90120 Federal Register / Vol. 88, No. 249 / Friday, December 29, 2023 / Rules and Regulations 

(d) Each contract shall include a 

schedule for rate requests and describe 

the information necessary to include in 

a complete rate request. Upon receipt of 

a request for a change in rates or charges 

the Director shall, as soon as practicable 

but not more than 20 days of receipt of 

the request, provide the concessioner 

with a written determination that the 

request is complete, or where the 

Director determines the request 

incomplete, a description of the 

information required for the request to 

be determined complete. Where changes 

in rates and charges have been 

requested and the request has been 

deemed complete, concessioners shall 

be allowed to notify visitors making 

reservations 90 or more days in advance 

of the anticipated rates. Those rates are 

subject to adjustment prior to the visit 

based upon the Director’s review and 

final decision about the requested rate 

change . The Director shall issue a final 

decision approving or rejecting a request 

by a concessioner to change rates and 

charges to the public within 10 days of 

receipt of a complete request in 

accordance with the conditions 

described in the contract, except for 

those change requests requiring a full 

comparability study, for which the 

Director shall issue a decision as soon 

as possible and in no event longer than 

30 days after receipt of the complete 

request. If the Director does not approve 

of the rates and charges proposed by the 

concessioner, the Director must provide 

in writing the substantive basis for any 

disapproval. These timeframes will be 

exceeded only in extraordinary 

circumstances and the concessioner 

must be notified in writing of such 

circumstances. If the Director fails to 

meet the timeframes described above, 

and has not notified the concessioner in 

writing of the existence of extraordinary 

circumstances justifying delay, a 

concessioner may implement the 

requested change to rates and charges 

until the Director issues a final written 

decision. If the Director denies the 

requested change to rates and charges 

after implementation by the 

concessioner, the Director will not 

require the concessioner to retroactively 

adjust any rates or charges for services 

booked prior to the Director’s denial. 

Maureen Foster, 

Chief of Staff, Office of the Assistant Secretary 

for Fish and Wildlife and Parks. 

[FR Doc. 2023–28659 Filed 12–28–23; 8:45 am] 

BILLING CODE 4312–51–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Part 70 

RIN 2900–AS03 

Changes in Rates VA Pays for Special 

Modes of Transportation; Delay of 

Effective Date 

AGENCY: Department of Veterans Affairs. 

ACTION: Final rule; delay of effective 

date. 

SUMMARY: The Department of Veterans 

Affairs (VA) published in the Federal 

Register on February 16, 2023, a final 

rule to amend its beneficiary travel 

regulations to establish a new payment 

methodology for special modes of 

transportation available through the VA 

beneficiary travel program. The 

preamble of that final rule stated the 

effective date was February 16, 2024. 

This rulemaking delays that effective 

date to February 16, 2025. 

DATES: The effective date for the final 

rule published February 16, 2023, at 88 

FR 10032, is delayed from February 16, 

2024, until February 16, 2025. 

FOR FURTHER INFORMATION CONTACT: Ben 

Williams, Director, Veterans 

Transportation Program (15MEM), 

Veterans Health Administration, 

Department of Veterans Affairs, 810 

Vermont Avenue NW, Washington, DC 

20420, (404) 828–5691. (This is not a 

toll-free number.) 

SUPPLEMENTARY INFORMATION: On 

November 5, 2020, VA proposed 

amending its beneficiary travel 

regulations to implement the 

discretionary authority in 38 U.S.C. 

111(b)(3)(C), which permits VA to pay 

the lesser of the actual charge for 

ambulance transportation or the amount 

determined by the Centers for Medicare 

and Medicaid Services (CMS) Medicare 

Part B Ambulance Fee Schedule 

(hereafter referred to the CMS 

ambulance fee schedule) established 

under section 1834(l) of the Social 

Security Act (42 U.S.C. 1395m(l)), 

unless VA has entered into a contract 

for that transportation. We provided a 

60-day comment period that ended on 

January 4, 2021, and we received six 

comments, five of which were 

substantive. Those five comments all 

raised similar concerns to 38 CFR 

70.30(a)(4) introductory text and (a)(4)(i) 

and (ii) as proposed, related to using the 

CMS ambulance fee schedule or, in the 

case of travel by modes other than 

ambulance, the posted rates from each 

State. We responded to all comments in 

a final rule published in the Federal 

Register on February 16, 2023 (88 FR 

10032), wherein we stated that we 

would not make changes from the 

proposed rule related to application of 

the CMS ambulance fee schedule but 

would delay the effective date of the 

final rule by one year (to be February 16, 

2024) to ensure that ambulance 

providers have adequate time to adjust 

to VA’s new methodology for 

calculating ambulance rates (88 FR 

10035). We further stated in the final 

rule that such adjustment could include 

ambulance providers entering 

negotiations with VA to contract for 

payment rates different than those 

under the CMS ambulance fee schedule, 

as contemplated in the final rule. 

Since publication of the final rule, 

however, VA has received feedback 

from both internal and external 

stakeholders, including VA employees, 

ambulance providers, and industry 

experts, that more time is necessary for 

successful implementation of the rule. 

Specifically, the delay of the effective 

date is necessary to accommodate 

unforeseen difficulties in air ambulance 

broker contracting. These difficulties 

relate to air ambulance brokers requiring 

a contract or subcontract in place with 

all potential air ambulance providers 

that covers emergency, non-VA initiated 

trips. Based on this feedback and 

evaluation of the continued effort that 

would be required by air ambulance 

brokers to negotiate and enter into 

contracts before February 16, 2024, VA 

is delaying the effective date of the 

regulation by one year. VA believes a 

12-month delay is appropriate based on 

its experience with contracting, 

especially in circumstances like this 

where subcontracting actions are 

required. 

Administrative Procedure Act 

The Administrative Procedure Act 

(APA), codified in part at 5 U.S.C. 553, 

generally requires that agencies publish 

substantive rules in the Federal Register 

for notice of proposed rulemaking and 

to solicit public comment. However, 

pursuant to 5 U.S.C. 553(b)(B) of the 

APA, general notice and the opportunity 

for public comment are not required 

with respect to a rulemaking when an 

‘‘agency for good cause finds (and 

incorporates the finding and a brief 

statement of reasons therefor in the 

rules issued) that notice and public 

procedure thereon are impracticable, 

unnecessary, or contrary to the public 

interest.’’ 

VA finds that there is good cause 

under the APA to issue this rule without 

prior notice and opportunity for public 

comment. The final rule published at 88 

FR 10032 will become effective 

February 16, 2024. Given the 


ddrumheller on DSK120RN23PROD with RULES1
Federal Register / Vol. 88, No. 249 / Friday, December 29, 2023 / Rules and Regulations 90121 

imminence of the effective date, seeking 

prior notice and the opportunity for 

public comment on this delay is 

impractical. Specifically, if prior notice 

and opportunity for public comment are 

required to delay the effective date to 

February 16, 2025, this final rule will 

not be issued prior to February 16, 2024. 

As a result, the current final rule will 

become effective February 16, 2024, and 

ambulance providers without contracts 

in place would be subject to those 

payment methodologies until contracts 

have been implemented. For those 

entities engaged in the contracting 

process, this is likely to cause confusion 

and uncertainty. 

VA also finds that prior notice and 

opportunity for comment would be 

contrary to the public interest because it 

could adversely impact veteran care or 

result in veterans being billed directly 

for services. Under the new regulation, 

VA will pay the lesser of actual charge 

associated with an air ambulance 

service, or the CMS ambulance fee 

schedule rate for that service, unless a 

separate rate has been established based 

on local contracts between air 

ambulance providers and local VA 

medical centers. As discussed above, 

since publication of the final rule, VA 

has received feedback that more time is 

necessary to accommodate unforeseen 

difficulties in air ambulance broker 

contracting, which relate to air 

ambulance brokers requiring a contract 

or subcontract in place with all 

potential air ambulance providers that 

covers emergency, non-VA initiated 

trips. The negotiation and 

implementation of these contracts will 

not be completed by February 16, 2024. 

As a result, absent the delayed effective 

date, the current final rule will go into 

effect on February 16, 2024, and 

ambulance providers would be subject 

to those payment methodologies until 

contracts have been implemented. This 

could be especially concerning for those 

entities whose negotiated rates could be 

higher than the applicable CMS 

ambulance fee schedule rate in the 

event VA determines it may be justified 

based on local considerations, such as 

for rural areas. Air ambulance providers 

contend that the Medicare 

reimbursement rate that would apply 

absent a contract is unsustainable for 

their business operations, potentially 

leading to reduction in the availability 

of air ambulance services for veterans. 

While VA is not aware that veterans are 

currently receiving preferential 

treatment from air ambulance providers 

by virtue of VA paying billed charges, 

or that such preferential treatment 

would stop were VA to pay CMS 

ambulance fee schedule rates in the 

absence of a contract, VA acknowledges 

that there is a risk that veterans could 

be billed directly for the difference 

between the Medicare rate that VA pays 

for emergency, non-VA initiated trips 

and the amount billed by the ambulance 

provider. For these reasons, VA finds 

that good cause exists to dispense with 

the prior notice and public comment 

procedures for this final rule, as it 

concludes that such procedures are 

impracticable and contrary to the public 

interest pursuant to 5 U.S.C. 553(b)(B). 

Signing Authority 

Denis McDonough, Secretary of 

Veterans Affairs, approved and signed 

this document on December 22, 2023, 

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. 

Jeffrey M. Martin, 

Assistant Director, Office of Regulation Policy 

& Management, Office of General Counsel, 

Department of Veterans Affairs. 

[FR Doc. 2023–28726 Filed 12–28–23; 8:45 am] 

BILLING CODE 8320–01–P 

ENVIRONMENTAL PROTECTION 

AGENCY 

40 CFR Part 52 

[EPA–R06–OAR–2022–0907; FRL–11174– 

02–R6] 

Air Plan Approval; Arkansas; 

Revisions to Rule 19 of the Arkansas 

Plan 

AGENCY: Environmental Protection 

Agency (EPA). 

ACTION: Final rule. 

SUMMARY: Pursuant to the Federal Clean 

Air Act (CAA or the Act), the 

Environmental Protection Agency (EPA) 

is approving portions of the revisions to 

the Arkansas State Implementation Plan 

(SIP) including revisions to the 

Arkansas Pollution Control and Ecology 

Commission’s (‘‘Commission’’ or 

APC&EC) Rule No. 19, Rules of the 

Arkansas Plan of Implementation for 

Air Pollution Control submitted by the 

Arkansas Department of Energy and 

Environment, Division of 

Environmental Quality (DEQ) via the 

Arkansas Governor’s Office on June 22, 

2022. Most of the revisions are 

administrative in nature and make the 

SIP current with Federal rules. 

DATES: This rule is effective on January 

29, 2024. 

ADDRESSES: The EPA has established a 

docket for this action under Docket ID 

No. EPA–R06–OAR–2022–0907. All 

documents in the docket are listed on 

the https://www.regulations.gov 

website. Although listed in the index, 

some information is not publicly 

available, e.g., Confidential Business 

Information or other information whose 

disclosure is restricted by statute. 

Certain other material, such as 

copyrighted material, is not placed on 

the internet. Publicly available docket 

materials are available electronically 

through https://www.regulations.gov. 

FOR FURTHER INFORMATION CONTACT: 

Clovis Steib, EPA Region 6 Office, 

Infrastructure and Ozone Section, 214– 

665–7566, steib.clovis@epa.gov. Please 

call or email the contact listed above if 

you need alternative access to material 

indexed but not provided in the docket. 

SUPPLEMENTARY INFORMATION: 

Throughout this document ‘‘we,’’ ‘‘us,’’ 

and ‘‘our’’ means the EPA. 

I. Background 

The background for this action is 

discussed in detail in our August 22, 

2023, proposal (88 FR 57014) and the 

accompanying Technical Support 

Document (TSD), available in the docket 

for this rule. In our August 2023 

proposal we proposed to approve 

portions of the revisions to the Arkansas 

State Implementation Plan (SIP) 

including revisions to the Arkansas 

Pollution Control and Ecology 

Commission’s Regulation No. 19, Rules 

of the Arkansas Plan of Implementation 

for Air Pollution Control submitted by 

the Arkansas Department of Energy and 

Environment, Division of 

Environmental Quality (ADEQ) via the 

Arkansas Governor’s Office on June 22, 

2022. The proposal included revisions 

to remove certain outdated provisions 

and update other provisions that are 

incorporated into Regulation 19. 

Specific provisions to be partially 

repealed are those in Chapter 10 of 

APC&EC Regulation 19 regarding the 

control of volatile organic compounds 

(VOC) from certain source categories in 

Pulaski County, and provisions repealed 

from the Clean Air Interstate Rule 

(CAIR) in Chapter 14, and informational 

provisions regarding sources eligible or 

subject to best available retrofit 

technology (BART) requirements for 

Regional Haze in Chapter 15. All of the 

repealed provisions were either 

superseded by other rules or otherwise 

no longer necessary. One of the 

revisions restructured the regulations 

and organized them as ‘‘rules,’’ such 

that ‘‘Regulation No. 19’’ became ‘‘Rule 

No. 19,’’ Rules of the Arkansas Plan of 


ddrumheller on DSK120RN23PROD with RULES1