30080 Federal Register / Vol. 83, No. 124 / Wednesday, June 27, 2018 / Rules and Regulations 

Dated: June 4, 2018. 

George Sigounas, 

Administrator, Health Resources and Services 

Administration. 

Approved: June 21, 2018. 

Alex M. Azar II, 

Secretary, Department of Health and Human 

Services. 

List of Subjects in 42 CFR Part 5a 

Health care, Health care professionals, 

Public health, Rural health. 

PART 5a—[REMOVED] 

■ For reasons set out in the preamble, 

and under the authority at 5 U.S.C. 301, 

HHS amends 42 CFR chapter I by 

removing part 5a. 

[FR Doc. 2018–13835 Filed 6–26–18; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

42 CFR Part 23 

RIN 0906–AB15 

Removing Outmoded Regulations 

Regarding the National Health Service 

Corps Program 

AGENCY: Health Resources and Services 

Administration (HRSA), HHS. 

ACTION: Final rule. 

SUMMARY: This action removes 

outmoded regulations for the National 

Health Service Corps (NHSC) Program. 

The regulations were promulgated to 

implement Section 338G of the Public 

Health Service (PHS) Act, relating to 

private practice loans. The regulations 

have not been updated since they were 

issued in 1986. The regulations are no 

longer relevant or needed as the NHSC 

has not made private practice loan 

opportunities available since the 1980s, 

and does not plan to do so in the 

foreseeable future. The removal of these 

regulations will not create any 

challenges for other programs, as the 

law and regulations apply solely to 

NHSC clinicians. 

DATES: This action is effective July 27, 

2018. 

FOR FURTHER INFORMATION CONTACT: 

Sweta Maheshwari J.D., Legislative 

Analyst, Division of Policy and Shortage 

Designation, Bureau of Health 

Workforce, HRSA, 5600 Fishers Lane, 

Room 11W21A, Rockville, MD 20857, 

by phone at (301) 945–3527, or by email 

at smaheshwari@hrsa.gov. 

SUPPLEMENTARY INFORMATION: In 

response to Executive Order 13777 and 

Executive Order 13563, Sec. 6(a), which 

direct agencies to repeal existing 

regulations that are ‘‘outmoded’’ from 

the Code of Federal Regulations (CFR), 

HHS is removing 42 CFR part 23, 

subpart B (§§ 23.21 through 23.35) and 

subpart C (§ 23.41). Furthermore, HHS 

has determined that there is good cause 

to bypass notice and comment and 

proceed to a final rule, pursuant to 5 

U.S.C. 553(b)(B). The action is noncontroversial, as it merely removes 

certain provisions from the CFR that are 

obsolete. Given the length of time 

(approximately 30 years) since the 

private practice loan provision has been 

utilized, it is HHS’s assessment that the 

agency is unlikely to receive any 

comments opposing the repeal of these 

regulations. Thus, a comment period 

prior to finalization of this rule is 

unnecessary. This rule poses no new 

substantive requirements or burdens on 

the public. 

Background 

In 1986, HHS issued implementing 

regulations, as directed in Section 338G 

of the PHS Act, specifying the interest 

rate and loan repayment terms for 

private practice special loans to former 

Corps members and interest rate and 

loan repayment terms for private 

practice start-up loans to NHSC 

scholarship recipients. 

The provision for Special Loans for 

Former Corps Members to Enter Private 

Practice authorized the Secretary to 

make a one-time loan up to $25,000 to 

a Corps member. In exchange, the Corps 

member reciprocated by committing to 

serve as a full-time private practice 

provider in a Health Professional 

Shortage Area (HPSA) for a minimum of 

two years. The intent of these 

regulations was to retain Corps members 

in HPSAs after the completion of their 

service obligation. The regulation is no 

longer relevant as the NHSC has not 

made such loan opportunities available 

since the 1980s and, therefore, no longer 

needs to set repayment terms for private 

practice start-up loans. HRSA does not 

intend to restart this loan program, as 

the NHSC program currently has a 

retention rate of 88%, making additional 

incentives unnecessary. 

Section 338G also authorizes Private 

Start-Up Loans. At the time the statute 

was enacted, only the NHSC 

Scholarship Program existed. Scholars 

were able to apply for up to $25,000 to 

purchase or lease the equipment and 

supplies needed for providing health 

services in their private practices. The 

intention of the program was to offer 

further incentives to recruit health 

professions students into the program. 

The regulation is no longer relevant 

since the NHSC has not made such loan 

opportunities available since the 1980s 

and, therefore, no longer has need to set 

repayment terms for private practice 

start-up loans. Furthermore, the NHSC 

Scholarship Program is significantly 

oversubscribed, and no further 

incentives are necessary to recruit 

health professions students. 

Removing these regulations will not 

have an impact on the NHSC program. 

There is no specific appropriations 

authority to support Section 338G of the 

PHS Act; the authorization of 

appropriation at 338H supports all the 

activities under Subpart III (which 

includes the NHSC Loan Repayment 

and Scholarship Programs). The repeal 

of these regulations will not create any 

challenges for other programs, as the 

law and regulations apply solely to 

NHSC clinicians. 

Executive Orders 12866, 13563, 13771, 

and 13777 

Executive Orders 12866 and 13563 

direct agencies to assess all costs and 

benefits of available regulatory 

alternatives and, if regulation is 

necessary, to select regulatory 

approaches that maximize net benefits 

(including potential economic, 

environmental, public health and safety 

effects, distributive impacts, and 

equity). Executive Order 13771 directs 

agencies to categorize all impacts which 

generate or alleviate costs associated 

with regulatory burden and to 

determine the actions net incremnatal 

effect. 

Section 3(f) of Executive Order 12866 

defines a ‘‘significant regulatory action’’ 

as an action that is likely to result in a 

rule: (1) Having an annual effect on the 

economy of $100 million or more in any 

1 year, or adversely and materially 

affecting a sector of the economy, 

productivity, competition, jobs, the 

environment, public health or safety, or 

State, local or Tribal governments or 

communities (also referred to as 

‘‘economically significant’’); (2) creating 

a serious inconsistency or otherwise 

interfering with an action taken or 

planned by another agency; (3) 

materially altering the budgetary 

impacts of entitlement grants, user fees, 

or loan programs or the rights and 

obligations of recipients thereof; or (4) 

raising novel legal or policy issues 

arising out of legal mandates, the 

President’s priorities, or the principles 

set forth in the Executive Order. 

A regulatory impact analysis (RIA) 

must be prepared for major rules with 

economically significant effects ($100 

million or more in any 1 year). HHS 

submits that this final rule is not 

‘‘economically significant’’ as measured 

by the $100 million threshold, and 

hence not a major rule under the 


nshattuck on DSK9F9SC42PROD with RULES
Federal Register / Vol. 83, No. 124 / Wednesday, June 27, 2018 / Rules and Regulations 30081 

Congressional Review Act. This rule has 

not been designated as a ‘‘significant 

regulatory action’’ under Executive 

Order 12866. Accordingly, this rule has 

not been reviewed by the Office of 

Management and Budget (OMB). 

Executive Order 13771, titled 

‘‘Reducing Regulation and Controlling 

Regulatory Costs,’’ was issued on 

January 30, 2017. HHS identifies this 

final rule as a deregulatory action 

(removing an obsolete rule from the 

Code of Federal Regulations). For the 

purposes of Executive Order 13771, this 

final rule is not a substantive rule; 

rather it is administrative in nature and 

provides no cost savings. 

Executive Order 13777, titled 

‘‘Enforcing the Regulatory Reform 

Agenda,’’ was issued on February 24, 

2017. As required by Section 3 of this 

Executive Order, HHS established a 

Regulatory Reform Task Force (HHS 

Task Force). Pursuant to Section 3(d)(ii), 

the HHS Task Force evaluated this 

rulemaking and determined that these 

regulations are ‘‘outdated, unnecessary, 

or ineffective.’’ Following this finding, 

the HHS Task Force advised the HRSA 

Administrator to initiate this 

rulemaking to remove the obsolete 

regulations from the Code of Federal 

Regulations. 

Regulatory Flexibility Act 

This action will not have a significant 

economic impact on a substantial 

number of small entities. Therefore, the 

regulatory flexibility analysis provided 

for under the Regulatory Flexibility Act 

is not required. 

Paperwork Reduction Act 

This action does not affect any 

information collections. 

Dated: June 4, 2018. 

George Sigounas, 

Administrator, Health Resources and Services 

Administration. 

Approved: June 21, 2018. 

Alex M. Azar II, 

Secretary, Department of Health and Human 

Services. 

List of Subjects in 42 CFR Part 23 

Health, Health professions. 

For reasons set out in the preamble, 

and under the authority at 5 U.S.C. 301, 

HHS amends 42 CFR part 23 as follows: 

PART 23—NATIONAL HEALTH 

SERVICE CORPS 

■ 1. The authority citation for part 23 

continues to read as follows: 

Authority: Secs. 333, 338E(c), and 

338C(e)(1), Public Health Service Act. 90 

Stat. 2272, as amended, 95 Stat. 905, 97 Stat. 

1345 (42 U.S.C. 254f et seq.), 95 Stat. 912 (42 

U.S.C. 254p(c)), 95 Stat. 910 (42 U.S.C. 

254n(e)(1)). 

Subparts B and C [Removed] 

■ 2. Remove subpart B, consisting of 

§§ 23.21 through 23.35, and subpart C, 

consisting of § 23.41. 

[FR Doc. 2018–13837 Filed 6–26–18; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

42 CFR Part 130 

RIN 0906–AB13 

Removing Outmoded Regulations 

Regarding the Ricky Ray Hemophilia 

Relief Fund Program 

AGENCY: Health Resources and Services 

Administration, HHS. 

ACTION: Final rule. 

SUMMARY: This action removes the 

outmoded regulations for the Ricky Ray 

Hemophilia Relief Fund Program. The 

program and its implementing 

regulation have been rendered obsolete 

by the statutory language in the 

authorizing legislation stating that the 

Fund should terminate on the 

expiration of the 5-year period 

beginning on the date of the enactment 

of the Act. The statute was enacted on 

November 12, 1998; thus, the fund 

expired on November 12, 2003. 

DATES: This action is effective July 27, 

2018. 

FOR FURTHER INFORMATION CONTACT: 

Sweta Maheshwari J.D., Legislative 

Analyst, Division of Policy and Shortage 

Designation, Bureau of Health 

Workforce, HRSA, 5600 Fishers Lane, 

Room 11W21A, Rockville, MD 20857, 

by phone at (301) 945–3527, or by email 

at smaheshwari@hrsa.gov. 

SUPPLEMENTARY INFORMATION: In 

response to Executive Order 13563, Sec. 

6(a), which urges agencies to repeal 

existing regulations that are outmoded 

from the Code of Federal Regulations 

(CFR), HHS is removing 42 CFR part 

130. HHS believes that there is good 

cause to bypass notice and comment 

and proceed to a final rule, pursuant to 

5 U.S.C. 553(b)(3)(B). The action is noncontroversial, as it merely removes a 

provision from the CFR that is obsolete. 

This rule poses no new substantive 

requirements on the public. 

Background 

The Ricky Ray Hemophilia Relief 

Fund Act of 1998 (Pub. L. 105–369) 

established the Ricky Ray Hemophilia 

Relief Fund Program designed to 

provide payments to individuals with 

blood-clotting disorders, such as 

hemophilia, who contracted HIV 

through the use of antihemophilic factor 

administered between July 1, 1982, and 

December 31, 1987. The Act also 

provided for payments to certain 

persons who contracted HIV from an 

individual as described above and 

certain specified survivors. 

HHS promulgated 42 CFR part 130 to 

establish the proper regulatory 

framework for program implementation. 

The regulation can be conceptualized as 

four parts: The process for payment, the 

documentation required to prove 

eligibility, the petition process, and the 

reconsideration process. The Ricky Ray 

Hemophilia Relief Fund was authorized 

with a directive to pay $100,000 in 

compensation to eligible individuals. At 

that time, however, no funds were 

appropriated to implement this statute. 

In FY 2000, Congress appropriated $75 

million and, in FY 2001, Congress 

appropriated $580 million, for a total of 

$655 million. The appropriated amounts 

provided sufficient funding to make 

compassionate payments on all eligible 

petitions received by the program. The 

program received over 6,000 petitions 

resulting in approved payments over 

$550 million. 

The statutory language in the 

authorizing legislation stated that the 

‘‘Fund shall terminate upon the 

expiration of the 5-year period 

beginning on the date of the enactment 

of this Act.’’ The statute was enacted on 

November 12, 1998; thus, the fund 

expired on November 12, 2003. The 

program is no longer in effect or funded. 

The repeal of this regulation should not 

create any challenges for other 

programs, as the regulation was strictly 

for the implementation of the Ricky Ray 

Hemophilia Relief Fund program, which 

has not been in operation for almost 14 

years. 

Executive Orders 12866, 13563, 13771, 

and 13777 

Executive Orders 12866 and 13563 

direct agencies to assess all costs and 

benefits of available regulatory 

alternatives and, if regulation is 

necessary, to select regulatory 

approaches that maximize net benefits 

(including potential economic, 

environmental, public health and safety 

effects, distributive impacts, and 

equity). Executive Order 13771 directs 

agencies to categorize all impacts which 

generate or alleviate costs associated 

with regulatory burden and to 

determine the actions net incremnatal 

effect. 


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