Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Uniform Health Maintenance Organization (HMO) Benefit-Prime Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and Their Dependents, 34292-34293 [2013-13503]

Agencies

• DEPARTMENT OF DEFENSE
• Office of the Secretary

[Federal Register Volume 78, Number 110 (Friday, June 7, 2013)]
[Proposed Rules]
[Pages 34292-34293]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-13503]


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DEPARTMENT OF DEFENSE

Office of the Secretary

32 CFR Part 199

[DOD-2011-HA-0136]
RIN 0720-AB56


Civilian Health and Medical Program of the Uniformed Services 
(CHAMPUS); TRICARE Uniform Health Maintenance Organization (HMO) 
Benefit--Prime Enrollment Fee Exemption for Survivors of Active Duty 
Deceased Sponsors and Medically Retired Uniformed Services Members and 
Their Dependents

AGENCY: Office of the Secretary, DoD.

ACTION: Proposed rule.

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SUMMARY: This proposed rule would establish an exception to the usual 
rule that TRICARE Prime enrollment fees are uniform for the group of 
retirees and their dependents. Survivors and medically retired members 
are part of the retiree group under TRICARE rules. This exception would 
allow Survivors of Active Duty Deceased Sponsors and Medically Retired 
Uniformed Services Members and their Dependents enrolled in Prime to be 
exempt from future increases in TRICARE Prime enrollment fees. The 
Prime beneficiaries in these categories prior to 10/1/2013 would have 
their annual enrollment fee frozen at their current annual rate (FY 
2011 rate $230 per single or $460 per family, FY 2012 rate $260 or 
$520, or the FY 2013 rate $269.38 or $538.56). The beneficiaries added 
to these categories on or after 10/1/2013 would have their fee frozen 
at the rate in effect at the time they are classified in either 
category and enroll in Prime or, if not enrolling, at the rate in 
effect at the time of enrollment. The fee remains frozen as long as at 
least one family member remains enrolled in Prime and there is not a 
break in enrollment. The fee charged for the dependent(s) of a 
Medically Retired Uniformed Services Member would not change if the 
dependent(s) was later re-classified a Survivor.

DATES: Written comments received at the address indicated below by 
August 6, 2013 will be considered and addressed in the final rule.

ADDRESSES: You may submit comments, identified by docket number and or 
RIN number and title, by any of the following methods:
     Federal eRulemaking Portal: https://www.regulations.gov. 
Follow the instructions for submitting comments.
     Mail: Federal Docket Management System Office, 1160 
Defense Pentagon, Washington, DC 20301-1160. Instructions: All 
submissions received must include the agency name and docket number or 
Regulatory Information Number (RIN) for this Federal Register document. 
The general policy for comments and other submissions from dependents 
of the public is to make these submissions available for public viewing 
on the Internet at https://regulations.gov as they are received without 
change, including any personal identifiers or contact information.

FOR FURTHER INFORMATION CONTACT: Ralph (Doug) McBroom, (703) 681-0039, 
TRICARE Management Activity, TRICARE Policy and Operations Directorate. 
Questions regarding payment of specific claims under the TRICARE 
allowable charge method should be addressed to the appropriate TRICARE 
contractor.

SUPPLEMENTARY INFORMATION: With respect to TRICARE Prime enrollment 
fees, the regulation (32 CFR 199.18(c)) currently includes the 
following provision: ``The specific enrollment fee requirements shall 
be published annually by the Assistant Secretary of Defense (Health 
Affairs), and shall be uniform within the following groups: dependents 
of active duty members in pay grades of E-4 and below; active duty 
dependents of sponsors in pay grades E-5 and above; and retirees and 
their dependents.'' There is no enrollment fee for active duty 
dependents. The annual enrollment fee

[[Page 34293]]

for retirees and their dependents since the program began was $230 per 
person or $460 per family until FY 2012. In FY 2012, the Department of 
Defense implemented a modest increase ($2.50 per person or $5.00 per 
family per month) in the enrollment fees for retirees and their 
dependents to $260 per person or $520 per family, followed by annual 
indexing. For FY 2013, the fee was increased per the National Defense 
Authorization Act for FY 2012 using the same Cost of Living Adjustment 
(COLA) percentage (3.6%) used to increase military retired pay. This 
increased the fees for FY 2013 to $269.38 per person or $538.56 per 
family.
    Although the increases have been modest, TRICARE intends to exempt 
from this increase Survivors of Active Duty Deceased Sponsors and 
Medically Retired Uniformed Services Members and their Dependents 
enrolled in Prime. The enrollment fees for the current beneficiaries in 
these categories would remain at their current rate. The beneficiaries 
added to these categories on or after 10/1/2013 would have their fee 
frozen at the rate in effect at the time they are classified in either 
category and enroll in Prime or, if not enrolling, at the rate in 
effect at the time of enrollment. The fee remains frozen as long as at 
least one family member remains enrolled in TRICARE Prime and there is 
not a break in enrollment. To allow this exemption to be implemented, a 
change to the regulation is needed to authorize an exception to the 
general rule that the enrollment fees ``shall be uniform'' for the 
group of retirees and their dependents. (Survivors and medically 
retired members are part of the retiree group under TRICARE rules.) 
This proposed rule articulates that change. It provides that as an 
exception to the requirement for uniformity within the group of 
retirees and their dependents, the Assistant Secretary of Defense 
(Health Affairs) may exempt Survivors of Active Duty Deceased Sponsors 
and Medically Retired Uniformed Services Members and their dependents 
from increases in enrollment fees that occur on or after October 1, 
2013.
    It is the Department's intent that the exemption will apply only to 
the beneficiaries in the two categories specified above and only if 
they enroll in TRICARE Prime. If a beneficiary in one of the categories 
does not enroll in Prime, but later elects to enroll, their rate would 
be frozen at the rate in effect at the time of enrollment. If a 
beneficiary dis-enrolls from Prime and later re-enrolls, their rate 
would be frozen at the rate in effect at re-enrollment. The fee charged 
for a dependent of a Medically Retired Uniformed Services Member would 
not change if the dependent was later re-classified a Survivor and 
remained enrolled in Prime.

Regulatory Procedures

    Executive Orders 12866 and 13563 require certain regulatory 
assessments for any significant regulatory action that would result in 
an annual effect on the economy of $100 million or more, or have other 
substantial impacts. The Congressional Review Act establishes certain 
procedures for major rules, defined as those with similar major 
impacts. The Regulatory Flexibility Act (RFA) requires that each 
Federal agency prepare, and make available for public comment, a 
regulatory flexibility analysis when the agency issues a regulation 
that would have significant impact on a substantial number of small 
entities. This proposed rule will have none of those effects. Nor does 
it establish information collection requirements under the Paperwork 
Reduction Act. Nor for purposes of Executive Order 13132 does it have 
federalism implications affecting States.

List of Subjects in 32 CFR Part 199

    Claims, Handicapped, Health insurance, and Military personnel.
    Accordingly, 32 CFR part 199 is proposed to be amended as follows:

PART 199--[AMENDED]

0
1. The authority citation for part 199 continues to read as follows:

    Authority: 5 U.S.C. 301; 10 U.S.C. chapter 55.

0
2. Section 199.18 is amended by adding at the end of paragraph (c)(1) a 
new sentence to read as follows:


Sec.  199.18  Uniform HMO Benefit.

* * * * *
    (c) Enrollment fee under the uniform HMO benefit. (1) * * * As an 
exception to the requirement for uniformity within the group of 
retirees and their dependents, the Assistant Secretary of Defense 
(Health Affairs) may exempt Survivors of Active Duty Deceased Sponsors 
and Medically Retired Uniformed Services Members and their Dependents 
from increases in enrollment fees that occur on or after October 1, 
2013.
* * * * *

    Dated: May 16, 2013.
Patricia L. Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2013-13503 Filed 6-6-13; 8:45 am]
BILLING CODE 5001-06-P