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. Prices of

new books are listed in the first FEDERAL

REGISTER issue of each week.

Rules and Regulations Federal Register

35259

Vol. 65, No. 107

Friday, June 2, 2000

OFFICE OF PERSONNEL

MANAGEMENT

5 CFR Part 890

RIN 3206 AJ03 (3206 AI63)

Federal Employees Health Benefits

(FEHB) Program and Department of

Defense (DoD) Demonstration Project

AGENCY: Office of Personnel

Management.

ACTION: Final rule.

SUMMARY: OPM is issuing a final

regulation to implement the portion of

the National Defense Authorization Act

for 1999 that establishes authority for a

demonstration project under which

certain Medicare and other eligible DoD

beneficiaries can enroll in health benefit

plans in certain geographic areas under

the Federal Employees Health Benefits

(FEHB) Program. The demonstration

project will run for a period of three

years from January 1, 2000, through

December 31, 2002. This regulation

specifies only the requirements that

differ from existing FEHB Program

regulations because of unique aspects of

the demonstration project.

DATES: The effective date of this

regulation is July 3, 2000.

FOR FURTHER INFORMATION CONTACT:

Michael W. Kaszynski, Policy Analyst,

Insurance Policy and Information

Division, OPM, Room 3425, 1900 E

Street, NW., Washington, DC 20415–

0001. He can also be reached at (202)

606–0004 or by electronic mail (E-mail)

at: mwkaszyn@opm.gov.

SUPPLEMENTARY INFORMATION: The

purpose of this regulation is to

implement the portion of the National

Defense Authorization Act for 1999,

Public Law 105–261, that amended

chapter 55 of title 10, United States

Code, and chapter 89 of title 5, United

States Code, to establish a

demonstration project under which

certain Medicare and other eligible DoD

beneficiaries can enroll in health benefit

plans offered under the FEHB Program.

The legislation was signed into law on

October 17, 1998. The demonstration

project will run for a period of three

years from January 1, 2000, through

December 31, 2002. DoD, with OPM

concurrence, has selected eight

geographic areas to serve as

demonstration areas. The legislation

requires that between 6 and 10

geographic areas be selected. No more

than 66,000 individuals can participate

in the demonstration project at any one

time. Beneficiaries who are provided

coverage under the demonstration

project will not be eligible to receive

care at a military medical treatment

facility or to enroll in a health care plan

under DoD’s TRICARE program.

Individuals who disenroll or cancel

enrollment from the demonstration

project are not eligible to reenroll in the

demonstration project. OPM will

establish separate risk pools for

developing demonstration project

enrollee premium rates. The

government contribution for

demonstration enrollees will be paid by

DoD and cannot exceed the maximum

percentage or dollar amount that the

government would have contributed

had the enrollee been enrolled as a

regular FEHB enrollee in the same

health benefits plan and at the same

level of benefits.

The legislation requires OPM and

DoD to jointly produce and submit two

reports to Congress designed to assess

the viability of expanding access to the

FEHB Program to certain Medicare and

other eligible DoD beneficiaries

permanently. The first report is due by

April 1, 2001; the second is due by

December 31, 2002. The reports will

focus on enrollee participation levels,

impact on Medicare Part B enrollment,

premium rates and costs as compared to

those for regular FEHB enrollees, impact

on accessibility of care in military

treatment facilities, impact on medical

readiness and training in military

treatment facilities, impact on the cost,

accessibility, and availability of

prescription drugs for DoD beneficiaries,

and recommendations on eligibility and

enrollment.

OPM has determined it necessary to

specify certain differences from existing

FEHB Program regulations because of

the unique features of the demonstration

project. This regulation amends Part 890

of title 5, Code of Federal Regulations

(CFR) to authorize these differences.

Should the program be extended beyond

the three year demonstration project

period, we will regulate to address any

necessary changes to these provisions.

On July 6,1999, OPM published an

interim regulation in the Federal

Register (64 FR 36237). OPM

subsequently received one comment

from a trade association representing

FEHB fee-for-service/PPO plans. The

commenter indicated that the regulation

does not address whether FEHB carriers

must issue certificates of creditable

coverage required under the Health

Insurance Portability and

Accountability Act (HIPAA) and asked

if this was required under the

demonstration project. The regulation is

intended to change normal FEHB

Program practice where specifically

indicated. It is not intended to affect

practices that have not been specifically

addressed. Therefore, carriers must

issue certificates of creditable coverage

to meet the requirements of HIPAA for

demonstration project enrollees the

same as they do for regular FEHB

Program enrollees.

Other minor clarifying changes have

been made to the regulation.

Regulatory Flexibility Act

I certify that this regulation will not

have a significant economic impact on

a substantial number of small entities

because the regulation will only affect

health insurance carriers under the

Federal Employees Health Benefits

Program.

Executive Order 12866, Regulatory

Review

This rule has been reviewed by the

Office of Management and Budget in

accordance with Executive Order 12866.

List of Subjects in 5 CFR Part 890

Administrative practice and

procedure, Government employees,

Health facilities, Health insurance,

Health professionals, Hostages, Iraq,

Kuwait, Lebanon, Reporting and record

keeping requirements, Retirement.

Office of Personnel Management.

Janice R. Lachance,

Director.

For the reasons set forth in the

preamble, OPM is amending 5 CFR part

890 as follows:

35260 Federal Register / Vol. 65, No. 107 / Friday, June 2, 2000 / Rules and Regulations

PART 890—FEDERAL EMPLOYEES

HEALTH BENEFITS PROGRAM

1. The authority citation for part 890

is revised to read as follows:

Authority: 5 U.S.C. 8913; § 890.803 also

issued under 50 U.S.C. 403p, 22 U.S.C. 4069c

and 4069c–1; subpart L also issued under

sec. 599C of Pub. L. 101–513, 104 Stat. 2064,

as amended; § 890.102 also issued under

sections 11202(f), 11232(e), 11246 (b) and (c)

of Pub. L. 105–33, 111 Stat. 251; and section

721 of Pub. L. 105–261, 112 Stat. 2061.

PART 890—FEDERAL EMPLOYEES

HEALTH BENEFITS PROGRAM

2. A new Subpart M is revised to read

as follows:

Subpart M—Department of Defense Federal

Employees Health Benefits Program

Demonstration Project

Sec.

890.1301 Purpose.

890.1302 Duration.

890.1303 Eligibility.

890.1304 Enrollment.

890.1305 Termination and cancellation.

890.1306 Government premium

contributions.

890.1307 Data collection.

890.1308 Carrier participation.

Subpart M—Department of Defense

Federal Employees Health Benefits

Program Demonstration Project

§ 890.1301 Purpose.

The purpose of this subpart is to

implement section 721 of the National

Defense Authorization Act for 1999,

Public Law 105–261. This section

amended chapter 55 of title 10, United

States Code, and chapter 89 of title 5,

United States Code, to establish a

demonstration project under which

certain Medicare and other eligible

Department of Defense (DoD)

beneficiaries can enroll in health benefit

plans offered under the Federal

Employees Health Benefits (FEHB)

Program in certain geographic areas.

The legislation was signed into law on

October 17, 1998. The demonstration

project will run for a period of three

years. The legislation requires the Office

of Personnel Management (OPM) and

DoD to jointly produce and submit two

reports to Congress designed to assess

the viability of expanding access to the

FEHB Program to certain Medicare and

other eligible DoD beneficiaries

permanently. OPM is authorizing

certain differences from regular FEHB

Program practices in order to ensure the

successful implementation of the

demonstration project. This regulation

authorizes those differences.

§ 890.1302 Duration.

The demonstration project will run

from January 1, 2000, through December

31, 2002.

§ 890.1303 Eligibility.

(a) To enroll in the demonstration

project, an individual must live within

one of the demonstration areas and meet

the definition of an eligible beneficiary

in 10 U.S.C. 1108(b). An eligible

beneficiary under this subpart is—

(1) A member or former member of

the uniformed services described in

section 1074(b) of title 10, United States

Code, who is entitled to hospital

insurance benefits under part A of title

XVIII of the Social Security Act (42

U.S.C. 1395c et seq.);

(2) An individual who is an

unremarried former spouse of a member

or former member described in section

1072(2)(F) or section 1072(2)(G) of title

10, United States Code;

(3) An individual who is—

(i) A dependent of a deceased member

or former member described in section

1076(b) or 1076(a)(2)(B) of title 10,

United States Code, or of a member who

died while on active duty for a period

of more than 30 days; and

(ii) A ‘‘member of family’’ as defined

in section 8901(5) of title 5, United

States Code; or

(4) An individual who is—

(i) A dependent of a living member or

former member described in section

1076(b)(1) of title 10, United States

Code, who is entitled to hospital

insurance benefits under part A of title

XVIII of the Social Security Act,

regardless of the member’s or former

member’s eligibility for such hospital

insurance benefits; and

(ii) A ‘‘member of family’’ as defined

in section 8901(5) of title 5, United

States Code.

(b) An eligible beneficiary may enroll

in an FEHB plan under chapter 89 of

title 5, United States Code, for self-only

coverage or for self and family coverage.

A self and family enrollment will

include coverage of a dependent of the

military member or former member who

meets the definition of a ‘‘member of

family’’ in section 8901(5) of title 5,

United States Code. A self and family

enrollment will not cover a person

related to the eligible beneficiary that

does not qualify as a ‘‘member of

family’’ (as defined in section 8901(5) of

title 5, United States Code) of the

military member or former member.

(c) A person eligible for coverage

under this subpart shall not be required

to satisfy any eligibility criteria

specified in chapter 89 of title 5, United

States Code, or in other subparts of this

part (except as provided in paragraphs

(a)(3), (a)(4), and (b) of this section) as

a condition for enrollment in health

benefit plans offered through the FEHB

Program under the demonstration

project.

(d) When determining whether an

individual is a ‘‘member of family’’

under section 8901(5) of title 5, United

States Code, for purposes of paragraph

(a)(3) and (a)(4) of this section, a DoD

member or former member described in

section 1076(b) or 1076(a)(2)(B) of title

10, United States Code, shall be deemed

to be an employee under chapter 89 of

title 5, United States Code. The sole

purpose for deeming these members or

former members of the uniformed

services employees under chapter 89 of

title 5, United States Code, is to

determine which of their dependents

can enroll as eligible beneficiaries in the

demonstration project.

(e) A person who is eligible to enroll

in the FEHB Program as an employee as

defined in section 8901(1) of title 5,

United States Code, is not eligible to

enroll in an FEHB plan under the

demonstration project.

§ 890.1304 Enrollment.

(a) Open Season for eligible

beneficiaries will be held concurrent

with the Open Season for regular FEHB

enrollees. Open Seasons will be held in

the years 1999, 2000 and 2001. Eligible

beneficiaries will be able to enroll for

coverage, change enrollment tiers (e.g.,

self-only or self and family), or change

health benefit plans or plan options

during these periods.

(b) Enrolled eligible beneficiaries are

required to pay associate membership

dues if they enroll in open employee

organization sponsored plans that are

participating in the demonstration

project.

(c) DoD will deny enrollment of

eligible beneficiaries when the total

number of eligible beneficiaries and

family members enrolled in the

demonstration project reaches 66,000.

(d) Eligible beneficiaries can enroll

only in health plans offered by health

benefit carriers who are participating in

the demonstration project.

(e) Eligible beneficiaries and family

members enrolled in the demonstration

project are not eligible to obtain services

from military medical treatment

facilities or to enroll in a health care

plan under the TRICARE Program.

(f) An eligible beneficiary enrolled in

an FEHB plan under the demonstration

project may change health benefits

plans and coverage in the same manner

as any other FEHB Program enrollee,

except as provided for in this subpart.

Federal Register / Vol. 65, No. 107 / Friday, June 2, 2000 / Rules and Regulations 35261

§ 890.1305 Termination and cancellation.

(a) If an enrolled eligible beneficiary

moves out of a demonstration area, the

enrollment of the eligible beneficiary

and all family members will be

terminated. If an enrolled eligible

beneficiary moves to an area located

within a demonstration area, he or she

will continue to be eligible to

participate in the demonstration project.

If the eligible beneficiary was enrolled

prior to the move in an HMO that does

not serve the new demonstration area,

the eligible beneficiary will have an

opportunity to select a new health plan

offered by a carrier participating in the

demonstration project in the new area.

If the eligible beneficiary was enrolled

in a fee-for-service plan prior to the

move and moves to another area that is

within an existing demonstration area,

the eligible beneficiary can maintain his

or her current coverage.

(b) If an enrolled eligible beneficiary

disenrolls, cancels, or terminates

enrollment for any reason, he or she will

not be eligible to reenroll in the

demonstration project. Once coverage

ends, eligible beneficiaries and all

family members have the right to

resume all of the benefits to which they

are entitled to under title 10 of the

United States Code. Medicare-covered

eligible beneficiaries and their eligible

family members who had Medigap

policies prior to their enrollment in the

demonstration project are entitled to

reinstate that coverage under the

conditions stated in section 1108(l) of

title 10, United States Code.

(c) Eligible beneficiaries and their

family members are eligible for

Temporary Continuation of Coverage

(TCC) under the conditions and for the

durations described in subpart K or

until the end of the demonstration

project, whichever occurs first. The

effective date of TCC for eligible

beneficiaries or their eligible family

members will be the day after other

coverage under this subpart ends.

Eligible beneficiaries or their eligible

family members selecting TCC must

enroll in a health plan offered by a

carrier participating in the

demonstration project. If an eligible

beneficiary or eligible family member

enrolled in DoD TCC moves from a

demonstration project area, coverage

ends. DoD TCC enrollees will be

responsible for paying the entire DoD

premium rate (OPM’s approved net-tocarrier DoD rate plus 4 percent for

contingency and administration

reserves) plus 2 percent of this premium

rate for administration of the program.

DoD will make arrangements to collect

premiums plus the 2 percent

administrative charge from eligible

beneficiaries and forward them to

OPM’s Employees Health Benefits Fund.

OPM will establish procedures for

receiving the 2 percent administrative

payment into the Employees Health

Benefits Fund and making this amount

available to DoD for administration of

the program.

(d) Enrolled eligible beneficiaries are

not eligible for the temporary extension

of coverage and conversion

opportunities described in subpart D of

this part.

§ 890.1306 Government premium

contributions.

The Secretary of Defense is

responsible for the government

contribution for enrolled eligible

beneficiaries and family members. The

government contribution toward

demonstration project premium rates

will be determined in accordance with

subpart E of this part.

§ 890.1307 Data collection.

Each carrier will compile, maintain,

and when requested by OPM or DoD,

report data on its plan’s experience

necessary to produce reports containing

the following information and analysis:

(a) The number of eligible

beneficiaries who elect to participate in

the demonstration project.

(b) The number of eligible

beneficiaries who elected to participate

in the demonstration project and did not

have Medicare Part B coverage before

electing to participate.

(c) The costs of health benefits

charges and the costs (direct and

indirect) of administering the benefits

and services provided to eligible

beneficiaries who elect to participate in

the demonstration project as compared

to similarly situated enrollees in the

FEHB Program.

(d) Prescription drug costs for

demonstration project beneficiaries.

§ 890.1308 Carrier participation.

(a) All carriers who participate in the

FEHB Program and provide benefits to

enrollees in the geographic areas

selected as demonstration project areas

must participate in the demonstration

project, except as provided for in

paragraphs (b), (c), and (d) of this

section.

(b) Carriers who have less than 300

FEHB enrollees may, but are not

required to, participate in the

demonstration project.

(c) Carriers may, but are not required

to, participate in the demonstration

project if their service area overlaps a

small portion (as determined by OPM)

of a demonstration project geographic

area.

(d) Carriers offering fee-for-service

plans with enrollment limited to

specific groups will not participate in

the demonstration project.

[FR Doc. 00–13850 Filed 6–1–00; 8:45 am]

BILLING CODE 6325–01–U

DEPARTMENT OF AGRICULTURE

Animal and Plant Health Inspection

Service

7 CFR Part 301

[Docket No. 00–034–1]

Plum Pox

AGENCY: Animal and Plant Health

Inspection Service, USDA.

ACTION: Interim rule and request for

comments.

SUMMARY: We are quarantining part of

Adams County, PA, due to the detection

of plum pox in that region and are

restricting the interstate movement of

certain articles from the quarantined

area that present a risk of transmitting

plum pox. This action is necessary on

an emergency basis to prevent the

spread of plum pox to noninfested areas

of the United States.

DATES: This interim rule is effective on

June 2, 2000. We invite you to comment

on this docket. We will consider all

comments that we receive by August 1,

2000.

ADDRESSES: Please send your comment

and three copies to: Docket No. 00–034–

1 Regulatory Analysis and

Development, PPD, APHIS, Suite 3C03,

4700 River Road, Unit 118, Riverdale,

MD 20737–1238.

Please state that your comment refers

to Docket No. 00–034–1.

You may read any comments that we

receive on this docket in our reading

room. The reading room is located in

room 1141 of the USDA South Building,

14th Street and Independence Avenue,

SW., Washington, DC. Normal reading

room hours are 8 a.m. to 4:30 p.m.,

Monday through Friday, except

holidays. To be sure someone is there to

help you, please call (202) 690–2817

before coming.

APHIS documents published in the

Federal Register, and related

information, including the names of

organizations and individuals who have

commented on APHIS dockets, are

available on the Internet at http://

www.aphis.usda.gov/ppd/rad/

webrepor.html.

FOR FURTHER INFORMATION CONTACT: Mr.

Stephen Poe, Operations Officer, USDA,