2288 Federal Register / Vol. 76, No. 9 / Thursday, January 13, 2011 / Proposed Rules 

legally required for this temporary 

scheduling order. Therefore, I hereby 

order that this paragraph (the first full 

paragraph in the right column on page 

71637), as well as the ‘‘Regulatory 

Flexibility Act’’ heading that precedes it, 

be stricken. 

DEA also inadvertently included in its 

Notice of Intent a certification relating 

to the Congressional Review Act. The 

Congressional Review Act only applies 

to ‘‘final’’ rules. Accordingly, inclusion 

of the paragraph relating to the 

Congressional Review Act in the Notice 

of Intent was premature. Therefore, I 

hereby order that this paragraph (the 

fifth paragraph in the right column on 

page 71637 and continued on the top of 

page 71638), as well as the 

‘‘Congressional Review Act’’ heading 

that precedes it, also be stricken. 

Dated: January 7, 2011. 

Michele M. Leonhart, 

Administrator. 

[FR Doc. 2011–683 Filed 1–10–11; 4:15 pm] 

BILLING CODE 4410–09–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[DoD–2010–HA–0113; RIN 0720–AB46] 

TRICARE; Changes Included in the 

National Defense Authorization Act for 

Fiscal Year 2010; Enhancement of 

Transitional Dental Care for Members 

of the Reserve Component on Active 

Duty for More Than 30 Days in Support 

of a Contingency Operation 

AGENCY: Office of the Secretary, DoD. 

ACTION: Proposed rule. 

SUMMARY: The Department is publishing 

this proposed rule to implement section 

703 of the National Defense 

Authorization Act for Fiscal Year 2010 

(NDAA for FY10). Specifically, that 

legislation amends the transitional 

health care dental benefits for Reserve 

Component members on active duty for 

more than 30 days in support of a 

contingency operation. The legislation 

entitles these Reserve Component 

members to dental care in the same 

manner as a member of the uniformed 

services on active duty for more than 30 

days, thus providing care to the Reserve 

member in both military dental 

treatment facilities and authorized 

private sector dental care. This 

proposed rule does not eliminate any 

medical or dental care that is currently 

covered as transitional health care for 

the member. However the member’s 

dependents are not entitled to this 

enhanced benefit. 

At present, the transitional health care 

dental benefits for Reserve Component 

members includes space available care 

in military dental treatment facilities 

and eligibility for the TRICARE Dental 

Program (TDP). The implementation of 

section 703 of NDAA for FY10 will 

enhance the dental benefit to include 

space required care in military dental 

treatment facilities; military dental 

treatment facility referred care to the 

private sector; and authorized remote 

dental care in the private sector during 

the 180 day transitional health care 

period. Both dental treatment facility 

referred care and remote care will be 

administered by TRICARE’s Active Duty 

Dental Program (ADDP). TDP eligibility 

will begin after the transitional health 

care period ends. 

Reserve Component family members 

are also eligible for the TRICARE Dental 

Program (TDP). These family members 

pay 100% of the premiums while their 

sponsor is in Reserve status. If their 

sponsor is activated for more than 30 

days, the TDP enrolled Reserve 

Component family members obtain the 

same benefits as any other TDP enrolled 

active duty family members with the 

Government subsidizing 60 percent of 

the premium cost for enrolled active 

duty family members. This change in 

status and subsidy occurs automatically. 

Upon the sponsor’s deactivation, the 

family members automatically revert to 

Reserve Component family member TDP 

status and pay 100% of the TDP 

premium cost. With the proposed rule, 

there is no change to status or eligibility 

for family members. 

DATES: Written comments received at 

the address indicated below by March 

14, 2011 will be accepted. 

ADDRESSES: You may submit comments, 

identified by docket number and/or RIN 

number and title, by any of the 

following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Mail: Federal Docket Management 

System Office, 1160 Defense 

Pentagon, Room 3C843, Washington, 

DC 20301–1160. 

Instructions: All submissions received 

must include the agency name and 

docket number or Regulatory 

Information Number (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 

http://regulations.gov as they are 

received without change, including any 

personal identifiers or contact 

information. 

FOR FURTHER INFORMATION CONTACT: 

CAPT Robert H. Mitton, Office of the 

Assistant Secretary of Defense (Health 

Affairs), TRICARE Management 

Activity, telephone (703) 681–0039. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Currently, Reserve Component 

members who separate from active duty 

after serving for more than 30 days in 

support of a contingency operation are 

entitled to dental care under the 

transitional assistance medical program 

in the same manner as a dependent. 

This consists of only space-available 

dental care in a military dental 

treatment facility and is very limited. 

This proposed rule amends the 

transitional health care dental benefit 

for Reserve Component members who 

were on active duty for more than 30 

days in support of a contingency 

operation by providing those members’ 

dental care the same as that for a 

member of the uniformed services on 

active duty for more than 30 days. This 

enhanced benefit does not apply to 

members’ dependents. 

As mentioned, the transitional health 

care dental benefits for Reserve 

Component members include space 

available care in military dental 

treatment facilities. Additionally, 

Reserve Component members are 

eligible for the TRICARE Dental 

Program (TDP). The TDP provides 

comprehensive dental care insurance 

and requires premium and cost-share 

payments but includes an annual 

maximum per enrollee per contract year 

for non-orthodontic services. This 

means that the total payments for 

covered dental services (except 

orthodontic services) for each enrolled 

member will not exceed the annual 

maximum amount in any contract year. 

The Government subsidizes 60 percent 

of the premium cost for enrolled 

Reserve Component members. If 

activated for more than 30 days in 

support of a contingency operation, a 

TDP enrolled Reserve Component 

member is automatically disenrolled 

from the TDP and automatically reenrolled upon deactivation. 

Under the proposed rule, a TDP 

enrolled Reserve Component member 

activated for more than 30 days is still 

automatically disenrolled from the TDP; 

however, the Reserve Component 

member will not be automatically reenrolled upon deactivation because the 

member will be entitled to the same 

dental benefits as an active duty 

member. The Reserve Component 


srobinson on DSKHWCL6B1PROD with PROPOSALS
Federal Register / Vol. 76, No. 9 / Thursday, January 13, 2011 / Proposed Rules 2289 

member will be TDP eligible and 

automatically re-enrolled in the TDP 

after the Transitional Health Care period 

is completed. 

Reserve Component family members 

are also eligible for the TRICARE Dental 

Program (TDP). These family members 

pay 100% of the premiums while their 

sponsor is in Reserve status. If their 

sponsor is activated for more than 30 

days, the TDP enrolled Reserve 

Component family members obtain the 

same benefits as any other TDP enrolled 

active duty family members with the 

Government subsidizing 60 percent of 

the premium cost for enrolled active 

duty family members. This change in 

status and subsidy occurs automatically. 

Upon the sponsor’s deactivation, the 

family members automatically revert to 

Reserve Component family member TDP 

status and pay 100% of the TDP 

premium cost. With the proposed rule, 

there is no change to status or eligibility 

for family members. 

II. Regulatory Procedures 

Executive Order 12866 requires that a 

comprehensive regulatory impact 

analysis be performed on any 

economically significant regulatory 

action, defined as one that would result 

in an annual effect of $100 million or 

more on the national economy or which 

would have other substantial impacts. 

The Regulatory Flexibility Act (RFA) 

requires that each Federal agency 

prepare, and make available for public 

comment, a regulatory flexibility 

analysis when the agency issues a 

regulation which would have a 

significant impact on a substantial 

number of small entities. This rule is 

not an economically significant 

regulatory action and will not have a 

significant impact on a substantial 

number of small entities for purposes of 

the RFA. Thus this proposed rule is not 

subject to any of these requirements. 

This proposed rule would amend the 

Code of Federal Regulations to conform 

to the new statutory authority. Public 

comments are invited. All comments 

will be carefully considered. A 

discussion of the major issues received 

by public comments will be included 

with the issuance of the final rule. 

This rule does not contain unfunded 

mandates. It 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. 

This rule will not impose additional 

information collection requirements on 

the public under the Paperwork 

Reduction Act of 1995 (44 U.S.C. 3501– 

3511). 

We have examined the impact(s) of 

the proposed rule under Executive 

Order 13132 and it does not have 

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 power 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—CIVILIAN HEALTH AND 

MEDICAL PROGRAM OF THE 

UNIFORMED SERVICES (CHAMPUS) 

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 199.3 is amended by 

revising paragraph (e)(3) to read as 

follows: 

§ 199.3 Eligibility. 

* * * * * 

(e) * * * 

(3) TAMP benefits under TRICARE 

begin on the day after the member is 

separated from active duty, and, if such 

separation occurred on or after 

November 6, 2003, end 180 days after 

such date. TRICARE benefits available 

to both the member and eligible family 

members are generally those available to 

family members of members of the 

uniformed services under this Part. 

However, during TAMP eligibility, a 

member of a Reserve Component as 

described in paragraph (e)(1)(ii) of this 

section, is entitled to dental care to 

which a member of the uniformed 

services on active duty for more than 30 

days is entitled. Each branch of service 

will determine eligibility for its 

members and eligible family members 

and provide data to DEERS. 

* * * * * 

3. § 199.13 is amended by revising 

paragraph (c)(3)(ii)(E)(1) to read as 

follows: 

§ 199.13 TRICARE Dental Program. 

* * * * * 

(c) * * * 

(3) * * * 

(ii) * * * 

(E) * * * 

(1) Changes in status of active duty, 

Selected Reserve or Individual Ready 

Reserve member. When the active duty, 

Selected Reserve or Individual Ready 

Reserve member is separated, 

discharged, retired, transferred to the 

Standby or Retired Reserve, his or her 

enrolled dependents and/or the enrolled 

Selected Reserve or Individual Ready 

Reserve member loses eligibility and 

enrollment as of 11:59 p.m. on the last 

day of the month in which the change 

in status takes place. When the Selected 

Reserve or Individual Ready Reserve 

member is ordered to active duty for a 

period of more than 30 days without a 

break in service, the member loses 

eligibility and is disenrolled, if 

previously enrolled; however, their 

enrolled dependents maintain their 

eligibility and previous enrollment 

subject to eligibility, enrollment and 

disenrollment provisions described in 

this section and in the TDP contract. 

(i) Reserve component members 

separated from active duty in support of 

a contingency operation. When a 

member of a reserve component who is 

separated from active duty to which 

called or ordered in support of a 

contingency operation if the active duty 

is for more than 30 days, the member 

becomes eligible for Transitional Health 

Care pursuant to 10 U.S.C. 1145(a) and 

the member is entitled to dental care to 

which a member of the uniformed 

services on active duty for more than 30 

days is entitled. Thus the member has 

no requirement for the TDP and is not 

eligible to purchase the TDP. Upon the 

termination of Transitional Health Care 

eligibility, the member regains TDP 

eligibility and is reenrolled, if 

previously enrolled. 

(ii) Dependents of members separated 

from active duty in support of a 

contingency operation. Dependents of a 

member of a reserve component who is 

separated from active duty to which 

called or ordered in support of a 

contingency operation if the active duty 

is active for more than 30 days maintain 

their eligibility and previous 

enrollment, subject to eligibility, 

enrollment and disenrollment 

provisions described in this section and 

in the TDP contract. During the 

member’s Transitional Health Care 

eligibility, the dependents are 

considered family members of Reserve 

Component members. 

(iii) Members separated from active 

duty and not covered by 10 U.S.C. 

1145(a)(2)(B). When the previously 

enrolled active duty member is 

transferred back to the Selected Reserve 

or Individual Ready Reserve, other than 

pursuant to 10 U.S.C. 1145(2)(B), 

without a break in service, the member 

regains TDP eligibility and is reenrolled; 

however, enrolled dependents maintain 


srobinson on DSKHWCL6B1PROD with PROPOSALS
2290 Federal Register / Vol. 76, No. 9 / Thursday, January 13, 2011 / Proposed Rules 

their eligibility and previous enrollment 

subject to eligibility, enrollment and 

disenrollment provisions described in 

this section and in the TDP contract. 

(iv) Eligible dependents of an active 

duty, Selected Reserve or Individual 

Ready Reserve member serving a 

sentence of confinement in conjunction 

with a sentence of punitive discharge 

are still eligible for the TDP until such 

time as the active duty, Selected Reserve 

or Individual Ready Reserve member’s 

discharge is executed. 

* * * * * 

Dated: January 4, 2011. 

Patricia L. Toppings, 

OSD Federal Register Liaison Officer, 

Department of Defense. 

[FR Doc. 2011–623 Filed 1–12–11; 8:45 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[DOD–2010–HA–0094; RIN 0720–AB42] 

TRICARE; Reimbursement for Travel 

for Specialty Care Under Exceptional 

Circumstances 

AGENCY: Office of the Secretary, DoD. 

ACTION: Proposed rule. 

SUMMARY: This proposed rule 

implements section 634 of the National 

Defense Authorization Act for Fiscal 

Year 2010 which amends Section 1074i 

of title 10, United States Code, to permit 

reimbursement for reasonable travel 

expenses for active duty members of the 

uniformed Services and their 

dependents, and accompaniment, to a 

specialty care provider under such 

exceptional circumstances as the 

Secretary of Defense may proscribe. The 

Department of Defense through its 

military treatment facilities and its 

robust managed care program, TRICARE 

Prime, is able to fulfill the medical 

needs of the majority of its active duty 

members and their families. However, 

in some locations where active duty 

members and their families live due to 

the duty assignment of the member, the 

medical resources in the military 

treatment facilities and the managed 

care networks may not meet all of the 

specialty care needs of these members 

and their families within normal access 

standards. Reimbursement of reasonable 

travel expenses for required specialty 

care that is more than 100 miles from 

the primary care manager’s office is 

currently a benefit under paragraph (a) 

of section 1074i, title 10, United States 

Code for any covered beneficiary 

enrolled in the TRICARE Prime 

program, including the active duty 

members and their dependents. 

However this proposed rule extends a 

travel reimbursement for active duty 

members of the armed forces and their 

families who, because of an exceptional 

circumstance involving the duty 

assignment of the active duty member of 

the armed forces, are required to travel 

less than 100 miles but more than 60 

minutes in drive time to access needed 

specialty care. This travel 

reimbursement benefit is limited to 

those active duty members and their 

dependents, and accompaniment, 

enrolled in Prime or TRICARE Prime 

Remote. The Director, TRICARE 

Management Activity, shall issue 

procedures and guidelines under which 

authorization for reimbursement of 

travel expenses will be issued after 

verification that the member, family 

member, and/or accompaniment, must 

travel less than 100 miles but more than 

60 minutes drive time from the military 

treatment facility or their primary care 

manager’s office to receive required 

specialty care. 

DATES: Comments must be received on 

or before March 14, 2011. 

ADDRESSES: You may submit comments, 

identified by docket number and/or RIN 

number and title, by any of the 

following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Mail: Federal Docket Management 

System Office, 1160 Defense Pentagon, 

Washington, DC 20301–1160. 

Instructions: All submissions received 

must include the agency name and 

docket number or Regulatory 

Information Number (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 viewing on the Internet at http:// 

regulations.gov as they are received 

without change, including any personal 

identifiers or contact information. 

FOR FURTHER INFORMATION CONTACT: 

TRICARE Policy and Operations, 

TRICARE Management Activity, 5111 

Leesburg Pike, Suite 810, Falls Church, 

VA 22041. 

SUPPLEMENTARY INFORMATION: 

I. Introduction and Background 

The TRICARE benefit was directed by 

Congress in section 1097 of the National 

Defense Authorization Act for Fiscal 

Year 1995. For further information on 

TRICARE, the reader may refer to the 

final rule regarding TRICARE published 

in the Federal Register on October 5, 

1995. 

Travel for Specialty Care 

Managed care support contractors are 

required to establish adequate networks 

throughout regions to complement 

military treatment facilities and support 

TRICARE Prime and Extra. However, 

there are many active duty members of 

the uniformed Services and their 

families who are required by the 

member’s duty assignment to live in 

certain more remote areas where there 

are insufficient numbers or types of 

specialty or subspecialty providers to 

provide care within normal drive-time 

access standards notwithstanding the 

due diligence of the contractors in 

developing the network around the 

military treatment facilities or their 

diligence in finding network providers 

for those members or families enrolled 

in TRICARE Prime Remote. Under such 

exceptional circumstances as identified 

under procedures and guidelines issued 

by the Director, TRICARE Management 

Activity, reasonable travel expenses to 

obtained specialty care for which the 

enrollee has been referred may be 

reimbursed. The specific location or 

identity of these military treatment 

facilities and the specific TRICARE 

Prime Remote locations and the types of 

specialists or sub-specialists shall be 

determined in accordance with 

guidelines issued by the Assistant 

Secretary of Defense for Health Affairs. 

The guidelines shall include identity of 

the specific military treatment facility or 

TRICARE Prime Remote area, validation 

by either, or both, the facility 

commander and/or the Director of the 

TRICARE Regional Office that the 

specialty care provider or category of 

specialty care provider required to 

provide care to the active duty member 

and their dependents, are not available 

within a 60 minute drive time, but are 

available within 100 miles of the 

military treatment facility or primary 

care manager’s office. The Director of 

the TRICARE Regional Office shall also 

verify that the Managed Care Support 

Contractor has used due diligence in 

attempting to enroll the needed 

specialists who do meet the drive time 

specialty care access standards, into the 

network. The Director, TRICARE 

Management Activity shall establish 

and make available a list of military 

treatment facilities and category of 

specialty providers for which these 

reasonable travel expenses shall be 

allowed. For members, and families, 

enrolled in TPR the Director shall 

ensure that adequate coordination of 

care and travel benefits is provided to 


srobinson on DSKHWCL6B1PROD with PROPOSALS