[Federal Register Volume 62, Number 233 (Thursday, December 4, 1997)]
[Proposed Rules]
[Pages 64191-64192]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-31610]



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DEPARTMENT OF DEFENSE

Office of the Secretary

32 CFR Part 199

[DoD 6010.8-R]
RIN 0720-AA43


Civilian Health and Medical Program of the Uniformed Services 
(CHAMPUS); Waiver of Collection of Payments Due From Certain Persons 
Unaware of Loss of CHAMPUS Eligibility

AGENCY: Office of the Secretary, DoD.

ACTION: Proposed rule.

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SUMMARY: This proposed rule authorizes the waiver of collection of 
payments due from individuals who lost their CHAMPUS eligibility when 
they became eligible for Medicare Part A, due to disability or end 
stage renal disease.

DATES: Written comments will be accepted until February 2, 1998.

ADDRESSES: Forward comments to the Office of the Assistant Secretary of 
Defense (Health Affairs), 1B657 Pentagon, Washington, DC 20301-1200.

FOR FURTHER INFORMATION CONTACT:
Cynthia P. Speight, Office of Health Services Financing Policy, (703) 
697-8975.

SUPPLEMENTARY INFORMATION: Formerly, under Title 10 United States Code, 
Section 1086(d), a beneficiary lost eligibility for CHAMPUS when he or 
she became eligible for Medicare Part A, including when eligibility was 
due to disability or end stage renal disease. Payments made after the 
beneficiary attained eligibility for Medicare Part A were erroneous 
payments and subject to collection under the Federal Claims Collection 
Act. In 1991, Congress amended 10 U.S.C. 1086(d) to provide that those 
persons eligible for Medicare by reason of disability or end stage 
renal disease who are enrolled in the supplementary medical insurance 
program under Medicare Part B retain eligibility for CHAMPUS, secondary 
to Medicare coverage. Section 743 of the National Defense Authorization 
Act for Fiscal Year 1996, Public Law 104-106, provides authority, 
effective February 10, 1996, to waive the collection of erroneous 
civilian health care benefits from a person under age 65 who lost 
eligibility for civilian care due to eligibility for Medicare as a 
result of disability or end stage renal disease. The period of this 
waiver authority begins January 1, 1967, and ends on the later of July 
1, 1996, or the termination date of any special enrollment Medicare 
period established by law for such person.
    Since most payments made under CHAMPUS are paid directly to 
participating providers of care, and not to the beneficiary, the 
proposed rule also provides for the waiver of collection of such 
payments made to participating providers. These providers are paid 
based on a contractual agreement of benefits by the beneficiaries. If 
the claim for these benefits cannot be paid due to ineligibility of the 
beneficiary, the beneficiary indebtedness to the provider would remain. 
Thus, the authority to relieve disabled CHAMPUS beneficiaries from the 
indebtedness arising from these erroneous payments does not depend upon 
who actually received the payments.

Regulatory Procedures

    Executive Order 12866 requires that a regulatory impact analysis be 
performed on any significant regulatory action, defined as one which 
would have an annual effect on the economy of $100 million or more, or 
have other significant effects.
    The Regulatory Flexibility Act requires that each federal agency 
prepare a regulatory flexibility analysis when the agency issues 
regulations which would have a significant impact on a substantial 
number of small entities. This proposed rule is not significant 
regulatory action under E.O. 12886, nor would it have a significant 
impact on small entities. The changes set forth in the proposed rule 
are minor revisions to the existing regulation. In addition, this 
proposed rule does not impose new information collection requirements 
for purposes of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-
3511). This is a proposed rule. All public comments are invited.

List of Subjects in 32 CFR Part 199

    Claims, Health insurance, Individuals with disabilities, Military 
personnel.

    Accordingly, 32 CFR part 199 is proposed to be amended 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 199.11 is amended as follows:
    a. By revising paragraphs (b)(1) and (g) heading.
    b. By redesignating paragraphs (g)(3), (g)(4), (g)(5), (g)(6), 
(g)(7), (g)(8) and (g)(9) as paragraphs (g)(4), (g)(5), (g)(6), (g)(7), 
(g)(8), (g)(9) and (g)(10), respectively.
    c. By adding paragraph (g)(3) and revising newly redesignated 
paragraph (g)(10).
    The additions and revisions read as follows:


Sec. 199.11  Overpayments recovery.

 * * * * *
    (b) * * *
    (1) Federal statutory authority. The Federal Claims Collection Act 
(31 U.S.C. 3701 et seq.) provides the basic authority under which 
claims may be asserted pursuant to this section. It is implemented by 
joint regulations issued by the Department of Justice and the General 
Accounting Office, 4 CFR parts 101 through 105. Thereunder, the heads 
of federal agencies or their designees are required to attempt 
collection of all claims of the United States for money or property 
arising out of the activities of their respective agencies. These 
officials may, with respect to claims that do not exceed $20,000, 
exclusive of interest, and in conformity with the standards promulgated 
in the joint regulations, compromise, suspend, or terminate collection 
action on such claims. Section 743 of the National Defense 
Authorization Act for Fiscal Year 1996 (Pub. L. 104-106, 110 Stat. 186) 
authorizes the waiver (see paragraph (g)(3) of this section) of 
collection of overpayments otherwise due from a person after the 
termination of the person's CHAMPUS eligibility, because the person 
became eligible for Medicare Part A by reason of disability or end-
stage renal disease.
 * * * * *
    (g) Compromise, waiver, suspension or termination of collection 
actions arisings under the Federal Claims Collection Act.
 * * * * *
    (3) Waiver of collection of erroneous payments due from certain 
persons unaware of loss of CHAMPUS eligibility. (i) The Director, 
OCHAMPUS may waive collection of payments otherwise due from certain 
persons as a result of health benefits received under this Part after 
the termination of the person's eligibility for such benefits. Waiver 
may be granted if collection of such payments would be against equity 
and good conscience and not in the best interest of the United States. 
These criteria are met by a finding that there is no indication of 
fraud, misrepresentation, fault, or lack of good faith on the part of 
the person who received the erroneous payment or any other person 
having an interest in obtaining such waiver.
    (ii) Persons eligible for waiver. The following persons are 
eligible for waiver:

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    (A) A person who:
    (1) Is entitled to Medicare Part A by reason of disability or end 
stage renal disease;
    (2) In the absence of such entitlement, would have been eligible 
for CHAMPUS under section 1086 of title 10, United States Code; and
    (3) At the time of the receipt of such benefits, was under age 65.
    (B) Any participating provider of care who received direct payment 
for care provided to a person described in paragraph (g)(3)(ii)(A) of 
this section pursuant to an assignment of benefits from such person.
    (iii) The authority to waive collection of payments under this 
section shall apply with regard to health benefits provided during the 
period beginning January 1, 1967, and ending on the later of: the 
termination date of any special enrollment period for Medicare Part B 
provided specifically for such persons; or July 1, 1996.
* * * * *
    (10) Effect of compromise, waiver, suspension or termination of 
collection action. Pursuant to the Internal Revenue Code, 26 U.S.C. 
6041, compromises and terminations of undisputed debts not discharged 
in a Title 11 bankruptcy case and totaling $600 or more for the year 
will be reported to the Internal Revenue Service in the manner 
prescribed for inclusion in the debtor's gross income for that year. 
Any action taken under this paragraph (g) regarding the compromise of a 
federal claim, or waiver or suspension or termination of collection 
action on a federal claim is not an initial determination for purposes 
of the appeal procedures of Sec. 199.10.
* * * * * * *
    Dated: November 26, 1997.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 97-31610 Filed 12-3-97; 8:45 am]
BILLING CODE 5000-04-M