Expanded Access to Non-VA Care Through the Veterans Choice Program, 21893-21897 [2018-10054]
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Federal Register / Vol. 83, No. 92 / Friday, May 11, 2018 / Rules and Regulations
TABLE 1 OF § 165.801—SECTOR OHIO VALLEY ANNUAL AND RECURRING SAFETY ZONES—Continued
Date
Sponsor/name
93. 1 day—One weekend in August.
*
*
*
*
Parkersburg Homecoming
tival-Fireworks.
*
Dated: May 7, 2018.
M.B. Zamperini,
Captain, U. S. Coast Guard, Captain of the
Port Sector Ohio Valley.
[FR Doc. 2018–10088 Filed 5–10–18; 8:45 am]
BILLING CODE 9110–04–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 17
RIN 2900–AP60
Expanded Access to Non-VA Care
Through the Veterans Choice Program
Department of Veterans Affairs.
Final rule.
AGENCY:
ACTION:
The Department of Veterans
Affairs (VA) adopts as final, with no
change, an interim final rule revising its
medical regulations that implement
section 101 of the Veterans Access,
Choice, and Accountability Act of 2014,
as amended, (hereafter referred to as
‘‘the Choice Act’’), which requires VA to
establish a program (hereafter referred to
as the ‘‘Veterans Choice Program’’ or the
‘‘Program’’) to furnish hospital care and
medical services through eligible nonVA health care providers to eligible
veterans who either cannot be seen
within the wait-time goals of the
Veterans Health Administration (VHA)
or who qualify based on their place of
residence or face an unusual or
excessive burden in traveling to a VA
medical facility. Those revisions
contained in the interim final rule,
which is now adopted as final, were
required by amendments to the Choice
Act made by the Construction
Authorization and Choice Improvement
Act of 2014, and by the Surface
Transportation and Veterans Health
Care Choice Improvement Act of 2015.
VA published an interim final rule on
December 1, 2015, implementing those
regulatory revisions, and we received
seven public comments. This final rule
responds to those public comments and
does not make any further regulatory
revisions.
DATES: Effective date: This rule is
effective on May 11, 2018.
FOR FURTHER INFORMATION CONTACT:
Joseph Duran, Director, Policy and
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SUMMARY:
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Sector Ohio Valley location
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Fes-
Parkersburg, WV ..........................
Planning, Office of Community Care
(10D1A1), Veterans Health
Administration, Department of Veterans
Affairs, 810 Vermont Avenue NW,
Washington, DC 20420, (303) 372–4629.
(This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: The
Choice Act, Public Law 113–146, was
enacted on August 7, 2014. Further
amendments to the Choice Act were
made by Public Laws 113–175, 113–235,
114–19, 114–41, and 115–26. Under
these authorities, VA established the
Veterans Choice Program and published
regulations at 38 CFR 17.1500 through
17.1540. This final rule revises VA
regulations in accordance with the
amendments to the Choice Act made by
Public Laws 114–19 and 114–41. Public
Law 114–19, the Construction
Authorization and Choice Improvement
Act, amended the Choice Act to define
additional criteria that VA may use to
determine that a veteran’s travel to a VA
medical facility is an ‘‘unusual or
excessive burden.’’ Public Law 114–41,
the Surface Transportation and Veterans
Health Care Choice Improvement Act of
2015, amended the Choice Act to
expand eligibility for the Veterans
Choice Program to all veterans enrolled
in the VA health care system, to remove
the 60-day limit on an episode of care,
modify the wait-time and 40-mile
distance eligibility criteria, and expand
provider eligibility based on criteria as
determined by VA. VA published an
interim final rule on December 1, 2015,
to implement these amendments to the
Choice Act. 80 FR 74991. We received
seven comments on the interim final
rule and respond to those comments in
the discussion below. We are adopting
as final the interim final rule with no
revisions.
Comments regarding changes in
Public Law 114–19 related to the
‘‘unusual or excessive burden’’
standard.
Section 3(a)(2) of Public Law 114–19
amended section 101(b)(2)(D)(ii)(II) of
the Choice Act by defining additional
criteria that could be the basis for
finding that a veteran faced an ‘‘unusual
or excessive burden’’ in traveling to
receive care in a VA medical facility,
including environmental factors such as
roads that are not accessible to the
general public, traffic, or hazardous
weather; a medical condition that affects
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Ohio River mile
(West Virginia).
183.5–185.5
the ability to travel; or other factors, as
determined by the Secretary. The
interim final rule revised
§ 17.1510(b)(4)(ii) to include
environmental factors such as roads that
are not accessible to the general public,
traffic, or hazardous weather, or a
medical condition that affects the ability
to travel. The interim final rule also
added three ‘‘other factors’’ to
§ 17.1510(b)(4)(ii)(A) through (C): The
nature or simplicity of the hospital care
or medical services the veteran requires;
how frequently the veteran needs such
hospital care; or medical services, and
the need for an attendant, which is
defined as a person who provides
required aid and/or physical assistance
to the veteran, for a veteran to travel to
a VA medical facility for hospital care
or medical services. VA received one
positive comment in support of the
revisions to § 17.1510(b)(4)(ii), and we
thank the commenter for this feedback.
VA did not receive any comments that
suggested changes to the revisions to
§ 17.1510(b)(4)(ii), and therefore does
not make further regulatory revisions.
Comments regarding changes in
Public Law 114–41 related to veteran
eligibility, periods of follow up care,
wait times, distance requirements, and
provider eligibility.
Section 4005(b) of Public Law 114–41
amended section 101 of the Choice Act
to remove the August 1, 2014,
enrollment date restriction, thereby
making all veterans enrolled in the VA
health care system under § 17.36
potentially eligible for the Program if
they meet its other eligibility criteria.
Section 17.1510 was therefore revised in
the interim final rule to codify this
expanded eligibility for the Program. VA
implemented this change ahead of the
§ 17.1510 revision, as this change was
not subject to notice and comment
because it had an immediate effective
date and VA did not need to interpret
the language of the public law to give it
effect. VA also did not receive any
comments on this revision, and does not
make any further regulatory revisions.
Section 4005(a) of Public Law 114–41
amended section 101(h) of the Choice
Act by removing the 60-day limitation
on an ‘‘episode of care.’’ Sec. 4005(a),
Public Law 114–41, 129 Stat. 443. The
definition of ‘‘episode of care’’ in
§ 17.1505 was therefore revised in the
interim final rule by removing the
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phrase ‘‘which lasts no longer than 60
days from the date of the first
appointment with a non-VA health care
provider,’’ and the 60-day limitation
was replaced with a 1-year limitation,
consistent with VA’s authority in
section 101(c)(1)(B)(i) of the Choice Act
to establish a timeframe for
authorization of care. VA received one
comment in support of this change, but
this comment also suggested that VA
make exceptions to the 1-year
limitation, particularly for chronic
conditions, to avoid the possibility of
the unnecessary cessation of care due to
reauthorization requirements. The
comment further suggested that VA
should provide more specific
information regarding what a
community provider would need to
submit to VA to obtain a broader
authorization beyond 1-year, and that
VA should provide more details on the
process community providers may
follow to ‘‘provide additional care
outside the scope of the authorized
course of treatment.’’ We agree that
veterans should not experience
cessations of treatment for an ongoing
condition if they require care beyond
one year; the regulations do therefore
allow reauthorization for additional
episodes of care as needed. However,
we believe that it is important that VA
reauthorize an episode of care annually
even in those instances where it is
apparent at the time of the initial
authorization that the condition is
chronic and care will be required for
greater than one year. A chronic medical
condition may change over time,
resulting in a need to reexamine the
authorized scope of care. Annual
reauthorization of an episode of care
provides an opportunity for VA to
review the scope of the episode of care
with the healthcare provider and make
necessary revisions to meet the needs of
the veteran. Care may only be provided
within the scope of the authorized
episode of care, as defined in § 17.1505
as a ‘‘necessary course of treatment,
including follow-up appointments and
ancillary and specialty services’’ for
identified health care needs. If a
community provider believes that a
veteran needs additional care outside
the scope of the authorized course of
treatment, the health care provider must
contact VA prior to administering such
care to ensure that this care is
authorized and therefore will be paid for
by VA. Details regarding what specific
information must be submitted or what
processes must be followed to obtain
authorizations for additional episodes of
care, or for an authorization to provide
care not authorized as part of the
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episode of care, is too specific for a
regulation, but information is available
from the contractors that administer the
Choice program and from VA when the
care is authorized under a Choice
provider agreement. VA continually
works with the contractors and with
community providers to improve
education and processes under the
Program. VA does not make any further
regulatory revisions based on this
comment.
Section 4005(d) of Public Law 114–41
amended section 101(b)(2)(A) of the
Choice Act to create eligibility for
veterans that are unable to be scheduled
for an appointment within ‘‘the period
determined necessary for [clinically
necessary] care or services if such
period is shorter than’’ VHA’s wait time
goals. Section 4005(d), Public Law 114–
41, 129 Stat. 443. This new wait-times
based criterion was added as paragraph
(b)(1)(ii) of § 17.1510, and created
eligibility when a veteran is unable to
schedule an appointment within a
period of time that VA determines is
clinically necessary and which is
shorter than VHA’s wait time goals. VA
received one positive comment in
support of this revision, and we thank
the commenter for this feedback. VA did
not receive any comments that
suggested changes to this revision, and
therefore does not make further
regulatory revisions.
Section 4005(e) of Public Law 114–41
amended section 101(b)(2)(B) of the
Choice Act to modify the 40-mile
distance eligibility criterion to provide
that veterans may be eligible if they
reside more than 40 miles from ‘‘(i) with
respect to a veteran who is seeking
primary care, a medical facility of the
Department, including a communitybased outpatient clinic, that is able to
provide such primary care by a full-time
primary care physician; or (ii) with
respect to a veteran not covered under
clause (i), the medical facility of the
Department, including a communitybased outpatient clinic, that is closest to
the residence of the veteran.’’ VA found
that it would be impracticable and not
veteran centric to apply a ‘‘seeking
primary care’’ eligibility criterion, and
therefore did not revise the general
40-mile requirement in § 17.1510(b)(1)
in the interim final rule to reflect such
a strict reading of the public law.
However, VA did revise § 17.1505 to
add a definition of ‘‘full-time primary
care physician,’’ as well as amend the
definition of ‘‘VA medical facility’’ to
require that such a facility have a fulltime primary care physician, so that for
purposes of determining distancerelated eligibility for the Program, VA
considered a qualifying VA medical
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facility to include only those facilities
with at least a full-time primary care
physician. VA received one positive
comment in support of this revision,
and we thank the commenter for this
feedback. VA did not receive any
comments that suggested changes to this
revision, and therefore does not make
further regulatory revisions.
Section 4005(c) of Public Law 114–41
amended sections 101(a)(1)(B) and
101(d) of the Choice Act to permit VA
to expand provider eligibility beyond
those providers expressly listed in
section 101(a)(1)(B) of the Choice Act, in
accordance with criteria as established
by VA. In the interim final rule, VA
revised § 17.1530(a) to refer to a new
paragraph (e) that established eligibility
for these other providers, and added a
new paragraph (e) to § 17.1530 to list
these providers specifically. VA also
revised § 17.1530(d) to reorganize
current requirements and add new
requirements for these providers, in
accordance with section 101(d)(5) of the
Choice Act. VA received two positive
comments in support of this revision,
and we thank the commenters for this
feedback. VA received one comment
that inquired whether, given the
expansion of eligible providers, such
providers were required to be Medicareparticipating providers. We clarify that
eligible providers in the Program
include but are not limited to Medicareparticipating providers, as established
in § 17.1530(a) and (e). With this
clarification, and because VA did not
receive any comments that suggested
changes to this revision, we therefore do
not make further regulatory revisions.
Miscellaneous Comments
The remaining five comments do not
specifically pertain to the regulatory
changes in the interim final rule, and
are addressed here in turn.
One commenter requested that the
end date of August 7, 2017, for the
Choice Act be removed and the program
made permanent. The Choice Act,
which was enacted on August 7, 2014,
in Public Law 113–146, specifically
prescribed that the Choice Program
would be temporary, operating for 3
years or until the funding was
exhausted, whichever came first. The
3-year sunset date was removed by
Public Law 115–26, and so the Choice
Program is authorized until the amounts
appropriated in the Choice Fund are
exhausted. Current regulations do not
discuss the termination date of the
Program, and VA does not make any
regulatory changes based on Public Law
115–26 or this comment.
Another commenter expressed a
generalized concern that the Choice
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Program created additional barriers to
access healthcare as well as expressed
specific concerns about the Choice
Program. To address the commenter’s
generalized concern related to barriers
to access, we acknowledge the
difficulties that some veterans have
experienced and expressed since the
inception of the Choice Program in
August 2014, and we are similarly
sympathetic to the commenter’s
expressed experiences. Congress
mandated that VA implement the
Choice Program in 90 days, and
implementing such an unprecedented
program in terms of VA care in the
community on a nationwide basis, in 90
days, resulted in growing pains for
veterans, community providers, and VA.
During the initial year of the Choice
Program, VA met with veterans,
community providers, leading
healthcare experts, and staff across the
country to hear concerns and identify
solutions. In order to immediately
implement changes to the Choice
Program, VA brought in new leadership
to oversee all Community Care
Programs. Under this new leadership,
VA quickly began to improve the Choice
Program and laid out a plan to drive
towards a future that delivers the best of
VA and the community. VA has
earnestly tried to implement the Choice
Program in accord with legal
requirements while being mindful of
veteran concerns and administrative
realities, and VA will continue to strive
to reduce any barriers communicated to
us by veterans. VA does not make any
regulatory changes to address the
commenter’s generalized concerns about
the Choice Program.
As to the commenter’s specific
concerns, the commenter stated that
there are no clear channels for
resolution of complaints or problems
when authorization for care has been
delayed. The commenter further
elaborated that it is difficult to access
the Choice Program call centers and,
once contact is made with the call
center, it is difficult to receive answers
from the employees working in the call
centers. The commenter suggested that
a process be put in place to address
complaint resolution. We interpret these
concerns to be limited to issues that
arise administratively when the veteran
is already enrolled in the Choice
Program, such as delays in
authorization, and not concerns
regarding eligibility to participate in the
Choice Program or concerns with
clinical decisions throughout the course
of treatment. Therefore, we further
interpret these concerns to relate to the
internal processes relating to
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administration of the program and do
not make any regulatory changes.
However, we describe below processes
and improvements that both VA and the
contractors that administer the Choice
Program have undertaken and which we
believe obviate the need for more formal
processes in regulation.
VA has taken affirmative steps to
decrease administrative burdens such as
delays in authorization and has
improved access to VA staff through the
VA call centers and the internet. For
instance, VA has reduced the
administrative burden for medical
record submission for community
providers by streamlining the
documents required. We also have
strived to improve veterans’ experience
with the call centers throughout the past
year. More specifically, in May 2015, it
took approximately 11 days to contact
the veteran, obtain their provider and
appointment preference, and work with
the community provider to schedule an
appointment; by May 2016, the average
number of days to accomplish those
tasks decreased to only 6. The Choice
Program call centers have also
continued to improve with a call
abandon rate of less than 2 percent; a
call hold time of no more than 7
seconds; and first-time call resolution
over of 96 percent. In addition, Veterans
are able to contact VA directly through
this website that is available to the
public: https://www.va.gov/opa/
choiceact/. The website contains
information about the program, a phone
number that veterans can call in order
to speak to a person directly, and also
contains a live chat option that is
available to veterans Monday through
Friday from 8 a.m. to 8 p.m., eastern
standard time. The vendors who
administer the Choice Program
additionally have processes in place for
veterans who experience delays when
receiving care in the community. The
complaints and grievance processes for
the contractors, TriWest and Health Net,
are available at their public websites,
respectively: https://www.triwest.com/
globalassets/documents/veteranservices/complaint-grievance_form.pdf
and https://www.hnfs.com/content/
hnfs/home/va/provider/resources/
resources/grievances.html.
The commenter next expressed the
specific concern that rural veterans are
disproportionately negatively impacted
by barriers created by the Choice Act
and VA and that such veterans’
feedback is not heard by VA as a result
of their disability status and geographic
location. We first clarify that VA strives
to gain feedback from all veterans,
including those who live in rural areas,
about their experiences with the Choice
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Program. To obtain feedback from all
veterans, regardless of their geographic
location, VA developed a Survey of
Healthcare Experiences of Patients
(SHEP) for veterans to complete after
receiving Choice care. We further
acknowledge that there are unique
problems that affect rural veterans and
that it may be more difficult for rural
veterans to obtain health care near their
residence. In this regard, the 40-mile
distance criterion in the Choice Program
regulations at § 17.1510(b)(2) is
designed to address accessibility issues
that affect rural Veterans. Particularly,
the 40-mile criterion has been
interpreted by VA to consider driving
distance and not straight line distance
(see 80 FR 22906, April 24, 2015), and
to further interpret that this distance
must be from a Veteran’s residence to a
VA medical facility that has at least one
full time equivalent primary care
physician (see 80 FR 74991, December
1, 2015). Both of these interpretations
we believe increase the number of rural
veterans eligible for the program, and
VA otherwise actively seeks and
documents the concerns of rural
veterans that participate in the Choice
program with its SHEP survey as
described above. Therefore, we make no
regulatory changes based on this
comment.
The commenter also stated that the
Choice Program has created
coordination of care issues for non-VA
providers who administer health care
for veterans. The commenter did not
elaborate on what those issues are or
how the Choice Program created them,
or whether the interim final rule
exacerbated the issues, and the
commenter also did not suggest any
changes to alleviate the issues. We do
acknowledge that there may have been
difficulty with coordination of care at
the inception of the Choice Program,
and, to enhance coordination of care for
veterans, we have embedded Choice
contractor staff with VA staff at 14 VA
facilities, and continue to increase the
number of embedded Choice contractor
staff locations. As the commenter did
not provide enough specificity for
suggested regulatory changes, and we
believe VA has undertaken efforts to
mitigate coordination of care issues, we
do not make any regulatory revisions
based on this comment.
Finally, the commenter explained that
it was easier to seek care prior to the
Choice Program and that, even though
the Program is voluntary, veterans are
being told that they must use the Choice
Program over VA care and other VA care
in the community permitted by legal
authorities other than the Choice Act.
We first clarify that the Choice Program
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is voluntary and veterans are provided
the option of obtaining care solely at VA
medical facilities. Significantly, the
Choice Program is designed to respect
and guarantee a veteran’s choice to see
a VA provider or a non-VA provider if
they meet Choice Program criteria. In
fact, if an eligible veteran elects to
receive covered care through the Choice
Program, VA is required by the Choice
Act to furnish the care through the
Program. In addition, the Choice Act
authorized VA to purchase care through
Choice provider agreements, which
gives VA greater flexibility when
furnishing care through the Choice
Program. VA recognizes that some
veterans faced administrative barriers
and hurdles while seeking care through
the Choice Program and that some
veterans may have found it was easier
in the past to seek VA care in the
community under legal authorities other
than the Choice Act. To ensure the
Choice Program provides high quality
and accessible care, VA has made and
will continue to make improvements by
working with Congress, our community
providers, our Choice Program
contractors and within VA. Therefore,
we do not make any further regulatory
revisions based on this comment.
The final three comments are beyond
the scope of the interim final rule and
we will not make any regulatory
changes based on the comments. One
commenter expressed concern about the
recertification process to become a
vendor and contract with VA through
‘‘vetbiz.gov.’’ The process of
vendorization on vetbiz.gov does not
apply for clinical providers under the
Choice Act. As the commenter did not
otherwise reference the interim final
rule or the Choice Program regulations
generally, nor did the commenter state
how the ability to recertify as a vendor
was affected by the interim final rule or
Choice regulations, we find that the
comment is beyond the scope of the
rulemaking.
Another commenter supported the
interim final rule because it would
enable the commenter to access
community care near the commenter’s
residence in Panama. Care under the
Choice Program is not provided outside
of the United States. VA’s only authority
to provide care abroad is through the
foreign medical care provisions in 38
U.S.C. 1724, and the Choice Act did not
affect this limitation.
Another commenter expressed a
concern over the potentially
burdensome nature of the
administrative requirements to
participate in the Choice Program.
Specifically, the commenter requested
that VA be mindful that an overly
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complicated process to apply to
participate in the Choice Program may
deter people who are eligible and
entitled to participate in the Program.
The commenter did not specify what
these burdens are or if they were made
worse by revisions in the interim final
rule. Therefore, we interpret the
comment to be general in scope.
Although the interim final rule and the
Choice regulations contain eligibility
criteria, they do not contain any
requirements or guidance for how to
apply to participate in the Choice
Program. Therefore, we find that the
comment is not within the scope of the
rulemaking and we will not make any
regulatory changes based on this
comment.
Effect of Rulemaking
Title 38 of the Code of Federal
Regulations, as confirmed by this final
rule, represents VA’s implementation of
its legal authority on this subject. Other
than future amendments to this
regulation or governing statutes, no
contrary guidance or procedures are
authorized. All existing or subsequent
VA guidance must be read to conform
with this rulemaking if possible or, if
not possible, such guidance is
superseded by this rulemaking.
Paperwork Reduction Act
Although this action contains
provisions constituting collections of
information, at 38 CFR 17.1530(d),
under the Paperwork Reduction Act of
1995 (44 U.S.C. 3501–3521), no new or
proposed revised collections of
information are associated with this
final rule. The information collection
requirements for § 17.1530(d) are
currently approved by the Office of
Management and Budget (OMB) and
have been assigned OMB control
number 2900–0823.
Executive Orders 12866, 13563, and
13771
Executive Orders 12866 and 13563
direct agencies to assess the costs and
benefits of available regulatory
alternatives and, when regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety
effects, and other advantages;
distributive impacts; and equity).
Executive Order 13563 (Improving
Regulation and Regulatory Review)
emphasizes the importance of
quantifying both costs and benefits,
reducing costs, harmonizing rules, and
promoting flexibility. Executive Order
12866 (Regulatory Planning and
Review) defines a ‘‘significant
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regulatory action,’’ which requires
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 that this is an economically
significant regulatory action under
Executive Order 12866. VA’s regulatory
impact analysis can be found as a
supporting document at https://
www.regulations.gov, usually within 48
hours after the rulemaking document is
published. Additionally, a copy of the
rulemaking and its regulatory impact
analysis are available on VA’s website at
https://www.va.gov/orpm/, by following
the link for ‘‘VA Regulations Published
From FY 2004 Through Fiscal Year to
Date.’’ VA’s impact analysis can be
found as a supporting document at
https://www.regulations.gov, usually
within 48 hours after the rulemaking
document is published. Additionally, a
copy of the rulemaking and its impact
analysis are available on VA’s website at
https://www.va.gov/orpm by following
the link for VA Regulations Published
from FY 2004 through FYTD. This rule
is not subject to the requirements of E.O.
13771 because this rule results in no
more than de minimis costs.
Congressional Review Act
This regulatory action is a major rule
under the Congressional Review Act, 5
U.S.C. 801–08, because it may result in
an annual effect on the economy of $100
million or more. Although this
regulatory action constitutes a major
rule within the meaning of the
Congressional Review Act, 5 U.S.C.
804(2), it is not subject to the 60-day
delay in effective date applicable to
major rules under 5 U.S.C. 801(a)(3)
because the Secretary finds that good
cause exists under 5 U.S.C. 808(2) to
make this regulatory action effective on
the date of publication, consistent with
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the reasons given for the publication of
the interim final rule. In accordance
with 5 U.S.C. 801(a)(1), VA will submit
to the Comptroller General and to
Congress a copy of this regulatory action
and VA’s Regulatory Impact Analysis.
64.045—VHA Outpatient Ancillary
Services; 64.046—VHA Inpatient
Psychiatry; 64.047—VHA Primary Care;
64.048—VHA Mental Health Clinics;
64.049—VHA Community Living
Center; 64.050—VHA Diagnostic Care.
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
1 year. This final rule will have no such
effect on State, local, and tribal
governments, or on the private sector.
List of Subjects in 38 CFR Part 17
Administrative practice and
procedure, Alcohol abuse, Alcoholism,
Claims, Day care, Dental health, Drug
abuse, Government contracts, Grant
programs-health, Grant programsveterans, Health care, Health facilities,
Health professions, Health records,
Homeless, Mental health programs,
Nursing homes, Reporting and
recordkeeping requirements, Travel and
transportation expenses, Veterans.
sradovich on DSK3GMQ082PROD with RULES
Regulatory Flexibility Act
The Secretary hereby certifies that
this final rule will 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 final rule
will not have a significant economic
impact on participating eligible entities
and providers who enter into
agreements with VA. To the extent there
is any such impact, it will result in
increased business and revenue for
them. We also do not believe there will
be a significant economic impact on
insurance companies, as claims will
only be submitted for care that will
otherwise have been received whether
such care was authorized under this
Program or not. 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.
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic
Assistance numbers and titles for the
programs affected by this document are
as follows: 64.008—Veterans
Domiciliary Care; 64.011—Veterans
Dental Care; 64.012—Veterans
Prescription Service; 64.013—Veterans
Prosthetic Appliances; 64.014—
Veterans State Domiciliary Care;
64.015—Veterans State Nursing Home
Care; 64.024—VA Homeless Providers
Grant and Per Diem Program; 64.026—
Veterans State Adult Day Health Care;
64.029—Purchase Care Program;
64.035—Veterans Transportation
Program; 64.038—Grants for the Rural
Veterans Coordination Pilot; 64.039—
CHAMPVA; 64.040—VHA Inpatient
Medicine; 64.041—VHA Outpatient
Specialty Care; 64.042—VHA Inpatient
Surgery; 64.043—VHA Mental Health
Residential; 64.044—VHA Home Care;
VerDate Sep<11>2014
22:27 May 10, 2018
Jkt 244001
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. Gina
S. Farrisee, Deputy Chief of Staff,
Department of Veterans Affairs,
approved this document Janaury 12,
2018, for publication.
Dated: May 8, 2018.
Consuela Benjamin,
Regulations Development Coordinator, Office
of Regulation Policy & Management, Office
of the Secretary, Department of Veterans
Affairs.
PART 17—MEDICAL
Accordingly, the interim rules
amending 38 CFR part 17 which were
published at 80 FR 74991 on December
1, 2015, and 81 FR 24026 on April 25,
2016, are adopted as final without
change.
■
[FR Doc. 2018–10054 Filed 5–10–18; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 17
RIN 2900–AQ06
Authority of Health Care Providers To
Practice Telehealth
Department of Veterans Affairs.
Final rule.
AGENCY:
ACTION:
The Department of Veterans
Affairs (VA) is amending its medical
regulations by standardizing the
delivery of care by VA health care
providers through telehealth. This rule
ensures that VA health care providers
can offer the same level of care to all
SUMMARY:
PO 00000
Frm 00057
Fmt 4700
Sfmt 4700
21897
beneficiaries, irrespective of the State or
location in a State of the VA health care
provider or the beneficiary. This final
rule achieves important Federal
interests by increasing the availability of
mental health, specialty, and general
clinical care for all beneficiaries.
DATES: This final rule is effective June
11, 2018.
FOR FURTHER INFORMATION CONTACT:
Kevin Galpin, MD, Executive Director
Telehealth Services, Veterans Health
Administration Office of Connected
Care, 810 Vermont Avenue NW,
Washington, DC 20420, (404) 771–8794,
(this is not a toll-free number),
Kevin.Galpin@va.gov.
SUPPLEMENTARY INFORMATION: In a
document published in the Federal
Register on October 2, 2017, VA
proposed to amend its medical
regulations by standardizing the
delivery of health care by VA health
care providers through telehealth. 82 FR
45756. VA provided a 30-day comment
period, which ended on November 1,
2017. We received 75 comments on the
proposed rule.
Section 7301 of title 38, United States
Code (U.S.C.), establishes the general
functions of the Veterans Health
Administration (VHA) within VA, and
establishes that its primary function is
to ‘‘provide a complete medical and
hospital service for the medical care and
treatment of veterans, as provided in
this title and in regulations prescribed
by the Secretary [of Veterans Affairs
(Secretary)] pursuant to this title.’’ See
38 U.S.C. 7301(b). The Secretary is
responsible for the proper execution and
administration of all laws administered
by the Department and for the control,
direction, and management of the
Department, including agency personnel
and management matters. See 38 U.S.C.
303. To this end, Congress authorized
the Secretary ‘‘to prescribe all rules and
regulations which are necessary or
appropriate to carry out the laws
administered by the Department and are
consistent with those laws.’’ See 38
U.S.C. 501(a). The Under Secretary for
Health is directly responsible to the
Secretary for the operation of VHA. See
38 U.S.C. 305(b). Unless specifically
otherwise provided, the Under Secretary
for Health, as the head of VHA, is
authorized to ‘‘prescribe all regulations
necessary to the administration of the
Veterans Health Administration,’’
subject to the approval of the Secretary.
See 38 U.S.C. 7304.
To allow VA to carry out its medical
care mission, Congress also established
a comprehensive personnel system for
certain VA health care providers,
independent of the civil service rules.
E:\FR\FM\11MYR1.SGM
11MYR1
Agencies
[Federal Register Volume 83, Number 92 (Friday, May 11, 2018)]
[Rules and Regulations]
[Pages 21893-21897]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-10054]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 17
RIN 2900-AP60
Expanded Access to Non-VA Care Through the Veterans Choice
Program
AGENCY: Department of Veterans Affairs.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) adopts as final, with
no change, an interim final rule revising its medical regulations that
implement section 101 of the Veterans Access, Choice, and
Accountability Act of 2014, as amended, (hereafter referred to as ``the
Choice Act''), which requires VA to establish a program (hereafter
referred to as the ``Veterans Choice Program'' or the ``Program'') to
furnish hospital care and medical services through eligible non-VA
health care providers to eligible veterans who either cannot be seen
within the wait-time goals of the Veterans Health Administration (VHA)
or who qualify based on their place of residence or face an unusual or
excessive burden in traveling to a VA medical facility. Those revisions
contained in the interim final rule, which is now adopted as final,
were required by amendments to the Choice Act made by the Construction
Authorization and Choice Improvement Act of 2014, and by the Surface
Transportation and Veterans Health Care Choice Improvement Act of 2015.
VA published an interim final rule on December 1, 2015, implementing
those regulatory revisions, and we received seven public comments. This
final rule responds to those public comments and does not make any
further regulatory revisions.
DATES: Effective date: This rule is effective on May 11, 2018.
FOR FURTHER INFORMATION CONTACT: Joseph Duran, Director, Policy and
Planning, Office of Community Care (10D1A1), Veterans Health
Administration, Department of Veterans Affairs, 810 Vermont Avenue NW,
Washington, DC 20420, (303) 372-4629. (This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: The Choice Act, Public Law 113-146, was
enacted on August 7, 2014. Further amendments to the Choice Act were
made by Public Laws 113-175, 113-235, 114-19, 114-41, and 115-26. Under
these authorities, VA established the Veterans Choice Program and
published regulations at 38 CFR 17.1500 through 17.1540. This final
rule revises VA regulations in accordance with the amendments to the
Choice Act made by Public Laws 114-19 and 114-41. Public Law 114-19,
the Construction Authorization and Choice Improvement Act, amended the
Choice Act to define additional criteria that VA may use to determine
that a veteran's travel to a VA medical facility is an ``unusual or
excessive burden.'' Public Law 114-41, the Surface Transportation and
Veterans Health Care Choice Improvement Act of 2015, amended the Choice
Act to expand eligibility for the Veterans Choice Program to all
veterans enrolled in the VA health care system, to remove the 60-day
limit on an episode of care, modify the wait-time and 40-mile distance
eligibility criteria, and expand provider eligibility based on criteria
as determined by VA. VA published an interim final rule on December 1,
2015, to implement these amendments to the Choice Act. 80 FR 74991. We
received seven comments on the interim final rule and respond to those
comments in the discussion below. We are adopting as final the interim
final rule with no revisions.
Comments regarding changes in Public Law 114-19 related to the
``unusual or excessive burden'' standard.
Section 3(a)(2) of Public Law 114-19 amended section
101(b)(2)(D)(ii)(II) of the Choice Act by defining additional criteria
that could be the basis for finding that a veteran faced an ``unusual
or excessive burden'' in traveling to receive care in a VA medical
facility, including environmental factors such as roads that are not
accessible to the general public, traffic, or hazardous weather; a
medical condition that affects the ability to travel; or other factors,
as determined by the Secretary. The interim final rule revised Sec.
17.1510(b)(4)(ii) to include environmental factors such as roads that
are not accessible to the general public, traffic, or hazardous
weather, or a medical condition that affects the ability to travel. The
interim final rule also added three ``other factors'' to Sec.
17.1510(b)(4)(ii)(A) through (C): The nature or simplicity of the
hospital care or medical services the veteran requires; how frequently
the veteran needs such hospital care; or medical services, and the need
for an attendant, which is defined as a person who provides required
aid and/or physical assistance to the veteran, for a veteran to travel
to a VA medical facility for hospital care or medical services. VA
received one positive comment in support of the revisions to Sec.
17.1510(b)(4)(ii), and we thank the commenter for this feedback. VA did
not receive any comments that suggested changes to the revisions to
Sec. 17.1510(b)(4)(ii), and therefore does not make further regulatory
revisions.
Comments regarding changes in Public Law 114-41 related to veteran
eligibility, periods of follow up care, wait times, distance
requirements, and provider eligibility.
Section 4005(b) of Public Law 114-41 amended section 101 of the
Choice Act to remove the August 1, 2014, enrollment date restriction,
thereby making all veterans enrolled in the VA health care system under
Sec. 17.36 potentially eligible for the Program if they meet its other
eligibility criteria. Section 17.1510 was therefore revised in the
interim final rule to codify this expanded eligibility for the Program.
VA implemented this change ahead of the Sec. 17.1510 revision, as this
change was not subject to notice and comment because it had an
immediate effective date and VA did not need to interpret the language
of the public law to give it effect. VA also did not receive any
comments on this revision, and does not make any further regulatory
revisions.
Section 4005(a) of Public Law 114-41 amended section 101(h) of the
Choice Act by removing the 60-day limitation on an ``episode of care.''
Sec. 4005(a), Public Law 114-41, 129 Stat. 443. The definition of
``episode of care'' in Sec. 17.1505 was therefore revised in the
interim final rule by removing the
[[Page 21894]]
phrase ``which lasts no longer than 60 days from the date of the first
appointment with a non-VA health care provider,'' and the 60-day
limitation was replaced with a 1-year limitation, consistent with VA's
authority in section 101(c)(1)(B)(i) of the Choice Act to establish a
timeframe for authorization of care. VA received one comment in support
of this change, but this comment also suggested that VA make exceptions
to the 1-year limitation, particularly for chronic conditions, to avoid
the possibility of the unnecessary cessation of care due to
reauthorization requirements. The comment further suggested that VA
should provide more specific information regarding what a community
provider would need to submit to VA to obtain a broader authorization
beyond 1-year, and that VA should provide more details on the process
community providers may follow to ``provide additional care outside the
scope of the authorized course of treatment.'' We agree that veterans
should not experience cessations of treatment for an ongoing condition
if they require care beyond one year; the regulations do therefore
allow reauthorization for additional episodes of care as needed.
However, we believe that it is important that VA reauthorize an episode
of care annually even in those instances where it is apparent at the
time of the initial authorization that the condition is chronic and
care will be required for greater than one year. A chronic medical
condition may change over time, resulting in a need to reexamine the
authorized scope of care. Annual reauthorization of an episode of care
provides an opportunity for VA to review the scope of the episode of
care with the healthcare provider and make necessary revisions to meet
the needs of the veteran. Care may only be provided within the scope of
the authorized episode of care, as defined in Sec. 17.1505 as a
``necessary course of treatment, including follow-up appointments and
ancillary and specialty services'' for identified health care needs. If
a community provider believes that a veteran needs additional care
outside the scope of the authorized course of treatment, the health
care provider must contact VA prior to administering such care to
ensure that this care is authorized and therefore will be paid for by
VA. Details regarding what specific information must be submitted or
what processes must be followed to obtain authorizations for additional
episodes of care, or for an authorization to provide care not
authorized as part of the episode of care, is too specific for a
regulation, but information is available from the contractors that
administer the Choice program and from VA when the care is authorized
under a Choice provider agreement. VA continually works with the
contractors and with community providers to improve education and
processes under the Program. VA does not make any further regulatory
revisions based on this comment.
Section 4005(d) of Public Law 114-41 amended section 101(b)(2)(A)
of the Choice Act to create eligibility for veterans that are unable to
be scheduled for an appointment within ``the period determined
necessary for [clinically necessary] care or services if such period is
shorter than'' VHA's wait time goals. Section 4005(d), Public Law 114-
41, 129 Stat. 443. This new wait-times based criterion was added as
paragraph (b)(1)(ii) of Sec. 17.1510, and created eligibility when a
veteran is unable to schedule an appointment within a period of time
that VA determines is clinically necessary and which is shorter than
VHA's wait time goals. VA received one positive comment in support of
this revision, and we thank the commenter for this feedback. VA did not
receive any comments that suggested changes to this revision, and
therefore does not make further regulatory revisions.
Section 4005(e) of Public Law 114-41 amended section 101(b)(2)(B)
of the Choice Act to modify the 40-mile distance eligibility criterion
to provide that veterans may be eligible if they reside more than 40
miles from ``(i) with respect to a veteran who is seeking primary care,
a medical facility of the Department, including a community-based
outpatient clinic, that is able to provide such primary care by a full-
time primary care physician; or (ii) with respect to a veteran not
covered under clause (i), the medical facility of the Department,
including a community-based outpatient clinic, that is closest to the
residence of the veteran.'' VA found that it would be impracticable and
not veteran centric to apply a ``seeking primary care'' eligibility
criterion, and therefore did not revise the general 40-mile requirement
in Sec. 17.1510(b)(1) in the interim final rule to reflect such a
strict reading of the public law. However, VA did revise Sec. 17.1505
to add a definition of ``full-time primary care physician,'' as well as
amend the definition of ``VA medical facility'' to require that such a
facility have a full-time primary care physician, so that for purposes
of determining distance-related eligibility for the Program, VA
considered a qualifying VA medical facility to include only those
facilities with at least a full-time primary care physician. VA
received one positive comment in support of this revision, and we thank
the commenter for this feedback. VA did not receive any comments that
suggested changes to this revision, and therefore does not make further
regulatory revisions.
Section 4005(c) of Public Law 114-41 amended sections 101(a)(1)(B)
and 101(d) of the Choice Act to permit VA to expand provider
eligibility beyond those providers expressly listed in section
101(a)(1)(B) of the Choice Act, in accordance with criteria as
established by VA. In the interim final rule, VA revised Sec.
17.1530(a) to refer to a new paragraph (e) that established eligibility
for these other providers, and added a new paragraph (e) to Sec.
17.1530 to list these providers specifically. VA also revised Sec.
17.1530(d) to reorganize current requirements and add new requirements
for these providers, in accordance with section 101(d)(5) of the Choice
Act. VA received two positive comments in support of this revision, and
we thank the commenters for this feedback. VA received one comment that
inquired whether, given the expansion of eligible providers, such
providers were required to be Medicare- participating providers. We
clarify that eligible providers in the Program include but are not
limited to Medicare-participating providers, as established in Sec.
17.1530(a) and (e). With this clarification, and because VA did not
receive any comments that suggested changes to this revision, we
therefore do not make further regulatory revisions.
Miscellaneous Comments
The remaining five comments do not specifically pertain to the
regulatory changes in the interim final rule, and are addressed here in
turn.
One commenter requested that the end date of August 7, 2017, for
the Choice Act be removed and the program made permanent. The Choice
Act, which was enacted on August 7, 2014, in Public Law 113-146,
specifically prescribed that the Choice Program would be temporary,
operating for 3 years or until the funding was exhausted, whichever
came first. The 3-year sunset date was removed by Public Law 115-26,
and so the Choice Program is authorized until the amounts appropriated
in the Choice Fund are exhausted. Current regulations do not discuss
the termination date of the Program, and VA does not make any
regulatory changes based on Public Law 115-26 or this comment.
Another commenter expressed a generalized concern that the Choice
[[Page 21895]]
Program created additional barriers to access healthcare as well as
expressed specific concerns about the Choice Program. To address the
commenter's generalized concern related to barriers to access, we
acknowledge the difficulties that some veterans have experienced and
expressed since the inception of the Choice Program in August 2014, and
we are similarly sympathetic to the commenter's expressed experiences.
Congress mandated that VA implement the Choice Program in 90 days, and
implementing such an unprecedented program in terms of VA care in the
community on a nationwide basis, in 90 days, resulted in growing pains
for veterans, community providers, and VA. During the initial year of
the Choice Program, VA met with veterans, community providers, leading
healthcare experts, and staff across the country to hear concerns and
identify solutions. In order to immediately implement changes to the
Choice Program, VA brought in new leadership to oversee all Community
Care Programs. Under this new leadership, VA quickly began to improve
the Choice Program and laid out a plan to drive towards a future that
delivers the best of VA and the community. VA has earnestly tried to
implement the Choice Program in accord with legal requirements while
being mindful of veteran concerns and administrative realities, and VA
will continue to strive to reduce any barriers communicated to us by
veterans. VA does not make any regulatory changes to address the
commenter's generalized concerns about the Choice Program.
As to the commenter's specific concerns, the commenter stated that
there are no clear channels for resolution of complaints or problems
when authorization for care has been delayed. The commenter further
elaborated that it is difficult to access the Choice Program call
centers and, once contact is made with the call center, it is difficult
to receive answers from the employees working in the call centers. The
commenter suggested that a process be put in place to address complaint
resolution. We interpret these concerns to be limited to issues that
arise administratively when the veteran is already enrolled in the
Choice Program, such as delays in authorization, and not concerns
regarding eligibility to participate in the Choice Program or concerns
with clinical decisions throughout the course of treatment. Therefore,
we further interpret these concerns to relate to the internal processes
relating to administration of the program and do not make any
regulatory changes. However, we describe below processes and
improvements that both VA and the contractors that administer the
Choice Program have undertaken and which we believe obviate the need
for more formal processes in regulation.
VA has taken affirmative steps to decrease administrative burdens
such as delays in authorization and has improved access to VA staff
through the VA call centers and the internet. For instance, VA has
reduced the administrative burden for medical record submission for
community providers by streamlining the documents required. We also
have strived to improve veterans' experience with the call centers
throughout the past year. More specifically, in May 2015, it took
approximately 11 days to contact the veteran, obtain their provider and
appointment preference, and work with the community provider to
schedule an appointment; by May 2016, the average number of days to
accomplish those tasks decreased to only 6. The Choice Program call
centers have also continued to improve with a call abandon rate of less
than 2 percent; a call hold time of no more than 7 seconds; and first-
time call resolution over of 96 percent. In addition, Veterans are able
to contact VA directly through this website that is available to the
public: https://www.va.gov/opa/choiceact/. The website contains
information about the program, a phone number that veterans can call in
order to speak to a person directly, and also contains a live chat
option that is available to veterans Monday through Friday from 8 a.m.
to 8 p.m., eastern standard time. The vendors who administer the Choice
Program additionally have processes in place for veterans who
experience delays when receiving care in the community. The complaints
and grievance processes for the contractors, TriWest and Health Net,
are available at their public websites, respectively: https://www.triwest.com/globalassets/documents/veteran-services/complaint-grievance_form.pdf and https://www.hnfs.com/content/hnfs/home/va/provider/resources/resources/grievances.html.
The commenter next expressed the specific concern that rural
veterans are disproportionately negatively impacted by barriers created
by the Choice Act and VA and that such veterans' feedback is not heard
by VA as a result of their disability status and geographic location.
We first clarify that VA strives to gain feedback from all veterans,
including those who live in rural areas, about their experiences with
the Choice Program. To obtain feedback from all veterans, regardless of
their geographic location, VA developed a Survey of Healthcare
Experiences of Patients (SHEP) for veterans to complete after receiving
Choice care. We further acknowledge that there are unique problems that
affect rural veterans and that it may be more difficult for rural
veterans to obtain health care near their residence. In this regard,
the 40-mile distance criterion in the Choice Program regulations at
Sec. 17.1510(b)(2) is designed to address accessibility issues that
affect rural Veterans. Particularly, the 40-mile criterion has been
interpreted by VA to consider driving distance and not straight line
distance (see 80 FR 22906, April 24, 2015), and to further interpret
that this distance must be from a Veteran's residence to a VA medical
facility that has at least one full time equivalent primary care
physician (see 80 FR 74991, December 1, 2015). Both of these
interpretations we believe increase the number of rural veterans
eligible for the program, and VA otherwise actively seeks and documents
the concerns of rural veterans that participate in the Choice program
with its SHEP survey as described above. Therefore, we make no
regulatory changes based on this comment.
The commenter also stated that the Choice Program has created
coordination of care issues for non-VA providers who administer health
care for veterans. The commenter did not elaborate on what those issues
are or how the Choice Program created them, or whether the interim
final rule exacerbated the issues, and the commenter also did not
suggest any changes to alleviate the issues. We do acknowledge that
there may have been difficulty with coordination of care at the
inception of the Choice Program, and, to enhance coordination of care
for veterans, we have embedded Choice contractor staff with VA staff at
14 VA facilities, and continue to increase the number of embedded
Choice contractor staff locations. As the commenter did not provide
enough specificity for suggested regulatory changes, and we believe VA
has undertaken efforts to mitigate coordination of care issues, we do
not make any regulatory revisions based on this comment.
Finally, the commenter explained that it was easier to seek care
prior to the Choice Program and that, even though the Program is
voluntary, veterans are being told that they must use the Choice
Program over VA care and other VA care in the community permitted by
legal authorities other than the Choice Act. We first clarify that the
Choice Program
[[Page 21896]]
is voluntary and veterans are provided the option of obtaining care
solely at VA medical facilities. Significantly, the Choice Program is
designed to respect and guarantee a veteran's choice to see a VA
provider or a non-VA provider if they meet Choice Program criteria. In
fact, if an eligible veteran elects to receive covered care through the
Choice Program, VA is required by the Choice Act to furnish the care
through the Program. In addition, the Choice Act authorized VA to
purchase care through Choice provider agreements, which gives VA
greater flexibility when furnishing care through the Choice Program. VA
recognizes that some veterans faced administrative barriers and hurdles
while seeking care through the Choice Program and that some veterans
may have found it was easier in the past to seek VA care in the
community under legal authorities other than the Choice Act. To ensure
the Choice Program provides high quality and accessible care, VA has
made and will continue to make improvements by working with Congress,
our community providers, our Choice Program contractors and within VA.
Therefore, we do not make any further regulatory revisions based on
this comment.
The final three comments are beyond the scope of the interim final
rule and we will not make any regulatory changes based on the comments.
One commenter expressed concern about the recertification process to
become a vendor and contract with VA through ``vetbiz.gov.'' The
process of vendorization on vetbiz.gov does not apply for clinical
providers under the Choice Act. As the commenter did not otherwise
reference the interim final rule or the Choice Program regulations
generally, nor did the commenter state how the ability to recertify as
a vendor was affected by the interim final rule or Choice regulations,
we find that the comment is beyond the scope of the rulemaking.
Another commenter supported the interim final rule because it would
enable the commenter to access community care near the commenter's
residence in Panama. Care under the Choice Program is not provided
outside of the United States. VA's only authority to provide care
abroad is through the foreign medical care provisions in 38 U.S.C.
1724, and the Choice Act did not affect this limitation.
Another commenter expressed a concern over the potentially
burdensome nature of the administrative requirements to participate in
the Choice Program. Specifically, the commenter requested that VA be
mindful that an overly complicated process to apply to participate in
the Choice Program may deter people who are eligible and entitled to
participate in the Program. The commenter did not specify what these
burdens are or if they were made worse by revisions in the interim
final rule. Therefore, we interpret the comment to be general in scope.
Although the interim final rule and the Choice regulations contain
eligibility criteria, they do not contain any requirements or guidance
for how to apply to participate in the Choice Program. Therefore, we
find that the comment is not within the scope of the rulemaking and we
will not make any regulatory changes based on this comment.
Effect of Rulemaking
Title 38 of the Code of Federal Regulations, as confirmed by this
final rule, represents VA's implementation of its legal authority on
this subject. Other than future amendments to this regulation or
governing statutes, no contrary guidance or procedures are authorized.
All existing or subsequent VA guidance must be read to conform with
this rulemaking if possible or, if not possible, such guidance is
superseded by this rulemaking.
Paperwork Reduction Act
Although this action contains provisions constituting collections
of information, at 38 CFR 17.1530(d), under the Paperwork Reduction Act
of 1995 (44 U.S.C. 3501-3521), no new or proposed revised collections
of information are associated with this final rule. The information
collection requirements for Sec. 17.1530(d) are currently approved by
the Office of Management and Budget (OMB) and have been assigned OMB
control number 2900-0823.
Executive Orders 12866, 13563, and 13771
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,'' which requires 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 that this is an economically significant regulatory
action under Executive Order 12866. VA's regulatory impact analysis can
be found as a supporting document at https://www.regulations.gov,
usually within 48 hours after the rulemaking document is published.
Additionally, a copy of the rulemaking and its regulatory impact
analysis are available on VA's website at https://www.va.gov/orpm/, by
following the link for ``VA Regulations Published From FY 2004 Through
Fiscal Year to Date.'' VA's impact analysis can be found as a
supporting document at https://www.regulations.gov, usually within 48
hours after the rulemaking document is published. Additionally, a copy
of the rulemaking and its impact analysis are available on VA's website
at https://www.va.gov/orpm by following the link for VA Regulations
Published from FY 2004 through FYTD. This rule is not subject to the
requirements of E.O. 13771 because this rule results in no more than de
minimis costs.
Congressional Review Act
This regulatory action is a major rule under the Congressional
Review Act, 5 U.S.C. 801-08, because it may result in an annual effect
on the economy of $100 million or more. Although this regulatory action
constitutes a major rule within the meaning of the Congressional Review
Act, 5 U.S.C. 804(2), it is not subject to the 60-day delay in
effective date applicable to major rules under 5 U.S.C. 801(a)(3)
because the Secretary finds that good cause exists under 5 U.S.C.
808(2) to make this regulatory action effective on the date of
publication, consistent with
[[Page 21897]]
the reasons given for the publication of the interim final rule. In
accordance with 5 U.S.C. 801(a)(1), VA will submit to the Comptroller
General and to Congress a copy of this regulatory action and VA's
Regulatory Impact Analysis.
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 1 year. This final rule will have no such effect on
State, local, and tribal governments, or on the private sector.
Regulatory Flexibility Act
The Secretary hereby certifies that this final rule will 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 final rule will not have a significant economic impact on
participating eligible entities and providers who enter into agreements
with VA. To the extent there is any such impact, it will result in
increased business and revenue for them. We also do not believe there
will be a significant economic impact on insurance companies, as claims
will only be submitted for care that will otherwise have been received
whether such care was authorized under this Program or not. 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.
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic Assistance numbers and titles for
the programs affected by this document are as follows: 64.008--Veterans
Domiciliary Care; 64.011--Veterans Dental Care; 64.012--Veterans
Prescription Service; 64.013--Veterans Prosthetic Appliances; 64.014--
Veterans State Domiciliary Care; 64.015--Veterans State Nursing Home
Care; 64.024--VA Homeless Providers Grant and Per Diem Program;
64.026--Veterans State Adult Day Health Care; 64.029--Purchase Care
Program; 64.035--Veterans Transportation Program; 64.038--Grants for
the Rural Veterans Coordination Pilot; 64.039--CHAMPVA; 64.040--VHA
Inpatient Medicine; 64.041--VHA Outpatient Specialty Care; 64.042--VHA
Inpatient Surgery; 64.043--VHA Mental Health Residential; 64.044--VHA
Home Care; 64.045--VHA Outpatient Ancillary Services; 64.046--VHA
Inpatient Psychiatry; 64.047--VHA Primary Care; 64.048--VHA Mental
Health Clinics; 64.049--VHA Community Living Center; 64.050--VHA
Diagnostic Care.
List of Subjects in 38 CFR Part 17
Administrative practice and procedure, Alcohol abuse, Alcoholism,
Claims, Day care, Dental health, Drug abuse, Government contracts,
Grant programs-health, Grant programs-veterans, Health care, Health
facilities, Health professions, Health records, Homeless, Mental health
programs, Nursing homes, Reporting and recordkeeping requirements,
Travel and transportation expenses, Veterans.
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. Gina S.
Farrisee, Deputy Chief of Staff, Department of Veterans Affairs,
approved this document Janaury 12, 2018, for publication.
Dated: May 8, 2018.
Consuela Benjamin,
Regulations Development Coordinator, Office of Regulation Policy &
Management, Office of the Secretary, Department of Veterans Affairs.
PART 17--MEDICAL
0
Accordingly, the interim rules amending 38 CFR part 17 which were
published at 80 FR 74991 on December 1, 2015, and 81 FR 24026 on April
25, 2016, are adopted as final without change.
[FR Doc. 2018-10054 Filed 5-10-18; 8:45 am]
BILLING CODE 8320-01-P