TRICARE: Prescribing of Physical Therapy, Occupational Therapy, and Speech Therapy by Other Allied Health Professionals Acting Within the Scope of Their License, 13855-13857 [2019-06795]
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Federal Register / Vol. 84, No. 67 / Monday, April 8, 2019 / Proposed Rules
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IV. Procedural Determinations
Executive Order 12866—Regulatory
Planning and Review
Pursuant to Office of Management and
Budget (OMB) Guidance dated October
12, 1993, the approval of state program
amendments is exempted from OMB
review under Executive Order 12866.
List of Subjects in 30 CFR Part 948
Intergovernmental relations, Surface
mining, Underground mining.
Dated: October 11, 2018.
Thomas D. Shope,
Regional Director, Appalachian Region.
[FR Doc. 2019–06826 Filed 4–5–19; 8:45 am]
13855
The Department of Defense
(DoD) proposes an amendment to the
TRICARE regulation. Specifically, this
proposed rule will allow coverage of
otherwise authorized physical therapy
(PT), occupational therapy (OT), and
speech therapy (ST) for TRICARE
beneficiaries when such services are
prescribed by an authorized TRICARE
Allied Health Professional acting within
the scope of their license.
DATES: Written comments received at
the address indicated below by June 7,
2019 will be accepted.
ADDRESSES: You may submit comments,
identified by docket number and/or
Regulatory Information Number (RIN)
number and title, by either of the
following methods:
• Federal eRulemaking Portal:
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Department of Defense, Office
of the Chief Management Officer,
Directorate for Oversight and
Compliance, Regulatory and Advisory
Committee Division, 4800 Mark Center
Drive, Mailbox #24, Suite 08D09,
Alexandria, VA 22350–1700.
Instructions: All submissions received
must include the agency name and
docket number or RIN for this Federal
Register document. The general policy
for comments and other submissions
from members of the public is to make
these submissions available for public
viewing on the internet at https://
www.regulations.gov as they are
received without change, including any
personal identifiers or contact
information.
SUMMARY:
FOR FURTHER INFORMATION CONTACT:
Amber Butterfield, Defense Health
Agency, TRICARE Health Plan, Medical
Benefits and Reimbursement Division,
(303) 676–3565.
SUPPLEMENTARY INFORMATION:
BILLING CODE 4310–05–P
I. Executive Summary and Overview
A. Purpose of the Regulatory Action
DEPARTMENT OF DEFENSE
Office of the Secretary
32 CFR Part 199
[Docket ID: DOD–2017–HA–0058]
RIN 0720–AB71
TRICARE: Prescribing of Physical
Therapy, Occupational Therapy, and
Speech Therapy by Other Allied Health
Professionals Acting Within the Scope
of Their License
Office of the Secretary,
Department of Defense.
ACTION: Proposed rule.
AGENCY:
PO 00000
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This proposed rule will permit
coverage of services prescribed by
TRICARE-authorized individual allied
health professionals for PT, OT, and ST.
The current language of Title 32 Code of
Federal Regulations (CFR),
§ 199.4(c)(3)(x) states that PT, OT, and
ST may be cost-shared when services
are prescribed and monitored by a
physician, certified physician assistant,
or certified nurse practitioner. In
addition, 32 CFR 199.6(c)(3)(iii)(K)(2)
currently states that the services of other
individual paramedical providers, such
as licensed registered PT, OT, and ST,
can be considered for benefits on a feefor-service basis only if the beneficiary
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13856
Federal Register / Vol. 84, No. 67 / Monday, April 8, 2019 / Proposed Rules
This rule allows TRICARE coverage of
otherwise authorized PT, OT, and ST
services when prescribed by TRICARE
authorized allied health professionals
when the allied health professional is
acting within the scope of his/her
license.
Once beneficiaries initiate an episode
of care with an Other Allied Health
Professional for a covered disease or
condition, they need not return to their
Primary Care Manager for an office visit
to obtain an examination and referral for
PT, OT, or ST services. Assuming two
hours by appointment (appointment,
travel, waiting room, exam room),
beneficiaries will save approximately
20,000 hours each year by not having to
visit their referring provider prior to
seeking PT, OT, or ST services.
Referring providers will also save time,
approximately 2,200 hours (15 minutes
for a podiatrist to consult with a
referring provider regarding a PT
prescription) each year, as a result of
reduced coordination and paperwork.
The proposed amendment to cover
PT, OT, and ST services, when
prescribed by a TRICARE-authorized
Allied Health Professionals acting
within the scope of their license, is not
expected to increase the amount of
otherwise covered PT, OT, and ST
services. This is because prescriptions
for such services are currently being
written by those providers authorized to
do so under the TRICARE program or
those providers are countersigning
prescriptions from Allied Health
Professionals, such as a podiatrist. The
DoD does anticipate, however, that there
may be a marginal increase in
administrative costs to accommodate
changes to our contractors’ systems,
although the overall result of this
change will create an efficiency in the
process.
This proposed rule does not create
new costs to the government, because it
falls under the Transfer Payment clause
in accordance with OMB Circular A–4.
As this rule proposes, TRICARE
payments for physical, occupational or
speech therapy services provided to
military beneficiaries and prescribed by
Other Allied Health Professionals,
represents an ‘‘Insurance Payment’’ as
described in OMB Circular A–4.
C. Expected Impact and Costs
II. Regulatory Procedures
The primary impact of this rule will
result in less time and expense spent by
beneficiaries and referring providers to
obtain necessary medical services and
supplies. Almost 10,000 beneficiaries
visited a primary care provider after
seeking care from a podiatrist, but prior
to PT services, in 2017. With an average
copay/cost-share of $24 across networks
and TRICARE programs, this rule will
conservatively save beneficiaries up to
$230,000 per year in cost-sharing and
will conservatively save TRICARE $1.1
million per year as a result of reduced
visits to referring providers.
Executive Order 12866, ‘‘Regulatory
Planning and Review’’ and Executive
Order 13563, ‘‘Improving Regulation
and Regulatory Review’’
Executive Orders 13563 and 12866
direct agencies to assess all costs and
benefits of available regulatory
alternatives and, if regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety
effects, distribute impacts, and equity).
Executive Order 13563 emphasizes the
importance of quantifying both costs
is referred by a physician, certified
physician assistant, or certified nurse
practitioner and a physician, certified
physician assistant, or certified nurse
practitioner provides continuing and
ongoing oversight and supervision of
the program or episode of treatment
provided by these individual
paramedical providers. As a result,
otherwise authorized PT, OT, and ST
services for TRICARE beneficiaries are
not covered benefits when other Allied
Health Professionals, such as Doctors of
Podiatry, even when acting within their
scope of license, prescribe the services.
State governments generally regulate
the licensure and practice of health care
professionals, and DoD limits TRICARE
benefits coverage to services and
supplies furnished by otherwise
authorized TRICARE individual
professional providers performing
within the scope of their state licenses
or certifications. State scope of practice
laws vary with regard to the range of
services, and some include the authority
to prescribe PT, OT, and ST. After
assessing the information available, DoD
has determined that it is unnecessarily
restrictive not to cover otherwise
authorized PT, OT, and ST services for
TRICARE beneficiaries merely because
the services are ordered by a nonphysician. Therefore, the regulation is
being amended to allow TRICARE
coverage of PT, OT, and ST services
when ordered by other Allied Health
Professionals who are TRICARE
authorized providers and acting within
the scope of their state license or
certificate.
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B. Summary of the Major Provisions of
the Proposed Rule
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and benefits, of reducing costs, of
harmonizing rules, and of promoting
flexibility. This proposed rule has been
designated a ‘‘significant regulatory
action,’’ although not economically
significant, under section 3(f) of
Executive Order 12866. This proposed
rule is not anticipated to have an annual
effect on the economy of $100M or
more.
Accordingly, this rule has been
reviewed by the Office of Management
and Budget.
Executive Order (E.O.) 13771,
‘‘Reducing Regulation and Controlling
Regulatory Costs’’
E.O. 13771 seeks to control costs
associated with the government
imposition of private expenditures
required to comply with Federal
regulations and to reduce regulations
that impose such costs. Consistent with
the analysis of transfer payments under
OMB Circular A–4, this proposed rule
does not involve regulatory costs subject
to E.O. 13771.
Congressional Review Act, 5 U.S.C.
804(2)
Under the Congressional Review Act,
a major rule may not take effect until at
least 60 days after submission to
Congress of a report regarding the rule.
A major rule is one that would have an
annual effect on the economy of $100M
or more or have certain other impacts.
This proposed rule is not a major rule
under the Congressional Review Act.
Public Law 96–354, ‘‘Regulatory
Flexibility Act’’ (RFA), (5 U.S.C. 601)
The Regulatory Flexibility Act (RFA)
requires that each Federal agency
analyze options for regulatory relief of
small businesses if a rule has a
significant impact on a substantial
number of small entities. For purposes
of the RFA, small entities include small
businesses, nonprofit organizations, and
small governmental jurisdictions. This
proposed rule is not an economically
significant regulatory action, and it will
not have a significant impact on a
substantial number of small entities.
Therefore, it is certified that this rule is
not subject to the requirements of the
RFA.
Public Law 104–4, Sec. 202, ‘‘Unfunded
Mandates Reform Act’’
Section 202 of the Unfunded
Mandates Reform Act of 1995, requires
that agencies assess anticipated costs
and benefits before issuing any rule
whose mandates require spending in,
any one year of $100M, as of 1995
exchange rate, updated annually for
inflation. That threshold level is
E:\FR\FM\08APP1.SGM
08APP1
Federal Register / Vol. 84, No. 67 / Monday, April 8, 2019 / Proposed Rules
currently approximately $140M. This
proposed rule will not mandate any
requirements for state, local, or tribal
governments or the private sector.
Public Law 96–511, ‘‘Paperwork
Reduction Act’’ (44 U.S.C. Chapter 35)
This rulemaking does not contain a
‘‘collection of information’’
requirement, and will not impose
additional information collection
requirements on the public under Public
Law 96–511, ‘‘Paperwork Reduction
Act’’ (44 U.S.C. chapter 35).
Executive Order 13132, ‘‘Federalism’’
This proposed rule has been
examined for its impact under Executive
Order 13132, and it does not contain
policies that have federalism
implications that would have
substantial direct effects on the States,
on the relationship between the national
Government and the States, or on the
distribution of powers and
responsibilities among the various
levels of Government. Therefore,
consultation with State and local
officials is not required.
List of Subjects in 32 CFR Part 199
Claims, Dental health, Health care,
Health insurance, Individuals with
disabilities, Military personnel.
Accordingly, 32 CFR part 199 is
proposed to be amended as follows:
Authority: 5 U.S.C. 301; 10 U.S.C. Chapter
55.
2. Section 199.4 is amended by
revising paragraph (c)(3)(x)(A) to read as
follows:
■
Basic program benefits.
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*
*
*
*
(c) * * *
(3) * * *
(x) * * *
(A) The services are prescribed and
monitored by a physician or other
TRICARE authorized allied health
professional acting within the scope of
their license.
*
*
*
*
*
■ 3. Section 199.6 is amended by
revising paragraph (c)(3)(iii)(K)(2) to
read as follows:
TRICARE-authorized providers.
*
*
*
*
*
(c) * * *
(3) * * *
(iii) * * *
(K) * * *
(2) The services of the following
individual professional providers of
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BILLING CODE 5001–06–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
RIN 0938–AT55
1. The authority citation for part 199
continues to read as follows:
§ 199.6
[FR Doc. 2019–06795 Filed 4–5–19; 8:45 am]
[CMS–3355–N]
■
*
Dated: April 2, 2019.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
42 CFR Part 493
PART 199—[AMENDED]
§ 199.4
care, to be considered for benefits on a
fee-for-service basis, may be provided
only if the beneficiary is referred by a
physician or other TRICARE authorized
Allied Health Professional acting within
the scope of their license and a
physician or other TRICARE authorized
Allied Health Professional acting within
the scope of their license must also
provide continuing and ongoing
oversight and supervision of the
program or episode of treatment
provided by these individual
paramedical providers.
*
*
*
*
*
Clinical Laboratory Improvement
Amendments of 1988 (CLIA)
Proficiency Testing Regulations
Related to Analytes and Acceptable
Performance; Extension of Comment
Period
Centers for Medicare &
Medicaid Services (CMS), HHS; Centers
for Disease Control and Prevention
(CDC), HHS.
ACTION: Proposed rule; extension of
comment period.
AGENCY:
This document extends the
comment period for the notice of
proposed rulemaking with comment
entitled ‘‘Clinical Laboratory
Improvement Amendments of 1988
(CLIA) Proficiency Testing Regulations
Related to Analytes and Acceptable
Performance’’ that appeared in the
February 4, 2019 Federal Register. The
comment period for the proposed rule,
which would end on April 5, 2019, is
extended 60 days.
DATES: The comment period for the
proposed rule published February 4,
2019, at 84 FR 1536, is extended to 5
p.m., eastern daylight time, on June 4,
2019.
ADDRESSES: You may submit comments
as outlined in the February 4, 2019
SUMMARY:
PO 00000
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13857
proposed rule (84 FR 1536). Please
choose only one method listed.
FOR FURTHER INFORMATION CONTACT:
Sarah Bennett, CMS, (410) 786–3531; or
Nancy Anderson, CDC, (404) 498–2741.
SUPPLEMENTARY INFORMATION:
In the ‘‘Clinical Laboratory
Improvement Amendments of 1988
(CLIA) Proficiency Testing Regulations
Related to Analytes and Acceptable
Performance’’ proposed rule that
appeared in the February 4, 2019
Federal Register (84 FR 1536), we
solicited public comments on proposed
changes to current proficiency testing
(PT) analytes, including acceptance
limits, in addition to technical changes
to the PT referral regulations to more
closely align them with the CLIA
statute.
We received an inquiry from several
PT programs regarding the 60-day
comment period for the proposed rule.
The commenters stated that providing
all stakeholders additional time to
review and comment would allow them
to conduct a more comprehensive
review in order to develop detailed
responses to the technical aspects of this
proposed rule given that it would
represent the first comprehensive
change to the PT regulations since the
implementation of CLIA in 1992.
In order to maximize the opportunity
for the public to provide meaningful
input to CMS and CDC, we believe that
it is important to allow additional time
for the public to prepare comments on
the proposed rule. In addition, we
believe that granting an extension to the
public comment period in this instance
would further our overall objective to
obtain public input on the potential
changes related to PT that we are
considering. Therefore, we are
extending the comment period for the
proposed rule for an additional 60 days.
Dated: March 29, 2019.
Seema Verma,
Administrator, Centers for Medicare &
Medicaid Services.
Dated: April 1, 2019.
Robert Redfield,
Director, Centers for Disease Control and
Prevention and Administrator, Agency for
Toxic Substances and Disease Registry.
[FR Doc. 2019–06819 Filed 4–4–19; 8:45 am]
BILLING CODE 4120–01–P
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]]>Agencies
[Federal Register Volume 84, Number 67 (Monday, April 8, 2019)]
[Proposed Rules]
[Pages 13855-13857]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-06795]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
32 CFR Part 199
[Docket ID: DOD-2017-HA-0058]
RIN 0720-AB71
TRICARE: Prescribing of Physical Therapy, Occupational Therapy,
and Speech Therapy by Other Allied Health Professionals Acting Within
the Scope of Their License
AGENCY: Office of the Secretary, Department of Defense.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Defense (DoD) proposes an amendment to the
TRICARE regulation. Specifically, this proposed rule will allow
coverage of otherwise authorized physical therapy (PT), occupational
therapy (OT), and speech therapy (ST) for TRICARE beneficiaries when
such services are prescribed by an authorized TRICARE Allied Health
Professional acting within the scope of their license.
DATES: Written comments received at the address indicated below by June
7, 2019 will be accepted.
ADDRESSES: You may submit comments, identified by docket number and/or
Regulatory Information Number (RIN) number and title, by either of the
following methods:
Federal eRulemaking Portal: www.regulations.gov. Follow
the instructions for submitting comments.
Mail: Department of Defense, Office of the Chief
Management Officer, Directorate for Oversight and Compliance,
Regulatory and Advisory Committee Division, 4800 Mark Center Drive,
Mailbox #24, Suite 08D09, Alexandria, VA 22350-1700.
Instructions: All submissions received must include the agency name
and docket number or RIN for this Federal Register document. The
general policy for comments and other submissions from members of the
public is to make these submissions available for public viewing on the
internet at https://www.regulations.gov as they are received without
change, including any personal identifiers or contact information.
FOR FURTHER INFORMATION CONTACT: Amber Butterfield, Defense Health
Agency, TRICARE Health Plan, Medical Benefits and Reimbursement
Division, (303) 676-3565.
SUPPLEMENTARY INFORMATION:
I. Executive Summary and Overview
A. Purpose of the Regulatory Action
This proposed rule will permit coverage of services prescribed by
TRICARE-authorized individual allied health professionals for PT, OT,
and ST. The current language of Title 32 Code of Federal Regulations
(CFR), Sec. 199.4(c)(3)(x) states that PT, OT, and ST may be cost-
shared when services are prescribed and monitored by a physician,
certified physician assistant, or certified nurse practitioner. In
addition, 32 CFR 199.6(c)(3)(iii)(K)(2) currently states that the
services of other individual paramedical providers, such as licensed
registered PT, OT, and ST, can be considered for benefits on a fee-for-
service basis only if the beneficiary
[[Page 13856]]
is referred by a physician, certified physician assistant, or certified
nurse practitioner and a physician, certified physician assistant, or
certified nurse practitioner provides continuing and ongoing oversight
and supervision of the program or episode of treatment provided by
these individual paramedical providers. As a result, otherwise
authorized PT, OT, and ST services for TRICARE beneficiaries are not
covered benefits when other Allied Health Professionals, such as
Doctors of Podiatry, even when acting within their scope of license,
prescribe the services.
State governments generally regulate the licensure and practice of
health care professionals, and DoD limits TRICARE benefits coverage to
services and supplies furnished by otherwise authorized TRICARE
individual professional providers performing within the scope of their
state licenses or certifications. State scope of practice laws vary
with regard to the range of services, and some include the authority to
prescribe PT, OT, and ST. After assessing the information available,
DoD has determined that it is unnecessarily restrictive not to cover
otherwise authorized PT, OT, and ST services for TRICARE beneficiaries
merely because the services are ordered by a non-physician. Therefore,
the regulation is being amended to allow TRICARE coverage of PT, OT,
and ST services when ordered by other Allied Health Professionals who
are TRICARE authorized providers and acting within the scope of their
state license or certificate.
B. Summary of the Major Provisions of the Proposed Rule
This rule allows TRICARE coverage of otherwise authorized PT, OT,
and ST services when prescribed by TRICARE authorized allied health
professionals when the allied health professional is acting within the
scope of his/her license.
C. Expected Impact and Costs
The primary impact of this rule will result in less time and
expense spent by beneficiaries and referring providers to obtain
necessary medical services and supplies. Almost 10,000 beneficiaries
visited a primary care provider after seeking care from a podiatrist,
but prior to PT services, in 2017. With an average copay/cost-share of
$24 across networks and TRICARE programs, this rule will conservatively
save beneficiaries up to $230,000 per year in cost-sharing and will
conservatively save TRICARE $1.1 million per year as a result of
reduced visits to referring providers.
Once beneficiaries initiate an episode of care with an Other Allied
Health Professional for a covered disease or condition, they need not
return to their Primary Care Manager for an office visit to obtain an
examination and referral for PT, OT, or ST services. Assuming two hours
by appointment (appointment, travel, waiting room, exam room),
beneficiaries will save approximately 20,000 hours each year by not
having to visit their referring provider prior to seeking PT, OT, or ST
services. Referring providers will also save time, approximately 2,200
hours (15 minutes for a podiatrist to consult with a referring provider
regarding a PT prescription) each year, as a result of reduced
coordination and paperwork.
The proposed amendment to cover PT, OT, and ST services, when
prescribed by a TRICARE-authorized Allied Health Professionals acting
within the scope of their license, is not expected to increase the
amount of otherwise covered PT, OT, and ST services. This is because
prescriptions for such services are currently being written by those
providers authorized to do so under the TRICARE program or those
providers are countersigning prescriptions from Allied Health
Professionals, such as a podiatrist. The DoD does anticipate, however,
that there may be a marginal increase in administrative costs to
accommodate changes to our contractors' systems, although the overall
result of this change will create an efficiency in the process.
This proposed rule does not create new costs to the government,
because it falls under the Transfer Payment clause in accordance with
OMB Circular A-4. As this rule proposes, TRICARE payments for physical,
occupational or speech therapy services provided to military
beneficiaries and prescribed by Other Allied Health Professionals,
represents an ``Insurance Payment'' as described in OMB Circular A-4.
II. Regulatory Procedures
Executive Order 12866, ``Regulatory Planning and Review'' and Executive
Order 13563, ``Improving Regulation and Regulatory Review''
Executive Orders 13563 and 12866 direct agencies to assess all
costs and benefits of available regulatory alternatives and, if
regulation is necessary, to select regulatory approaches that maximize
net benefits (including potential economic, environmental, public
health and safety effects, distribute impacts, and equity). Executive
Order 13563 emphasizes the importance of quantifying both costs and
benefits, of reducing costs, of harmonizing rules, and of promoting
flexibility. This proposed rule has been designated a ``significant
regulatory action,'' although not economically significant, under
section 3(f) of Executive Order 12866. This proposed rule is not
anticipated to have an annual effect on the economy of $100M or more.
Accordingly, this rule has been reviewed by the Office of
Management and Budget.
Executive Order (E.O.) 13771, ``Reducing Regulation and Controlling
Regulatory Costs''
E.O. 13771 seeks to control costs associated with the government
imposition of private expenditures required to comply with Federal
regulations and to reduce regulations that impose such costs.
Consistent with the analysis of transfer payments under OMB Circular A-
4, this proposed rule does not involve regulatory costs subject to E.O.
13771.
Congressional Review Act, 5 U.S.C. 804(2)
Under the Congressional Review Act, a major rule may not take
effect until at least 60 days after submission to Congress of a report
regarding the rule. A major rule is one that would have an annual
effect on the economy of $100M or more or have certain other impacts.
This proposed rule is not a major rule under the Congressional
Review Act.
Public Law 96-354, ``Regulatory Flexibility Act'' (RFA), (5 U.S.C. 601)
The Regulatory Flexibility Act (RFA) requires that each Federal
agency analyze options for regulatory relief of small businesses if a
rule has a significant impact on a substantial number of small
entities. For purposes of the RFA, small entities include small
businesses, nonprofit organizations, and small governmental
jurisdictions. This proposed rule is not an economically significant
regulatory action, and it will not have a significant impact on a
substantial number of small entities. Therefore, it is certified that
this rule is not subject to the requirements of the RFA.
Public Law 104-4, Sec. 202, ``Unfunded Mandates Reform Act''
Section 202 of the Unfunded Mandates Reform Act of 1995, requires
that agencies assess anticipated costs and benefits before issuing any
rule whose mandates require spending in, any one year of $100M, as of
1995 exchange rate, updated annually for inflation. That threshold
level is
[[Page 13857]]
currently approximately $140M. This proposed rule will not mandate any
requirements for state, local, or tribal governments or the private
sector.
Public Law 96-511, ``Paperwork Reduction Act'' (44 U.S.C. Chapter 35)
This rulemaking does not contain a ``collection of information''
requirement, and will not impose additional information collection
requirements on the public under Public Law 96-511, ``Paperwork
Reduction Act'' (44 U.S.C. chapter 35).
Executive Order 13132, ``Federalism''
This proposed rule has been examined for its impact under Executive
Order 13132, and it does not contain policies that have federalism
implications that would have substantial direct effects on the States,
on the relationship between the national Government and the States, or
on the distribution of powers and responsibilities among the various
levels of Government. Therefore, consultation with State and local
officials is not required.
List of Subjects in 32 CFR Part 199
Claims, Dental health, Health care, Health insurance, Individuals
with disabilities, Military personnel.
Accordingly, 32 CFR part 199 is proposed to be amended as follows:
PART 199--[AMENDED]
0
1. The authority citation for part 199 continues to read as follows:
Authority: 5 U.S.C. 301; 10 U.S.C. Chapter 55.
0
2. Section 199.4 is amended by revising paragraph (c)(3)(x)(A) to read
as follows:
Sec. 199.4 Basic program benefits.
* * * * *
(c) * * *
(3) * * *
(x) * * *
(A) The services are prescribed and monitored by a physician or
other TRICARE authorized allied health professional acting within the
scope of their license.
* * * * *
0
3. Section 199.6 is amended by revising paragraph (c)(3)(iii)(K)(2) to
read as follows:
Sec. 199.6 TRICARE-authorized providers.
* * * * *
(c) * * *
(3) * * *
(iii) * * *
(K) * * *
(2) The services of the following individual professional providers
of care, to be considered for benefits on a fee-for-service basis, may
be provided only if the beneficiary is referred by a physician or other
TRICARE authorized Allied Health Professional acting within the scope
of their license and a physician or other TRICARE authorized Allied
Health Professional acting within the scope of their license must also
provide continuing and ongoing oversight and supervision of the program
or episode of treatment provided by these individual paramedical
providers.
* * * * *
Dated: April 2, 2019.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2019-06795 Filed 4-5-19; 8:45 am]
BILLING CODE 5001-06-P
