52272 Federal Register / Vol. 76, No. 162 / Monday, August 22, 2011 / Rules and Regulations 

the HEOA. That document inadvertently 

included minor technical errors in the 

amendments to 34 CFR part 668. This 

document corrects the final regulations. 

DATES: August 22, 2011. 

FOR FURTHER INFORMATION CONTACT: 

Marty Guthrie, U.S. Department of 

Education, 1990 K Street, NW., room 

8042, Washington, DC 20006–8502. 

Telephone: (202) 219–7031 or via the 

Internet at: Marty.Guthrie@ed.gov. 

If you use a telecommunications 

device for the deaf (TDD), call the 

Federal Relay Service (FRS), toll free, at 

1–800–877–8339. 

Individuals with disabilities can 

obtain this document in an accessible 

format (e.g., braille, large print, 

audiotape, or compact disc) on request 

to the contact person listed in this 

section. 

SUPPLEMENTARY INFORMATION: This 

document corrects minor technical 

errors included in the final regulations 

which were published in the Federal 

Register on October 28, 2009 (74 FR 

55626). 

Electronic Access to This Document: 

The official version of this document is 

the document published in the Federal 

Register. Free Internet access to the 

official edition of the Federal Register 

and the Code of Federal Regulations is 

available via the Federal Digital System 

at: http://www.gpo.gov/fdsys. At this 

site you can view this document, as well 

as all other documents of this 

Department published in the Federal 

Register, in text or Adobe Portable 

Document Format (PDF). To use PDF 

you must have Adobe Acrobat Reader, 

which is available free at the site. 

You may also access documents of the 

Department published in the Federal 

Register by using the article search 

feature at: http:// 

www.federalregister.gov. Specifically, 

through the advanced search feature at 

this site, you can limit your search to 

documents published by the 

Department. 

List of Subjects in 34 CFR Part 668 

Administrative practice and 

procedure, Colleges and universities, 

Consumer protection, Education, Loan 

programs—education, Reporting and 

recordkeeping requirements, Student 

aid. 

Accordingly, 34 CFR part 668 is 

corrected by making the following 

correcting amendments: 

PART 668—STUDENT ASSISTANCE 

GENERAL PROVISIONS 

■ 1. The authority citation for part 668 

continues to read as follows: 

Authority: 20 U.S.C. 1001, 1002, 1003, 

1070g, 1085, 1088, 1091, 1092, 1094, 1099c, 

and 1099c–1, unless otherwise noted. 

§ 668.16 [Corrected] 

■ 2. In § 668.16(m)(2)(iv), add the word 

‘‘will’’ after the word ‘‘we’’. 

§ 668.213 [Corrected] 

■ 3. In § 668.213— 

■ A. In paragraph (g)(1), add the words 

‘‘or of a rate described in paragraph 

(a)(2) of this section’’ after the words 

‘‘you receive the notice of your loss of 

eligibility’’. 

■ B. In paragraph (g)(2), add the words 

‘‘or of a rate described in paragraph 

(a)(2) of this section’’ after the words 

‘‘you receive the notice of your loss of 

eligibility’’. 

(Catalog of Federal Domestic Assistance 

Numbers: 84.032 Federal Family Education 

Loan Program; 84.038 Federal Perkins Loan 

Program; 84.268 William D. Ford Federal 

Direct Loan Program.) 

Dated: August 17, 2011. 

Eduardo M. Ochoa, 

Assistant Secretary for Postsecondary 

Education. 

[FR Doc. 2011–21356 Filed 8–19–11; 8:45 am] 

BILLING CODE 4000–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Part 17 

RIN 2900–AN85 

Technical Revisions To Conform to the 

Caregivers and Veterans Omnibus 

Health Services Act of 2010 

AGENCY: Department of Veterans Affairs. 

ACTION: Final rule. 

SUMMARY: This final rule amends 

Department of Veterans Affairs (VA) 

medical regulations to incorporate 

statutory amendments. Certain statutes 

authorizing VA health care benefits 

were amended by the Caregivers and 

Veterans Omnibus Health Services Act 

of 2010. The statutory amendments 

affect enrollment in certain health care 

priority categories and exempt 

catastrophically disabled veterans from 

copayment requirements. 

DATES: Effective Date: This final rule is 

effective August 22, 2011. 

FOR FURTHER INFORMATION CONTACT: 

Roscoe Butler, Deputy Director, 

Business Policy, Chief Business Office 

(163), Veterans Health Administration, 

Department of Veterans Affairs, 810 

Vermont Avenue, NW., Washington, DC 

20420, (202) 461–1586. (This is not a 

toll free number). 

SUPPLEMENTARY INFORMATION: This 

document amends 38 CFR part 17 to 

conform certain sections with statutory 

amendments made by sections 511 

through 513 of the Caregivers and 

Veterans Omnibus Health Services Act 

of 2010 (the Act), Public Law 163–111. 

Sections 512 and 513 of the Act 

amended statutory provisions affecting 

the enrollment of veterans in the VA 

health care system. VA’s enrollment 

regulation, 38 CFR 17.36, must be 

revised accordingly. 

First, section 512 of the Act amended 

38 U.S.C. 1705(a)(3) to add ‘‘veterans 

who were awarded the [M]edal of 

[H]onor under [10 U.S.C.] 3741, 6241 or 

8741 or [14 U.S.C.] 491’’ to the list of 

veterans included in enrollment priority 

category three. Accordingly, we have 

revised 38 CFR 17.36(b)(3), our 

regulation implementing enrollment 

priority category three, consistent with 

the amendment of section 1705 . 

Second, section 513 of the Act 

amended 38 U.S.C. 1710(e) to prescribe 

August 2, 1990, through November 11, 

1998, as the specific period of time for 

enrollment eligibility based on active 

duty service in the Southwest Asia 

theater of operations during the Gulf 

War. Consistent with the statutory 

amendment, we are amending 

§ 17.36(a)(3) and (b)(6) to include those 

specific dates. 

Third, section 511 of the Act amended 

title 38, United States Code (U.S.C.), to 

add section 1730A, which reads as 

follows: ‘‘Notwithstanding subsections 

(f) and (g) of [38 U.S.C. 1710 and 

1722A(a)] or any other provision of law, 

the Secretary may not require a veteran 

who is catastrophically disabled, as 

defined by the Secretary, to make any 

copayment for the receipt of hospital 

care or medical services under the laws 

administered by the Secretary.’’ In 

current 38 CFR 17.108(d), VA exempts 

10 classes of veterans from the 

copayment requirements for inpatient 

hospital care or outpatient medical care. 

In current 38 CFR 17.110(c), we exempt 

8 classes of veterans from copayment 

requirements for medication. Finally, in 

current 38 CFR 17.111(f), we exempt 7 

classes of veterans from payment 

requirements for extended care services. 

Consistent with section 1730A, we are 

amending each of these regulations to 

add the new exemption for 

catastrophically disabled veterans. 

Regarding the copayment exemption 

for extended care services, we note that 

under section 1730A, VA may exempt 

copayments for extended care services 

that are considered hospital care or 

medical services. In 38 U.S.C. 

1701(6)(E), Congress defined ‘‘medical 

services’’ as including 

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Federal Register / Vol. 76, No. 162 / Monday, August 22, 2011 / Rules and Regulations 52273 

‘‘[n]oninstitutional extended care 

services, including alternatives to 

institutional extended care that the 

Secretary may furnish directly, by 

contract, or through provision of case 

management by another provider or 

payer.’’ VA has long defined 

‘‘noninstitutional’’ as ‘‘a service that 

does not include an overnight stay.’’ We 

assume that Congress was aware of 

these definitions and intended that we 

would interpret section 1730A 

consistent with them. Accordingly, we 

interpret section 1730A as exempting 

catastrophically disabled veterans from 

copayments charged for adult day 

health care, non-institutional geriatric 

evaluation, and non-institutional respite 

care, as described in current 38 CFR 

17.111. These are the only extended 

care services listed in § 17.111 that do 

not require an overnight stay. 

Copayments for all other extended care 

services still apply (including Nursing 

Home Care). 

We note that VA provides a number 

of additional extended care services not 

listed in current 38 CFR 17.111. These 

services include, homemaker/home 

health aide, purchased skilled home 

care, home based primary care, and any 

other noninstitutional alternative 

extended care services. Despite not 

being listed under current § 17.111, the 

copayment exemption will apply to 

these services because VA considers 

them ‘‘medical services’’ under the 

definition in section 1701(6)(E). 

Catastrophically disabled veterans will 

be exempt from copayments for such 

services under new § 17.108(d)(11). 

Current § 17.36(e) defines 

‘‘catastrophically disabled’’ to mean ‘‘a 

permanent severely disabling injury, 

disorder, or disease that compromises 

the ability to carry out the activities of 

daily living to such a degree that the 

individual requires personal or 

mechanical assistance to leave home or 

bed or requires constant supervision to 

avoid physical harm to self or others.’’ 

This is the only definition of the term 

in VA’s medical regulations. Although 

§ 17.36(e) applies to enrollment, in 

section 1730A, Congress prescribed the 

exemptions for any catastrophically 

disabled veteran, ‘‘as defined by the 

Secretary.’’ We interpret section 1730A 

as requiring application of VA’s current 

regulation defining the term. We note 

that there is no legislative history 

suggesting that Congress intended a 

different definition of the term for 

purposes of copayment exemptions. 

Rather, it is reasonable to conclude that 

Congress intended to liberalize the 

benefits for certain veterans enrolled by 

VA under § 17.36(e). Thus, consistent 

with our interpretation of section 

1730A, we have explicitly incorporated 

the current definition of 

‘‘catastrophically disabled’’ in 38 CFR 

17.108(d)(11). 

Administrative Procedure Act 

This final rule incorporates statutory 

provisions or interprets those 

provisions. Therefore, in accordance 

with 5 U.S.C. 553(b)(A), the provisions 

of the Administrative Procedure Act 

(APA) regarding notice of proposed 

rulemaking and opportunities for public 

participation are not applicable. 

Further, pursuant to section 553(d)(2), 

this final rule is exempt from the APA’s 

30-day delayed effective date 

requirement. 

Executive Order 12866 

Executive Order 12866 directs 

agencies to assess all costs and benefits 

of available regulatory alternatives and, 

when regulation is necessary, to select 

regulatory approaches that maximize 

net benefits (including potential 

economic, environmental, public health 

and safety, and other advantages; 

distributive impacts; and equity). The 

Executive Order classifies a regulatory 

action as a ‘‘significant regulatory 

action,’’ requiring review by the Office 

of Management and Budget (OMB) 

unless OMB waives such review, if it is 

a regulatory action that is likely to result 

in a rule that may: (1) Have an annual 

effect on the economy of $100 million 

or more or adversely affect in a material 

way the economy, a sector of the 

economy, productivity, competition, 

jobs, the environment, public health or 

safety, or state, local, or Tribal 

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 the Executive 

Order. 

The economic, interagency, 

budgetary, legal, and policy 

implications of this final rule have been 

examined and it has been determined 

not to be a significant regulatory action 

under Executive Order 12866. 

Unfunded Mandates 

The Unfunded Mandates Reform Act 

of 1995 requires, at 2 U.S.C. 1532, that 

agencies prepare an assessment of 

anticipated costs and benefits before 

issuing any rule that may result in 

expenditure by state, local, or Tribal 

governments, in the aggregate, or by the 

private sector, of $100 million or more 

(adjusted annually for inflation) in any 

given year. This final rule would have 

no such effect on state, local, or Tribal 

governments, or on the private sector. 

Paperwork Reduction Act 

This final rule does not contain any 

collections of information under the 

Paperwork Reduction Act (44 U.S.C. 

3501–3520). 

Regulatory Flexibility Act 

The Secretary hereby certifies that 

this final rule will not have a significant 

economic impact on a substantial 

number of small entities as they are 

defined in the Regulatory Flexibility 

Act, 5 U.S.C. 601–612. This rule will not 

cause a significant economic impact on 

health care providers, suppliers, or 

entities since only a small portion of the 

business of such entities concerns VA 

beneficiaries. Therefore, pursuant to 5 

U.S.C. 605(b), this rule is exempt from 

the initial and final regulatory flexibility 

analysis requirements of §§ 603 and 604. 

Catalog of Federal Domestic Assistance 

Numbers 

The Catalog of Federal Domestic 

Assistance numbers and titles are 

64.009 Veterans Medical Care Benefits, 

64.010 Veterans Nursing Home Care, 

and 64.011 Veterans Dental Care. 

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. John 

R. Gingrich, Chief of Staff, Department 

of Veterans Affairs, approved this 

document on July 6, 2011, for 

publication. 

List of Subjects in 38 CFR Part 17 

Administrative practice and 

procedure, Alcohol abuse, Alcoholism, 

Claims, Day care, Dental health, Drug 

abuse, Foreign relations, Government 

contracts, Grant programs-health, 

Government programs-veterans, Health 

care, Health facilities, Health 

professions, Health records, Homeless, 

Medical and dental schools, Medical 

devices, Medical research, Mental 

health programs, Nursing home care, 

Veterans. 

Dated: August 16, 2011. 

Robert C. McFetridge, 

Director of Regulation Policy and 

Management, Office of the General Counsel, 

Department of Veterans Affairs. 

For the reasons stated in the 

preamble, the Department of Veterans 

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52274 Federal Register / Vol. 76, No. 162 / Monday, August 22, 2011 / Rules and Regulations 

Affairs amends 38 CFR part 17 as 

follows: 

PART 17—MEDICAL 

■ 1. The authority citation for Part 17 

continues to read as follows: 

Authority: 38 U.S.C. 501, and as noted in 

specific sections. 

■ 2. Amend § 17.36 by: 

■ a. In paragraph (a)(3), removing ‘‘, or 

any’’ and adding, in its place, ‘‘(the 

period between August 2, 1990, and 

November 11, 1998), or any’’. 

■ b. In paragraph (b)(3), removing 

‘‘Purple Heart’’ and adding, in its place, 

‘‘Medal of Honor or Purple Heart’’. 

■ c. In paragraph (b)(6), removing ‘‘, or 

for any’’ and adding, in its place, ‘‘(the 

period between August 2, 1990, and 

November 11, 1998), or for any’’. 

■ 3. Amend § 17.108 by: 

■ a. In paragraphs (d)(1) through (8), 

removing the semicolons at the end of 

each paragraph and adding, in each 

place, a period. 

■ b. In paragraph (d)(9), removing ‘‘; or’’ 

at the end of the paragraph and adding, 

in its place, a period; 

■ c. Adding paragraph (d)(11). 

■ d. Revising the authority citation at 

the end of the section. 

The addition and revision read as 

follows: 

§ 17.108 Copayments for inpatient hospital 

care and outpatient medical care. 

* * * * * 

(d) * * * 

(11) A veteran who VA determines to 

be catastrophically disabled, as defined 

in 38 CFR 17.36(e). 

* * * * * 

(Authority: 38 U.S.C. 501, 1710, 1730A) 

■ 4. Amend § 17.110 by: 

■ a. In paragraphs (c)(1) through (6), 

removing the semicolons at the end of 

each paragraph and adding, in each 

place, a period. 

■ b. In paragraph (c)(7), removing ‘‘; 

and’’ and adding, in its place, a period. 

■ c. Adding paragraph (c)(9). 

■ d. Revising the authority citation at 

the end of the section. 

The addition and revision read as 

follows: 

§ 17.110 Copayments for medication. 

* * * * * 

(c) * * * 

(9) A veteran who VA determines to 

be catastrophically disabled, as defined 

in 38 CFR 17.36(e). 

(Authority: 38 U.S.C. 501, 1710, 1720D, 

1722A, 1730A) 

■ 5. Amend § 17.111 by: 

■ a. In paragraphs (f)(1) through (f)(5), 

removing the semicolons at the end of 

each paragraph and adding, in each 

place a period. 

■ b. In paragraph (f)(6), removing ‘‘; or’’ 

and adding, in its place, a period. 

■ c. Adding paragraph (f)(8). 

The addition reads as follows: 

§ 17.111 Copayments for extended care 

services. 

* * * * * 

(f) * * * 

(8) A veteran who VA determines to 

be catastrophically disabled, as defined 

in 38 CFR 17.36(e), is exempt from 

copayments for adult day health care, 

non-institutional respite care, and noninstitutional geriatric care. 

* * * * * 

[FR Doc. 2011–21291 Filed 8–19–11; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Part 51 

RIN 2900–AN96 

Expansion of State Home Care for 

Parents of a Child Who Died While 

Serving in the Armed Forces 

AGENCY: Department of Veterans Affairs. 

ACTION: Final rule. 

SUMMARY: This document amends 

Department of Veterans Affairs (VA) 

regulations concerning the payment of 

per diem to a State for providing 

nursing home care to eligible veterans. 

The amendments remove a restriction 

on VA’s payment of per diem, which 

required all non-veteran residents of a 

State home to be spouses of veterans, or 

parents of veterans all of whose children 

died while serving in the Armed Forces 

of the United States. Under this final 

rule, non-veteran residents of the State 

home must be spouses of veterans, or 

parents of veterans any of whose 

children died while serving in the 

Armed Forces. 

DATES: Effective Date: This final rule is 

effective August 22, 2011. 

FOR FURTHER INFORMATION CONTACT: 

Nancy Quest, Chief, State Veterans 

Home Clinical & Survey Oversight, 

Geriatrics and Extended Care Services 

(114), Veterans Health Administration, 

Department of Veterans Affairs, 810 

Vermont Avenue, NW., Washington, DC 

20420, (202) 461–6064. (This is not a 

toll free number.) 

SUPPLEMENTARY INFORMATION: Under 

current 38 CFR 51.210(d), VA pays per 

diem to a State for providing nursing 

home care to eligible veterans in a State 

home if, among other things, all nonveteran residents of the home are 

spouses of veterans or parents of 

veterans all of whose children died 

while serving in the Armed Forces of 

the United States. In Public Law 111– 

246, Congress mandated that VA 

administer § 51.210(d) to permit a State 

home to provide services to ‘‘a nonveteran any of whose children died 

while serving in the Armed Forces.’’ 

This final rule implements Public Law 

111–246 by amending § 51.210(d) to 

incorporate the language mandated by 

Congress. As amended, § 51.210(d) 

allows States to admit parents, ‘‘any’’ of 

whose children died while serving in 

the Armed Forces, to State homes 

without affecting VA per diem 

payments to States for care provided to 

veterans. 

Effect of Rulemaking 

Title 38, Code of Federal Regulations, 

as revised by this final rule, represents 

VA’s implementation of its exclusive 

legal authority on this subject. Other 

than future amendments to this 

regulation or governing statute or public 

law, no contrary rules or procedures are 

authorized. All existing or subsequent 

VA guidance must be read to conform 

with this rulemaking if possible or, if 

not possible, such guidance is 

superseded by this rulemaking. 

Administrative Procedure Act 

These amendments incorporate a 

specific program requirement mandated 

by Congress. Accordingly, this rule is 

exempt from the prior notice-andcomment and delayed-effective-date 

requirements of 5 U.S.C. 553. 

Executive Order 12866 

Executive Order 12866 directs 

agencies to assess all costs and benefits 

of available regulatory alternatives and, 

when regulation is necessary, to select 

regulatory approaches that maximize 

net benefits (including potential 

economic, environmental, public health 

and safety, and other advantages; 

distributive impacts; and equity). The 

Executive Order classifies a regulatory 

action as a ‘‘significant regulatory 

action,’’ requiring review by the Office 

of Management and Budget (OMB) 

unless OMB waives such review, if it is 

a regulatory action that is likely to result 

in a rule that may: (1) Have an annual 

effect on the economy of $100 million 

or more or adversely affect in a material 

way the economy, a sector of the 

economy, productivity, competition, 

jobs, the environment, public health or 

safety, or State, local, or Tribal 

governments or communities; (2) create 

a serious inconsistency or otherwise 

interfere with an action taken or 

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