This section of the FEDERAL REGISTER

contains notices to the public of the proposed

issuance of rules and regulations. The

purpose of these notices is to give interested

persons an opportunity to participate in the

rule making prior to the adoption of the final

rules.

Proposed Rules Federal Register

33881

Vol. 63, No. 119

Monday, June 22, 1998

DEPARTMENT OF TRANSPORTATION

Federal Aviation Administration

14 CFR Part 71

[Airspace Docket No. 98–ANM–12]

Proposed Revision of Class E

Airspace; Price, UT

AGENCY: Federal Aviation

Administration (FAA), DOT.

ACTION: Notice of Proposed Rulemaking

(NPRM).

SUMMARY: This proposal would provide

additional controlled airspace to

accommodate the development of a new

Standard Instrument Approach

Procedure (SIAP) utilizing the Global

Positioning System (GPS) at the Carbon

County Airport. This new SIAP requires

airspace extending upward from 1200

feet above the surface in order to

contain an associated holding

procedure.

DATES: Comments must be received on

or before August 6, 1998.

ADDRESSES: Send comments on the

proposal in triplicate to: Manager,

Airspace Branch, ANM–520, Federal

Aviation Administration, Docket No.

98–ANM–12, 1601 Lind Avenue SW,

Renton, Washington 98055–4056.

The official docket may be examined

in the office of the Assistant Chief

Counsel for the Northwest Mountain

Region at the same address.

An informal docket may also be

examined during normal business hours

in the office of the Manager, Air Traffic

Division, Airspace Branch, at the

address listed above.

FOR FURTHER INFORMATION CONTACT:

Dennis Ripley, ANM–520.6, Federal

Aviation Administration, Docket No.

98–ANM–12, 1601 Lind Avenue SW,

Renton, Washington 98055–4056;

telephone number: (425) 227–2527.

SUPPLEMENTARY INFORMATION:

Comments Invited

Interested parties are invited to

participate in this proposed rulemaking

by submitting such written data, views,

or arguments as they may desire.

Comments that provide the factual basis

supporting the views and suggestions

presented are particularly helpful in

developing reasoned regulatory

decisions on the proposal. Comments

are specifically invited on the overall

regulatory, aeronautical, economic,

environmental, and energy related

aspects of the proposal.

Communications should identify the

airspace docket number and be

submitted in triplicate to the address

listed above. Commenters wishing the

FAA to acknowledge receipt of their

comments on this notice must submit

with those comments a self-addressed,

stamped postcard on which the

following statement is made:

‘‘Comments to Airspace Docket No. 98–

ANM–12.’’ The postcard will be date/

time stamped and returned to the

commenter. All communications

received on or before the specified

closing date for comments will be

considered before taking action on the

proposed rule. The proposal contained

in this notice may be changed in the

light of comments received. All

comments submitted will be available

for examination at the address listed

above both before and after the closing

date for comments. A report

summarizing each substantive public

contact with FAA personnel concerned

with this rulemaking will be filed in the

docket.

Availability of NPRM’s

Any person may obtain a copy of this

NPRM by submitting a request to the

Federal Aviation Administration,

Airspace Branch, ANM–520, 1601 Lind

Avenue SW, Renton, Washington

98055–4056. Communications must

identify the notice number of this

NPRM. Persons interested in being

placed on a mailing list for future

NPRM’s should also request a copy of

Advisory Circular No. 11–2A, which

describes the application procedure.

The Proposal

The FAA is considering an

amendment to Title 14 Code of Federal

Regulations, part 71 (14 CFR part 71) to

revise Class E airspace at Price, UT. This

amendment would provide additional

airspace necessary to fully encompass

the GPS Runway 36 SIAP to the Carbon

County Airport, Price, UT. This

amendment proposes to add a 1200-foot

Class E area extension to the south in

order to accommodate a holding pattern

for the SIAP. The holding pattern is

required to meet necessary airspace

criteria for aircraft transitioning between

the terminal and en route environments.

The FAA establishes Class E airspace

extending upward from 700 feet AGL

where necessary to contain aircraft

transitioning between the terminal and

en route environments. The intended

effect of this proposal is designed to

provide safe and efficient use of the

navigable airspace and to promote safe

flight operations under IFR at the

Carbon County Airport and between the

terminal and en route transition stages.

The area would be depicted on

aeronautical charts for pilot reference.

The coordinates for this airspace docket

are based on North American Datum 83.

Class E airspace areas extending upward

from 700 feet or more above the surface

of the earth, are published in Paragraph

6005 of FAA Order 7400.9E dated

September 10, 1997, and effective

September 16, 1997, which is

incorporated by reference in 14 CFR

71.1. The Class E airspace designation

listed in this document would be

published subsequently in the Order.

The FAA has determined that this

proposed regulation only involves an

established body of technical

regulations for which frequent and

routine amendments are necessary to

keep them operationally current. It,

therefore, (1) is not a ‘‘significant

regulatory action’’ under Executive

Order 12866; (2) is not a ‘‘significant

rule’’ under DOT Regulatory Policies

and Procedures (44 FR 11034; February

26, 1979); and (3) does not warrant

preparation of a Regulatory Evaluation

as the anticipated impact is so minimal.

Since this is a routine matter that will

only affect air traffic procedures and air

navigation, it is certified that this rule,

when promulgated, will not have a

significant economic impact on a

substantial number of small entities

under the criteria of the Regulatory

Flexibility Act.

List of Subjects in 14 CFR Part 71

Airspace, Incorporation by reference,

Navigation (air).

The Proposed Amendment

In consideration of the foregoing, the

Federal Aviation Administration
33882 Federal Register / Vol. 63, No. 119 / Monday, June 22, 1998 / Proposed Rules

proposes to amend 14 CFR part 71 as

follows:

PART 71—DESIGNATION OF CLASS A,

CLASS B, CLASS C, CLASS D, AND

CLASS E AIRSPACE AREAS;

AIRWAYS; ROUTES; AND REPORTING

POINTS

1. The authority citation for 14 CFR

part 71 continues to read as follows:

Authority: 49 U.S.C. 106(g), 40103, 40113,

40120; E.O. 10854, 24 FR 9565, 3 CFR, 1959–

1963 Comp., p. 389.

§ 71.1 [Amended]

2. The incorporation by reference in

14 CFR 71.1 of the Federal Aviation

Administration Order 7400.9E, Airspace

Designations and Reporting Points,

dated September 10, 1997, and effective

September 16, 1997, is amended as

follows:

Paragraph 6005 Class E airspace areas

extending upward from 700 feet or more

above the surface of the earth.

* * * * *

ANM UT E5 Price, UT

Price, Carbon County Airport, UT

(Lat. 39°36′43′′ N, long. 110°45′02′′ W)

Carbon VOR/DME

(Lat. 39°36′11′′ N, long. 110°45′13′′ W)

That airspace extending upward from 700

feet above the surface within a 4.3-mile

radius of the Carbon VOR/DME, and within

1.8 miles each side of the 200° radial of the

Carbon VOR/DME extending from the 4.3-

mile radius to 7 miles south of the Carbon

VOR/DME; that airspace extending upward

from 1,200 feet above the surface bounded by

a line beginning at lat. 39°50′00′′ N, long.

111°00′00′′ W; to lat. 39°45′00′′ N, long.

110°30′00′′ W; to lat. 39°05′00′′ N, long.

110°30′00′′ W; to lat. 39°05′00′′ N, long.

111°00′00′′ W; to lat. 39°21′00′′ N, long.

111°05′00′′ W; thence to point of beginning;

excluding that airspace within Federal

Airways, the Moab, UT, and the Salt Lake

City, UT, Class E airspace areas.

* * * * *

Issued in Seattle, Washington, on June 8,

1998.

Joe E. Gingles,

Acting Assistant Manager, Air Traffic

Division, Northwest Mountain Region.

[FR Doc. 98–16546 Filed 6–19–98; 8:45 am]

BILLING CODE 4910–13–M

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 410 and 414

[HCFA–1906–P]

RIN 0938–AI44

Medicare Program; Payment for

Teleconsultations in Rural Health

Professional Shortage Areas

AGENCY: Health Care Financing

Administration (HCFA), HHS.

ACTION: Proposed rule.

SUMMARY: This proposed rule would

implement parts of section 4206 of the

Balanced Budget Act of 1997 by

amending our regulations to provide for

payment for professional consultation

by a physician and certain other

practitioners via interactive

telecommunication systems. Payment

may be made if the physician or other

practitioner is furnishing a service for

which payment may be made under

Medicare to a beneficiary residing in a

rural area that is designated as a health

professional shortage area.

This proposed rule would also

establish a methodology for determining

the amount of payments made for the

consultation.

DATES: Comments will be considered if

we receive them at the appropriate

address, as provided below, no later

than 5 p.m. on August 21, 1998.

ADDRESSES: Mail written comments (1

original and 3 copies) to the following

address: Health Care Financing

Administration, Department of Health

and Human Services, Attention: HCFA–

1906–P, P.O. Box 26676, Baltimore, MD

21207–0519.

If you prefer, you may deliver your

written comments (1 original and 3

copies) to one of the following

addresses:

Room 309–G, Hubert H. Humphrey

Building, 200 Independence Avenue,

SW., Washington, DC 20201, or

Room C5–09–26, 7500 Security

Boulevard, Baltimore, MD 21244–

1850.

Because of staffing and resource

limitations, we cannot accept comments

by facsimile (FAX) transmission. In

commenting, please refer to file code

HCFA–1906–P. Comments received

timely will be available for public

inspection as they are received,

generally beginning approximately 3

weeks after publication of a document,

in Room 309–G of the Department’s

offices at 200 Independence Avenue,

SW., Washington, DC, on Monday

through Friday of each week from 8:30

a.m. to 5 p.m. (phone: (202) 690–7890).

FOR FURTHER INFORMATION CONTACT:

Craig Dobyski, (410) 786–4584.

SUPPLEMENTARY INFORMATION:

I. Background

A. General

Telemedicine is the use of

telecommunications to furnish medical

information and services. Generally, two

different kinds of technology are in use

in telemedicine. One technology is twoway interactive video. This technology

is used, for example, when a

consultation involving the patient, the

primary care giver, and a specialist is

necessary. The videoconferencing

equipment at two (or more) locations

permits a ‘‘real-time’’ or ‘‘live’’

consultation to take place, providing for

two-way exchange of information

between the locations during the

examination. We refer to this process as

‘‘teleconsultation.’’ Teleconsultation

typically involves a primary care

practitioner with a patient at a remote,

rural (spoke) site and a medical

specialist (consultant) at an urban or

referral center (hub) facility, with the

primary care practitioner seeking advice

from the consultant concerning the

patient’s condition or course of

treatment.

The other technology, called ‘‘store

and forward,’’ is used to transfer video

images from one location to another. A

camera or similar device records (stores)

an image(s) that is then sent (forwarded)

via telecommunications media to

another location for later viewing. The

sending of x-rays, computed

tomography scans, or magnetic

resonance images are common storeand-forward applications. The original

image may be recorded and/or

forwarded in digital or analog format

and may include video ‘‘clips’’ such as

ultrasound examinations, where the

series of images that are sent may show

full motion when reviewed at the

receiving location.

Currently, Medicare allows payment

for those telemedicine applications in

which, under conventional health care

delivery, the medical service does not

require face-to-face ‘‘hands on’’ contact

between patient and physician. For

example, Medicare permits coverage of

teleradiology, which is the most widely

used and reimbursed form of

telemedicine, as well as physician

interpretation of electrocardiogram and

electroencephalogram readings that are

transmitted electronically. In contrast,

Medicare does not cover other

physicians services delivered through

telecommunications systems because,