Third Party Billing for Medical Care Provided Under Special Treatment Authorities, 31452-31454 [2018-14573]

Download as PDF 31452 Federal Register / Vol. 83, No. 130 / Friday, July 6, 2018 / Rules and Regulations Removal of this part does not reduce burden or cost on the public in any way, nor does it add any costs. This burden ended in 2003. Kaho‘olawe Island was used by the armed forces of the United States as a training area, including bombing and gunnery training ranges, under authority granted by Executive Order No. 10436 of February 20, 1953. The Commanding Officer, Naval Base Pearl Harbor controlled entry to the area. Title X of the Fiscal Year 1994 Department of Defense Appropriations Act directed the Navy to convey Kaho‘olawe and its surrounding waters to the state of Hawaii. As directed by Title X, and in accordance with a required memorandum of understanding between the U.S. Navy and the State of Hawaii, the Navy transferred the title of the island of Kaho‘olawe to the state of Hawaii on May 9, 1994. On November 11, 2003, upon the completion of UXO clearance and environmental restoration, control of access to Kaho‘olawe was passed from the United States to the State of Hawaii. Since that time, Navy has not exercised access control to Kaho‘olawe Island or its adjacent waters. List of Subjects in 32 CFR Part 763 Federal buildings and facilities, Military law, National defense measures. PART 763—[REMOVED] Accordingly, by the authority of 5 U.S.C. 301, 32 CFR part 763 is removed. ■ Dated: June 28, 2018. E.K. Baldini, Lieutenant Commander, Judge Advocate General’s Corps, U.S. Navy, Federal Register Liaison Officer. [FR Doc. 2018–14508 Filed 7–5–18; 8:45 am] BILLING CODE 3810–FF–P DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 117 [Docket No. USCG–2018–0505] sradovich on DSK3GMQ082PROD with RULES Drawbridge Operation Regulation; Gulf Intracoastal Waterway, Indian Rocks Beach, FL Coast Guard, DHS. Notice of deviation from drawbridge regulation. AGENCY: ACTION: The Coast Guard has issued a temporary deviation from the operating schedule that governs the Indian Rocks (SR688) Bridge across the Gulf SUMMARY: VerDate Sep<11>2014 16:23 Jul 05, 2018 Jkt 244001 Intracoastal Waterway, mile 128.2, Indian Rocks Beach, FL. The deviation is necessary to accommodate repairs to the Bridge. This deviation allows the bridge to open, at requested times, a single leaf, and with a 6 hour notice for double leaf openings. DATES: This deviation is effective without actual notice from July 6, 2018 through 6 p.m. on July 31, 2018. For the purposes of enforcement, actual notice will be used from 6 a.m. May 29, 2018, until July 6, 2018. ADDRESSES: The docket for this deviation, USCG–2018–0505 is available at https://www.regulations.gov. Type the docket number in the ‘‘SEARCH’’ box and click ‘‘SEARCH’’. Click on Open Docket Folder on the line associated with this deviation. FOR FURTHER INFORMATION CONTACT: If you have questions on this temporary deviation, call or email MST1 Deborah A. Schneller, Coast Guard Sector Saint Petersburg Waterways Management; telephone (813) 228–2194 x8133, email Deborah.A.Schneller@uscg.mil. SUPPLEMENTARY INFORMATION: Florida Department of Transportation (FDOT), bridge owner, via Quinn Construction Inc, has requested a temporary deviation from the operation that governs the Indian Rocks Bridge across the Gulf Intracoastal Waterway, mile 128.2. This deviation is necessary to facilitate mechanical and electrical repairs, painting, roadway and sidewalk grating replacement which includes concrete removal, and spall repair. The bridge is a double-leaf bascule bridge and has a vertical clearance in the closed to navigation position of 21 feet at mean high water. The current operating schedule is set out in 33 CFR 117.5. Under this temporary deviation, the bridge will operate on demand but single leaf only and with a 6 hour notice for double leaf openings. This section of the Gulf Intracoastal Waterway is predominantly used by a variety of vessels including U.S. government vessels, small commercial vessels and recreational vessels. The Coast Guard has carefully considered the restrictions with waterway users in publishing this temporary deviation. Vessels able to pass through the bridge in the closed position may do so at anytime. The bridge will be able to open for emergencies and there is no immediate alternate route for vessels to pass. The Coast Guard will also inform the users of the waterways through our Local and Broadcast Notices to Mariners of the change in operating schedule for the bridge so that vessel operators can arrange their transits to minimize any PO 00000 Frm 00012 Fmt 4700 Sfmt 4700 impact caused by the temporary deviation. In accordance with 33 CFR 117.35(e), the drawbridge must return to its regular operating schedule immediately at the end of the effective period of this temporary deviation. This deviation from the operating regulations is authorized under 33 CFR 117.35. Dated: June 25, 2018. Barry L. Dragon, Director, Bridge Branch, Seventh Coast Guard District. [FR Doc. 2018–14521 Filed 7–5–18; 8:45 am] BILLING CODE 9110–04–P DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900–AP20 Third Party Billing for Medical Care Provided Under Special Treatment Authorities Department of Veterans Affairs. Final rule. AGENCY: ACTION: The Department of Veterans Affairs (VA) is amending its medical regulations to clarify that VA will not bill third party payers for care and services provided by VA under certain statutory provisions, which we refer to as ‘‘special treatment authorities.’’ These special treatment authorities direct VA to provide care and services to veterans based upon discrete exposures or experiences that occurred during active military, naval, or air service. VA is authorized, but not required by law, to recover or collect charges for care and services provided to veterans for non-service-connected disabilities. This rule establishes that VA will not exercise its authority to recover or collect reasonable charges from third party payers for care and services provided under the special treatment authorities. DATES: This final rule is effective August 6, 2018. FOR FURTHER INFORMATION CONTACT: Joseph Duran, Director, Policy and Planning, VHA Office of Community Care (10D1A1), Veterans Health Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (303–370–1637). (This is not a toll-free number.) SUPPLEMENTARY INFORMATION: In a document published in the Federal Register on November 22, 2017, VA proposed to amend its regulation concerning billing third party payers for SUMMARY: E:\FR\FM\06JYR1.SGM 06JYR1 sradovich on DSK3GMQ082PROD with RULES Federal Register / Vol. 83, No. 130 / Friday, July 6, 2018 / Rules and Regulations health care received under its special treatment authorities. 82 FR 55547. VA is authorized by law under 38 U.S.C. 1729 to recover or collect reasonable charges from third parties under certain situations for care and services provided for non-serviceconnected disabilities. VA does not have authority to recover or collect charges from third parties for care or services provided for service-connected disabilities. Under the statutes referred to as the special treatment authorities, VA provides care and services to veterans for conditions and disabilities that are related to certain exposures or experiences during active military, naval, or air service, regardless of whether such condition or disability is formally adjudicated by the Veterans Benefits Administration (VBA) to be service-connected. These authorities are codified at 38 U.S.C. 1710(a)(2)(F) and (e), 1720D, and 1720E. These statutory provisions do not expressly refer to the conditions or disabilities resulting from such exposures or experiences as service-connected. Therefore, if veterans meet the eligibility criteria of these discrete categories in law, they receive the health care benefits enumerated in the special treatment authorities. A brief description of each of the special treatment authorities follows. Subject to the availability of appropriations, the limitations found in 38 U.S.C. 1710(e)(2) and (3), and the definitions in 1710(e)(4), under section 1710(a)(2)(F), VA provides hospital care and medical services, and may furnish nursing home care, to veterans who were exposed to specified hazards or served under certain circumstances as identified in 38 U.S.C. 1710(e). The exposures include herbicide exposure, ionizing radiation, and certain chemical and biological weapons testing, and circumstances of service include service in the Southwest Asia theater during the Persian Gulf War and at Camp Lejeune during specified time periods. A more comprehensive list of the specific exposures and disabilities is located at 38 U.S.C. 1710(e). Under 38 U.S.C. 1720D, VA may provide counseling and appropriate care and services to help veterans overcome psychological trauma, which in the judgment of a mental health professional employed by VA, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment that occurred while the veteran was serving on active duty, active duty for training, or inactive duty training. Under 38 U.S.C. 1720E, VA is authorized to provide any veteran VerDate Sep<11>2014 16:23 Jul 05, 2018 Jkt 244001 whose service records include documentation of nasopharyngeal radium irradiation treatments a medical examination, hospital care, medical services, and nursing home care that is needed for the treatment of any cancer of the head or neck that the Secretary finds may be associated with the veteran’s receipt of those treatments in active military, naval, or air service. Additionally, notwithstanding the absence of such documentation, VA may provide such care to a veteran who served as an aviator in the active military, naval, or air service before the end of the Korean conflict or a veteran who underwent submarine training in active naval service before January 1, 1965. The special treatment authorities do not require an adjudication of serviceconnection to establish eligibility for care. These veterans are eligible under those authorities for treatment of specific conditions, which although not adjudicated as service-connected, are treated as the practical equivalent for medical care purposes. Therefore, in the proposed rule, we proposed adding a new paragraph (a)(9) in § 17.101 to exclude from recovery or collections any reasonable charges from third parties for care and services provided under the special treatment authorities. VA provided a 60-day comment period, which ended on January 22, 2018. We received 2 comments on the proposed rule. One commenter explained that he was born at Camp Lejeune and that he and his family members have illnesses that he believes are related to exposures while on the base. He questioned why he was denied eligibility for the Camp Lejeune family member program and stated that more people should be eligible for the program. While we are sympathetic to the commenter, this rulemaking only codifies VA’s practice of not exercising its discretionary authority in section 1729 to recover or collect from a third party the cost of care and services provided under a special treatment authority, by creating an exception to 38 CFR 17.101. This comment is, therefore, beyond the scope of the rulemaking and we make no changes based on this comment. The other commenter raised concerns about the commenter’s claim for unspecified benefits and a subsequent court decision that are not related to this regulation. The comment is beyond the scope of this rulemaking and we make no changes based on this comment. Based on the rationale set forth in the SUPPLEMENTARY INFORMATION to the proposed rule and in this final rule, VA PO 00000 Frm 00013 Fmt 4700 Sfmt 4700 31453 is adopting the proposed rule as a final rule with no changes. Effect of Rulemaking Title 38 of the Code of Federal Regulations, as revised by this final rulemaking, 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 17.101, under the Paperwork Reduction Act of 1995, 44 U.S.C. 3501–3521), no new or proposed collections of information are associated with this final rule. The information collection requirements for § 17.101 are currently approved by the Office of Management and Budget (OMB) and have been assigned OMB control number 2900– 0606. 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. We are not imposing any new requirements that would have such an effect. Our standards almost entirely conform to the existing statutory requirements and existing practices in the program. Therefore, pursuant to 5 U.S.C. 605(b), this rule is exempt from the initial and final regulatory flexibility analysis requirements of sections 603 and 604. 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 E:\FR\FM\06JYR1.SGM 06JYR1 31454 Federal Register / Vol. 83, No. 130 / Friday, July 6, 2018 / Rules and Regulations Review) defines a ‘‘significant regulatory action,’’ requiring review by OMB, unless OMB waives such review, 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 final rule have been examined, and it has been determined not to be a significant regulatory action under Executive Order 12866. 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 Fiscal Year To Date.’’ This rule is not an E.O. 13771 regulatory action because this rule is not significant under E.O. 12866 sradovich on DSK3GMQ082PROD with RULES 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 an expenditure by State, local, and tribal governments, in the aggregate, or by the private sector, of $100 million or more (adjusted annually for inflation) in any one year. This final rule would have no such effect on State, local, and tribal governments, or on the private sector. Catalog of Federal Domestic Assistance The Catalog of Federal Domestic Assistance numbers and titles for the programs affected by this document are 64.011—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; 64.026—Veterans State Adult Day Health Care; 64.029— Purchase Care Program; 64.033—VA VerDate Sep<11>2014 16:23 Jul 05, 2018 Jkt 244001 Supportive Services for Veteran Families Program; 64.034—VA Grants for Adaptive Sports Programs for Disabled Veterans and Disabled Members of the Armed Forces; 64.035— Veterans Transportation Program; 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, Foreign relations, Government contracts, Grant programs-health, Grant programs-veterans, Health care, Health facilities, Health professions, Health records, Homeless, Medical and dental schools, Medical devices, Medical research, Mental health programs, Nursing home care, Philippines, Reporting and recordkeeping requirements, Scholarships and fellows, Travel, 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. Jacquelyn Hayes-Byrd, Acting Chief of Staff, Department of Veterans Affairs, approved this document on June 28, 2018, for publication. Dated: July 2, 2018. Consuela Benjamin, Regulation Development Coordinator, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. For the reasons set forth in the preamble, VA amends 38 CFR part 17 as follows: PART 17—MEDICAL 1. The authority citation for part 17 continues to read in part as follows: ■ Authority: 38 U.S.C. 501, and as noted in specific sections. * * * * * 2. Amend § 17.101 by: a. Adding paragraph (a)(9). b. Revising the authority citation at the end of the section. ■ ■ ■ PO 00000 Frm 00014 Fmt 4700 Sfmt 4700 The addition and revision read as follows: § 17.101 Collection or recovery by VA for medical care or services provided or furnished to a veteran for a nonserviceconnected disability. (a) * * * (9) Care provided under special treatment authorities. (i) Notwithstanding any other provisions in this section, VA will not seek recovery or collection of reasonable charges from a third party payer for: (A) Hospital care, medical services, and nursing home care provided by VA or at VA expense under 38 U.S.C. 1710(a)(2)(F) and (e). (B) Counseling and appropriate care and services furnished to veterans for psychological trauma authorized under 38 U.S.C. 1720D. (C) Medical examination, and hospital care, medical services, and nursing home care furnished to veteran for cancer of the head or neck as authorized under 38 U.S.C. 1720E. (ii) VA may continue to exercise its right to recover or collect reasonable charges from third parties, pursuant to this section, for the cost of care that VA provides to these same veterans for conditions and disabilities that VA determines are not covered by any of the special treatment authorities. * * * * * (Authority: 38 U.S.C. 101, 501, 1701, 1705, 1710, 1720D, 1720E, 1721, 1722, 1729) [FR Doc. 2018–14573 Filed 7–5–18; 8:45 am] BILLING CODE 8320–01–P ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA–R04–OAR–2017–0642; FRL–9980– 50—Region 4] Air Plan Approval; AL; Section 128 Board Requirements for Infrastructure SIPs Environmental Protection Agency (EPA). ACTION: Final rule. AGENCY: The Environmental Protection Agency (EPA) is taking final action to approve a State Implementation Plan (SIP) submission, submitted by the State of Alabama, through the Alabama Department of Environmental Management (ADEM), on October 24, 2017, and a portion of a December 9, 2015, infrastructure SIP submission. The October 24, 2017 submission addresses the general Clean Air Act (CAA or Act) conflict of interest SUMMARY: E:\FR\FM\06JYR1.SGM 06JYR1

Agencies

[Federal Register Volume 83, Number 130 (Friday, July 6, 2018)]
[Rules and Regulations]
[Pages 31452-31454]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-14573]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AP20


Third Party Billing for Medical Care Provided Under Special 
Treatment Authorities

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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

SUMMARY: The Department of Veterans Affairs (VA) is amending its 
medical regulations to clarify that VA will not bill third party payers 
for care and services provided by VA under certain statutory 
provisions, which we refer to as ``special treatment authorities.'' 
These special treatment authorities direct VA to provide care and 
services to veterans based upon discrete exposures or experiences that 
occurred during active military, naval, or air service. VA is 
authorized, but not required by law, to recover or collect charges for 
care and services provided to veterans for non-service-connected 
disabilities. This rule establishes that VA will not exercise its 
authority to recover or collect reasonable charges from third party 
payers for care and services provided under the special treatment 
authorities.

DATES: This final rule is effective August 6, 2018.

FOR FURTHER INFORMATION CONTACT: Joseph Duran, Director, Policy and 
Planning, VHA Office of Community Care (10D1A1), Veterans Health 
Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, 
Washington, DC 20420, (303-370-1637). (This is not a toll-free number.)

SUPPLEMENTARY INFORMATION: In a document published in the Federal 
Register on November 22, 2017, VA proposed to amend its regulation 
concerning billing third party payers for

[[Page 31453]]

health care received under its special treatment authorities. 82 FR 
55547.
    VA is authorized by law under 38 U.S.C. 1729 to recover or collect 
reasonable charges from third parties under certain situations for care 
and services provided for non-service-connected disabilities. VA does 
not have authority to recover or collect charges from third parties for 
care or services provided for service-connected disabilities.
    Under the statutes referred to as the special treatment 
authorities, VA provides care and services to veterans for conditions 
and disabilities that are related to certain exposures or experiences 
during active military, naval, or air service, regardless of whether 
such condition or disability is formally adjudicated by the Veterans 
Benefits Administration (VBA) to be service-connected. These 
authorities are codified at 38 U.S.C. 1710(a)(2)(F) and (e), 1720D, and 
1720E. These statutory provisions do not expressly refer to the 
conditions or disabilities resulting from such exposures or experiences 
as service-connected. Therefore, if veterans meet the eligibility 
criteria of these discrete categories in law, they receive the health 
care benefits enumerated in the special treatment authorities. A brief 
description of each of the special treatment authorities follows.
    Subject to the availability of appropriations, the limitations 
found in 38 U.S.C. 1710(e)(2) and (3), and the definitions in 
1710(e)(4), under section 1710(a)(2)(F), VA provides hospital care and 
medical services, and may furnish nursing home care, to veterans who 
were exposed to specified hazards or served under certain circumstances 
as identified in 38 U.S.C. 1710(e). The exposures include herbicide 
exposure, ionizing radiation, and certain chemical and biological 
weapons testing, and circumstances of service include service in the 
Southwest Asia theater during the Persian Gulf War and at Camp Lejeune 
during specified time periods. A more comprehensive list of the 
specific exposures and disabilities is located at 38 U.S.C. 1710(e).
    Under 38 U.S.C. 1720D, VA may provide counseling and appropriate 
care and services to help veterans overcome psychological trauma, which 
in the judgment of a mental health professional employed by VA, 
resulted from a physical assault of a sexual nature, battery of a 
sexual nature, or sexual harassment that occurred while the veteran was 
serving on active duty, active duty for training, or inactive duty 
training.
    Under 38 U.S.C. 1720E, VA is authorized to provide any veteran 
whose service records include documentation of nasopharyngeal radium 
irradiation treatments a medical examination, hospital care, medical 
services, and nursing home care that is needed for the treatment of any 
cancer of the head or neck that the Secretary finds may be associated 
with the veteran's receipt of those treatments in active military, 
naval, or air service. Additionally, notwithstanding the absence of 
such documentation, VA may provide such care to a veteran who served as 
an aviator in the active military, naval, or air service before the end 
of the Korean conflict or a veteran who underwent submarine training in 
active naval service before January 1, 1965.
    The special treatment authorities do not require an adjudication of 
service-connection to establish eligibility for care. These veterans 
are eligible under those authorities for treatment of specific 
conditions, which although not adjudicated as service-connected, are 
treated as the practical equivalent for medical care purposes. 
Therefore, in the proposed rule, we proposed adding a new paragraph 
(a)(9) in Sec.  17.101 to exclude from recovery or collections any 
reasonable charges from third parties for care and services provided 
under the special treatment authorities. VA provided a 60-day comment 
period, which ended on January 22, 2018. We received 2 comments on the 
proposed rule.
    One commenter explained that he was born at Camp Lejeune and that 
he and his family members have illnesses that he believes are related 
to exposures while on the base. He questioned why he was denied 
eligibility for the Camp Lejeune family member program and stated that 
more people should be eligible for the program. While we are 
sympathetic to the commenter, this rulemaking only codifies VA's 
practice of not exercising its discretionary authority in section 1729 
to recover or collect from a third party the cost of care and services 
provided under a special treatment authority, by creating an exception 
to 38 CFR 17.101. This comment is, therefore, beyond the scope of the 
rulemaking and we make no changes based on this comment.
    The other commenter raised concerns about the commenter's claim for 
unspecified benefits and a subsequent court decision that are not 
related to this regulation. The comment is beyond the scope of this 
rulemaking and we make no changes based on this comment.
    Based on the rationale set forth in the SUPPLEMENTARY INFORMATION 
to the proposed rule and in this final rule, VA is adopting the 
proposed rule as a final rule with no changes.

Effect of Rulemaking

    Title 38 of the Code of Federal Regulations, as revised by this 
final rulemaking, 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 17.101, under the Paperwork Reduction Act of 
1995, 44 U.S.C. 3501-3521), no new or proposed collections of 
information are associated with this final rule.
    The information collection requirements for Sec.  17.101 are 
currently approved by the Office of Management and Budget (OMB) and 
have been assigned OMB control number 2900-0606.

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. We are not imposing any new requirements that would have such an 
effect. Our standards almost entirely conform to the existing statutory 
requirements and existing practices in the program. Therefore, pursuant 
to 5 U.S.C. 605(b), this rule is exempt from the initial and final 
regulatory flexibility analysis requirements of sections 603 and 604.

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

[[Page 31454]]

Review) defines a ``significant regulatory action,'' requiring review 
by OMB, unless OMB waives such review, 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 final rule have been examined, and it has been 
determined not to be a significant regulatory action under Executive 
Order 12866. 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 Fiscal Year To Date.'' This rule is not 
an E.O. 13771 regulatory action because this rule is not significant 
under E.O. 12866

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in an expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any one year. This final rule would have no such effect 
on State, local, and tribal governments, or on the private sector.

Catalog of Federal Domestic Assistance

    The Catalog of Federal Domestic Assistance numbers and titles for 
the programs affected by this document are 64.011--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; 64.026--Veterans State Adult 
Day Health Care; 64.029--Purchase Care Program; 64.033--VA Supportive 
Services for Veteran Families Program; 64.034--VA Grants for Adaptive 
Sports Programs for Disabled Veterans and Disabled Members of the Armed 
Forces; 64.035--Veterans Transportation Program; 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, Foreign relations, 
Government contracts, Grant programs-health, Grant programs-veterans, 
Health care, Health facilities, Health professions, Health records, 
Homeless, Medical and dental schools, Medical devices, Medical 
research, Mental health programs, Nursing home care, Philippines, 
Reporting and recordkeeping requirements, Scholarships and fellows, 
Travel, 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. Jacquelyn 
Hayes-Byrd, Acting Chief of Staff, Department of Veterans Affairs, 
approved this document on June 28, 2018, for publication.

    Dated: July 2, 2018.
Consuela Benjamin,
Regulation Development Coordinator, Office of Regulation Policy & 
Management, Office of the Secretary, Department of Veterans Affairs.

    For the reasons set forth in the preamble, VA amends 38 CFR part 17 
as follows:

PART 17--MEDICAL

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

    Authority:  38 U.S.C. 501, and as noted in specific sections.
* * * * *
0
2. Amend Sec.  17.101 by:
0
a. Adding paragraph (a)(9).
0
b. Revising the authority citation at the end of the section.
    The addition and revision read as follows:


Sec.  17.101   Collection or recovery by VA for medical care or 
services provided or furnished to a veteran for a nonservice-connected 
disability.

    (a) * * *
    (9) Care provided under special treatment authorities. (i) 
Notwithstanding any other provisions in this section, VA will not seek 
recovery or collection of reasonable charges from a third party payer 
for:
    (A) Hospital care, medical services, and nursing home care provided 
by VA or at VA expense under 38 U.S.C. 1710(a)(2)(F) and (e).
    (B) Counseling and appropriate care and services furnished to 
veterans for psychological trauma authorized under 38 U.S.C. 1720D.
    (C) Medical examination, and hospital care, medical services, and 
nursing home care furnished to veteran for cancer of the head or neck 
as authorized under 38 U.S.C. 1720E.
    (ii) VA may continue to exercise its right to recover or collect 
reasonable charges from third parties, pursuant to this section, for 
the cost of care that VA provides to these same veterans for conditions 
and disabilities that VA determines are not covered by any of the 
special treatment authorities.
* * * * *

(Authority: 38 U.S.C. 101, 501, 1701, 1705, 1710, 1720D, 1720E, 
1721, 1722, 1729)


[FR Doc. 2018-14573 Filed 7-5-18; 8:45 am]
 BILLING CODE 8320-01-P
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