Confidentiality of Certain Medical Records Under the MISSION Act, 407 [2018-28285]

Download as PDF 407 Rules and Regulations Federal Register Vol. 84, No. 18 Monday, January 28, 2019 This section of the FEDERAL REGISTER contains regulatory documents having general applicability and legal effect, most of which are keyed to and codified in the Code of Federal Regulations, which is published under 50 titles pursuant to 44 U.S.C. 1510. The Code of Federal Regulations is sold by the Superintendent of Documents. DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 Confidentiality of Certain Medical Records Under the MISSION Act Department of Veterans Affairs. Notification of change to agency practice. AGENCY: ACTION: This Department of Veterans Affairs (VA) document provides an update to VA’s requirements for obtaining a signed release of information for third party billing practices from VA beneficiaries with a sensitive diagnosis under the United States Code to align with the amendments made by the VA MISSION Act of 2018. DATES: Effective January 28, 2019. FOR FURTHER INFORMATION CONTACT: Jennifer Adams, Office of Community Care (10D), Veterans Health Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, Jennifer.Adams26@va.gov, (615) 355– 1539. This is not a toll free number. SUPPLEMENTARY INFORMATION: On June 6, 2018, section 132 of Public Law 115– 182, the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (MISSION Act), amended 38 U.S.C. 7332, Confidentiality of certain medical records, which protects certain sensitive diagnoses (i.e., drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus, or sickle cell anemia) from being disclosed unless expressly authorized by the patient. The VA Mission Act of 2018 amended section 7332 by providing a new exception to the requriment that a patient must expressely authorize VA to disclose medical records containing a sensitive diagnosis. The exception removed VA’s requirement when VA is amozie on DSK3GDR082PROD with RULES SUMMARY: VerDate Sep<11>2014 16:01 Jan 25, 2019 Jkt 247001 billing a third-party for medical care cost recovery. In addition to this document, VA will announce these changes on Veteranfacing websites to reach as many VA beneficiaires as possible. VA will also conduct a briefing with Veteran Service Organizations to ensure they are informed of the changes. For any VA beneficiary who has previously signed a release of information declining to allow VA to bill encounters containing a sensitive diagnosis, VA will provide a one-time notification prior to submitting claims with a sensitive diagnosis to a third-party health insurer. The written notification will include a summary of the new law, how the change affects the patient, and a description of the types of services affected by the change. After all of the aforementioned notifications are complete, VA will begin submitting claims to health insurance companies for encounters with dates of service on or after the publication date of this document in the Federal Register that contain a sensitive diagnosis without a signed release of information. While VA’s billing authorities allow for a window of up to 6 years to bill a health insurance company for services provided, VA will not pursue any back billing for these services unless a signed Request For and Authorization to Release Medical Records or Health Information (VHA– 10–5345) form for such release has been received from the patient. All required payer policies still apply to any services submitted for reimbursement. 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. Robert L. Wilkie, Secretary, Department of Veterans Affairs, approved this document on December 21, 2018, for publication. Dated: December 21, 2018. Luvenia Potts, Program Specialist, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. [FR Doc. 2018–28285 Filed 1–25–19; 8:45 am] BILLING CODE 8320–01–P PO 00000 Frm 00001 Fmt 4700 Sfmt 4700 DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 622 [Docket No. 101206604–1758–02] RIN 0648–XG732 Coastal Migratory Pelagic Resources of the Gulf of Mexico and Atlantic Region; Commercial Trip Limit Reduction for Spanish Mackerel in the Atlantic Southern Zone National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Temporary rule; trip limit reduction. AGENCY: NMFS reduces the commercial trip limit of Atlantic migratory group Spanish mackerel in or from the exclusive economic zone (EEZ) in the southern zone to 500 lb (227 kg) per day. This trip limit reduction is necessary to maximize the socioeconomic benefits of the commercial quota for the southern zone. DATES: This rule is effective from 6 a.m., local time, January 27, 2019, until 12:01 a.m., local time, March 1, 2019. FOR FURTHER INFORMATION CONTACT: Mary Vara, NMFS Southeast Regional Office, telephone: 727–824–5305, or email: mary.vara@noaa.gov. SUPPLEMENTARY INFORMATION: The fishery for coastal migratory pelagic fish includes king mackerel, Spanish mackerel, and cobia, and is managed under the Fishery Management Plan for the Coastal Migratory Pelagic Resources of the Gulf of Mexico and South Atlantic (FMP). The FMP was prepared by the Gulf of Mexico and South Atlantic Fishery Management Councils and is implemented under the authority of the Magnuson-Stevens Fishery Conservation and Management Act (Magnuson-Stevens Act) by regulations at 50 CFR part 622. All weights in this temporary rule apply as either round or gutted weight. Framework Amendment 1 to the FMP (79 FR 69058; November 20, 2014) implemented a commercial annual catch limit (equal to the commercial quota) of 3.33 million lb (1.51 million kg) for the Atlantic migratory group of SUMMARY: E:\FR\FM\28JAR1.SGM 28JAR1

Agencies

[Federal Register Volume 84, Number 18 (Monday, January 28, 2019)]
[Rules and Regulations]
[Page 407]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-28285]



========================================================================
Rules and Regulations
                                                Federal Register
________________________________________________________________________

This section of the FEDERAL REGISTER contains regulatory documents 
having general applicability and legal effect, most of which are keyed 
to and codified in the Code of Federal Regulations, which is published 
under 50 titles pursuant to 44 U.S.C. 1510.

The Code of Federal Regulations is sold by the Superintendent of Documents. 

========================================================================


Federal Register / Vol. 84, No. 18 / Monday, January 28, 2019 / Rules 
and Regulations

[[Page 407]]



DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17


Confidentiality of Certain Medical Records Under the MISSION Act

AGENCY: Department of Veterans Affairs.

ACTION: Notification of change to agency practice.

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

SUMMARY: This Department of Veterans Affairs (VA) document provides an 
update to VA's requirements for obtaining a signed release of 
information for third party billing practices from VA beneficiaries 
with a sensitive diagnosis under the United States Code to align with 
the amendments made by the VA MISSION Act of 2018.

DATES: Effective January 28, 2019.

FOR FURTHER INFORMATION CONTACT: Jennifer Adams, Office of Community 
Care (10D), Veterans Health Administration, Department of Veterans 
Affairs, 810 Vermont Avenue NW, Washington, DC 20420, 
Jennifer.Adams26@va.gov, (615) 355-1539. This is not a toll free 
number.

SUPPLEMENTARY INFORMATION: On June 6, 2018, section 132 of Public Law 
115-182, the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson 
VA Maintaining Internal Systems and Strengthening Integrated Outside 
Networks Act of 2018 (MISSION Act), amended 38 U.S.C. 7332, 
Confidentiality of certain medical records, which protects certain 
sensitive diagnoses (i.e., drug abuse, alcoholism or alcohol abuse, 
infection with the human immunodeficiency virus, or sickle cell anemia) 
from being disclosed unless expressly authorized by the patient. The VA 
Mission Act of 2018 amended section 7332 by providing a new exception 
to the requriment that a patient must expressely authorize VA to 
disclose medical records containing a sensitive diagnosis. The 
exception removed VA's requirement when VA is billing a third-party for 
medical care cost recovery.
    In addition to this document, VA will announce these changes on 
Veteran-facing websites to reach as many VA beneficiaires as possible. 
VA will also conduct a briefing with Veteran Service Organizations to 
ensure they are informed of the changes. For any VA beneficiary who has 
previously signed a release of information declining to allow VA to 
bill encounters containing a sensitive diagnosis, VA will provide a 
one-time notification prior to submitting claims with a sensitive 
diagnosis to a third-party health insurer. The written notification 
will include a summary of the new law, how the change affects the 
patient, and a description of the types of services affected by the 
change.
    After all of the aforementioned notifications are complete, VA will 
begin submitting claims to health insurance companies for encounters 
with dates of service on or after the publication date of this document 
in the Federal Register that contain a sensitive diagnosis without a 
signed release of information. While VA's billing authorities allow for 
a window of up to 6 years to bill a health insurance company for 
services provided, VA will not pursue any back billing for these 
services unless a signed Request For and Authorization to Release 
Medical Records or Health Information (VHA-10-5345) form for such 
release has been received from the patient. All required payer policies 
still apply to any services submitted for reimbursement.

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. Robert L. 
Wilkie, Secretary, Department of Veterans Affairs, approved this 
document on December 21, 2018, for publication.

    Dated: December 21, 2018.
Luvenia Potts,
Program Specialist, Office of Regulation Policy & Management, Office of 
the Secretary, Department of Veterans Affairs.
[FR Doc. 2018-28285 Filed 1-25-19; 8:45 am]
 BILLING CODE 8320-01-P