Update: Enrollment-Provision of Hospital and Outpatient Care to Medal of Honor Veterans, 7813-7815 [2019-03747]

Download as PDF Federal Register / Vol. 84, No. 43 / Tuesday, March 5, 2019 / Rules and Regulations Authority: 46 U.S.C. 70041; 33 CFR 1.05– 2. In § 100.35(c), remove the text ‘‘33 U.S.C. 1233’’ and add in its place the text ‘‘46 U.S.C. 70041’’. i. Remove the text ‘‘the Ports and Waterways Safety Act, 33 U.S.C. 1221– 1232’’ and add in its place the text ‘‘46 U.S.C. Chapter 700’’; and ■ ii. Remove the text ‘‘50 U.S.C. 191– 195’’ and add in its place the text ‘‘46 U.S.C. 70051–54’’. § 100.1401 § 165.838 1. § 100.35 [Amended] ■ [Amended] 3. In § 100.1401(e), remove the text ‘‘33 U.S.C. 1233’’ and add in its place the text ‘‘46 U.S.C. 70041’’. ■ ■ [Amended] 10. Amend § 165.838 as follows: a. In paragraph (b)(5), remove the text ‘‘the Ports and Waterways Safety Act, 33 U.S.C. 1221 et seq.’’ and add in its place the text ‘‘46 U.S.C. Chapter 700’’. ■ b. In paragraph (i), remove the text ‘‘the Ports and Waterways Safety Act, 33 U.S.C. 1221 et seq.’’ and add in its place the text ‘‘46 U.S.C. 70036 and 70041’’. ■ ■ PART 110—ANCHORAGE REGULATIONS 4. The authority citation for part 110 is revised to read as follows: ■ Authority: 33 U.S.C. 471, 2071, 46 U.S.C. 70034; 33 CFR 1.05–1; Department of Homeland Security Delegation No. 0170.1. 5. In § 110.1a, revise the section heading and paragraph (a) introductory text to read as follows: ■ Dated: February 27, 2019. Katia Kroutil, Chief, Office of Regulations and Administrative Law, U.S. Coast Guard. [FR Doc. 2019–03856 Filed 3–4–19; 8:45 am] BILLING CODE 9110–04–P § 110.1a Anchorages under Ports and Waterways Safety provisions. (a) The anchorages listed in this section are regulated under 46 U.S.C. Chapter 700, ‘‘Ports and Waterways Safety’’: * * * * * DEPARTMENT OF VETERANS AFFAIRS PART 147—SAFETY ZONES Update: Enrollment—Provision of Hospital and Outpatient Care to Medal of Honor Veterans 38 CFR Part 17 RIN 2900–AQ34 6. The authority citation for part 147 is revised to read as follows: ■ Authority: 14 U.S.C. 544; 43 U.S.C. 1333; 33 CFR 1.05–1; Department of Homeland Security Delegation No. 0170.1. PART 165—REGULATED NAVIGATION AREAS AND LIMITED ACCESS AREAS 7. The authority citation for part 165 is revised to read as follows: ■ Authority: 46 U.S.C. 70034, 70051; 33 CFR 1.05–1, 6.04–1, 6.04–6, and 160.5; Department of Homeland Security Delegation No. 0170.1. 8. In part 165: a. Revise all references to ‘‘33 U.S.C. 1226’’ to read ‘‘46 U.S.C. 70116’’. ■ b. Revise all references to ‘‘33 U.S.C. 1231’’ to read ‘‘46 U.S.C. 70034’’. ■ c. Revise all references to ‘‘33 U.S.C. 1232’’ to read ‘‘46 U.S.C. 70036’’. ■ d. Revise all references to ‘‘50 U.S.C. 191’’ to read ‘‘46 U.S.C. 70051’’. ■ e. Revise all references to ‘‘50 U.S.C. 192’’ to read ‘‘46 U.S.C. 70052’’. amozie on DSK9F9SC42PROD with RULES ■ ■ § 165.9 [Amended] 9. Amend § 165.9 as follows: a. In paragraph (b), remove the text ‘‘the Ports and Waterways Safety Act, 33 U.S.C. 1221–1232’’ and add in its place the text ‘‘46 U.S.C. 70001–70041’’. ■ b. In paragraph (c): ■ ■ VerDate Sep<11>2014 16:03 Mar 04, 2019 Jkt 247001 Department of Veterans Affairs Final rule. AGENCY: ACTION: The Department of Veterans Affairs (VA) is amending its medical regulations governing eligibility for VA health care and copayment requirements to conform to recent statutory changes. VA is changing its enrollment criteria to move Medal of Honor recipients from priority category three to priority category one, and exempting recipients of the Medal of Honor from copayments for inpatient care, outpatient care, medications, and extended care services. DATES: This final rule is effective on March 5, 2019. FOR FURTHER INFORMATION CONTACT: Stacey Echols Sr., CP, FAC–P/PM, Business Policy, VHA Member Services; 810 Vermont Avenue NW, Washington, DC 20420; (404) 828–5281. (This is not a toll-free number.) SUPPLEMENTARY INFORMATION: SUMMARY: Enrollment Eligibility Section 1705 of title 38, United States Code (38 U.S.C. 1705), requires VA to implement a national enrollment system to manage the delivery of its health care services and also contains priority PO 00000 Frm 00021 Fmt 4700 Sfmt 4700 7813 categories for determining eligibility for enrollment in VA’s health care system. In its original enactment, section 1705 did not include receipt of the Medal of Honor as a criterion for eligibility in a priority category. See Public Law 104– 262 (October 9, 1996). In 2010, Congress amended section 1705 by adding Medal of Honor recipients to priority category three. See Public Law 111–163 (May 5, 2010). VA has implemented section 1705 in regulation at 38 Code of Federal Regulations (CFR) 17.36. In the Jeff Miller and Richard Blumenthal Veterans Health Care and Benefits Improvement Act of 2016, Congress elevated Medal of Honor recipients’ health care enrollment eligibility from priority category three to priority category one. Public Law (Pub. L.) 114–315 (December 16, 2016). This final rulemaking updates 38 CFR 17.36 to reflect the current statutory requirement that VA place Medal of Honor recipients in priority category one. VA therefore is removing award of the Medal of Honor as a criterion from paragraph (b)(3) and inserting it as a criterion in paragraph (b)(1). Copayments Several sections in Chapter 17 of title 38, U.S.C. require VA to collect copayments from certain veterans for various types of care and medication. Section 1710 of 38 U.S.C., for example, directs VA to provide hospital care and medical services to numerous categories of veterans, and requires VA to charge certain categories of veterans copayments for the care and services provided. Section 1710B allows VA to furnish extended care services to certain categories of veterans, including several categories who are not required to pay copayments. Section 1722A requires VA to charge copayments for medications, excepting several categories of veterans who are not required to pay copayments. While Public Law 111–163 added Medal of Honor awardees to Priority Group 3, it did not exempt these veterans from VA copayment requirements. Section 603 of Public Law 114–315 amended 38 U.S.C. 1710(a)(2)(D), 1710B(c)(2), and 1722A(a)(3) to afford Medal of Honor recipients specific exemptions to the copayments required for hospital care and medical services, extended care services, and medications. VA has regulated copayments for the aforementioned benefits at 38 CFR 17.108, 17.110, and 17.111. This final rulemaking adds §§ 17.108(d)(13), 17.110(c)(11), and 17.111(f)(10) to reflect the statutory changes exempting Medal of Honor recipients from copayments for the E:\FR\FM\05MRR1.SGM 05MRR1 7814 Federal Register / Vol. 84, No. 43 / Tuesday, March 5, 2019 / Rules and Regulations listed health care services and medications. Executive Order 12866, 13563, and 13771 Administrative Procedure Act 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,’’ requiring review by the Office of Management and Budget (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 the Executive Order. The economic, interagency, budgetary, legal, and policy implications of this 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 http:// 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 http:// 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. This final rule implements the specific requirements mandated by Public Law 114–315 that VA place Medal of Honor recipients into priority category one for purposes of enrollment eligibility and exempt those veterans from certain copayments. Accordingly, because this rule simply incorporates current statutory requirements, VA finds there is good cause to exempt this rule from the prior notice-and-comment and delayed-effective-date requirements, in accordance with 5 U.S.C. 553(b)(B) and 5 U.S.C. 553(d)(3). 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 38 CFR 17.36 contains provisions constituting collections of information 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 § 17.36 are currently approved by the Office of Management and Budget (OMB) and have been assigned OMB control number 2900–0091. amozie on DSK9F9SC42PROD with RULES Regulatory Flexibility Act The Regulatory Flexibility Act, 5 U.S.C. 601–612, is not applicable to this rulemaking because notice of proposed rulemaking is not required. 5 U.S.C. 601(2), 603(a), 604(a). In any event, the Secretary hereby certifies that this rule does not have a significant economic impact on a substantial number of small entities as they are defined in the Regulatory Flexibility Act. This rule directly affects only individuals and does not directly affect small entities. 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. VerDate Sep<11>2014 16:03 Mar 04, 2019 Jkt 247001 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 one year. This final rule will 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 64.007, Blind Rehabilitation Centers; 64.008, Veterans Domiciliary Care; 64.009, Veterans Medical Care Benefits; 64.010, Veterans Nursing Home 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; 64.018, Sharing Specialized Medical Resources; 64.019, Veterans Rehabilitation Alcohol and Drug Dependence; 64.022, Veterans Home Based Primary Care; and 64.024, VA Homeless Providers Grant and Per Diem Program. 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, Medical and dental schools, Medical devices, Medical research, Mental health programs, Nursing homes, Reporting and recordkeeping requirements, Travel and transportation expenses, Veterans. Signing Authority The Secretary of Veterans Affairs 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 February 26, 2019, for publication. Unfunded Mandates Dated: February 26, 2019. Consuela Benjamin, Regulations Development Coordinator, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. 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 For the reasons stated in the preamble, Department of Veterans Affairs amends 38 CFR part 17 as follows: PO 00000 Frm 00022 Fmt 4700 Sfmt 4700 E:\FR\FM\05MRR1.SGM 05MRR1 Federal Register / Vol. 84, No. 43 / Tuesday, March 5, 2019 / Rules and Regulations 5. Amend § 17.111 by adding paragraph (f)(10) to read 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 § 17.36 by revising paragraphs (b)(1) and (3) to reads as follows: ■ * * * * * (b) * * * (1) Veterans with a singular or combined rating of 50 percent or greater based on one or more service-connected disabilities or unemployability; and veterans awarded the Medal of Honor. * * * * * (3) Veterans who are former prisoners of war; veterans awarded the Purple Heart; veterans with a singular or combined rating of 10 percent or 20 percent based on one or more serviceconnected disabilities; veterans who were discharged or released from active military service for a disability incurred or aggravated in the line of duty; veterans who receive disability compensation under 38 U.S.C. 1151; veterans whose entitlement to disability compensation is suspended pursuant to 38 U.S.C. 1151, but only to the extent that such veterans’ continuing eligibility for that care is provided for in the judgment or settlement described in 38 U.S.C. 1151; veterans whose entitlement to disability compensation is suspended because of the receipt of military retired pay; and veterans receiving compensation at the 10 percent rating level based on multiple noncompensable service-connected disabilities that clearly interfere with normal employability. * * * * * ■ 3. Amend § 17.108 by adding paragraph (d)(13) to read as follows: § 17.108 Copayments for inpatient hospital care and outpatient medical care. * * * * (d) * * * (13) A veteran who was awarded the Medal of Honor. * * * * * ■ 4. Amend § 17.110 by adding paragraph (c)(11) to read as follows: amozie on DSK9F9SC42PROD with RULES * Copayments for medications. * * * * * (c) * * * (11) Medication for a veteran who was awarded the Medal of Honor. * * * * * VerDate Sep<11>2014 16:03 Mar 04, 2019 Jkt 247001 * * * * * (f) * * * (10) A veteran who was awarded the Medal of Honor. * * * * * [FR Doc. 2019–03747 Filed 3–4–19; 8:45 am] § 17.36 Enrollment—provision of hospital and outpatient care to veterans. § 17.110 § 17.111 Copayments for extended care services. BILLING CODE 8320–01–P POSTAL REGULATORY COMMISSION 39 CFR Part 3020 [Docket Nos. MC2010–21 and CP2010–36] Update to Product List Postal Regulatory Commission. Final rule. AGENCY: ACTION: The Commission is updating the competitive product list. This action reflects a publication policy adopted by Commission order. The referenced policy assumes periodic updates. The updates are identified in the body of this document. The competitive product list, which is re-published in its entirety, include these updates. DATES: Effective Date: March 5, 2019. For applicability dates, see SUPPLEMENTARY INFORMATION. FOR FURTHER INFORMATION CONTACT: David A. Trissell, General Counsel, at 202–789–6800. SUPPLEMENTARY INFORMATION: Applicability Dates: October 16, 2018, Priority Mail Contract 466 (MC2019–1 and CP2019–1); October 17, 2018, Priority Mail Contract 467 (MC2019–2 and CP2019–2); October 25, 2018, Priority Mail Contract 468 (MC2019–5 and CP2019–4); October 25, 2018, Priority Mail Contract 470 (MC2019–7 and CP2019–6); October 25, 2018, Priority Mail Contract 469 (MC2019–6 and CP2019–5); October 26, 2018, Priority Mail Contract 471 (MC2019–8 and CP2019–7); October 26, 2018, Priority Mail Express & Priority Mail Contract 73 (MC2019–9 and CP2019–8); October 26, 2018, Priority Mail Express & Priority Mail Contract 74 (MC2019–10 and CP2019–9); November 16, 2018, Priority Mail Contract 472 (MC2019–11 and CP2019–10); November 21, 2018, Priority Mail Contract 473 (MC2019–12 and CP2019–12); November 21, 2018, First-Class Package Service Contract 95 (MC2019–13 and CP2019–13); November 21, 2018, Priority Mail Contract 474 (MC2019–14 and CP2019– 14); November 21, 2018, Priority Mail & First-Class Package Service Contract 90 SUMMARY: PO 00000 Frm 00023 Fmt 4700 Sfmt 4700 7815 (MC2019–15 and CP2019–15); November 21, 2018, Priority Mail Express & Priority Mail Contract 75 (MC2019–16 and CP2019–16); November 27, 2018, Priority Mail Contract 475 (MC2019–18 and CP2019– 18); November 27, 2018, Priority Mail Contract 477 (MC2019–20 and CP2019– 20); November 27, 2018, Priority Mail Contract 476 (MC2019–19 and CP2019– 19); November 28, 2018, Priority Mail Express, Priority Mail & First-Class Package Service Contract 46 (MC2019– 21 and CP2019–21); November 29, 2018, Priority Mail Express, Priority Mail & First-Class Package Service Contract 47 (MC2019–22 and CP2019–23); November 29, 2018, Priority Mail Express Contract 66 (MC2019–24 and CP2019–25); November 29, 2018, Priority Mail Contract 478 (MC2019–23 and CP2019–24); November 29, 2018, Priority Mail Express Contract 67 (MC2019–25 and CP2019–26); November 30, 2018, Priority Mail Contract 479 (MC2019–26 and CP2019– 27); November 30, 2018, Priority Mail Contract 480 (MC2019–27 and CP2019– 28); November 30, 2018, Priority Mail Contract 481 (MC2019–28 and CP2019– 29); November 30, 2018, Priority Mail Contract 482 (MC2019–29 and CP2019– 30); November 30, 2018, Priority Mail Contract 483 (MC2019–30 and CP2019– 31); December 7, 2018, First-Class Package Service Contract 96 (MC2019– 33 and CP2019–34); December 7, 2018, Priority Mail Express & Priority Mail Contract 76 (MC2019–34 and CP2019– 35); December 7, 2018, Priority Mail Express & Priority Mail Contract 77 (MC2019–35 and CP2019–36); December 7, 2018, Priority Mail Contract 484 (MC2019–31 and CP2019– 32); December 7, 2018, Priority Mail Express Contract 68 (MC2019–32 and CP2019–33); December 11, 2018, Priority Mail Contract 485 (MC2019–36 and CP2019–38); December 11, 2018, Priority Mail Contract 486 (MC2019–37 and CP2019–39); December 18, 2018, Priority Mail Contract 487 (MC2019–38 and CP2019–40); December 18, 2018, Priority Mail Contract 488 (MC2019–39 and CP2019–41); December 18, 2018, Priority Mail Contract 489 (MC2019–40 and CP2019–42); December 20, 2018, Priority Mail Contract 490 (MC2019–41 and CP2019–44); December 20, 2018, Priority Mail Contract 491 (MC2019–42 and CP2019–45); December 20, 2018, Priority Mail Contract 492 (MC2019–43 and CP2019–46); December 20, 2018, Priority Mail Contract 493 (MC2019–44 and CP2019–47); December 20, 2018, Priority Mail Contract 494 (MC2019–45 and CP2019–48); December 21, 2018, Priority Mail & First-Class Package E:\FR\FM\05MRR1.SGM 05MRR1

Agencies

[Federal Register Volume 84, Number 43 (Tuesday, March 5, 2019)]
[Rules and Regulations]
[Pages 7813-7815]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-03747]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AQ34


Update: Enrollment--Provision of Hospital and Outpatient Care to 
Medal of Honor Veterans

AGENCY: Department of Veterans Affairs

ACTION: Final rule.

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

SUMMARY: The Department of Veterans Affairs (VA) is amending its 
medical regulations governing eligibility for VA health care and 
copayment requirements to conform to recent statutory changes. VA is 
changing its enrollment criteria to move Medal of Honor recipients from 
priority category three to priority category one, and exempting 
recipients of the Medal of Honor from copayments for inpatient care, 
outpatient care, medications, and extended care services.

DATES: This final rule is effective on March 5, 2019.

FOR FURTHER INFORMATION CONTACT: Stacey Echols Sr., CP, FAC-P/PM, 
Business Policy, VHA Member Services; 810 Vermont Avenue NW, 
Washington, DC 20420; (404) 828-5281. (This is not a toll-free number.)

SUPPLEMENTARY INFORMATION:

Enrollment Eligibility

    Section 1705 of title 38, United States Code (38 U.S.C. 1705), 
requires VA to implement a national enrollment system to manage the 
delivery of its health care services and also contains priority 
categories for determining eligibility for enrollment in VA's health 
care system. In its original enactment, section 1705 did not include 
receipt of the Medal of Honor as a criterion for eligibility in a 
priority category. See Public Law 104-262 (October 9, 1996). In 2010, 
Congress amended section 1705 by adding Medal of Honor recipients to 
priority category three. See Public Law 111-163 (May 5, 2010). VA has 
implemented section 1705 in regulation at 38 Code of Federal 
Regulations (CFR) 17.36.
    In the Jeff Miller and Richard Blumenthal Veterans Health Care and 
Benefits Improvement Act of 2016, Congress elevated Medal of Honor 
recipients' health care enrollment eligibility from priority category 
three to priority category one. Public Law (Pub. L.) 114-315 (December 
16, 2016).
    This final rulemaking updates 38 CFR 17.36 to reflect the current 
statutory requirement that VA place Medal of Honor recipients in 
priority category one. VA therefore is removing award of the Medal of 
Honor as a criterion from paragraph (b)(3) and inserting it as a 
criterion in paragraph (b)(1).

Copayments

    Several sections in Chapter 17 of title 38, U.S.C. require VA to 
collect copayments from certain veterans for various types of care and 
medication. Section 1710 of 38 U.S.C., for example, directs VA to 
provide hospital care and medical services to numerous categories of 
veterans, and requires VA to charge certain categories of veterans 
copayments for the care and services provided. Section 1710B allows VA 
to furnish extended care services to certain categories of veterans, 
including several categories who are not required to pay copayments. 
Section 1722A requires VA to charge copayments for medications, 
excepting several categories of veterans who are not required to pay 
copayments. While Public Law 111-163 added Medal of Honor awardees to 
Priority Group 3, it did not exempt these veterans from VA copayment 
requirements.
    Section 603 of Public Law 114-315 amended 38 U.S.C. 1710(a)(2)(D), 
1710B(c)(2), and 1722A(a)(3) to afford Medal of Honor recipients 
specific exemptions to the copayments required for hospital care and 
medical services, extended care services, and medications. VA has 
regulated copayments for the aforementioned benefits at 38 CFR 17.108, 
17.110, and 17.111. This final rulemaking adds Sec. Sec.  
17.108(d)(13), 17.110(c)(11), and 17.111(f)(10) to reflect the 
statutory changes exempting Medal of Honor recipients from copayments 
for the

[[Page 7814]]

listed health care services and medications.

Administrative Procedure Act

    This final rule implements the specific requirements mandated by 
Public Law 114-315 that VA place Medal of Honor recipients into 
priority category one for purposes of enrollment eligibility and exempt 
those veterans from certain copayments. Accordingly, because this rule 
simply incorporates current statutory requirements, VA finds there is 
good cause to exempt this rule from the prior notice-and-comment and 
delayed-effective-date requirements, in accordance with 5 U.S.C. 
553(b)(B) and 5 U.S.C. 553(d)(3).

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 38 CFR 17.36 contains provisions constituting collections 
of information 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.  17.36 are currently approved by the Office of 
Management and Budget (OMB) and have been assigned OMB control number 
2900-0091.

Regulatory Flexibility Act

    The Regulatory Flexibility Act, 5 U.S.C. 601-612, is not applicable 
to this rulemaking because notice of proposed rulemaking is not 
required. 5 U.S.C. 601(2), 603(a), 604(a). In any event, the Secretary 
hereby certifies that this rule does not have a significant economic 
impact on a substantial number of small entities as they are defined in 
the Regulatory Flexibility Act. This rule directly affects only 
individuals and does not directly affect small entities. 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.

Executive Order 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,'' requiring review by the Office of 
Management and Budget (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 the Executive Order.
    The economic, interagency, budgetary, legal, and policy 
implications of this 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 http://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 
http://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 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 one year. This final rule will 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 64.007, Blind Rehabilitation 
Centers; 64.008, Veterans Domiciliary Care; 64.009, Veterans Medical 
Care Benefits; 64.010, Veterans Nursing Home 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; 64.018, Sharing Specialized Medical 
Resources; 64.019, Veterans Rehabilitation Alcohol and Drug Dependence; 
64.022, Veterans Home Based Primary Care; and 64.024, VA Homeless 
Providers Grant and Per Diem Program.

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, Medical and 
dental schools, Medical devices, Medical research, Mental health 
programs, Nursing homes, Reporting and recordkeeping requirements, 
Travel and transportation expenses, Veterans.

Signing Authority

    The Secretary of Veterans Affairs 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 February 26, 2019, for publication.

    Dated: February 26, 2019.
Consuela Benjamin,
Regulations Development Coordinator, Office of Regulation Policy & 
Management, Office of the Secretary, Department of Veterans Affairs.

    For the reasons stated in the preamble, Department of Veterans 
Affairs amends 38 CFR part 17 as follows:

[[Page 7815]]

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.  17.36 by revising paragraphs (b)(1) and (3) to reads as 
follows:


Sec.  17.36  Enrollment--provision of hospital and outpatient care to 
veterans.

* * * * *
    (b) * * *
    (1) Veterans with a singular or combined rating of 50 percent or 
greater based on one or more service-connected disabilities or 
unemployability; and veterans awarded the Medal of Honor.
* * * * *
    (3) Veterans who are former prisoners of war; veterans awarded the 
Purple Heart; veterans with a singular or combined rating of 10 percent 
or 20 percent based on one or more service-connected disabilities; 
veterans who were discharged or released from active military service 
for a disability incurred or aggravated in the line of duty; veterans 
who receive disability compensation under 38 U.S.C. 1151; veterans 
whose entitlement to disability compensation is suspended pursuant to 
38 U.S.C. 1151, but only to the extent that such veterans' continuing 
eligibility for that care is provided for in the judgment or settlement 
described in 38 U.S.C. 1151; veterans whose entitlement to disability 
compensation is suspended because of the receipt of military retired 
pay; and veterans receiving compensation at the 10 percent rating level 
based on multiple noncompensable service-connected disabilities that 
clearly interfere with normal employability.
* * * * *

0
3. Amend Sec.  17.108 by adding paragraph (d)(13) to read as follows:


Sec.  17.108  Copayments for inpatient hospital care and outpatient 
medical care.

* * * * *
    (d) * * *
    (13) A veteran who was awarded the Medal of Honor.
* * * * *

0
4. Amend Sec.  17.110 by adding paragraph (c)(11) to read as follows:


Sec.  17.110  Copayments for medications.

* * * * *
    (c) * * *
    (11) Medication for a veteran who was awarded the Medal of Honor.
* * * * *

0
5. Amend Sec.  17.111 by adding paragraph (f)(10) to read as follows:


Sec.  17.111  Copayments for extended care services.

* * * * *
    (f) * * *
    (10) A veteran who was awarded the Medal of Honor.
* * * * *
[FR Doc. 2019-03747 Filed 3-4-19; 8:45 am]
BILLING CODE 8320-01-P