57690 Federal Register / Vol. 76, No. 180 / Friday, September 16, 2011 / Proposed Rules 

market for which the Secretary 

determines in published guidance in the 

Federal Register or in the Internal 

Revenue Bulletin (see § 601.601(d)(2)(ii) 

of this chapter) that such market has 

rules adequate to carry out the purposes 

of section 1256. 

(b) Effective/applicability date. The 

rule of this section applies to taxable 

years ending on or after the date the 

final regulations are published in the 

Federal Register. 

Steven T. Miller, 

Deputy Commissioner for Services and 

Enforcement. 

[FR Doc. 2011–23665 Filed 9–15–11; 8:45 am] 

BILLING CODE 4830–01–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[Docket ID DOD–2011–HA–0059] 

RIN 0720–AB52 

TRICARE; Elimination of the NonAvailability Statement (NAS) 

Requirement for Non-Emergency 

Inpatient Mental Health Care 

AGENCY: Office of the Secretary, 

Department of Defense. 

ACTION: Proposed rule. 

SUMMARY: This proposed rule eliminates 

the requirement that states a NAS is 

needed for non-emergency inpatient 

mental health care in order for a 

TRICARE Standard beneficiary’s claim 

to be paid. 

DATES: Comments must be received on 

or before November 15, 2011. 

ADDRESSES: You may submit comments, 

identified by docket number and/or RIN 

number and title, by any of the 

following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov . Follow the 

instructions for submitting comments. 

• Mail: Federal Docket Management 

System Office, 4800 Mark Center Drive, 

2nd Floor, East Tower, Suite 02G09, 

Alexandria, VA 22350–3100. 

Instructions: All submissions received 

must include the agency name and 

docket number or Regulatory 

Information Number (RIN) for this 

Federal Register document. The general 

policy for comments and other 

submissions from members of the public 

is to make these submissions available 

for viewing on the Internet at http:// 

regulations.gov as they are received 

without change, including any personal 

identifiers or contact information. 

FOR FURTHER INFORMATION CONTACT: Mr. 

Richard Hart, TRICARE Policy and 

Operations, TRICARE Management 

Activity, 5111 Leesburg Pike, Suite 810, 

Falls Church, VA 22041. 

SUPPLEMENTARY INFORMATION: 

I. Introduction and Background 

Under TRICARE Prime (as provided 

in 32 CFR, section 199.17), the military 

medical treatment facility (MTF) has the 

right of first refusal for specialty 

services requested by a civilian 

provider, if the services are available at 

the MTF. If a TRICARE Prime 

beneficiary living near a MTF is referred 

for specialty care by a civilian provider 

and the service is available at the MTF, 

the MTF may decide to provide the care. 

If services are refused by the MTF, the 

referral will be allowed with a network 

provider. As a result, the issuance of 

NAS(s) has been eliminated and are 

only required for non-enrolled 

beneficiaries who live within the MTF 

catchment area for non-emergency 

inpatient mental health care. Currently, 

the number of NASs issued is negligible 

as most mental health admissions are 

emergency admissions. Requiring a NAS 

for a relative few non-emergency 

inpatient mental health admissions is 

disproportionate to the cost of 

maintaining the systems necessary to 

process and coordinate the NAS. This 

proposed rule eliminates the 

requirement for a NAS for nonemergency inpatient mental health care 

in order for the TRICARE Standard 

beneficiary’s claim to be paid. 

II. Regulatory Procedures 

Executive Order 12866, ‘‘Regulatory 

Planning and Review’’; Executive Order 

13563, ‘‘Improving Regulation and 

Regulatory Review’’; and Public Law 

96–354, ‘‘Regulatory Flexibility Act’’ 

(5 U.S.C. 601) 

Executive Orders 12866 and 13563 

require 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 proposed 

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 

proposed 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. 

Sec. 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 199.4 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 199.4 is amended by 

removing and reserving paragraph (a)(9) 

as follows: 

§ 199.4 Basic program benefits. 

* * * * * 

(a) * * * 

(9) [RESERVED] 

* * * * * 

Dated: August 24, 2011. 

Patricia L. Toppings, 

OSD Federal Register Liaison Officer, 

Department of Defense. 

[FR Doc. 2011–23766 Filed 9–15–11; 8:45 am] 

BILLING CODE 5001–06–P 

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