Federal Register / Vol. 79, No. 250 / Wednesday, December 31, 2014 / Rules and Regulations 78707 

adversely affect in a material way the 

economy; a section of the economy; 

productivity; competition; jobs; the 

environment; public health or safety; or 

State, local, or tribunal 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 these Executive Orders. 

Unfunded Mandates Reform Act (Sec. 

202, Pub. L. 104–4) 

It has been determined that this final 

rule does not contain a Federal mandate 

that may result in the expenditure by 

State, local and tribal governments, in 

aggregate, or by the private sector, of 

$100 million or more in any one year. 

Public Law 96–354, ‘‘Regulatory 

Flexibility Act’’ (5 U.S.C. 601) 

It has been certified that this final rule 

is not subject to the Regulatory 

Flexibility Act (5 U.S.C. 601) because it 

would not, if promulgated, have a 

significant economic impact on a 

substantial number of small entities. Set 

forth in the final rule are minor 

revisions to the existing regulation. The 

DoD does not anticipate a significant 

impact on the Program. 

Public Law 96–511, ‘‘Paperwork 

Reduction Act’’ (44 U.S.C. Chapter 35) 

It has been determined that this final 

rule does not impose reporting or 

recordkeeping requirements under the 

Paperwork Act of 1995. 

Executive Order 13132, Federalism 

It has been determined that this final 

rule does not have federalism 

implications, as set forth in Executive 

Order 13132. This rule does not have 

substantial direct effects on: 

(1) The States; 

(2) The relationship between the 

National Government and the States; or 

(3) The distribution of power and 

responsibilities among the various 

levels of Government. 

List of Subjects in 32 CFR Part 199 

Claims, Dental health, Health care, 

Health insurance, Individuals with 

disabilities, and Military personnel. 

Accordingly, 32 CFR part 199 is 

amended to read as follows: 

PART 199—[AMENDED] 

■ 1. The authority citation for part 199 

continues to read as follows: 

Authority: 5 U.S.C. 301; 10 U.S.C. chapter 

55. 

■ 2. Section 199.4 is amended by 

revising paragraphs (e)(9) and (g)(63) to 

read as follows: 

§ 199.4 Basic program benefits. 

* * * * * 

(e) * * * 

(9) Care related to non-covered initial 

surgery or treatment. (i) Benefits are 

available for otherwise covered services 

and supplies required in the treatment 

of complications resulting from a noncovered incident of treatment (such as 

nonadjunctive dental care or cosmetic 

surgery) but only if the later 

complication represents a separate 

medical condition such as a systemic 

infection, cardiac arrest, and acute drug 

reaction. Benefits may not be extended 

for any later care or a procedure related 

to the complication that essentially is 

similar to the initial non-covered care. 

Examples of complications similar to 

the initial episode of care (and thus not 

covered) would be repair of facial 

scarring resulting from dermabrasion for 

acne. 

(ii) Benefits are available for 

otherwise covered services and supplies 

required in the treatment of 

complications (unfortunate sequelae) 

and any necessary follow-on care 

resulting from a non-covered incident of 

treatment provided in an MTF, when 

the initial non-covered service has been 

authorized by the MTF Commander and 

the MTF is unable to provide the 

necessary treatment of the 

complications or required follow-on 

care, according to the guidelines 

adopted by the Director, DHA, or a 

designee. 

(iii) Benefits are available for 

otherwise covered services and supplies 

required in the treatment of 

complications (unfortunate sequelae) 

and any necessary follow-on care 

resulting from a non-covered incident of 

treatment provided in the private sector 

pursuant to a properly granted waiver 

under § 199.16(f). The Director, DHA, or 

designee, shall issue guidelines for 

implementing this provision. 

* * * * * 

(g) * * * 

(63) Non-covered condition/

treatment, unauthorized provider. All 

services and supplies (including 

inpatient institutional costs) related to a 

non-covered condition or treatment, 

including any necessary follow-on care 

or the treatment of complications, are 

excluded from coverage except as 

provided under paragraph (e)(9) of this 

section. In addition, all services and 

supplies provided by an unauthorized 

provider are excluded. 

* * * * * 

Dated: December 22, 2014. 

Aaron Siegel, 

Alternate OSD Federal Register Liaison 

Officer, Department of Defense. 

[FR Doc. 2014–30307 Filed 12–30–14; 8:45 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[DOD–2013–HA–0053] 

RIN 0720–AB59 

TRICARE Program; Clarification of 

Benefit Coverage of Durable 

Equipment and Ordering or 

Prescribing Durable Equipment; 

Clarification of Benefit Coverage of 

Assistive Technology Devices Under 

the Extended Care Health Option 

Program 

AGENCY: Office of the Secretary, DoD. 

ACTION: Final rule. 

SUMMARY: This final rule modifies the 

TRICARE regulation to add a definition 

of assistive technology (AT) devices for 

purposes of benefit coverage under the 

TRICARE Extended Care Health Option 

(ECHO) Program and to amend the 

definitions of durable equipment (DE) 

and durable medical equipment (DME) 

to better conform the language in the 

regulation to the statute. The final rule 

amends the language that specifically 

limits ordering or prescribing of DME to 

only a physician under the Basic 

Program, as this amendment will allow 

certain other TRICARE authorized 

individual professional providers, 

acting within the scope of their 

licensure, to order or prescribe DME. 

This final rule also incorporates a policy 

clarification relating to luxury, deluxe, 

or immaterial features of equipment or 

devices. That is, TRICARE cannot 

reimburse for the luxury, deluxe, or 

immaterial features of equipment or 

devices, but can reimburse for the base 

or basic equipment or device that meet 

the beneficiary’s needs. Beneficiaries 

may choose to pay the provider for the 

luxury, deluxe, or immaterial features if 

they desire their equipment or device to 

have these ‘‘extra features.’’ 

DATES: This rule is effective January 30, 

2015. 


tkelley on DSK3SPTVN1PROD with RULES
78708 Federal Register / Vol. 79, No. 250 / Wednesday, December 31, 2014 / Rules and Regulations 

FOR FURTHER INFORMATION CONTACT: Gail 

L. Jones, (303) 676–3401. 

SUPPLEMENTARY INFORMATION: 

I. Executive Summary 

A. Purpose of the Final Rule 

1. Coverage for DE, DME and AT 

Devices. 

The National Defense Authorization 

Act for Fiscal Year 2002 revised the 

coverage of DE under TRICARE. Those 

revisions resulted in final amendments 

to the TRICARE regulation regarding the 

TRICARE Basic Program, effective 

December 13, 2004, as published in the 

Federal Register on October 12, 2004 

(69 FR 60547), and regarding the 

TRICARE Extended Health Care Option 

(ECHO) Program, effective September 

20, 2004, as published in the Federal 

Register on August 20, 2004 (69 FR 

51559). The original implementing 

regulations made a potentially 

confusing technical distinction between 

‘‘DE’’ and ‘‘DME’’; that is, ‘‘DE’’ was 

defined as an item that did not qualify 

as ‘‘DME’’ that otherwise might be 

available under the TRICARE ECHO 

Program. This final rule provides 

clarification by correcting the 

definitions and adding a definition of 

AT devices, which conforms to existing 

policy covering devices not otherwise 

qualifying as DE. 

2. Ordering and Prescribing DE and 

DME 

The current regulation in 

§ 199.4(d)(3)(ii)(A)(1) does not allow 

coverage of DME ordered by a 

TRICARE-authorized individual 

professional provider of care, with the 

exception of a doctor of medicine (MD) 

or a doctor of osteopathy (DO), even 

though it is permitted by his or her 

licensure. Paragraph (d)(3)(ii)(A)(1) 

specifically states, ‘‘Subject to the 

exceptions in paragraph (d)(3)(ii)(C) of 

this same section, only DME which is 

ordered by a physician for the specific 

use of the beneficiary shall be covered.’’ 

Paragraph (d)(1) also states that only a 

physician can order DME. This 

restriction causes two problems: 

• Certain other TRICARE authorized 

individual professional providers such 

as doctors of podiatric medicine 

(DPMs), doctors of optometry (ODs), 

doctors of dental surgery (DDSs), 

doctors of dental medicine (DMDs), 

certified nurse midwives (CNMs), 

certified nurse practitioners (CNPs), 

including certified clinical nurse 

specialists (CCNSs), certified registered 

nurse anesthetists (CRNAs), and 

certified psychiatric nurse specialists 

(CPNSs) cannot prescribe DME, even 

when acting within the scope of their 

licensure. 

• Beneficiaries cannot fill a 

prescription for DME prescribed by 

other non-physician professional 

providers, even when they act as a 

primary care provider, such as a CNP. 

State governments generally regulate 

the licensure and practice of specific 

types of health care professionals, and 

DoD limits TRICARE benefit 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 about the 

range of services and some include the 

authority to prescribe DME. DoD 

determines that it is unnecessarily 

restrictive to not cover DE (including 

DME) merely because it is ordered by an 

otherwise authorized non-physician 

allied health care professional and 

certain other authorized individual 

professional providers. Therefore, this 

final rule amends the regulation to 

allow TRICARE coverage of DE (except 

for cardiorespiratory monitor) when 

ordered by a physician, dentist, or any 

other TRICARE authorized nonphysician allied health care 

professional. This includes CNMs, 

CNPs/CCNSs, CRNAs, CPNSs, and 

certified physician assistants (CPAs), 

and certain other TRICARE authorized 

individual professional providers, 

namely DPMs, ODs, DDSs, and DMDs, 

when acting within the scope of their 

state license or certificate. 

Following further review of the 

applicable regulation, in proposing to 

expand the category of TRICARE 

authorized providers allowed to 

prescribe DE, the proposed amendment 

was not specific enough to include only 

physicians, dentists and other allied 

health care professionals consistent 

with the stated purpose of the proposed 

rule. Therefore, this final rule amends 

§ 199.4(d)(3)(ii)(A)(1) to limit those 

individual professional providers 

allowed to order DE to those listed in 

§ 199.6(c)(3)(i), (ii), or (iii). 

In addition, DoD must clarify that 

when the proposed rule referred to 

clinical nurse specialists (CNSs) as 

being able to prescribe DE for TRICARE 

beneficiaries, the reference should have 

been to certified clinical nurse 

specialists (CCNSs) and only those 

CCNSs that are recognized by TRICARE 

either as CNPs, CPNSs, or CNMs. 

Further, the proposed rule did not 

mention certified physician assistants 

(CPAs) as allied health care 

professionals authorized to prescribe 

DE. The applicable regulation includes 

CPAs as TRICARE authorized allied 

health care professionals at 

§ 199.6(c)(3)(iii)(H), and this final rule 

clarifies that CPAs are authorized to 

order DE for TRICARE beneficiaries. See 

the Public Comments section for 

additional information on both CCNSs 

and CPAs. 

The legal authorities for this final rule 

are 10 U.S.C. 1073, 1077(a)(12), 

1077(f)(1) and (2), 1077, 1079, and 1086 

respectively. Authority for the ECHO 

Program: 10 U.S.C. 1079(d) through (f); 

authority for TRICARE benefit coverage: 

10 U.S.C. 1079(a)(13), 1079(o), and 32 

CFR part 199; authority regarding 

specific categories of TRICARE 

authorized individual professional 

providers: § 199.6(c)(1)(iii) and (2)(i); 

authority for other allied health 

professionals as TRICARE authorized 

providers: § 199.6(c)(3)(iii). 

B. Summary of the Major Provisions of 

the Final Rule 

In this final rule, the regulatory 

language more appropriately conforms 

to that of the statutory language, which 

identifies ‘‘DME’’ as a subset of ‘‘DE’’ for 

purposes of the TRICARE Basic 

Program. Therefore, the final rule 

amends the TRICARE regulation on DE 

and clarifies that the policies applicable 

to DME (e.g., exclusion of luxury 

features and pricing methods) have been 

and are applicable to DE. DoD’s 

interpretation of the statute and 

regulation has been, and continues to 

be, that all DE authorized under the 

TRICARE Basic Program must be 

determined to be medically necessary 

for the treatment of an illness, injury or 

bodily malfunction before the 

equipment can be cost shared by 

TRICARE. Consequently, this technical 

revision does not change current 

policies for coverage of DE. 

This final rule clarifies that the 

TRICARE ECHO Program includes 

coverage of AT devices that do not 

otherwise qualify as DE, and adds a 

definition and specific criteria for 

coverage of AT devices for individuals 

qualified to receive benefits under the 

ECHO Program. 

This final rule also provides further 

clarification that if a beneficiary wishes 

to obtain an item of DE that has deluxe, 

luxury, or immaterial features, the 

beneficiary shall be responsible for the 

difference between the price of the item 

and the TRICARE allowable cost for an 

otherwise authorized item of DE 

without such features. 

Finally, the final rule emphasizes that 

certain other TRICARE authorized 

individual professional providers who 

are listed in the regulation as 

physicians, dentists or allied health care 

professionals, who are legally 


tkelley on DSK3SPTVN1PROD with RULES
Federal Register / Vol. 79, No. 250 / Wednesday, December 31, 2014 / Rules and Regulations 78709 

authorized to practice by the state, and 

when they are practicing within the 

scope of the license permitted by the 

state licensing authorities, may 

prescribe or order DE under the 

TRICARE Program. 

C. Summary of Costs and Benefits 

This final rule is not anticipated to 

have an annual effect on the economy 

of $100 million or more, making it not 

economically significant and non-major 

under the Executive Order and the 

Congressional Review Act. 

The technical revisions for coverage 

of DE do not change current policies. 

DoD’s interpretation of the statute and 

regulation has been, and will continue 

to be, that all equipment authorized 

under the TRICARE Basic Program must 

be determined to be medically necessary 

in the treatment of an illness, injury or 

bodily malfunction before the 

equipment can be cost shared by 

TRICARE. The amendment to remove 

the restriction that limits ordering or 

prescribing of DME to only an MD or 

DO is not expected to increase the 

amount of DE and DME prescribed 

because other providers are currently 

writing prescriptions—it only changes 

who prescribes it. However, DoD 

anticipates that there may be a marginal 

increase in administrative cost to 

accommodate changes to definitions. 

More importantly, this change will have 

no impact on beneficiaries eligible for 

DE. 

II. Discussion of Final Rule 

A. Final Rule Authority 

The legal authority for this final rule 

is 10 U.S.C. 1073, which authorizes the 

Secretary of Defense to administer the 

medical and dental benefits provided in 

10 U.S.C. chapter 55. The DoD is also 

authorized to provide DE under 10 

U.S.C. 1077(a)(12), which benefit is 

further defined in 10 U.S.C. 1077(f)(1) 

and (2). Although section 1077 defines 

benefits to be provided in the military 

treatment facilities (MTFs), these 

benefits are incorporated by reference 

for the benefits provided by healthcare 

providers in the private sector to active 

duty family members and retirees and 

their dependents through sections 1079 

and 1086 respectively. DoD is further 

authorized to provide a program, 

generally referred to as ECHO, for 

dependents of active duty members, 

who have a qualifying condition under 

section 1079(d) through (f). The ECHO 

Program may include DE not otherwise 

available under the TRICARE Basic 

Program and AT devices to assist in the 

reduction of the disabling effects of a 

qualifying condition. 

The DoD, in general, is only 

authorized to cover as TRICARE 

benefits, under section 1079(a)(13), 

section 1079(o), and 32 CFR part 199, 

any service or supply that is medically 

or psychologically necessary to prevent, 

diagnose or treat a mental or physical 

illness, injury, or bodily malfunction. 

Section 1079(a)(13) identifies specific 

categories of individual professional 

providers who may make the diagnosis 

and recommend the treatment. Section 

199.6(c)(1)(iii) requires TRICAREauthorized individual professional 

providers to provide medical service 

and care within the scope of their 

licensure and training consistent with 

the state practice act, or within the 

scope of the test, which is the basis for 

an individual’s certification by the state 

where the individual renders the 

service. Paragraph (2)(i) of this same 

section specifies that an individual must 

be currently licensed to render 

professional health care services in each 

state in which the individual renders 

services to TRICARE beneficiaries. Such 

license is required when a specific state 

provides, but does not require, license 

for a specific category of individual 

professional providers. Under 

§ 199.6(c)(3)(iii) of this part, certain 

individual professional providers, other 

than physicians and dentists, are 

identified as allied health professionals 

and authorized as TRICARE providers of 

care for covered services or supplies 

otherwise authorized by the regulation. 

Section 199.4(a)(1)(i) specifies the 

scope of benefits authorized for 

TRICARE beneficiaries, including 

requirements that the care be medically 

necessary in the diagnosis and treatment 

of illness or injury and that the care be 

provided by either authorized 

institutional providers or authorized 

individual professional providers or 

non-institutional providers. As defined 

in § 199.2(b), ‘‘medically necessary’’ 

incorporates the concept of ‘‘appropriate 

medical care,’’ which is further defined, 

in part, as requiring that a TRICARE 

authorized individual professional 

provider rendering medical care be 

qualified to perform such medical 

services, by reason of his or her training 

and education, and the provider is 

licensed, or certified by the state where 

the service is rendered or by an 

appropriate national organization, or 

otherwise meets TRICARE standards. 

B. Provisions of the Final Rule 

This final rule incorporates all the 

provisions set forth in the proposed 

rule, except that this final rule further 

amends § 199.4.(d)(3)(ii)(A)(1) to clarify 

that those individual professional 

providers allowed to order DE are 

limited to physicians, dentists and 

allied health care professionals listed in 

§ 199.6(c)((3)(i), (ii), or (iii). In addition, 

based on public comments received, 

and after further review of the 

applicable regulation, DoD clarifies that 

certified clinical nurse specialists 

(CCNSs) [when recognized by TRICARE 

as a CNP, CNM, or CPNS] and certified 

physician assistants (CPAs) are 

TRICARE authorized allied health care 

professionals who may order or 

prescribe DE under TRICARE when 

acting within the scope of their license 

or certification. See the Public 

Comments section for additional 

information. 

The provisions, which amend 32 CFR 

part 199, are specified as follows: 

§ 199.2 (Definitions) 

• ‘‘Duplicate Equipment.’’ AT devices 

are subject to the definition of duplicate 

equipment. 

• ‘‘Durable Equipment (DE).’’ To 

clarify that DE may be a covered benefit 

under the TRICARE Basic Program, 

consistent with 10 U.S.C. 1079(a)(5) and 

10 U.S.C. 1077(a)(12) and (f), DoD is 

revising the definition of DE as ‘‘(1) a 

medically necessary item, which can 

withstand repeated use; (2) is primarily 

and customarily used to serve a medical 

purpose; and, (3) is generally not useful 

to an individual in the absence of an 

illness or injury.’’ It includes DME, 

wheelchairs, iron lungs, and hospital 

beds. 

• ‘‘Durable Medical Equipment 

(DME).’’ Consistent with 10 U.S.C. 

1079(a)(5) and 10 U.S.C. 1077(a)(12) and 

(f), DoD is revising the definition of 

DME as ‘‘DE, which is medically 

appropriate to (1) improve, restore, or 

maintain the function of a malformed, 

diseased, or injured body part, or can 

otherwise minimize or prevent the 

deterioration of the beneficiary’s 

function or condition; or, (2) maximize 

the beneficiary’s function consistent 

with the beneficiary’s physiological or 

medical needs.’’ 

• ‘‘Assistive Technology (AT) 

Devices.’’ AT devices do not treat an 

underlying injury, illness or disease, or 

their symptoms. However, to clarify that 

the TRICARE ECHO Program includes 

coverage of AT devices, which do not 

otherwise qualify as DE, DoD is adding 

a definition of AT devices as 

‘‘equipment that generally helps 

overcome or remove a disability and is 

used to increase, maintain, or improve 

the functional capabilities of an 

individual. AT devices may include 

non-medical devices but do not include 

any structural alterations (e.g., 

wheelchair ramps or alterations to street 

curbs) or service animals (e.g., Seeing 


tkelley on DSK3SPTVN1PROD with RULES
78710 Federal Register / Vol. 79, No. 250 / Wednesday, December 31, 2014 / Rules and Regulations 

Eye dogs, hearing/handicapped 

assistance animals, etc.). AT devices are 

authorized only under coverage criteria 

to assist in the reduction of the 

disabling effects of a qualifying 

condition for individuals eligible to 

receive benefits under the ECHO 

program as provided in § 199.5.’’ 

§ 199.4 (Basic Program Benefits) 

DoD clarifies the following for 

purposes of benefit coverage of DE 

under the TRICARE Basic Program: 

• DE is an authorized benefit when 

medically necessary for the treatment of 

a covered illness or injury. 

• Authorized DE is a benefit when 

ordered by certain authorized 

individual professional providers listed 

in § 199.6(c)(3)(i), (ii), or (iii) of this part 

for the specific use of the beneficiary 

and the equipment provides the 

medically appropriate level of 

performance and quality for the 

beneficiary’s condition. 

• Unless otherwise excluded under 

the regulation, items authorized 

coverage as DE include (1) DME 

(including a cardiorespiratory monitor 

under certain conditions), (2) 

wheelchairs when medically 

appropriate to provide basic mobility, 

(3) iron lungs, and (4) hospital beds. An 

electric wheelchair or a TRICAREapproved alternative to an electric 

wheelchair may be used in lieu of a 

manual wheelchair when it is medically 

indicated and appropriate for the 

individual patient. 

• An item that provides a medically 

appropriate level of performance or 

quality for the beneficiary’s condition 

does not include luxury, deluxe, or 

immaterial items. Only the base or basic 

model of equipment shall be covered, 

unless any customization of the 

equipment owned by the beneficiary, or 

an accessory or item of supply for any 

DE is essential for (1) achieving 

therapeutic benefit for the beneficiary; 

(2) making the equipment serviceable; 

or (3) otherwise assuring the proper 

functioning of the equipment. If a 

beneficiary wishes to obtain an item of 

DE that has deluxe, luxury, or 

immaterial features, the beneficiary 

shall be responsible for the difference 

between the price of the item and the 

TRICARE allowable cost for an 

otherwise authorized item of DE 

without such features. 

• DE, which otherwise qualifies as a 

benefit, is excluded from coverage if (1) 

the beneficiary is a patient in a type of 

facility that ordinarily provides the 

same type of DE item to its patients at 

no additional charge in the usual course 

of providing its services; or (2) DE is 

available to the beneficiary from a 

Uniformed Services Medical Treatment 

Facility. 

• DE may be provided on a rental or 

purchase basis and coverage will be 

based on the price most advantageous to 

the government under established 

procedures. 

• Repairs of DE damaged while using 

the equipment in a manner inconsistent 

with its common use, and replacement 

of lost or stolen DE are excluded from 

Basic Program benefits. 

• Repairs of deluxe, luxury or 

immaterial features of DE are excluded 

from Basic Program benefits. 

§ 199.5 (TRICARE Extended Care Health 

Option (ECHO)) 

DoD clarifies the following for 

purposes of benefit coverage of DE and 

AT devices under the ECHO Program: 

• An AT device is authorized under 

certain coverage criteria when necessary 

to assist in the reduction of the 

disabling effects of a qualifying 

condition of the ECHO eligible 

beneficiary. For beneficiaries eligible for 

an individual education plan (IEP), AT 

devices that are recommended as part of 

the IEP may be covered. 

• For those beneficiaries who cease to 

meet the eligibility requirements for an 

IEP, AT devices under TRICARE ECHO 

Program must: 

—Be preauthorized; 

—Be prescribed by a TRICARE 

authorized provider; 

—Assist in the reduction of the 

disabling effects of the qualifying 

ECHO condition; and 

—Be an item or educational learning 

device normally included in an IEP. 

Further, the item must not be 

otherwise covered as a prosthetic, 

augmentative communication device, or 

a benefit under the TRICARE Basic 

Program. The implementing instructions 

for this provision will be outlined in the 

TRICARE Policy Manual. As with all 

aspects of this proposed rule, DoD 

invites the public’s comments on our 

approach regarding AT devices for those 

beneficiaries who cease to be eligible for 

an IEP. 

• Repairs of DE or AT devices 

damaged while using the equipment in 

a manner inconsistent with its common 

use, and replacement of lost or stolen 

DE or AT devices are excluded from 

ECHO coverage. 

• Repairs of deluxe, luxury or 

immaterial features of DE or AT devices 

are excluded from ECHO coverage. 

• Wheelchairs may exceed the basic 

mobility limitation when needed to 

mitigate the effects of the ECHO 

qualifying condition of the beneficiary. 

• DE may be provided on a rental or 

purchase basis and coverage will be 

based on the price most advantageous to 

the government under the same 

procedures established for pricing DE 

under the TRICARE Basic Program. 

III. Public Comments 

On August 8, 2013 (78 FR 48367– 

48373), the Office of the Secretary of 

Defense published a proposed rule and 

provided the public an opportunity to 

comment on implementing changes to 

the coverage of DE, ordering or 

prescribing DE and benefit coverage of 

AT devices under the ECHO Program. 

The comment period closed October 7, 

2013. 

As a result of publication of the 

proposed rule, DoD received 57 

comments. All of the commenters 

supported the policies we proposed, 

although there were concerns about 

physician assistants, nurse practitioners, 

and clinical nurse specialists not being 

included on the list of providers 

authorized to prescribe or order DE 

under the TRICARE Program. We 

appreciate all expressions of support 

and approval for the proposed 

guidelines. 

Response Regarding Physician 

Assistants 

Generally, the Program policy has 

been to recognize those authorized 

individual professional providers 

identified in 10 U.S.C. 1079(a)(13) when 

acting within the scope of their licenses 

and to allow direct reimbursement for 

authorized services they provide. 

However, § 199.14(j)(ix) allows an 

otherwise authorized physician to bill 

for the services of an authorized 

‘‘certified’’ physician assistant (CPA) 

under § 199.6(c)(3)(iii)(H), provided the 

CPA is acting within the scope of his or 

her license and is supervised by an 

employing physician. Therefore, the 

final rule will allow CPAs to prescribe 

or order DE under the supervision of the 

employing authorized physician who 

must bill under his or her National 

Provider Identifier (NPI) for services 

that a CPA furnishes incident to his or 

her professional services. 

Response Regarding Nurse Practitioners 

Nurse practitioners (NPs), by 

TRICARE law and regulation, are only 

recognized as individual professional 

providers when they qualify as 

‘‘certified’’ nurse practitioners (CNPs). 

For that reason, DoD will authorize only 

CNPs to prescribe or order DE when 

acting within the scope of their state 

license or certificate. 


tkelley on DSK3SPTVN1PROD with RULES
Federal Register / Vol. 79, No. 250 / Wednesday, December 31, 2014 / Rules and Regulations 78711 

Response Regarding Clinical Nurse 

Specialists 

‘‘Certified’’ clinical nurse specialists 

(CCNSs) are recognized as advanced 

practice nurses. They meet the same 

state requirements and coursework as 

any other advanced practice nurse (such 

as a CPN) whose practice similarly 

extends into the medical field, or for 

that matter, into any other medical 

professional area, and may use 

advanced practice nurse practitioner 

(APNP) or advanced practice nurse 

(APN) title when practicing within a 

CCNS’s scope of practice. Therefore, 

CCNSs when recognized by TRICARE 

under one of the existing categories of 

authorized allied health care 

professionals as found in 

§ 199.6(c)(3)(iii) are authorized to 

prescribe DE when acting within the 

scope of their state license or certificate. 

In this final rule, DoD considered all 

comments received during the comment 

period and responses to those comments 

are included in the above section of this 

final rule. 

IV. Regulatory Procedure 

Executive Order 12866, ‘‘Regulatory 

Planning and Review’’ and Executive 

Order 13563, ‘‘Improving Regulation 

and Regulatory Review’’ 

It has been determined that this final 

rule is not a significant regulatory 

action. This rule does not: 

(1) Have an annual effect on the 

economy of $100 million or more or 

adversely affect in a material way the 

economy; a section of the economy; 

productivity; competition; jobs; the 

environment; public health or safety; or 

State, local, or tribunal 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 these Executive Orders. 

Unfunded Mandates Reform Act (Sec. 

202, Pub. L. 104–4) 

It has been determined that this final 

rule does not contain a Federal mandate 

that may result in the expenditure by 

State, local and tribal governments, in 

aggregate, or by the private sector, of 

$100 million or more in any one year. 

Public Law 96–354, ‘‘Regulatory 

Flexibility Act’’ (5 U.S.C. 601) 

It has been certified that this final rule 

is not subject to the Regulatory 

Flexibility Act (5 U.S.C. 601) because it 

would not, if promulgated, have a 

significant economic impact on a 

substantial number of small entities. Set 

forth in the final rule are minor 

revisions to the existing regulation. The 

DoD does not anticipate a significant 

impact on the Program. 

Public Law 96–511, ‘‘Paperwork 

Reduction Act’’ (44 U.S.C. Chapter 35) 

It has been determined that this final 

rule does not impose reporting or 

recordkeeping requirements under the 

Paperwork Act of 1995. 

Executive Order 13132, Federalism 

It has been determined that this final 

rule does not have federalism 

implications, as set forth in Executive 

Order 13132. This rule does not have 

substantial direct effects on: 

(1) The States; 

(2) The relationship between the 

National Government and the States; or 

(3) The distribution of power and 

responsibilities among the various 

levels of Government. 

List of Subjects in 32 CFR Part 199 

Claims, Dental health, Health care, 

Health insurance, Individuals with 

disabilities, and Military personnel. 

Accordingly, 32 CFR part 199 is 

amended to read as follows: 

PART 199—[AMENDED] 

■ 1. The authority citation for part 199 

continues to read as follows: 

Authority: 5 U.S.C. 301; 10 U.S.C. chapter 

55. 

■ 2. Section 199.2, paragraph (b) is 

amended by adding the definition of 

‘‘Assistive technology devices’’ in 

alphabetical order and revising the 

definitions of ‘‘Duplicate equipment,’’ 

‘‘Durable equipment,’’ and ‘‘Durable 

medical equipment’’ to read as follows: 

§ 199.2 Definitions. 

* * * * * 

(b) * * * 

Assistive technology devices. 

Equipment that generally does not treat 

an underlying injury, illness, disease or 

their symptoms. Assistive technology 

devices are authorized only under the 

Extended Care Health Option (ECHO). 

Assistive technology devices help an 

ECHO beneficiary overcome or remove 

a disability and are used to increase, 

maintain, or improve the functional 

capabilities of an individual. Assistive 

technology devices may include nonmedical devices but do not include any 

structural alterations (e.g., permanent 

structure of wheelchair ramps or 

alterations to street curbs) service 

animals (e.g., Seeing Eye dogs, hearing/ 

handicapped assistance animals, etc.) or 

specialized equipment and devices 

whose primary purpose is to enable the 

individual to engage in sports or 

recreational events. Assistive 

technology devices are authorized only 

under coverage criteria determined by 

the Director, TRICARE Management 

Activity to assist in the reduction of the 

disabling effects of a qualifying 

condition for individuals eligible to 

receive benefits under the ECHO 

program, as provided in § 199.5. 

* * * * * 

Duplicate equipment. An item of 

durable equipment, durable medical 

equipment, or assistive technology 

items, as defined in this section that 

serves the same purpose that is served 

by an item of durable equipment, 

durable medical equipment, or assistive 

technology item previously cost-shared 

by TRICARE. For example, various 

models of stationary oxygen 

concentrators with no essential 

functional differences are considered 

duplicate equipment, whereas 

stationary and portable oxygen 

concentrators are not considered 

duplicates of each other because the 

latter is intended to provide the user 

with mobility not afforded by the 

former. Also, a manual wheelchair and 

electric wheelchair, both of which 

otherwise meet the definition of durable 

equipment or durable medical 

equipment, would not be considered 

duplicates of each other if each is found 

to provide an appropriate level of 

mobility. For the purpose of this Part, 

durable equipment, durable medical 

equipment, or assistive technology 

items that are essential in providing a 

fail-safe in-home life support system or 

that replace in-like-kind an item of 

equipment that is not serviceable due to 

normal wear, accidental damage, a 

change in the beneficiary’s condition, or 

has been declared adulterated by the 

U.S. FDA, or is being or has been 

recalled by the manufacturer is not 

considered duplicate equipment. 

Durable equipment. Equipment that— 

(1) Is a medically necessary item, 

which can withstand repeated use; 

(2) Is primarily and customarily used 

to serve a medical purpose; and 

(3) Is generally not useful to an 

individual in the absence of an illness 

or injury. It includes durable medical 

equipment as defined in § 199.2, 

wheelchairs, iron lungs, and hospital 


tkelley on DSK3SPTVN1PROD with RULES
78712 Federal Register / Vol. 79, No. 250 / Wednesday, December 31, 2014 / Rules and Regulations 

beds. It does not include equipment 

(including wheelchairs) used or 

designed primarily for use in sports or 

recreational activities. 

Durable medical equipment. Durable 

equipment that is medically appropriate 

to— 

(1) Improve, restore, or maintain the 

function of a malformed, diseased, or 

injured body part or can otherwise 

minimize or prevent the deterioration of 

the beneficiary’s function or condition; 

or 

(2) Maximize the beneficiary’s 

function consistent with the 

beneficiary’s physiological or medical 

needs. 

* * * * * 

■ 3. Section 199.4 is amended by 

revising paragraphs (a)(1)(i), (d)(1), 

(d)(3)(ii), and (g)(43) to read as follows: 

§ 199.4 Basic program benefits. 

(a) * * * 

(1)(i) Scope of benefits. Subject to all 

applicable definitions, conditions, 

limitations, or exclusions specified in 

this part, the CHAMPUS Basic Program 

will cost share medically necessary 

services and supplies required in the 

diagnosis and treatment of illness or 

injury, including maternity care and 

well-baby care. Benefits include 

specified medical services and supplies 

provided to eligible beneficiaries from 

authorized civilian sources such as 

hospitals, other authorized institutional 

providers, physicians, other authorized 

individual professional providers, and 

professional ambulance services, 

prescription drugs, authorized medical 

supplies, and rental or purchase of 

durable equipment. 

* * * * * 

(d) Other benefits—(1) General. 

Benefits may be extended for the 

allowable charge of those other covered 

services and supplies described in 

paragraph (d) of this section, which are 

provided in accordance with good 

medical practice and established 

standards of quality by those other 

authorized providers described in 

§ 199.6. Such benefits are subject to all 

applicable definitions, conditions, 

limitations, or exclusions as otherwise 

may be set forth in this or other chapters 

of this Regulation. To be considered for 

benefits under paragraph (d) of this 

section, the described services or 

supplies must be prescribed and 

ordered by a physician. Other 

authorized individual professional 

providers acting within their scope of 

licensure may also prescribe and order 

these services and supplies unless 

otherwise specified in paragraph (d) of 

this section. 

* * * * * 

(3) * * * 

(ii) Durable equipment—(A) Scope of 

benefit. (1) Durable equipment, which is 

for the specific use of the beneficiary 

and is ordered by an authorized 

individual professional provider listed 

in § 199.6(c)(3)(i), (ii) or (iii), acting 

within his or her scope of licensure 

shall be covered if the durable 

equipment meets the definition in 

§ 199.2 and— 

(i) Provides the medically appropriate 

level of performance and quality for the 

medical condition present and 

(ii) Is not otherwise excluded by this 

part. 

(2) Items that may be provided to a 

beneficiary as durable equipment 

include: 

(i) Durable medical equipment as 

defined in § 199.2; 

(ii) Wheelchairs. A wheelchair, which 

is medically appropriate to provide 

basic mobility, including reasonable 

additional costs for medically 

appropriate modifications to 

accommodate a particular physiological 

or medical need, may be covered as 

durable equipment. An electric 

wheelchair, or TRICARE approved 

alternative to an electric wheelchair 

(e.g., scooter) may be provided in lieu of 

a manual wheelchair when it is 

medically indicated and appropriate to 

provide basic mobility. Luxury or 

deluxe wheelchairs, as described in 

paragraph (d)(3)(ii)(A)(3) of this section, 

include features beyond those required 

for basic mobility of a particular 

beneficiary are not authorized. 

(iii) Iron lungs. 

(iv) Hospital beds. 

(v) Cardiorespiratory monitors under 

conditions specified in paragraph 

(d)(3)(ii)(B) of this section. 

(3) Whether a prescribed item of 

durable equipment provides the 

medically appropriate level of 

performance and quality for the 

beneficiary’s condition must be 

supported by adequate documentation. 

Luxury, deluxe, immaterial, or nonessential features, which increase the 

cost of the item relative to a similar item 

without those features, based on 

industry standards for a particular item 

at the time the equipment is prescribed 

or replaced for a beneficiary, are not 

authorized. Only the ‘‘base’’ or ‘‘basic’’ 

model of equipment (or more costeffective alternative equipment) shall be 

covered, unless customization of the 

equipment, or any accessory or item of 

supply for any durable equipment, is 

essential, as determined by the Director 

(or designee), for— 

(i) Achieving therapeutic benefit for 

the patient; 

(ii) Making the equipment serviceable; 

or 

(iii) Otherwise assuring the proper 

functioning of the equipment. 

* * * * * 

(B) * * * 

(C) Exclusions. Durable equipment, 

which is otherwise qualified as a benefit 

is excluded from coverage under the 

following circumstances: 

(1) Durable equipment for a 

beneficiary who is a patient in a type of 

facility that ordinarily provides the 

same type of durable equipment item to 

its patients at no additional charge in 

the usual course of providing its 

services. 

(2) Durable equipment, which is 

available to the beneficiary from a 

Uniformed Services Medical Treatment 

Facility. 

(D) Basis for reimbursement. (1) 

Durable equipment may be provided on 

a rental or purchase basis. Coverage of 

durable equipment will be based on the 

price most advantageous to the 

government taking into consideration 

the anticipated duration of the 

medically necessary need for the 

equipment and current price 

information for the type of item. The 

cost analysis must include a comparison 

of the total price of the item as a 

monthly rental charge, a lease-purchase 

price, and a lump-sum purchase price 

and a provision for the time value of 

money at the rate determined by the 

U.S. Department of Treasury. If a 

beneficiary wishes to obtain an item of 

durable equipment with deluxe, luxury, 

immaterial or non-essential features, the 

beneficiary may agree to accept 

TRICARE coverage limited to the 

allowable amount that would have 

otherwise been authorized for a similar 

item without those features. In that case, 

the TRICARE coverage is based upon 

the allowable amount for the kind of 

durable equipment normally used to 

meet the intended purpose (i.e., the 

standard item least costly). The provider 

shall not hold the beneficiary liable for 

deluxe, luxury, immaterial, or nonessential features that cannot be 

considered in determining the TRICARE 

allowable costs. However, the 

beneficiary shall be held liable if the 

provider has a specific agreement in 

writing from the beneficiary (or his or 

her representative) accepting liability 

for the itemized difference in costs of 

the durable equipment with deluxe, 

luxury, or immaterial features and the 

TRICARE allowable costs for an 

otherwise authorized item without such 

features. 


tkelley on DSK3SPTVN1PROD with RULES
Federal Register / Vol. 79, No. 250 / Wednesday, December 31, 2014 / Rules and Regulations 78713 

(2) In general, repairs of beneficiary 

owned durable equipment are covered 

when necessary to make the equipment 

serviceable and replacement of durable 

equipment is allowed when the durable 

equipment is not serviceable because of 

normal wear, accidental damage or 

when necessitated by a change in the 

beneficiary’s condition. However, 

repairs of durable equipment damaged 

while using the equipment in a manner 

inconsistent with its common use, and 

replacement of lost or stolen durable 

equipment are excluded from coverage. 

In addition, repairs of deluxe, luxury, or 

immaterial features of durable 

equipment are excluded from coverage. 

* * * * * 

(g) * * * 

(43) Exercise/relaxation/comfort/

sporting items or sporting devices. 

Exercise equipment, to include items 

primarily and customarily designed for 

use in sports or recreational activities, 

spas, whirlpools, hot tubs, swimming 

pools health club memberships or other 

such charges or items. 

* * * * * 

■ 4. Section 199.5 is amended by 

revising paragraphs (c)(2), (c)(8)(ii), and 

(c)(8)(iii), (d)(3), (d)(7) introductory text, 

(d)(7)(i), (d)(7)(iv), and (d)(8), (g)(2), and 

(h)(4), and adding new paragraph 

(d)(7)(v) to read as follows: 

§ 199.5 TRICARE extended care health 

option (ECHO). 

* * * * * 

(c) * * * 

(2) Medical, habilitative, rehabilitative 

services and supplies, durable 

equipment and assistive technology 

(AT) devices that assist in the reduction 

of the disabling effects of a qualifying 

condition. Benefits shall be provided in 

the beneficiary’s home or another 

environment, as appropriate. An AT 

device may be covered only if it is 

recommended in a beneficiary’s 

Individual Educational Program (IEP) 

or, if the beneficiary is not eligible for 

an IEP, the AT device is an item or 

educational learning device normally 

included in an IEP and is preauthorized 

under ECHO as an integral component 

of the beneficiary’s individual 

comprehensive health care services plan 

(including rehabilitation) as prescribed 

by a TRICARE authorized provider. 

(i) An AT device may be covered 

under ECHO only if it is not otherwise 

covered by TRICARE as durable 

equipment, a prosthetic, augmentation 

communication device, or other benefits 

under § 199.4. 

(ii) An AT device may include an 

educational learning device directly 

related to the beneficiary’s qualifying 

condition when recommended by an 

IEP and not otherwise provided by State 

or local government programs. If an 

individual is not eligible for an IEP, an 

educational learning device normally 

included in the IEP may be authorized 

as if directly related to the beneficiary’s 

qualifying condition and prescribed by 

a TRICARE authorized provider as part 

of the beneficiary’s individual 

comprehensive health care services 

plan. 

(iii) Electronic learning devices may 

include the hardware and software as 

appropriate. The Director, DHA, shall 

determine the types and (or) platforms 

of electronic devices and the 

replacement lifecycle of the hardware 

and its supporting software. All 

upgrades or replacements shall require 

a recommendation from the individual’s 

IEP or the individual’s comprehensive 

health care services plan. 

(iv) Duplicative or redundant 

hardware platforms are not authorized. 

Note to paragraph (c)(2)(iv): When one 

or more electronic platforms such as a 

desktop computer, laptop, notebook or 

tablet can perform the same functions in 

relation to the teaching or educational 

objective directly related to the 

qualifying condition, it is the intent of 

this provision to allow only one 

electronic platform that may be chosen 

by the beneficiary. Duplicative or 

redundant platforms are not allowed; 

however, a second platform may be 

obtained, if the individual’s IEP 

recommends one platform such as a 

computer for the majority of the 

learning objectives, but there exists 

another objective, which cannot be 

performed on that platform. In these 

limited circumstances, the beneficiary 

may submit a request with the above 

justification to the Director, TMA, who 

may authorize a second device. 

(v) AT devices damaged through 

improper use of the device as well as 

lost or stolen devices may not be 

replaced until the device would next be 

eligible for a lifecycle replacement. 

(vi) AT devices do not include 

equipment or devices whose primary 

purpose is to assist the individual to 

engage in sports or recreational 

activities. 

* * * * * 

(8) * * * 

(ii) Equipment adaptation. The 

allowable equipment and an AT device 

purchase shall include such services 

and modifications to the equipment as 

necessary to make the equipment usable 

for a particular ECHO beneficiary. 

(iii) Equipment maintenance. 

Reasonable repairs and maintenance of 

the beneficiary owned or rented DE or 

AT devices provided by this section 

shall be allowed while a beneficiary is 

registered in the ECHO Program. Repairs 

of DE and/or AT devices damaged while 

using the item in a manner inconsistent 

with its common use, and replacement 

of lost or stolen DE and/or AT devices 

are not authorized coverage as an ECHO 

benefit. In addition, repairs and 

maintenance of deluxe, luxury, or 

immaterial features of DE or AT devices 

are not authorized coverage as an ECHO 

benefit. 

(d) * * * 

(3) Structural alterations. Alterations 

to living space and permanent fixtures 

attached thereto, including alterations 

necessary to accommodate installation 

of equipment or AT devices to facilitate 

entrance or exit, are excluded. 

* * * * * 

(7) Equipment. Purchase or rental of 

DE and AT devices otherwise allowed 

by this section is excluded when: 

(i) The beneficiary is a patient in an 

institution or facility that ordinarily 

provides the same type of equipment or 

AT devices to its patients at no 

additional charge in the usual course of 

providing services; or 

* * * * * 

(iv) The item is a duplicate DE or an 

AT device, as defined in § 199.2. 

(v) The item (or charge for access to 

such items through health club 

membership or other activities) is 

exercise equipment including an item 

primarily and customarily designed for 

use in sports or recreational activities, 

spa, whirlpool, hot tub, swimming pool, 

an electronic device used to locate or 

monitor the location of the beneficiary, 

or other similar items or charges. 

(8) Maintenance agreements. 

Maintenance agreements for beneficiary 

owned or rented equipment or AT 

device are excluded. 

* * * * * 

(g) * * * 

(2) Equipment. (i) The TRICARE 

allowable amount for DE or AT devices 

shall be calculated in the same manner 

as DME allowable through section 199.4 

of this title, and accrues to the fiscal 

year benefit limit specified in paragraph 

(f)(3) of this section. 

(ii) Cost-share. A cost-share, as 

provided by paragraph (f)(2) of this 

section, is required for each month in 

which equipment or an AT device is 

purchased under this section. However, 

in no month shall a sponsor be required 

to pay more than one cost-share 

regardless of the number of benefits the 

sponsor’s dependents received under 

this section. 

* * * * * 

(h) * * * 


tkelley on DSK3SPTVN1PROD with RULES
78714 Federal Register / Vol. 79, No. 250 / Wednesday, December 31, 2014 / Rules and Regulations 

(4) Repair or maintenance of DE 

owned by the beneficiary or an AT 

device is exempt from the public 

facility-use certification requirements. 

* * * * * 

Dated: December 22, 2014. 

Aaron Siegel, 

Alternate OSD Federal Register Liaison 

Officer, Department of Defense. 

[FR Doc. 2014–30337 Filed 12–30–14; 8:45 am] 

BILLING CODE 5001–06–P 

POSTAL REGULATORY COMMISSION 

39 CFR Part 3020 

[Docket Nos. MC2010–21 and CP2010–36] 

Update to Product Lists 

AGENCY: Postal Regulatory Commission. 

ACTION: Final rule. 

SUMMARY: The Commission is updating 

the product lists. 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 product lists, which 

is re-published in its entirety, includes 

these updates. 

DATES: Effective Date: December 31, 

2014. 

Applicability Dates: See the 

SUPPLEMENTARY INFORMATION. 

FOR FURTHER INFORMATION CONTACT: 

David A. Trissell, General Counsel, at 

202–789–6800. 

SUPPLEMENTARY INFORMATION: This 

document identifies updates to the 

product lists, which appear as 

Appendix A to Subpart A of 39 CFR part 

3020—Mail Classification Schedule. 

Publication of the updated product lists 

in the Federal Register is addressed in 

the Postal Accountability and 

Enhancement Act (PAEA) of 2006. 

Applicability Dates: August 29, 2014, 

Priority Mail Contract 89 (MC2014–39 

and CP2014–72); September 10, 2014, 

Priority Mail Express Contract 19 

(MC2014–41 and CP2014–74); 

September 10, 2014, First-Class Package 

Service Contract 37 (MC2014–42 and 

CP2014–75); September 15, 2014, 

Priority Mail Express, Priority Mail & 

First-Class Package Service Contract 4 

(MC2014–43 and CP2014–76); October 

1, 2014, Priority Mail Contract 92 

(MC2014–46 and CP2014–82); October 

1, 2014, Priority Mail Contract 93 

(MC2014–47 and CP2014–83); October 

3, 2014, Priority Mail Contract 91 

(MC2014–45 and CP2014–81); October 

8, 2014, Priority Mail Contract 94 

(MC2014–48 and CP2014–84); October 

8, 2014, Priority Mail Contract 95 

(MC2014–49 and CP2014–85); October 

23, 2014, Market Test Customized 

Delivery (MT2014–1); October 24, 2014, 

Outbound Competitive International 

Merchandise Return Service Agreement 

with Royal Mail Group, Ltd. (CP2015– 

1); October 30, 2014, Priority Mail 

Express & Priority Mail Contract 16 

(MC2015–2 and CP2015–4); November 

5, 2014, Priority Mail Contract 97 

(MC2015–5 and CP2015–6); November 

5, 2014, Priority Mail Contract 98 

(MC2015–6 and CP2015–7); November 

5, 2014, Parcel Select Contract 8 

(MC2015–1 and CP2015–3); November 

10, 2014, Priority Mail Contract 96 

(MC2015–4 and CP2015–5); December 

5, 2014, Priority Mail Contract 101 

(MC2015–11 and CP2015–14); 

December 5, 2014, Priority Mail Express 

Contract 20 (MC2015–12 and CP2015– 

15); December 5, 2014, Priority Mail 

Contract 100 (MC2015–10 and CP2015– 

13); December 5, 2014, Priority Mail 

Contract 99 (MC2015–9 and CP2015–2); 

December 11, 2014, Priority Mail 

Express Contract 21 (MC2015–14 and 

CP2015–17); December 12, 2014, 

Priority Mail Contract 102 (MC2015–13 

and CP2015–16); December 19, 2014, 

Priority Mail Express Contract 23 

(MC2015–16 and CP2015–20). 

Authorization. The Commission 

process for periodic publication of 

updates was established in Docket Nos. 

MC2010–21 and CP2010–36, Order No. 

445, April 22, 2010, at 8. 

Changes. The product lists are being 

updated by publishing a replacement in 

its entirety of Appendix A to Subpart A 

of 39 CFR part 3020—Mail 

Classification Schedule. The following 

products are being added, removed, or 

moved within the product lists: 

1. Priority Mail Contract 89 (MC2014– 

39 and CP2014–72) (Order No. 2175), 

added August 29, 2014. 

2. Priority Mail Express Contact 19 

(MC2014–41 and CP2014–74) (Order 

No. 2178), added September 10, 2014. 

3. First-Class Package Service 

Contract 37 (MC2014–42 and CP2014– 

75) (Order No. 2179), added September 

10, 2014. 

4. Priority Mail Express, Priority Mail 

& First-Class Package Service Contract 4 

(MC2014–43 and CP2014–76), added 

September 15, 2014. 

5. Priority Mail Contract 92 (MC2014– 

46 and CP2014–82), added October 1, 

2014. 

6. Priority Mail Contract 93 (MC2014– 

47 and CP2014–83), added October 1, 

2014. 

7. Priority Mail Contract 91 (MC2014– 

45 and CP2014–81), added October 3, 

2014. 

8. Priority Mail Contract 94 (MC2014– 

48 and CP2014–84), added October 8, 

2014. 

9. Priority Mail Contact 95 (MC2014– 

49 and CP2014–85), added October 8, 

2014. 

10. Market Test Customized Delivery 

(MT2014–1), authorizing test October 

23, 2014. 

11. Outbound Competitive 

International Merchandise Return 

Service Agreement with Royal Mail 

Group, Ltd. (CP2015–1), added October 

24, 2014. 

12. Priority Mail Express & Priority 

Mail Contract 16 (MC2015–2 and 

CP2015–4), added October 30, 2014. 

13. Priority Mail Contract 97 

(MC2015–5 and CP2015–6), added 

November 5, 2014. 

14. Priority Mail Contract 98 

(MC2015–6 and CP2015–7), added 

November 5, 2014. 

15. Parcel Select Contract 8 (MC2015– 

1 and CP2015–3), added November 5, 

2014. 

16. Priority Mail Contract 96 

(MC2015–4 and CP2015–5), added 

November 10, 2014. 

17. Priority Mail Contract 101 

(MC2015–11 and CP2015–14), added 

December 5, 2014. 

18. Priority Mail Express Contract 20 

(MC2015–12 and CP2015–15), added 

December 5, 2014. 

19. Priority Mail Contract 100 

(MC2015–10 and CP2015–13), added 

December 5, 2014. 

20. Priority Mail Contract 99 

(MC2015–9 and CP2015–12), added 

December 5, 2014. 

21. Priority Mail Express Contract 21 

(MC2015–14 and CP2015–17), added 

December 11, 2014. 

22. Priority Mail Contract 102 

(MC2015–13 and CP2015–16), added 

December 12, 2014. 

23. Priority Mail Express Contract 23 

(MC2015–16 and CP2015–20), added 

December 19, 2014. 

Updated product lists. The referenced 

changes to the product lists are 

incorporated into Appendix A to 

Subpart A of 39 CFR part 3020—Mail 

Classification Schedule. 

List of Subjects in 39 CFR Part 3020 

Administrative practice and 

procedure, Postal Service. 

For the reasons discussed in the 

preamble, the Postal Regulatory 

Commission amends chapter III of title 

39 of the Code of Federal Regulations as 

follows: 

PART 3020—PRODUCT LISTS 

■ 1. The authority citation for part 3020 

continues to read as follows: 


tkelley on DSK3SPTVN1PROD with RULES