Extension of the Comprehensive Autism Care Demonstration for TRICARE Eligible Beneficiaries Diagnosed With Autism Spectrum Disorder, 58186-58187 [2017-26567]
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58186
Federal Register / Vol. 82, No. 236 / Monday, December 11, 2017 / Notices
III. Data
Type of Request: Regular (extension of
a currently approved information
collection).
Number of Respondents: 200.
Average Hours per Response: 20
minutes for initial completion of
certificate and 2 minutes for subsequent
billfish purchase recordkeeping.
Burden Hours: 43.
Needs and Uses: This request is for an
extension of a currently approved
information collection.
Under the provisions of the
Magnuson-Stevens Fishery
Conservation and Management Act (16
U.S.C. 1801 et seq.), NOAA is
responsible for management of the
Nation’s marine fisheries. In addition,
NOAA must comply with the United
States’ (U.S.) obligations under the
Atlantic Tunas Convention Act of 1975
(16 U.S.C. 971 et seq.). A Certificate of
Eligibility (COE) for Billfishes is
required under 50 CFR part 635 to
accompany all billfish, except for a
billfish landed in a Pacific state and
remaining in the state of landing. This
documentation certifies that the
accompanying billfish was not
harvested from the applicable Atlantic
Ocean management unit (described on
the NOAA sample certificate), and
identifies the vessel landing the billfish,
the vessel’s homeport, the port of
offloading, and the date of offloading.
The certificate must accompany the
billfish to any dealer or processor who
subsequently receives or possesses the
billfish. A standard certificate format is
not currently required to document the
necessary information, provided it
contains all of the information required.
The extension of this collection is
necessary to implement the
Consolidated Highly Migratory Species
Fishery Management Plan, which
contains conservation and management
measures that limit the Atlantic billfish
fishery to a recreational fishery.
Affected Public: Business or other forprofit organizations.
Frequency: On occasion.
Respondent’s Obligation: Mandatory.
This information collection request
may be viewed at reginfo.gov. Follow
the instructions to view Department of
Commerce collections currently under
review by OMB.
Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to OIRA_Submission@
omb.eop.gov or fax to (202) 395–5806.
OMB Control Number: 0648–0397.
Form Number: None.
Type of Review: Regular submission
(revision and extension of a currently
approved collection).
Affected Public: Individuals or
households; business or other for-profit
organizations; not-for-profit institutions.
Estimated Number of Respondents:
594.
Estimated Time per Response: 1 hour.
Estimated Total Annual Burden
Hours: 594 hours.
Estimated Total Annual Cost to
Public: $1,188.00.
IV. Request for Comments
Comments are invited on: (a) Whether
the proposed collection of information
is necessary for the proper performance
of the functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden
(including hours and cost) of the
proposed collection of information; (c)
ways to enhance the quality, utility, and
clarity of the information to be
collected; and (d) ways to minimize the
burden of the collection of information
on respondents, including through the
use of automated collection techniques
or other forms of information
technology.
Comments submitted in response to
this notice will be summarized and/or
included in the request for OMB
approval of this information collection;
they also will become a matter of public
record.
Dated: December 6, 2017.
Sarah Brabson,
NOAA PRA Clearance Officer.
[FR Doc. 2017–26663 Filed 12–8–17; 8:45 am]
BILLING CODE 3510–NK–P
DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric
Administration
daltland on DSKBBV9HB2PROD with NOTICES
Submission for OMB Review;
Comment Request
The Department of Commerce will
submit to the Office of Management and
Budget (OMB) for clearance the
following proposal for collection of
information under the provisions of the
Paperwork Reduction Act (44 U.S.C.
Chapter 35).
Agency: National Oceanic and
Atmospheric Administration (NOAA).
Title: Billfish Certificate of Eligibility.
OMB Control Number: 0648–0216.
Form Number(s): None.
VerDate Sep<11>2014
17:54 Dec 08, 2017
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Dated: December 6, 2017.
Sarah Brabson,
NOAA PRA Clearance Officer.
[FR Doc. 2017–26662 Filed 12–8–17; 8:45 am]
BILLING CODE 3510–22–P
DEPARTMENT OF DEFENSE
Office of the Secretary
Extension of the Comprehensive
Autism Care Demonstration for
TRICARE Eligible Beneficiaries
Diagnosed With Autism Spectrum
Disorder
Department of Defense.
Notice of an extension of a
comprehensive demonstration project
for all Applied Behavior Analysis (ABA)
services, including the tiered-model of
ABA, for all TRICARE eligible
beneficiaries diagnosed with Autism
Spectrum Disorder (ASD).
AGENCY:
ACTION:
This notice provides a fiveyear extension to the Military Health
System’s demonstration project entitled
Comprehensive Autism Care
Demonstration (‘‘Autism Care
Demonstration’’). The initial purpose
of the Autism Care Demonstration
(ACD) was to further analyze and
evaluate the appropriateness of the ABA
services tiered delivery model under
TRICARE (the medical benefit) in light
of current and anticipated Behavior
Analyst Certification Board guidelines.
Based on the agency’s experience in
administering ABA services under the
ACD, including engagement with
beneficiaries, providers, advocates,
associations, and other payers, much
more analysis and experience is
required in order to determine the
appropriate characterization of ABA
services as a medical treatment, or other
modalities, under the TRICARE program
coverage requirements—to include
further research and evaluation of the
results, whether Board Certified
Behavior Analysts may appropriately be
recognized and treated as independent
TRICARE authorized providers of a
proven medical benefit, and what
authorities are required to add ABA
services as a permanent benefit under
the TRICARE program—whether as a
proven medical benefit or otherwise.
DATES: The demonstration will continue
through December 31, 2023.
ADDRESSES: Defense Health Agency,
Health Plan Operations, 7700 Arlington
Boulevard, Suite 5101, Falls Church,
Virginia 22042.
FOR FURTHER INFORMATION CONTACT: For
questions pertaining to this
SUMMARY:
E:\FR\FM\11DEN1.SGM
11DEN1
daltland on DSKBBV9HB2PROD with NOTICES
Federal Register / Vol. 82, No. 236 / Monday, December 11, 2017 / Notices
demonstration project, please contact
Mr. Richard Hart at (703) 681–0047.
SUPPLEMENTARY INFORMATION: Under the
demonstration, the Department
implemented a provider model that
allows reimbursement for ABA services
rendered by providers who are not
otherwise eligible for reimbursement.
Additionally, since the implementation
of the demonstration, Congress directed
the agency to add outcome measures as
a requirement to the program. Through
revisions and accomodations to obtain
achievable information, these outcome
measures are aimed at assessing
individual progress for each beneficiary,
and provide limited utility to describe
the population, and the program, as a
whole. To acquire additional research
results that are essential to evaluating
the nature and efficacy of ABA services,
the appropriate characterization of ABA
providers, and the optimum means to
administer coverage of ABA services
under TRICARE, the agency is working
with the Congressionally Directed
Medical Research Program (CDMRP) to
award a contract to a research group to
analyze the TRICARE ACD participants’
outcome measures, particularly
assessing their responses to ABA service
delivery as a total population. The
CDMRP research study will be a
descriptive analysis that has the
potential to be the largest sample
population of ABA services for the
diagnosis of ASD in the entire body of
research literature, therefore
contributing significantly to the
understanding of the efficacy of ABA
service delivery. By extending the
demonstration, the government will not
only gain information about what
TRICARE beneficiaries are receiving
under the ACD and respective
outcomes, the government will also gain
greater insight and understanding of
ASD in the TRICARE population, ABA
services being delivered to TRICARE
beneficiaries, and outcomes data.
Additionally, as a next phase to
improve the ABA services benefit, the
Department will consult with
stakeholders and utilize best practices
identified in commercial and Medicaid
plans as a guide to explore the potential
for a single, nationwide contract to
manage ABA service delivery under the
ongoing authority of the ACD. This
reflects a beneficiary-centric approach
with many advantages that will provide
improved coordination of benefits
nationwide leading to improved
consistency, quality, and beneficiary
experience.
A determination of the future of ABA
under TRICARE and the efficacy of ABA
services as a medical benefit would be
VerDate Sep<11>2014
17:54 Dec 08, 2017
Jkt 244001
premature at this point for the reasons
stated above. It is therefore necessary for
the Department to extend the ACD
beyond its December 31, 2018,
expiration in order to implement this
multi-track approach. This approach
will advance the comprehensive
evaluation of ABA services for TRICARE
coverage for the duration of the CDRMP
research study under a single benefit
contract. This extension will also ensure
continuity of care for beneficiaries
currently receiving ABA services, and
for those beneficiaries who will be
diagnosed with ASD in the future, for
the duration of these ongoing initiatives
and a reasonable time thereafter for
analysis and appropriate TRICARE
program changes, to include seeking any
additional authorities that may be
required.
On June 16, 2014, the Department of
Defense published a notice in the
Federal Register (FR) (79 FR 34291), as
amended by 80 FR 30664 (May 29,
2015), of a TRICARE demonstration to
further analyze and evaluate the
appropriateness of the ABA tiered
delivery model under TRICARE. The
initial purpose of the demonstration was
to determine the appropriate provider
qualifications for the proper diagnosis of
ASD and for the provision of ABA
services, assess the feasibility and
advisability of establishing a beneficiary
cost share for ABA services for the
treatment of ASD, and develop more
efficient and appropriate means of
increasing access to and delivering of
ABA services under TRICARE while
creating a viable economic model and
maintaining administrative simplicity.
The ACD was implemented on July 25,
2014, and expires December 31, 2018.
ABA services are currently provided
through the ACD and managed by the
existing TRICARE regional managed
care support contractors. This approach
enabled TRICARE to quickly expand
access to ABA services for over 14,000
children diagnosed with ASD and
manage a comprehensive ABA benefit
program. However, in efforts to manage
ABA services similar to the TRICARE
Basic medical benefit, many rules have
been modified, or exceptions have been
made, such as diagnosis and referral
procedures, ABA provider qualifications
and credentialing, safety and quality
management reviews, and
reimbursement rate methodology.
Additionally, ABA services may involve
a lengthy period of care and as families
move or transfer across TRICARE
regions, many experience
inconsistencies in how the ABA
services benefit is managed between
TRICARE contracts. Based on lessons
learned, DHA now seeks to improve
PO 00000
Frm 00021
Fmt 4703
Sfmt 4703
58187
ABA services delivery with a more
unified approach to reduce variation
and ensure ABA services are directed to
beneficiaries in a manner that
maximizes clinically necessary benefits
to each child with minimal disruptions.
The Department is committed to
ensuring all TRICARE-eligible
beneficiaries diagnosed with ASD reach
their maximum potential, and that all
treatment provided supports this goal.
The need for effective treatment for the
diagnosis of ASD is unquestioned, and
while there is need for more scientific
evidence, ABA remains the most widely
accepted intervention. Therefore, the
Department is pursuing a more effective
method of delivering and validating the
effectiveness of these services. The
Department is exploring the potential
for a single, nationwide contract,
administered by a private sector health
care company, with specialized
experience and expertise in providing
ABA services, will significantly improve
the provision of ABA services to
military beneficiaries diagnosed with
ASD.
Consequently, the Department has
determined that extension of the
demonstration is both in the best
interest of TRICARE beneficiaries
diagnosed with ASD, and necessary to
fully evaluate the effectiveness of the
delivery model employed by the
demonstration while putting in-place a
nationwide contract. This extension will
determine whether the ACD meets its
stated purpose and provide the
Department with consistent and reliable
information necessary to make informed
decisions regarding the provision of the
ABA services benefit. This extension
will allow the Department to make a
formal decision regarding the use of that
delivery model in the long-term. The
demonstration continues to be
authorized by Title 10, United States
Code, Section 1092.
Dated: December 5, 2017.
Aaron Siegel,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 2017–26567 Filed 12–8–17; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
[Transmittal No. 17–58]
Arms Sales Notification
Defense Security Cooperation
Agency, Department of Defense.
ACTION: Arms sales notice.
AGENCY:
E:\FR\FM\11DEN1.SGM
11DEN1
]]>Agencies
[Federal Register Volume 82, Number 236 (Monday, December 11, 2017)]
[Notices]
[Pages 58186-58187]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-26567]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
Extension of the Comprehensive Autism Care Demonstration for
TRICARE Eligible Beneficiaries Diagnosed With Autism Spectrum Disorder
AGENCY: Department of Defense.
ACTION: Notice of an extension of a comprehensive demonstration project
for all Applied Behavior Analysis (ABA) services, including the tiered-
model of ABA, for all TRICARE eligible beneficiaries diagnosed with
Autism Spectrum Disorder (ASD).
-----------------------------------------------------------------------
SUMMARY: This notice provides a five-year extension to the Military
Health System's demonstration project entitled Comprehensive Autism
Care Demonstration (``Autism Care
Demonstration''). The initial purpose of the Autism Care
Demonstration (ACD) was to further analyze and evaluate the
appropriateness of the ABA services tiered delivery model under TRICARE
(the medical benefit) in light of current and anticipated Behavior
Analyst Certification Board guidelines. Based on the agency's
experience in administering ABA services under the ACD, including
engagement with beneficiaries, providers, advocates, associations, and
other payers, much more analysis and experience is required in order to
determine the appropriate characterization of ABA services as a medical
treatment, or other modalities, under the TRICARE program coverage
requirements--to include further research and evaluation of the
results, whether Board Certified Behavior Analysts may appropriately be
recognized and treated as independent TRICARE authorized providers of a
proven medical benefit, and what authorities are required to add ABA
services as a permanent benefit under the TRICARE program--whether as a
proven medical benefit or otherwise.
DATES: The demonstration will continue through December 31, 2023.
ADDRESSES: Defense Health Agency, Health Plan Operations, 7700
Arlington Boulevard, Suite 5101, Falls Church, Virginia 22042.
FOR FURTHER INFORMATION CONTACT: For questions pertaining to this
[[Page 58187]]
demonstration project, please contact Mr. Richard Hart at (703) 681-
0047.
SUPPLEMENTARY INFORMATION: Under the demonstration, the Department
implemented a provider model that allows reimbursement for ABA services
rendered by providers who are not otherwise eligible for reimbursement.
Additionally, since the implementation of the demonstration, Congress
directed the agency to add outcome measures as a requirement to the
program. Through revisions and accomodations to obtain achievable
information, these outcome measures are aimed at assessing individual
progress for each beneficiary, and provide limited utility to describe
the population, and the program, as a whole. To acquire additional
research results that are essential to evaluating the nature and
efficacy of ABA services, the appropriate characterization of ABA
providers, and the optimum means to administer coverage of ABA services
under TRICARE, the agency is working with the Congressionally Directed
Medical Research Program (CDMRP) to award a contract to a research
group to analyze the TRICARE ACD participants' outcome measures,
particularly assessing their responses to ABA service delivery as a
total population. The CDMRP research study will be a descriptive
analysis that has the potential to be the largest sample population of
ABA services for the diagnosis of ASD in the entire body of research
literature, therefore contributing significantly to the understanding
of the efficacy of ABA service delivery. By extending the
demonstration, the government will not only gain information about what
TRICARE beneficiaries are receiving under the ACD and respective
outcomes, the government will also gain greater insight and
understanding of ASD in the TRICARE population, ABA services being
delivered to TRICARE beneficiaries, and outcomes data.
Additionally, as a next phase to improve the ABA services benefit,
the Department will consult with stakeholders and utilize best
practices identified in commercial and Medicaid plans as a guide to
explore the potential for a single, nationwide contract to manage ABA
service delivery under the ongoing authority of the ACD. This reflects
a beneficiary-centric approach with many advantages that will provide
improved coordination of benefits nationwide leading to improved
consistency, quality, and beneficiary experience.
A determination of the future of ABA under TRICARE and the efficacy
of ABA services as a medical benefit would be premature at this point
for the reasons stated above. It is therefore necessary for the
Department to extend the ACD beyond its December 31, 2018, expiration
in order to implement this multi-track approach. This approach will
advance the comprehensive evaluation of ABA services for TRICARE
coverage for the duration of the CDRMP research study under a single
benefit contract. This extension will also ensure continuity of care
for beneficiaries currently receiving ABA services, and for those
beneficiaries who will be diagnosed with ASD in the future, for the
duration of these ongoing initiatives and a reasonable time thereafter
for analysis and appropriate TRICARE program changes, to include
seeking any additional authorities that may be required.
On June 16, 2014, the Department of Defense published a notice in
the Federal Register (FR) (79 FR 34291), as amended by 80 FR 30664 (May
29, 2015), of a TRICARE demonstration to further analyze and evaluate
the appropriateness of the ABA tiered delivery model under TRICARE. The
initial purpose of the demonstration was to determine the appropriate
provider qualifications for the proper diagnosis of ASD and for the
provision of ABA services, assess the feasibility and advisability of
establishing a beneficiary cost share for ABA services for the
treatment of ASD, and develop more efficient and appropriate means of
increasing access to and delivering of ABA services under TRICARE while
creating a viable economic model and maintaining administrative
simplicity. The ACD was implemented on July 25, 2014, and expires
December 31, 2018.
ABA services are currently provided through the ACD and managed by
the existing TRICARE regional managed care support contractors. This
approach enabled TRICARE to quickly expand access to ABA services for
over 14,000 children diagnosed with ASD and manage a comprehensive ABA
benefit program. However, in efforts to manage ABA services similar to
the TRICARE Basic medical benefit, many rules have been modified, or
exceptions have been made, such as diagnosis and referral procedures,
ABA provider qualifications and credentialing, safety and quality
management reviews, and reimbursement rate methodology. Additionally,
ABA services may involve a lengthy period of care and as families move
or transfer across TRICARE regions, many experience inconsistencies in
how the ABA services benefit is managed between TRICARE contracts.
Based on lessons learned, DHA now seeks to improve ABA services
delivery with a more unified approach to reduce variation and ensure
ABA services are directed to beneficiaries in a manner that maximizes
clinically necessary benefits to each child with minimal disruptions.
The Department is committed to ensuring all TRICARE-eligible
beneficiaries diagnosed with ASD reach their maximum potential, and
that all treatment provided supports this goal. The need for effective
treatment for the diagnosis of ASD is unquestioned, and while there is
need for more scientific evidence, ABA remains the most widely accepted
intervention. Therefore, the Department is pursuing a more effective
method of delivering and validating the effectiveness of these
services. The Department is exploring the potential for a single,
nationwide contract, administered by a private sector health care
company, with specialized experience and expertise in providing ABA
services, will significantly improve the provision of ABA services to
military beneficiaries diagnosed with ASD.
Consequently, the Department has determined that extension of the
demonstration is both in the best interest of TRICARE beneficiaries
diagnosed with ASD, and necessary to fully evaluate the effectiveness
of the delivery model employed by the demonstration while putting in-
place a nationwide contract. This extension will determine whether the
ACD meets its stated purpose and provide the Department with consistent
and reliable information necessary to make informed decisions regarding
the provision of the ABA services benefit. This extension will allow
the Department to make a formal decision regarding the use of that
delivery model in the long-term. The demonstration continues to be
authorized by Title 10, United States Code, Section 1092.
Dated: December 5, 2017.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2017-26567 Filed 12-8-17; 8:45 am]
BILLING CODE 5001-06-P
