, promulgated regulations that require mariners and other individuals granted unescorted access to secure areas of MTSAregulated vessels or facilities to undergo a security threat assessment by TSA and obtain a TWIC.2 This NPRM that is the subject of this public meeting, which would require owners and operators of certain types of vessels and facilities to use electronic TWIC readers, would advance the goals of the TWIC program. In crafting the proposals in the NPRM, the Coast Guard conducted a risk-based analysis of MTSA-regulated vessels and facilities to categorize them into one of three risk groups, labeled A, B, and C. Risk Group A is comprised of vessels and facilities that present the highest risk of being involved in a transportation security incident (TSI).3 The NPRM proposes TWIC reader requirements for vessels and facilities in Risk Group A. Under the NPRM, vessels and facilities in Risk Groups B and C present progressively lower risks, and would continue to 1 Public Law 107–295, 116 Stat. 2064 (Nov. 2, 2002). 2 Transportation Worker Identification Credential (TWIC) Implementation in the Maritime Sector; Hazardous Materials Endorsement for a Commercial Driver’s License, 72 FR 3492 (Jan. 25, 2007). 3 A transportation security incident is a security incident resulting in a significant loss of life, environmental damage, transportation system disruption, or economic disruption in a particular area, as defined in 46 U.S.C. 70101 (49 CFR 1572.103). VerDate Mar<15>2010 16:18 Apr 12, 2013 Jkt 229001 follow existing regulatory requirements for visual TWIC inspection. The Coast Guard believes that in addition to receiving written comments on the NPRM, a public meeting would benefit the impacted community by providing another forum to raise relevant issues. Also, the Security and Accountability For Every (SAFE) Port Act of 2006 4 requires the Coast Guard to hold at least one public hearing before promulgating final TWIC reader regulations (see 46 U.S.C. 70105(k)(3)). This public meeting will further enable the Coast Guard to craft policy informed by the public. You may view the NPRM, written comments, and supporting documents in the online docket by going to http:// www.regulations.gov and using ‘‘USCG– 2007–28915’’ as your search term. Locate the NPRM among the search results and use the filters on the left side of the page to search for specific types of documents. If you do not have access to the Internet, you may view the docket by visiting the Docket Management Facility in Room W12–140 on the ground floor of the Department of Transportation West Building, 1200 New Jersey Avenue SE., Washington, DC 20590, between 9:00 a.m. and 5:00 p.m., Monday through Friday, except Federal holidays. The Coast Guard has an agreement with the Department of Transportation to use its Docket Management Facility. We encourage you to participate by submitting comments either orally at the meeting or in writing. If you bring written comments to the meeting, you may submit them to Coast Guard personnel specified at the meeting to receive written comments. These comments will be submitted to our online public docket. All comments received will be posted without change to http://www.regulations.gov and will include any personal information you have provided. Anyone can search the electronic form of comments received into any of our dockets by the name of the individual submitting the comment (or signing the comment, if submitted on behalf of an association, business, labor union, or other entity). You may review a Privacy Act notice regarding our public dockets in the January 17, 2008, issue of the Federal Register (73 FR 3316). Information on Services for Individuals With Disabilities For information on facilities or services for individuals with disabilities 4 Public Law 109–347, 120 Stat. 1884 (Oct. 13, 2006). PO 00000 Frm 00018 Fmt 4702 Sfmt 4702 22219 or to request special assistance at the public meeting, contact LCDR Gregory Callaghan at the telephone number or email address indicated under the FOR FURTHER INFORMATION CONTACT section of this notice. Public Meeting The Coast Guard will hold a public meeting regarding the ‘‘Transportation Worker Identification Credential (TWIC)—Reader Requirements’’ NPRM (78 FR 17781) on Thursday, May 9, 2013 from 1:00 p.m. to 5:00 p.m., at the Chicago Marriott O’Hare, 8535 West Higgins Road, Chicago, Illinois 60631. The building is accessible by taxi, public transit, and privately-owned conveyance. Please note that the session may adjourn early if all business, concerns, and questions are addressed. We will post a written summary of the meeting and oral comments in the docket. Authority This notice is issued under the authority of 46 U.S.C. 70105(k)(3) and 5 U.S.C. 552(a). Dated: April 8, 2013. A.E. Tucci, Captain, U.S. Coast Guard, Chief, Office of Port and Facility Compliance (CG–FAC). [FR Doc. 2013–08735 Filed 4–12–13; 8:45 am] BILLING CODE 9110–04–P DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900–AO51 Removal of Penalty for Breaking Appointments Department of Veterans Affairs. Proposed rule. AGENCY: ACTION: The Department of Veterans Affairs (VA) proposes to remove a regulation that states that a veteran who misses two medical appointments without providing 24 hours’ notice and a reasonable excuse is deemed to have refused VA medical care. The current regulation states that no further treatment will be furnished to a veteran deemed to have refused care except in emergency situations, unless the veteran agrees to cooperate by keeping future appointments. VA believes that the current regulation is incompatible with regulatory changes implemented after the regulation was promulgated, is not in line with current practice, and is inconsistent with VA’s patient-centered approach to medical care. SUMMARY: E:\FR\FM\15APP1.SGM 15APP1 22220 Federal Register / Vol. 78, No. 72 / Monday, April 15, 2013 / Proposed Rules Comments must be received by VA on or before June 14, 2013. ADDRESSES: Written comments may be submitted through www.Regulations.gov; by mail or handdelivery to the Director, Regulations Management (02REG), Department of Veterans Affairs, 810 Vermont Ave. NW., Room 1068, Washington, DC 20420; or by fax to (202) 273–9026. Comments should indicate that they are submitted in response to ‘‘RIN 2900– AO51—Removal of Penalty for Breaking Appointments.’’ 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. FOR FURTHER INFORMATION CONTACT: Ethan Kalett, Director, Office of Regulatory Affairs (10B4), Department of Veterans Affairs, 810 Vermont Ave. NW., Washington, DC 20420; (202) 461– 5657. (This is not a toll-free number). SUPPLEMENTARY INFORMATION: Over the past two decades, there has been a dramatic shift in the United States toward providing patient-centered medical care. Under this approach, patients are equal partners in making treatment decisions, and health care providers deliver care in the least restrictive environment practicable. VA has adopted this approach and, whenever possible, eliminates both potential and proven barriers to care. This is especially important in cases where VA provides treatment to vulnerable veteran populations, veterans who rely on VA as their primary source of medical care, and those with service-connected disabilities. This rulemaking will eliminate a potential barrier to care by removing 38 CFR 17.100. Under the current regulation, breaking two medical appointments without providing at least 24 hours’ notice and a reasonable excuse is deemed a refusal to accept VA treatment. With the exception of emergency care, no further treatment is furnished until the veteran agrees to cooperate by keeping appointments. We propose to remove this regulation because denying follow up medical treatment for even a short period can interfere with continuity and coordination of care, and the punitive nature of the regulation could have a mstockstill on DSK4VPTVN1PROD with PROPOSALS DATES: VerDate Mar<15>2010 16:18 Apr 12, 2013 Jkt 229001 negative impact on the therapeutic relationship. In addition, VA has taken steps to encourage certain veterans to use our health services, including homeless veterans and other veterans who may not have readily available support such as reliable telephone access or dependable transportation to and from scheduled appointments. VA believes that refusing to provide further medical services to those patients because of broken appointments is counterproductive and may discourage them from attempting to access care in the future. Further, while the current regulation allows VA to provide treatment for an emergent condition, we do not believe this provides an adequate safety net for our patients, especially those with chronic or poorly controlled medical conditions. Finally, it is not the current practice of VA to deny care to an eligible enrolled veteran who breaks a scheduled appointment. VA’s outpatient appointment scheduling processes and procedures do not include documenting the reason given for a missed appointment. Thus, the proposed change will bring regulations in line with current practice. In a note to 38 CFR 17.107 we state, ‘‘Although VA may restrict the time, place, and/or manner of care under this section, VA will continue to offer the full range of needed medical care to which a patient is eligible under title 38 of the United States Code or Code of Federal Regulations. Patients have the right to accept or refuse treatments or procedures, and such refusal by a patient is not a basis for restricting the provision of care under this section.’’ Section 17.107 sets forth procedures for addressing disruptive behavior of patients by imposing reasonable restrictions on the care for which they are eligible. The regulation we intend to remove deems breaking an appointment without 24 hours’ notice and a reasonable excuse to be a refusal to accept VA treatment, and denies access to further care based on that refusal. We believe this is contrary to VA’s mission and core values, and to § 17.107. Effect of Rulemaking The Code of Federal Regulations, as proposed to be revised by this proposed rulemaking, would represent the exclusive legal authority on this subject. No contrary rules or procedures would be authorized. All VA guidance would be read to conform with this proposed rulemaking if possible or, if not possible, such guidance would be superseded by this rulemaking. PO 00000 Frm 00019 Fmt 4702 Sfmt 4702 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 they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601–612. This proposed rule would directly affect only individuals and would not directly affect small entities. Therefore, pursuant to 5 U.S.C. 605(b), this rulemaking is exempt from the initial and final regulatory flexibility analysis requirements of 5 U.S.C. 603 and 604. Executive Order 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 E:\FR\FM\15APP1.SGM 15APP1 Federal Register / Vol. 78, No. 72 / Monday, April 15, 2013 / Proposed Rules regulatory action under Executive Order 12866. Affairs proposes to amend 38 CFR part 17 as follows: (202) 646–4064 or (email) Luis.Rodriguez3@fema.dhs.gov. 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 the 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 one year. This proposed rule would have no such effect on State, local, and tribal governments, or on the private sector. PART 17—MEDICAL SUPPLEMENTARY INFORMATION: 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; and 64.022, Veterans Home Based Primary Care. 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 March 25, 2013, for publication. 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, Government programs—veterans, Health care, Health facilities, Health professions, Health records, Homeless, Medical and dental schools, Medical devices, Medical research, Mental health programs, Nursing homes, Reporting and recordkeeping requirements, Scholarships and fellowships, Travel and transportation expenses, Veterans. mstockstill on DSK4VPTVN1PROD with PROPOSALS 22221 Dated: April 10, 2013. Robert C. McFetridge, Director of Regulation Policy and Management, Office of General Counsel, Department of Veterans Affairs. For the reasons stated in the preamble, the Department of Veterans VerDate Mar<15>2010 16:18 Apr 12, 2013 Jkt 229001 1. The authority citation for part 17 continues to read as follows: ■ Authority: 38 U.S.C. 501, and as noted in specific sections. § 17.100 [Removed] 2. Remove § 17.100 and the undesignated center heading that precedes it. ■ [FR Doc. 2013–08794 Filed 4–12–13; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency 44 CFR Part 67 [Docket ID FEMA–2013–0002; Internal Agency Docket No. FEMA–B–1212] Proposed Flood Elevation Determinations Federal Emergency Management Agency, DHS. ACTION: Proposed rule; correction. AGENCY: On August 17, 2011, FEMA published in the Federal Register a proposed rule that contained an erroneous table. This notice provides corrections to that table, to be used in addition to the information published at 76 FR 50960. The table provided here represents the flooding sources, location of referenced elevations, effective and modified elevations, and communities affected for Pitt County, North Carolina, and Incorporated Areas. Specifically, it addresses the following flooding sources: Pea Branch and Reedy Branch. DATES: Comments are to be submitted on or before July 15, 2013. ADDRESSES: You may submit comments, identified by Docket No. FEMA–B– 1212, to Luis Rodriguez, Chief, Engineering Management Branch, Federal Insurance and Mitigation Administration, Federal Emergency Management Agency, 500 C Street SW., Washington, DC 20472, (202) 646–4064 or (email) Luis.Rodriguez3@fema.dhs.gov. FOR FURTHER INFORMATION CONTACT: Luis Rodriguez, Chief, Engineering Management Branch, Federal Insurance and Mitigation Administration, Federal Emergency Management Agency, 500 C Street SW., Washington, DC 20472, SUMMARY: PO 00000 Frm 00020 Fmt 4702 Sfmt 4702 The Federal Emergency Management Agency (FEMA) publishes proposed determinations of Base (1% annualchance) Flood Elevations (BFEs) and modified BFEs for communities participating in the National Flood Insurance Program (NFIP), in accordance with section 110 of the Flood Disaster Protection Act of 1973, 42 U.S.C. 4104, and 44 CFR 67.4(a). These proposed BFEs and modified BFEs, together with the floodplain management criteria required by 44 CFR 60.3, are minimum requirements. They should not be construed to mean that the community must change any existing ordinances that are more stringent in their floodplain management requirements. The community may at any time enact stricter requirements of its own or pursuant to policies established by other Federal, State, or regional entities. These proposed elevations are used to meet the floodplain management requirements of the NFIP and also are used to calculate the appropriate flood insurance premium rates for new buildings built after these elevations are made final, and for the contents in those buildings. In the proposed rule published at 76 FR 50960, in the August 17, 2011, issue of the Federal Register, FEMA published a table under the authority of 44 CFR 67.4. The table, entitled ‘‘Pitt County, North Carolina, and Incorporated Areas’’ did not address the flooding sources Pea Branch and Reedy Branch. That table omitted information as to the location of referenced elevation, effective and modified elevation in feet, and communities affected for those flooding sources. In this document, FEMA is publishing a table containing the accurate information, to address these prior errors. The information provided below should be used in addition to that previously published. Correction In proposed rule FR Doc. 2011–20966, beginning on page 50952 in the issue of August 17, 2011, make the following correction. On page 50957, add the following: E:\FR\FM\15APP1.SGM 15APP1

Agencies

[Federal Register Volume 78, Number 72 (Monday, April 15, 2013)]
[Proposed Rules]
[Pages 22219-22221]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-08794]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AO51


Removal of Penalty for Breaking Appointments

AGENCY: Department of Veterans Affairs.

ACTION: Proposed rule.

-----------------------------------------------------------------------

SUMMARY: The Department of Veterans Affairs (VA) proposes to remove a 
regulation that states that a veteran who misses two medical 
appointments without providing 24 hours' notice and a reasonable excuse 
is deemed to have refused VA medical care. The current regulation 
states that no further treatment will be furnished to a veteran deemed 
to have refused care except in emergency situations, unless the veteran 
agrees to cooperate by keeping future appointments. VA believes that 
the current regulation is incompatible with regulatory changes 
implemented after the regulation was promulgated, is not in line with 
current practice, and is inconsistent with VA's patient-centered 
approach to medical care.

[[Page 22220]]


DATES: Comments must be received by VA on or before June 14, 2013.

ADDRESSES: Written comments may be submitted through 
www.Regulations.gov; by mail or hand-delivery to the Director, 
Regulations Management (02REG), Department of Veterans Affairs, 810 
Vermont Ave. NW., Room 1068, Washington, DC 20420; or by fax to (202) 
273-9026. Comments should indicate that they are submitted in response 
to ``RIN 2900-AO51--Removal of Penalty for Breaking Appointments.'' 
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.

FOR FURTHER INFORMATION CONTACT: Ethan Kalett, Director, Office of 
Regulatory Affairs (10B4), Department of Veterans Affairs, 810 Vermont 
Ave. NW., Washington, DC 20420; (202) 461-5657. (This is not a toll-
free number).

SUPPLEMENTARY INFORMATION: Over the past two decades, there has been a 
dramatic shift in the United States toward providing patient-centered 
medical care. Under this approach, patients are equal partners in 
making treatment decisions, and health care providers deliver care in 
the least restrictive environment practicable. VA has adopted this 
approach and, whenever possible, eliminates both potential and proven 
barriers to care. This is especially important in cases where VA 
provides treatment to vulnerable veteran populations, veterans who rely 
on VA as their primary source of medical care, and those with service-
connected disabilities. This rulemaking will eliminate a potential 
barrier to care by removing 38 CFR 17.100.
    Under the current regulation, breaking two medical appointments 
without providing at least 24 hours' notice and a reasonable excuse is 
deemed a refusal to accept VA treatment. With the exception of 
emergency care, no further treatment is furnished until the veteran 
agrees to cooperate by keeping appointments.
    We propose to remove this regulation because denying follow up 
medical treatment for even a short period can interfere with continuity 
and coordination of care, and the punitive nature of the regulation 
could have a negative impact on the therapeutic relationship. In 
addition, VA has taken steps to encourage certain veterans to use our 
health services, including homeless veterans and other veterans who may 
not have readily available support such as reliable telephone access or 
dependable transportation to and from scheduled appointments. VA 
believes that refusing to provide further medical services to those 
patients because of broken appointments is counterproductive and may 
discourage them from attempting to access care in the future. Further, 
while the current regulation allows VA to provide treatment for an 
emergent condition, we do not believe this provides an adequate safety 
net for our patients, especially those with chronic or poorly 
controlled medical conditions.
    Finally, it is not the current practice of VA to deny care to an 
eligible enrolled veteran who breaks a scheduled appointment. VA's 
outpatient appointment scheduling processes and procedures do not 
include documenting the reason given for a missed appointment. Thus, 
the proposed change will bring regulations in line with current 
practice.
    In a note to 38 CFR 17.107 we state, ``Although VA may restrict the 
time, place, and/or manner of care under this section, VA will continue 
to offer the full range of needed medical care to which a patient is 
eligible under title 38 of the United States Code or Code of Federal 
Regulations. Patients have the right to accept or refuse treatments or 
procedures, and such refusal by a patient is not a basis for 
restricting the provision of care under this section.'' Section 17.107 
sets forth procedures for addressing disruptive behavior of patients by 
imposing reasonable restrictions on the care for which they are 
eligible. The regulation we intend to remove deems breaking an 
appointment without 24 hours' notice and a reasonable excuse to be a 
refusal to accept VA treatment, and denies access to further care based 
on that refusal. We believe this is contrary to VA's mission and core 
values, and to Sec.  17.107.

Effect of Rulemaking

    The Code of Federal Regulations, as proposed to be revised by this 
proposed rulemaking, would represent the exclusive legal authority on 
this subject. No contrary rules or procedures would be authorized. All 
VA guidance would be read to conform with this proposed rulemaking if 
possible or, if not possible, such guidance would be 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 they are defined in the Regulatory Flexibility Act, 5 
U.S.C. 601-612. This proposed rule would directly affect only 
individuals and would not directly affect small entities. Therefore, 
pursuant to 5 U.S.C. 605(b), this rulemaking is exempt from the initial 
and final regulatory flexibility analysis requirements of 5 U.S.C. 603 
and 604.

Executive Order 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

[[Page 22221]]

regulatory action under Executive Order 12866.

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 the 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 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; and 64.022, 
Veterans Home Based Primary Care.

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 March 25, 2013, for publication.

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, Government programs--
veterans, Health care, Health facilities, Health professions, Health 
records, Homeless, Medical and dental schools, Medical devices, Medical 
research, Mental health programs, Nursing homes, Reporting and 
recordkeeping requirements, Scholarships and fellowships, Travel and 
transportation expenses, Veterans.

    Dated: April 10, 2013.
Robert C. McFetridge,
Director of Regulation Policy and Management, Office of 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

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

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


Sec.  17.100  [Removed]

0
2. Remove Sec.  17.100 and the undesignated center heading that 
precedes it.
[FR Doc. 2013-08794 Filed 4-12-13; 8:45 am]
BILLING CODE 8320-01-P