This section of the FEDERAL REGISTER

contains regulatory documents having general

applicability and legal effect, most of which

are keyed to and codified in the Code of

Federal Regulations, which is published under

50 titles pursuant to 44 U.S.C. 1510.

The Code of Federal Regulations is sold by

the Superintendent of Documents.

Rules and Regulations Federal Register

407 

Vol. 84, No. 18 

Monday, January 28, 2019 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Part 17 

Confidentiality of Certain Medical 

Records Under the MISSION Act 

AGENCY: Department of Veterans Affairs. 

ACTION: Notification of change to agency 

practice. 

SUMMARY: This Department of Veterans 

Affairs (VA) document provides an 

update to VA’s requirements for 

obtaining a signed release of 

information for third party billing 

practices from VA beneficiaries with a 

sensitive diagnosis under the United 

States Code to align with the 

amendments made by the VA MISSION 

Act of 2018. 

DATES: Effective January 28, 2019. 

FOR FURTHER INFORMATION CONTACT: 

Jennifer Adams, Office of Community 

Care (10D), Veterans Health 

Administration, Department of Veterans 

Affairs, 810 Vermont Avenue NW, 

Washington, DC 20420, 

Jennifer.Adams26@va.gov, (615) 355– 

1539. This is not a toll free number. 

SUPPLEMENTARY INFORMATION: On June 6, 

2018, section 132 of Public Law 115– 

182, the John S. McCain III, Daniel K. 

Akaka, and Samuel R. Johnson VA 

Maintaining Internal Systems and 

Strengthening Integrated Outside 

Networks Act of 2018 (MISSION Act), 

amended 38 U.S.C. 7332, 

Confidentiality of certain medical 

records, which protects certain sensitive 

diagnoses (i.e., drug abuse, alcoholism 

or alcohol abuse, infection with the 

human immunodeficiency virus, or 

sickle cell anemia) from being disclosed 

unless expressly authorized by the 

patient. The VA Mission Act of 2018 

amended section 7332 by providing a 

new exception to the requriment that a 

patient must expressely authorize VA to 

disclose medical records containing a 

sensitive diagnosis. The exception 

removed VA’s requirement when VA is 

billing a third-party for medical care 

cost recovery. 

In addition to this document, VA will 

announce these changes on Veteranfacing websites to reach as many VA 

beneficiaires as possible. VA will also 

conduct a briefing with Veteran Service 

Organizations to ensure they are 

informed of the changes. For any VA 

beneficiary who has previously signed a 

release of information declining to allow 

VA to bill encounters containing a 

sensitive diagnosis, VA will provide a 

one-time notification prior to submitting 

claims with a sensitive diagnosis to a 

third-party health insurer. The written 

notification will include a summary of 

the new law, how the change affects the 

patient, and a description of the types 

of services affected by the change. 

After all of the aforementioned 

notifications are complete, VA will 

begin submitting claims to health 

insurance companies for encounters 

with dates of service on or after the 

publication date of this document in the 

Federal Register that contain a sensitive 

diagnosis without a signed release of 

information. While VA’s billing 

authorities allow for a window of up to 

6 years to bill a health insurance 

company for services provided, VA will 

not pursue any back billing for these 

services unless a signed Request For and 

Authorization to Release Medical 

Records or Health Information (VHA– 

10–5345) form for such release has been 

received from the patient. All required 

payer policies still apply to any services 

submitted for reimbursement. 

Signing Authority 

The Secretary of Veterans Affairs, or 

designee, approved this document and 

authorized the undersigned to sign and 

submit the document to the Office of the 

Federal Register for publication 

electronically as an official document of 

the Department of Veterans Affairs. 

Robert L. Wilkie, Secretary, Department 

of Veterans Affairs, approved this 

document on December 21, 2018, for 

publication. 

Dated: December 21, 2018. 

Luvenia Potts, 

Program Specialist, Office of Regulation 

Policy & Management, Office of the Secretary, 

Department of Veterans Affairs. 

[FR Doc. 2018–28285 Filed 1–25–19; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF COMMERCE 

National Oceanic and Atmospheric 

Administration 

50 CFR Part 622 

[Docket No. 101206604–1758–02] 

RIN 0648–XG732 

Coastal Migratory Pelagic Resources 

of the Gulf of Mexico and Atlantic 

Region; Commercial Trip Limit 

Reduction for Spanish Mackerel in the 

Atlantic Southern Zone 

AGENCY: National Marine Fisheries 

Service (NMFS), National Oceanic and 

Atmospheric Administration (NOAA), 

Commerce. 

ACTION: Temporary rule; trip limit 

reduction. 

SUMMARY: NMFS reduces the 

commercial trip limit of Atlantic 

migratory group Spanish mackerel in or 

from the exclusive economic zone (EEZ) 

in the southern zone to 500 lb (227 kg) 

per day. This trip limit reduction is 

necessary to maximize the 

socioeconomic benefits of the 

commercial quota for the southern zone. 

DATES: This rule is effective from 6 a.m., 

local time, January 27, 2019, until 12:01 

a.m., local time, March 1, 2019. 

FOR FURTHER INFORMATION CONTACT: 

Mary Vara, NMFS Southeast Regional 

Office, telephone: 727–824–5305, or 

email: mary.vara@noaa.gov. 

SUPPLEMENTARY INFORMATION: The 

fishery for coastal migratory pelagic fish 

includes king mackerel, Spanish 

mackerel, and cobia, and is managed 

under the Fishery Management Plan for 

the Coastal Migratory Pelagic Resources 

of the Gulf of Mexico and South 

Atlantic (FMP). The FMP was prepared 

by the Gulf of Mexico and South 

Atlantic Fishery Management Councils 

and is implemented under the authority 

of the Magnuson-Stevens Fishery 

Conservation and Management Act 

(Magnuson-Stevens Act) by regulations 

at 50 CFR part 622. All weights in this 

temporary rule apply as either round or 

gutted weight. 

Framework Amendment 1 to the FMP 

(79 FR 69058; November 20, 2014) 

implemented a commercial annual 

catch limit (equal to the commercial 

quota) of 3.33 million lb (1.51 million 

kg) for the Atlantic migratory group of 


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