47712 Federal Register / Vol. 75, No. 152 / Monday, August 9, 2010 / Rules and Regulations 

■ b. Redesignating paragraph 

(g)(2)(ii)(D) as (g)(2)(ii); and 

■ c. Revising paragraphs (c)(6), 

(c)(7)(iii), (f)(3)(i), (g)(2)(i), newly 

redesignated paragraph (g)(2)(ii), 

(g)(4)(iii), (h)(2), (h)(3)(v)(A), and (j) to 

read as follows: 

§ 199.5 TRICARE Extended Care Health 

Option (ECHO). 

* * * * * 

(c) * * * 

(6) Transportation of an ECHO 

beneficiary receiving benefits under 

paragraph (c)(5), and a medical 

attendant when necessary to assure the 

beneficiary’s safety, to or from a facility 

or institution to receive authorized 

ECHO services or items. 

(7) * * * 

(iii) The Government’s cost-share 

incurred for these services accrues to 

the fiscal year benefit limit of $36,000. 

* * * * * 

(f) * * * 

(3) * * * 

(i) ECHO. The total Government share 

of the cost of all ECHO benefits, except 

ECHO Home Health Care (EHHC) and 

EHHC respite care, provided in a given 

fiscal year to a beneficiary, may not 

exceed $36,000 after application of the 

allowable payment methodology. 

* * * * * 

(g) * * * 

(2) Equipment. (i) The TRICARE 

allowable amount for durable 

equipment shall be calculated in the 

same manner as durable medical 

equipment allowable through Section 

199.4, and accrues to the fiscal year 

benefit limit specified in paragraph 

(f)(3) of this section. 

(ii) Cost-share. A cost-share, as 

provided by paragraph (f)(2) of this 

section, is required for each month in 

which equipment is purchased under 

this section. However, in no month shall 

a sponsor be required to pay more than 

one cost-share regardless of the number 

of benefits the sponsor’s dependents 

received under this section. 

* * * * * 

(4) * * * 

(iii) The maximum monthly 

Government reimbursement for EHHC, 

including EHHC respite care, will be 

based on the actual number of hours of 

EHHC services rendered in the month, 

but in no case will it exceed one-twelfth 

of the annual maximum Government 

cost-share as determined in this section 

and adjusted according to the actual 

number of days in the month the 

services were provided. 

(h) * * * 

(2) Registration. Active duty sponsors 

must register potential ECHO-eligible 

beneficiaries through the Director, 

TRICARE Management Activity, or 

designee prior to receiving ECHO 

benefits. The Director, TRICARE 

Management Activity, or designee will 

determine ECHO eligibility and update 

the Defense Enrollment Eligibility 

Reporting System accordingly. Unless 

waived by the Director, TRICARE 

Management Activity or designee, 

sponsors must provide evidence of 

enrollment in the Exceptional Family 

Member Program provided by their 

branch of Service at the time they 

register their family member(s) for the 

ECHO. 

(3) * * * 

(v) Public facility use. (A) An ECHO 

beneficiary residing within a state must 

demonstrate that a public facility is not 

available and adequate to meet the 

needs of their qualifying condition. 

Such requirements shall apply to 

beneficiaries who request authorization 

for training, rehabilitation, special 

education, assistive technology, and 

institutional care in private nonprofit, 

public, and state institutions and 

facilities, and if appropriate for 

beneficiaries receiving institutional 

care, transportation to and from such 

institutions and facilities. The 

maximum Government cost-share for 

services that require demonstration of 

public facility non-availability or 

inadequacy is limited to $36,000 per 

fiscal year per beneficiary. Stateadministered plans for medical 

assistance under Title XIX of the Social 

Security Act (Medicaid) are not 

considered available and adequate 

facilities for the purpose of this section. 

* * * * * 

(j) Effective date. All changes to this 

section are effective as of October 14, 

2008, and claims for ECHO benefits 

provided on or after that date will be 

reprocessed retroactively to that date as 

necessary. 

Dated: July 26, 2010. 

Patricia L. Toppings, 

OSD Federal Register Liaison Officer, 

Department of Defense. 

[FR Doc. 2010–19312 Filed 8–6–10; 8:45 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[Docket ID: DOD–2009–HA–0097] 

RIN 0720–AB35 

TRICARE; Elimination of Voluntary 

Disenrollment Lock-Out 

AGENCY: Office of the Secretary, 

Department of Defense. 

ACTION: Final rule. 

SUMMARY: This final rule eliminates the 

1 year lock out for non-Active Duty 

members who disenroll from TRICARE 

Prime before their annual enrollment 

renewal date. 

DATES: Effective Date: September 8, 

2010. 

FOR FURTHER INFORMATION CONTACT: Ms. 

Kathleen Larkin, TRICARE Policy and 

Operations, TRICARE Management 

Activity, 5111 Leesburg Pike, Suite 810, 

Falls Church, VA 22041, telephone 

(703) 681–0039. 

SUPPLEMENTARY INFORMATION: 

I. Introduction and Background 

The TRICARE benefit was directed by 

Congress in section 1097 of the National 

Defense Authorization Act for Fiscal 

Year 1995. For further information on 

TRICARE, the reader may refer to the 

final rule regarding TRICARE published 

in the Federal Register on October 5, 

1995. 

Administrative Change 

When TRICARE Prime was 

implemented, it was envisioned that 

TRICARE Prime enrollees would 

transfer their enrollment when they 

moved to a new location. The reality is 

that some enrollees, such as college 

students, move several times a year. 

When TRICARE Prime is available at 

their new location, they transfer 

enrollment. However, TRICARE Prime 

might not be available at the gaining 

location, so they voluntarily disenroll in 

advance of their annual enrollment date. 

This automatically triggers a one year 

lock-out. This final rule eliminates the 

lock-out for active duty family members 

and allows TRICARE Prime enrollment 

when they relocate in an area that offers 

TRICARE Prime. 

II. Public Comments 

The proposed rule was published in 

the Federal Register on October 29, 

2009, for a 60-day comment period. We 

received one comment and we thank the 

person for commenting. 


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Federal Register / Vol. 75, No. 152 / Monday, August 9, 2010 / Rules and Regulations 47713 

Comment: As someone who deploys, 

leaving my spouse to contend with 

TRICARE issues, it is important that this 

rule is adopted. 

Response: We agree and are pleased to 

promulgate the rule. 

III. Regulatory Procedures 

Executive Order 12866, ‘‘Regulatory 

Planning and Review’’ and Public Law 

96–354, ‘‘Regulatory Flexibility Act’’ 

(5 U.S.C. 601) 

Executive Order 12866 requires that a 

comprehensive regulatory impact 

analysis be performed on any 

economically significant regulatory 

action, defined as one that would result 

in an annual effect of $100 million or 

more on the national economy or which 

would have other substantial impacts. 

The Regulatory Flexibility Act (RFA) 

requires that each Federal Agency 

prepare, and make available for public 

comment, a regulatory flexibility 

analysis when the agency issues a 

regulation which would have a 

significant impact on a substantial 

number of small entities. This final rule 

is not a significant regulatory action and 

will not have a significant impact on a 

substantial number of small entities for 

purposes of the RFA. Thus this final 

rule is not subject to any of these 

requirements. 

Paperwork Reduction Act of 1995 

(44 U.S.C. 3501–3511) 

This rule will not impose additional 

information collection requirements on 

the public. 

Executive Order 13132, ‘‘Federalism’’ 

We have examined the impacts of the 

rule under Executive Order 13132 and 

it does not have policies that have 

federalism implications that would have 

substantial direct effects on the States, 

on the relationship between the 

National Government and the States, or 

on the distribution of power and 

responsibilities among the various 

levels of government, therefore, 

consultation with State and local 

officials is not required. 

Section 202, Public Law 104–4, 

‘‘Unfunded Mandates Reform Act’’ 

This rule does not contain unfunded 

mandates. It does not contain a Federal 

mandate that may result in the 

expenditure by State, local and tribal 

governments, in aggregate, or by the 

private sector, of $100 million or more 

in any 1 year. 

List of Subjects in 32 CFR Part 199 

Claims, Dental health, Health care, 

Health insurance, Individuals with 

disabilities, Military personnel. 

■ Accordingly, 32 CFR part 199 is 

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 199.17 (o)(4) is revised to 

read as follows: 

§ 199.17 TRICARE program. 

* * * * * 

(o) * * * 

(4) Voluntary disenrollment. Any nonactive duty beneficiary may disenroll at 

any time. Disenrollment will take effect 

in accordance with administrative 

procedures established by the Assistant 

Secretary of Defense (Health Affairs). 

Retired beneficiaries and their family 

members who disenroll prior to their 

annual enrollment renewal date will not 

be eligible to reenroll in Prime for a -1- 

year period from the effective date of the 

disenrollment. Active Duty family 

members may change their enrollment 

status twice in an enrollment year. Any 

additional disenrollment changes will 

result in an enrollment lock out for a 1- 

year period from the effective date of the 

disenrollment. Enrollment rules may be 

waived by the Assistant Secretary of 

Defense (Health Affairs) based on 

extraordinary circumstances. 

* * * * * 

Dated: July 26, 2010. 

Patricia L. Toppings, 

OSD Federal Register Liaison Officer, 

Department of Defense. 

[FR Doc. 2010–19309 Filed 8–6–10; 8:45 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF HOMELAND 

SECURITY 

Coast Guard 

33 CFR Part 165 

[Docket No. USCG–2009–0931] 

RIN 1625–AA11 

Regulated Navigation Area; Galveston 

Channel, TX 

AGENCY: Coast Guard, DHS. 

ACTION: Final rule. 

SUMMARY: The Coast Guard is 

establishing a regulated navigation area 

(RNA) across the entire width of the 

Galveston Channel in the vicinity of 

Sector Field Office (SFO) Galveston, 

Texas. This RNA will require vessels to 

navigate at no wake speeds within this 

area. Vessel transits at greater than 

minimum safe speed and causing wake 

in this area will be prohibited unless 

specifically authorized by the Captain of 

the Port Houston-Galveston or a 

designated representative. This RNA is 

needed to protect the Coast Guard SFO 

Galveston assets, break wall, and piers 

from further damage associated with 

excessive wake and to protect ongoing 

base construction. 

DATES: This rule is effective September 

8, 2010. 

ADDRESSES: Comments and material 

received from the public, as well as 

documents mentioned in this preamble 

as being available in the docket, are part 

of docket USCG–2009–0931 and are 

available online by going to http:// 

www.regulations.gov, inserting USCG– 

2009–0931 in the ‘‘Keyword’’ box, and 

then clicking ‘‘Search.’’ This material is 

also available for inspection or copying 

at the Docket Management Facility (M– 

30), U.S. Department of Transportation, 

West Building Ground Floor, Room 

W12–140, 1200 New Jersey Avenue, SE., 

Washington, DC 20590, between 9 a.m. 

and 5 p.m., Monday through Friday, 

except Federal holidays. 

FOR FURTHER INFORMATION CONTACT: If 

you have questions on this rule, call or 

e-mail Lieutenant junior grade Margaret 

Brown, Coast Guard Sector HoustonGalveston, telephone (713) 678–9001, or 

e-mail margaret.a.brown@uscg.mil. If 

you have questions on viewing the 

docket, call Renee V. Wright, Program 

Manager, Docket Operations, telephone 

202–366–9826. 

SUPPLEMENTARY INFORMATION: 

Regulatory Information 

On April 13, 2010, we published a 

notice of proposed rulemaking (NPRM) 

entitled ‘‘Regulated Navigation Area; 

Galveston Channel’’ in the Federal 

Register (75 FR 18766). We received no 

comments on the proposed rule and are 

issuing the final rule without change 

from the NPRM. 

Basis and Purpose 

The basis for this rulemaking is the 

Coast Guard’s authority to establish 

regulated navigation areas, under 33 

U.S.C. 1226, 1231; 46 U.S.C. Chapter 

701, 3306, 3703; 50 U.S.C. 191, 195; 33 

CFR 1.05–1, 6.04–1, 6.04–6, 160.5; Pub. 

L. 107–295, 116 Stat. 2064; and 

Department of Homeland Security 

Delegation No. 0170.1. A regulated 

navigation area is a water area within a 

defined boundary for which regulations 

for vessels navigating within the area 

have been established, to control vessel 

traffic in a place determined to have 

hazardous conditions. 33 CFR 165.10; 


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