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 https://
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 https://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).
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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]
=======================================================================
-----------------------------------------------------------------------
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