45753 Federal Register / Vol. 82, No. 189 / Monday, October 2, 2017 / Proposed Rules 
on December 5, 2016, at 81 FR 87686) 
(annualized costs of $154 million); and 
20. The FMCSA’s final rule on Minimum 
Training Requirements for Entry-Level Commercial Motor Vehicle Operators (RIN: 
2126–AB66) (published on December 8, 2016, at 81 FR 88732) (annualized costs of $368 million). 
[FR Doc. 2017–21101 Filed 9–29–17; 8:45 am] 
BILLING CODE 4910–9X–P 
DEPARTMENT OF HEALTH AND 
HUMAN SERVICES 
Food and Drug Administration 
21 CFR Part 101 
[Docket Nos. FDA–2012–N–1210 and FDA– 
2004–N–0258] 
RIN 0910–ZA49 
Food Labeling: Revision of the 
Nutrition and Supplement Facts Labels and Serving Sizes of Foods That Can Reasonably Be Consumed at One Eating Occasion; Dual-Column Labeling; Updating, Modifying, and Establishing Certain Reference Amounts Customarily Consumed; Serving Size for Breath Mints; and Technical Amendments; Proposed Extension of Compliance Dates 
AGENCY : Food and Drug Administration, 
HHS. 
ACTION : Proposed rule. 
SUMMARY : The Food and Drug 
Administration (FDA or we) is proposing to extend the compliance dates by approximately 1.5 years for the final rules providing updated nutrition information on the label of food, including dietary supplements; defining a single-serving container; requiring dual-column labeling for certain containers; updating, modifying, and establishing certain reference amounts customarily consumed (RACCs); and amending the label serving size for breath mints. The final rules appeared in the Federal Register of May 27, 2016. We are taking this action because, after careful consideration, we have tentatively determined that additional time would help ensure that all manufacturers covered by the final rules have guidance from FDA to address, for example, certain technical questions we received after publication of the final rules, and that they are able to complete and print updated Nutrition Facts labels for their products before they are expected to be in compliance with the final rules. 
DATES : Submit either electronic or 
written comments on the proposed rule by November 1, 2017. ADDRESSES : You may submit comments 
on the extension of the compliance period as follows. Please note that late, untimely filed comments will not be considered. Electronic comments must be submitted on or before November 1, 2017. The https://www.regulations.gov electronic filing system will accept comments until midnight Eastern Time at the end of November 1, 2017. Comments received by mail/hand delivery/courier (for written/paper submissions) will be considered timely if they are postmarked or the delivery service acceptance receipt is on or before that date. 
Electronic Submissions 
Submit electronic comments in the 
following way: 
•Federal eRulemaking Portal: 
https://www.regulations.gov. Follow the 
instructions for submitting comments. 
Comments submitted electronically, including attachments, to https://www.regulations.gov will be posted to 
the docket unchanged. Because your comment will be made public, you are solely responsible for ensuring that your comment does not include any confidential information that you or a third party may not wish to be posted, such as medical information, your or anyone else’s Social Security number, or confidential business information, such as a manufacturing process. Please note that if you include your name, contact information, or other information that identifies you in the body of your comments, that information will be posted on https://www.regulations.gov. 
•If you want to submit a comment 
with confidential information that you do not wish to be made available to the public, submit the comment as a written/paper submission and in the manner detailed (see ‘‘Written/Paper Submissions’’ and ‘‘Instructions’’). 
Written/Paper Submissions 
Submit written/paper submissions as 
follows: 
•Mail/Hand delivery/Courier (for 
written/paper submissions): Dockets 
Management Staff (HFA–305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. 
•For written/paper comments 
submitted to the Dockets Management Staff, FDA will post your comment, as well as any attachments, except for information submitted, marked and identified, as confidential, if submitted as detailed in ‘‘Instructions.’’ 
Instructions: All submissions received 
must include the Docket Nos. FDA– 2012–N–1210 and FDA–2004–N–0258 for ‘‘Food Labeling: Revision of the Nutrition and Supplement Facts Labels and Serving Sizes of Foods That Can Reasonably Be Consumed at One Eating Occasion; Dual-Column Labeling; Updating, Modifying, and Establishing Certain Reference Amounts Customarily Consumed; Serving Size for Breath Mints; and Technical Amendments; Extension of Compliance Date.’’ Received comments, those filed in a timely manner (see 
ADDRESSES ), will be 
placed in the docket and, except for those submitted as ‘‘Confidential Submissions,’’ publicly viewable at https://www.regulations.gov or at the 
Dockets Management Staff between 9 a.m. and 4 p.m., Monday through Friday. 
•Confidential Submissions—To 
submit a comment with confidential information that you do not wish to be made publicly available, submit your comments only as a written/paper submission. You should submit two copies total. One copy will include the information you claim to be confidential with a heading or cover note that states ‘‘THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.’’ We will review this copy, including the claimed confidential information, in our consideration of comments. The second copy, which will have the claimed confidential information redacted/ blacked out, will be available for public viewing and posted on https://www.regulations.gov. Submit both copies to the Dockets Management Staff. If you do not wish your name and contact information to be made publicly available, you can provide this information on the cover sheet and not in the body of your comments and you must identify this information as ‘‘confidential.’’ Any information marked as ‘‘confidential’’ will not be disclosed except in accordance with 21 CFR 10.20 and other applicable disclosure law. For more information about FDA’s posting of comments to public dockets, see 80 FR 56469, September 18, 2015, or access the information at: https://www.gpo.gov/ fdsys/pkg/FR-2015-09-18/pdf/2015- 23389.pdf. 
Docket: For access to the docket to 
read background documents or the electronic and written/paper comments received, go to https://www.regulations.gov and insert the 
docket number, found in brackets in the heading of this document, into the ‘‘Search’’ box and follow the prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. 
FOR FURTHER INFORMATION CONTACT : 
Paula Trumbo, Center for Food Safety and Applied Nutrition (HFS–830), Food and Drug Administration, 5001 Campus 
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Dr., College Park, MD 20740, 240–402– 
2579. 
SUPPLEMENTARY INFORMATION : 
Table of Contents 
I. Background II. Description of the Proposed Rule III. Proposed Compliance Dates IV. Economic Analysis of Impacts V. Analysis of Environmental Impact VI. Paperwork Reduction Act of 1995 VII. Federalism VIII. References 
I. Background 
In the Federal Register of May 27, 
2016 (81 FR 33742 and 81 FR 34000), we published two final rules entitled ‘‘Food Labeling: Revision of the Nutrition and Supplement Facts Labels’’ (the Nutrition Facts Label Final Rule) and ‘‘Food Labeling: Serving Sizes of Foods That Can Reasonably Be Consumed At One Eating Occasion; Dual-Column Labeling; Updating, 
Modifying, and Establishing Certain Reference Amounts Customarily Consumed; Serving Size for Breath Mints; and Technical Amendments’’ (the Serving Size Final Rule). The Nutrition Facts Label Final Rule revises the Nutrition Facts label by: 
•Removing the declaration of 
‘‘Calories from fat’’ because current science supports a view that the type of fat is more relevant than overall total fat intake in increased risk of chronic diseases; 
•Requiring the declaration of the 
gram amount of ‘‘Added Sugars’’ in a serving of a product, establishing a Daily Reference Value (DRV), and requiring the percent Daily Value (DV) declaration for added sugars; 
•Changing ‘‘Sugars’’ to ‘‘Total 
Sugars’’ and requiring that ‘‘Includes ‘X’ g Added Sugars’’ be indented and declared directly below ‘‘Total Sugars’’ on the label; 
•Updating the list of vitamins and 
minerals of public health significance. For example, the Nutrition Facts Label Final Rule requires the declaration of vitamin D and potassium and permits, rather than requires, the declaration of vitamins A and C; 
•Updating certain reference values 
used in the declaration of percent DVs of nutrients on the Nutrition Facts and Supplement Facts labels; 
•Revising the format of the Nutrition 
Facts and Supplement Facts labels to increase the prominence of the term ‘‘Calories;’’ 
•Removing the requirement for the 
footnote table listing the reference values for certain nutrients for 2,000 and 2,500 calorie diets; and 
•Requiring the maintenance of 
records to support the declarations of certain nutrients under specified 
circumstances. 
The Serving Size Final Rule requires 
all containers, including containers of products with ‘‘large’’ RACCs (i.e., products with RACCs of at least 100 grams (g) or 100 milliliters (mL)), containing less than 200 percent of the RACC to be labeled as a single-serving container. Except for when certain exceptions apply, the Serving Size Final Rule further requires that containers and units that contain at least 200 percent and up to and including 300 percent of the RACC be labeled with a column of nutrition information within the Nutrition Facts label that lists the quantitative amounts and percent DVs for the entire container, in addition to the required column listing the quantitative amounts and percent DVs for a serving that is less than the entire container (i.e., the serving size derived 
from the RACC). The Serving Size Final Rule also updates, modifies, and establishes RACCs for certain foods and 
product categories. 
II. Description of the Proposed Rule 
We are proposing to extend the 
compliance date for manufacturers with 
$10 million or more in annual food sales in the final rules published on May 27, 2016, from July 26, 2018, to January 1, 2020, and the compliance date for manufacturers with less than $10 million in annual food sales in the final rules published on May 27, 2016, from July 26, 2019, to January 1, 2021. 
We emphasize that this proposed rule 
would only extend the compliance dates. Therefore, comments to this proposed rule should pertain to the extension of the compliance dates only. We are proposing to extend the compliance dates for the Nutrition Facts Label Final Rule and the Serving Size Final Rule, consistent with our authority in sections 403(q) and 701(a) of the Federal Food, Drug, and Cosmetic Act (the FD&C Act) (21 U.S.C. 343(q) and 371(a), respectively). 
III. Proposed Compliance Dates 
This proposed rule would extend the 
compliance date for manufacturers with 
$10 million or more in annual food sales in the final rules published on May 27, 2016, from July 26, 2018, to January 1, 2020, and the compliance date for manufacturers with less than $10 million in annual food sales in the final rules published on May 27, 2016, from July 26, 2019, to January 1, 2021. We are taking this action because, after careful consideration, we have tentatively determined that additional time would help ensure that all manufacturers covered by the rules have guidance from FDA to address, for example, certain 
technical questions we received after publication of the final rules (see Docket No. FDA–2016–D–4414 (pertaining to a draft guidance entitled ‘‘Questions and Answers on the Nutrition and Supplement Facts Labels Related to the Compliance Date, Added Sugars, and Declaration of Quantitative Amounts of Vitamins and Minerals: Guidance for Industry’’)), and that they are able to complete and print updated Nutrition Facts labels for their products before they are expected to be in compliance with the rules. Companies and trade associations with members covered by the rules have informed us that they have significant concerns about their ability to update all their labels by the compliance dates due to issues regarding (among other things) the need for upgrades to labeling software, the need to obtain nutrition information from suppliers, the number of products that would need new labels, and a limited time for reformulation of products. Consequently, we are proposing to extend the compliance dates to provide more time to comply with the Nutrition Facts Label and the Serving Size Final Rules. We propose extending the compliance date by approximately 1.5 years for both categories of manufacturers as a means to balance the importance of ensuring that industry has sufficient time to comply with complex new requirements, and the importance of decreasing costs, against the importance of minimizing the transition period during which consumers will see both the old and the new versions of the label in the marketplace. 
We are taking this action consistent 
with Executive Orders 13771 and 13563 and in response to the continued concern that companies and trade associations have shared with us regarding the time needed for implementation of the final rules and the need for FDA to provide further guidance to manufacturers subject to the final rules. Consistent with the policies set forth in these executive orders with respect to reducing burdens, reducing costs, maintaining flexibility, and improving effectiveness, we are therefore proposing to extend the compliance date for manufacturers with $10 million or more in annual food sales to January 1, 2020, and the compliance date for manufacturers with less than $10 million in annual food sales to January 1, 2021. 
Our goal is to complete this 
rulemaking as quickly as possible. However, we are aware that firms are 
working under the current compliance dates to come into compliance. Pending 
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completion of this rulemaking, we 
intend to exercise enforcement discretion with respect to the current July 26, 2018, and July 26, 2019, compliance dates. 
IV. Economic Analysis of Impacts 
We have examined the impacts of this 
proposed rule under Executive Order 
12866, Executive Order 13563, Executive Order 13771, the Regulatory Flexibility Act (5 U.S.C. 601–612), and the Unfunded Mandates Reform Act of 1995 (Pub. L. 104–4). Executive Orders 12866 and 13563 direct us to assess all 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, and other advantages; distributive impacts; and equity). Executive Order 13771 requires that the costs associated with significant new regulations ‘‘shall, to the extent permitted by law, be offset by the elimination of existing costs associated with at least two prior regulations.’’ We believe that this proposed rule is a significant regulatory action as defined by Executive Order 12866. 
Executive Order 13771, entitled 
‘‘Reducing Regulation and Controlling Regulatory Costs,’’ was issued on January 30, 2017. Section 2(a) of Executive Order 13771 requires an Agency, unless prohibited by law, to identify at least two existing regulations to be repealed when the Agency publicly proposes for notice and comment or otherwise promulgates a new regulation. In furtherance of this requirement, section 2(c) of Executive Order 13771 requires that the new incremental costs associated with new 
regulations shall, to the extent permitted by law, be offset by the elimination of existing costs associated with at least two prior regulations. This proposed rule is expected to be an Executive Order 13771 deregulatory action. Details on the estimated cost savings of this proposed rule can be found in the rule’s economic analysis. 
The Regulatory Flexibility Act 
requires us to analyze regulatory options that would minimize any significant impact of a rule on small entities when ‘‘the agency publishes a general notice of proposed rulemaking’’ (5 U.S.C. 601(2)). We have analyzed the proposed rule under the Regulatory Flexibility Act and propose to certify that, because the proposed rule only would extend the compliance dates for the Nutrition Facts Label and Serving Size Final Rules, the proposed rule would not have a significant economic impact on a substantial number of small entities. 
The Unfunded Mandates Reform Act 
of 1995 (section 202(a)) requires us to prepare a written statement, which includes an assessment of anticipated costs and benefits, before proposing ‘‘any rule that includes any Federal mandate that may result in the expenditure by State, local, and tribal governments, in the aggregate, or by the private sector, of $100,000,000 or more (adjusted annually for inflation) in any one year.’’ The current threshold after adjustment for inflation is $148 million, using the 2016 Implicit Price Deflator 
for the Gross Domestic Product. We have determined that the proposed rule would not result in any expenditure by industry in any year that meets or exceeds this amount. The principal benefit of this proposed 
rule to extend the compliance dates is the reduction in the costs to industry of meeting the compliance dates of the Nutrition Facts Label Final Rule and the Serving Size Final Rule. This reduction in costs can be attributed to a reduction in the relabeling and reformulation costs of the Nutrition Facts Label and Serving Size Final Rules. We estimate that, at the mean, the present value of the benefits (i.e., cost savings) of this 
proposed rule to extend the compliance dates over the next 20 years is $1.0 billion using either a 3 percent or 7 percent discount rate (2016$). This is illustrated in table 1. Extending the compliance dates by approximately 1.5 years would reduce the estimated benefits of the Nutrition Facts Label and Serving Size Final Rules because it would delay the realization by consumers of the full annual welfare gains of the Nutrition Facts Label and Serving Size Final Rules. More specifically, an extension of the compliance dates would delay the incorporation of the provisions of the Nutrition Facts Label and Serving Size Final Rules by food manufacturers into their products. We estimate that, at the mean, the present value of the forgone benefits of this proposed rule to extend the compliance dates over the next 20 years is $0.9 billion using either a 3 percent or 7 percent discount rate (2016$). This is also presented in table 1. We estimate that, at the mean, the present value of the net benefits (that is, cost savings minus forgone benefits) of this proposed rule to extend the compliance dates over the next 20 years is $0.1 billion using either a 3 percent or 7 percent discount rate (2016$). This is shown in table 1. 
TABLE 1—S UMMARY OF THE COSTSAVINGS TO INDUSTRY AND FOREGONE BENEFITS TO CONSUMERS OF THISPROPOSED  
RULETOEXTEND THE COMPLIANCE DATES  
[In billions of 2016] 
Discount rate 
(percent) Cost savings Foregone 
benefits Net benefits 
(cost 
savings¥ 
foregone 
benefits) 
Present Value .................................................................................................. 3 $1.0 $0.9 $0.1 
7 1.0 0.9 0.1 
Annualized Amount .......................................................................................... 3 0.07 0.06 0.01 
7 0.09 0.08 0.01 
Notes: Cost savings to industry, foregone benefits to consumers, and net benefits reflect mean estimates. This proposed rule to extend the 
compliance dates would extend the compliance dates of the Nutrition Facts Label and Serving Size Final Rules by approximately 1.5 years. 
Annualized Amount = Amount/Annualizing Factor. 3 percent annualizing factor = 14.88. 7 percent annualizing factor = 10.59. The annualizing 
factors are calculated by summing the inverse of 1 plus the discount rate to the power of the year (t = 1 through t = 20). 
For purposes of this analysis, we use 
the same methodology for estimating 
costs and benefits that we used in the original Regulatory Impact Analysis for the Final Rules. We previously acknowledged potential shortcomings with that approach (see 2016 Regulatory Impact Analysis at 79 n.34) but have not received comments about ways to 
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improve that analysis. We thus follow 
the same basic approach here. 
The full analysis of economic impacts 
is available in the docket for this proposed rule (Ref. 1) and at https://www.fda.gov/AboutFDA/ReportsManualsForms/Reports/EconomicAnalyses. 
V. Analysis of Environmental Impact 
We have determined under 21 CFR 
25.30(k) that this action is of a type that 
does not individually or cumulatively have a significant effect on the human environment. Therefore, neither an environmental assessment nor an environmental impact statement is required. 
VI. Paperwork Reduction Act of 1995 
This proposed rule contains no 
collection of information. Therefore, 
clearance by the Office of Management and Budget under the Paperwork Reduction Act of 1995 is not required. 
VII. Federalism 
We have analyzed this proposed rule 
in accordance with the principles set 
forth in Executive Order 13132. Section 4(a) of the Executive Order requires Agencies to ‘‘construe * * * a Federal statute to preempt State law only where the statute contains an express preemption provision or there is some other clear evidence that the Congress intended preemption of State law, or where the exercise of State authority conflicts with the exercise of Federal authority under the Federal statute.’’ Section 403A of the FD&C Act (21 U.S.C. 343–1) is an express preemption provision. Section 403A(a) of the FD&C Act provides that: ‘‘* * * no State or political subdivision of a State may directly or indirectly establish under any authority or continue in effect as to any food in interstate commerce—(4) any requirement for nutrition labeling of food that is not identical to the requirement of section 403(q) * * *.’’ The express preemption provision of section 403A(a) of the FD&C Act does not preempt any State or local requirement respecting a statement in the labeling of food that provides for a warning concerning the safety of the food or component of the food (section 6(c)(2) of the Nutrition Labeling and Education Act of 1990, Pub. L. 101–535, 104 Stat. 2353, 2364 (1990)). If this proposed rule is made final, the final rule would create requirements that fall within the scope of section 403A(a) of the FD&C Act. 
VIII. References 
The following reference is on display 
in the Dockets Management Staff (see ADDRESSES ) and is available for viewing 
by interested persons between 9 a.m. 
and 4 p.m., Monday through Friday; it is also available electronically at https:// 
www.regulations.gov. FDA has verified 
the Web site addresses, as of the date this document publishes in the Federal Register, but Web sites are subject to change over time. 
1. United States Department of Health and 
Human Services. United States Food and 
Drug Administration. Preliminary Regulatory Impact Analysis, Preliminary Regulatory Flexibility Analysis for Proposed Rule on ‘‘Food Labeling: Revision of the Nutrition and Supplement Facts Labels and Serving Sizes of Foods That Can Reasonably Be Consumed At One Eating Occasion; Dual-Column Labeling; Updating, Modifying, and Establishing Certain Reference Amounts Customarily Consumed; Serving Size for Breath Mints; and Technical Amendments; Extension of Compliance Dates.’’ September 2017. Available from http://www.fda.gov/AboutFDA/ReportsManualsForms/Reports/EconomicAnalyses. 
Dated: September 26, 2017. 
Anna K. Abram, 
Deputy Commissioner for Policy, Planning, 
Legislation, and Analysis. 
[FR Doc. 2017–21019 Filed 9–29–17; 8:45 am] 
BILLING CODE 4164–01–P 
DEPARTMENT OF VETERANS 
AFFAIRS 
38 CFR Part 17 
RIN 2900–AQ06 
Authority of Health Care Providers To 
Practice Telehealth 
AGENCY : Department of Veterans Affairs. 
ACTION : Proposed rule. 
SUMMARY : The Department of Veterans 
Affairs (VA) proposes to amend its medical regulations by standardizing the delivery of care by VA health care providers through telehealth. This rule would ensure that VA health care providers provide the same level of care to all beneficiaries, irrespective of the State or location in a State of the VA health care provider or the beneficiary. This proposed rule would achieve important Federal interests by increasing the availability of mental health, specialty, and general clinical care for all beneficiaries. 
DATES : Comments must be received on 
or before November 1, 2017. 
ADDRESSES : Written comments may be 
submitted through http://www.Regulations.gov by mail or hand- delivery to: Director, Regulation Policy and Management (00REG), Department of Veterans Affairs, 810 Vermont Ave. NW., Room 1063B, Washington, DC 20420; or by fax to (202) 273–9026. (This is not a toll-free telephone number.) Comments should indicate that they are submitted in response to ‘‘RIN 2900–AQ06-Authority of Health Care Providers to Practice Telehealth.’’ Copies of comments received will be available for public inspection in the Office of Regulation Policy and Management, Room 1068, between the hours of 8:00 a.m. and 4:30 p.m., Monday through Friday (except holidays). Please call (202) 461–4902 for an appointment. (This is not a toll-free telephone number.) In addition, during the comment period, comments may be viewed online through the Federal Docket Management System (FDMS) at http://www.regulations.gov. 
FOR FURTHER INFORMATION CONTACT : 
Kevin Galpin, MD, Executive Director Telehealth Services, Veterans Health Administration Office of Connected Care, 810 Vermont Avenue NW., Washington, DC 20420. (404) 771–8794. (This is not a toll-free number.) Kevin.Galpin@va.gov. 
SUPPLEMENTARY INFORMATION : Section 
7301 of title 38, United States Code (U.S.C.), establishes the general functions of the Veterans Health Administration (VHA) within VA, and establishes that its primary function is to ‘‘provide a complete medical and hospital service for the medical care and treatment of veterans, as provided in this title and in regulations prescribed by the Secretary [of Veterans Affairs (Secretary)] pursuant to this title.’’ 38 U.S.C. 7301(b). In carrying out this function, VHA must ensure that patient care is appropriate and safe and its health care providers meet or exceed generally accepted professional standards for patient care. In addition, because VA is a national health care provider, VHA must ensure that beneficiaries receive the same high level of care and access to care no matter where, in a State, a beneficiary or health care provider is located at the time the health care is provided. 
The Secretary is responsible for the 
proper execution and administration of all laws administered by the Department and for the control, direction, and management of the Department, including agency personnel and management matters. See 38 U.S.C. 303. To this end, Congress authorized the Secretary ‘‘to prescribe all rules and regulations which are necessary or appropriate to carry out the laws administered by the Department and are 
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