Federal Register / Vol. 82, No. 249 / Friday, December 29, 2017 / Rules and Regulations 61675 

information from various sources, such 

as the Board’s Budget and Personnel 

Committee, representatives from private 

research firms, and input from industry 

personnel. Alternative expenditure 

levels were discussed by these groups, 

based upon the relative value of various 

activities to the hazelnut industry. Many 

growers at the May 17, 2017, meeting 

were in favor of even greater spending 

by the Board on promotional activities 

for hazelnuts, while handlers were more 

conservative. 

The Board ultimately determined that 

2017–2018 marketing year expenditures 

of $878,627 were appropriate, and the 

recommended assessment rate, when 

combined with reserve funds and other 

income, should generate sufficient 

revenue to meet its budgeted expenses. 

Further, the Board will maintain a 

$180,000 emergency fund throughout 

the 2017–2018 marketing year in order 

to cover any unforeseen or emergency 

operational expenses. If the 2017–2018 

emergency funds are not expended, the 

resulting operating reserve would not 

exceed the limit authorized under the 

Order. 

A review of historical information and 

preliminary information pertaining to 

the upcoming marketing year indicates 

that the grower price for the 2017–2018 

marketing year could range between 

$0.81 and $1.80 per pound (NASS, 

2017). Therefore, the estimated 

assessment revenue for the 2017–2018 

marketing year as a percentage of total 

grower revenue could range between 

0.74 and 0.33 percent, respectively. 

This action increases the assessment 

obligation imposed on handlers. While 

assessments impose some additional 

costs on handlers, the costs are minimal 

and uniform on all handlers. Some of 

the additional costs may be passed on 

to growers. However, these costs would 

be offset by the benefits derived by the 

operation of the Marketing Order. In 

addition, the Board’s meeting was 

widely publicized throughout the 

Oregon and Washington hazelnut 

industry, and all interested persons 

were invited to attend the meeting and 

participate in Board deliberations on all 

issues. Like all Board meetings, the May 

17, 2017, meeting was a public meeting, 

and all entities, both large and small, 

were able to express views on this issue. 

In accordance with the Paperwork 

Reduction Act of 1995 (44 U.S.C. 

Chapter 35), the Order’s information 

collection requirements have been 

previously approved by OMB and 

assigned OMB No. 0581–0178, 

‘‘Vegetable and Specialty Crops.’’ No 

changes in those requirements are 

necessary as a result of this action. 

Should any changes become necessary, 

they would be submitted to OMB for 

approval. 

This final rule imposes no additional 

reporting or recordkeeping requirements 

on either small or large Oregon and 

Washington hazelnut handlers. As with 

all Federal marketing order programs, 

reports and forms are periodically 

reviewed to reduce information 

requirements and duplication by 

industry and public sector agencies. As 

noted in the initial regulatory flexibility 

analysis, USDA has not identified any 

relevant Federal rules that duplicate, 

overlap, or conflict with this final rule. 

AMS is committed to complying with 

the E-Government Act, to promote the 

use of the internet and other 

information technologies to provide 

increased opportunities for citizen 

access to Government information and 

services, and for other purposes. 

A proposed rule concerning this 

action was published in the Federal 

Register on August 18, 2017 (82 FR 

39369). Copies of the rule were mailed 

or sent via facsimile to all Board 

members and hazelnut handlers. 

Finally, the rule was made available 

through the internet by USDA and the 

Office of the Federal Register. A 30-day 

comment period ending September 18, 

2017, was provided to allow interested 

persons to respond to the proposal. 

Two comments were received during 

the comment period in response to the 

proposal. Both comments were 

generally in support of the assessment 

rate increase and believed that the 

action would have a minimal impact on 

consumers. However, one commenter 

was concerned that the notice and 

comment process for changes in 

assessment rates was burdensome, and 

the other commenter expressed the 

opinion that the assessment rate should 

have a time limit and should not be in 

effect indefinitely. 

Notice and comment rulemaking is 

required by statute for all changes made 

to marketing order regulations, 

including, but not limited to, 

establishment of assessment rates. In 

addition, all marketing order regulations 

are in effect indefinitely unless a 

specific effective period is defined in 

the regulation when it is established. 

The Board chose not to establish a 

specific time period for the regulation 

and is aware that the regulation will be 

effective indefinitely until changed. 

Accordingly, no changes will be made 

to the rule as proposed, based on the 

comments received. 

A small business guide on complying 

with fruit, vegetable, and specialty crop 

marketing agreements and orders may 

be viewed at: http://www.ams.usda.gov/ 

rules-regulations/moa/small-businesses. 

Any questions about the compliance 

guide should be sent to Richard Lower 

at the previously mentioned address in 

the FOR FURTHER INFORMATION CONTACT

section. 

After consideration of all relevant 

matter presented, including the 

information and recommendation 

submitted by the Board and other 

available information, it is hereby found 

that this rule, as hereinafter set forth, 

will tend to effectuate the declared 

policy of the Act. 

List of Subjects in 7 CFR Part 982 

Hazelnuts, Marketing agreements, 

Nuts, Reporting and recordkeeping 

requirements. 

For the reasons set forth in the 

preamble, 7 CFR part 982 is amended as 

follows: 

PART 982—HAZELNUTS GROWN IN 

OREGON AND WASHINGTON 

■ 1. The authority citation for 7 CFR 

part 982 continues to read as follows: 

Authority: 7 U.S.C. 601–674. 

■ 2. Section 982.340 is revised to read 

as follows: 

§ 982.340 Assessment rate. 

On and after July 1, 2017, an 

assessment rate of $0.006 per pound is 

established for Oregon and Washington 

hazelnuts. 

Dated: December 26, 2017. 

Bruce Summers, 

Acting Administrator, Agricultural Marketing 

Service. 

[FR Doc. 2017–28171 Filed 12–28–17; 8:45 am] 

BILLING CODE 3410–02–P 

DEPARTMENT OF TRANSPORTATION 

Federal Aviation Administration 

14 CFR Part 39 

[Docket No. FAA–2017–1179; Product 

Identifier 2017–NM–177–AD; Amendment 

39–19141; AD 2017–26–10] 

RIN 2120–AA64 

Airworthiness Directives; The Boeing 

Company Airplanes 

AGENCY: Federal Aviation 

Administration (FAA), DOT. 

ACTION: Final rule; request for 

comments. 

SUMMARY: We are superseding 

Airworthiness Directive (AD) 2015–08– 

01, which applied to certain The Boeing 

Company Model 757 airplanes. AD 

2015–08–01 required, depending on 


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61676 Federal Register / Vol. 82, No. 249 / Friday, December 29, 2017 / Rules and Regulations 

airplane configuration, installing new 

relays and bracket assemblies, 

inspecting to ensure that the new relays 

do not contact adjacent wire bundles, 

torqueing the bracket assembly 

installation nuts and ground stud nuts, 

retesting the bond resistance between 

the bracket assemblies and the terminal 

lugs on the ground studs, and doing 

related investigative and corrective 

actions if necessary. This AD does not 

retain any requirements, and instead 

requires deactivating the spoiler control 

module relays and capping and stowing 

the associated wiring on airplanes on 

which the actions required by AD 2015– 

08–01 have been done. This AD was 

prompted by a report of an 

uncommanded spoiler movement 

during flap configuration just before 

landing, on an airplane on which the 

actions required by AD 2015–08–01 had 

been done. We are issuing this AD to 

address the unsafe condition on these 

products. 

DATES: This AD is effective January 3, 

2018. 

The Director of the Federal Register 

approved the incorporation by reference 

of a certain publication listed in this AD 

as of January 3, 2018. 

We must receive comments on this 

AD by February 12, 2018. 

ADDRESSES: You may send comments, 

using the procedures found in 14 CFR 

11.43 and 11.45, by any of the following 

methods: 

• Federal eRulemaking Portal: Go to 

http://www.regulations.gov. Follow the 

instructions for submitting comments. 

• Fax: 202–493–2251. 

• Mail: U.S. Department of 

Transportation, Docket Operations, M– 

30, West Building Ground Floor, Room 

W12–140, 1200 New Jersey Avenue SE, 

Washington, DC 20590. 

• Hand Delivery: Deliver to Mail 

address above between 9 a.m. and 5 

p.m., Monday through Friday, except 

Federal holidays. 

For service information identified in 

this final rule, contact Boeing 

Commercial Airplanes, Attention: 

Contractual & Data Services (C&DS), 

2600 Westminster Blvd., MC 110–SK57, 

Seal Beach, CA 90740–5600; telephone 

562–797–1717; internet https://

www.myboeingfleet.com. You may view 

this service information at the FAA, 

Transport Standards Branch, 1601 Lind 

Avenue SW, Renton, WA. For 

information on the availability of this 

material at the FAA, call 425–227–1221. 

It is also available on the internet at 

http://www.regulations.gov by searching 

for and locating Docket No. FAA–2017– 

1179. 

Examining the AD Docket 

You may examine the AD docket on 

the internet at http://

www.regulations.gov by searching for 

and locating Docket No. FAA–2017– 

1179; or in person at the Docket 

Management Facility between 9 a.m. 

and 5 p.m., Monday through Friday, 

except Federal holidays. The AD docket 

contains this final rule, the regulatory 

evaluation, any comments received, and 

other information. The street address for 

the Docket Office (phone: 800–647– 

5527) is in the ADDRESSES section. 

Comments will be available in the AD 

docket shortly after receipt. 

FOR FURTHER INFORMATION CONTACT: 

Myra Kuck, Aerospace Engineer, Cabin 

Safety, Mechanical & Environmental 

Systems Section, FAA, Los Angeles 

ACO Branch, 3960 Paramount 

Boulevard, Lakewood, CA 90712–4137; 

phone: 562–627–5316; fax: 562–627– 

5210; email: Myra.J.Kuck@faa.gov. 

SUPPLEMENTARY INFORMATION: 

Discussion 

We issued AD 2015–08–01, 

Amendment 39–18137 (80 FR 21645, 

April 20, 2015) (‘‘AD 2015–08–01’’), for 

certain Model 757 airplanes. AD 2015– 

08–01 required, depending on airplane 

configuration, installing new relays and 

bracket assemblies, inspecting to ensure 

that the new relays do not contact 

adjacent wire bundles, torqueing the 

bracket assembly installation nuts and 

ground stud nuts, retesting the bond 

resistance between the bracket 

assemblies and the terminal lugs on the 

ground studs, and doing related 

investigative and corrective actions if 

necessary. AD 2015–08–01 resulted 

from numerous reports of unintended 

lateral oscillations during final 

approach, just before landing. We issued 

AD 2015–08–01 to reduce the chance of 

unintended lateral oscillations near 

touchdown, which could result in loss 

of lateral control of the airplane, and 

consequent airplane damage or injury to 

flight crew and passengers. 

Actions Since AD 2015–08–01 Was 

Issued 

Since we issued AD 2015–08–01, we 

have received a report of a momentary 

uncommanded spoiler movement 

during flap configuration just before 

landing, on a Model 757 airplane that 

had been inspected and modified in 

accordance with AD 2015–08–01. AD 

2015–08–01 requires accomplishment of 

Boeing Service Bulletin 757–27A0152, 

which is intended to reduce the chance 

of a pilot-induced oscillation (PIO) 

during quick flight maneuvers, such as 

the final phase of approach in strong 

wind conditions, by preventing the 

deployment, during landing operations, 

of spoiler pairs 1 and 12, and 5 and 8. 

Boeing’s subsequent investigation of 

Boeing Service Bulletin 757–27A0152 

found that a switch in one of the relays 

added by that service information had 

failed to an electrically open position. 

We are issuing this AD to correct the 

unsafe condition on these products. 

Related Service Information Under 1 

CFR Part 51 

We reviewed Boeing Alert Service 

Bulletin 757–27A0157, dated December 

18, 2017. The service information 

describes procedures for deactivating 

the spoiler control module relays and 

capping and stowing the associated 

wiring. This service information is 

reasonably available because the 

interested parties have access to it 

through their normal course of business 

or by the means identified in the 

ADDRESSES section. 

FAA’s Determination 

We are issuing this AD because we 

evaluated all the relevant information 

and determined the unsafe condition 

described previously is likely to exist or 

develop in other products of the same 

type design. 

AD Requirements 

This AD retains none of the 

requirements of AD 2015–08–01. This 

AD requires accomplishment of the 

actions identified as ‘‘RC’’ (required for 

compliance) in the Accomplishment 

Instructions of Boeing Alert Service 

Bulletin 757–27A0157, dated December 

18, 2017, described previously. For 

information on the procedures and 

compliance times, see this service 

information at http://

www.regulations.gov by searching for 

and locating Docket No. FAA–2017– 

1179. 

Interim Action 

We consider this AD interim action. If 

final action is later identified, we might 

consider further rulemaking then. 

FAA’s Justification and Determination 

of the Effective Date 

An unsafe condition exists that 

requires the immediate adoption of this 

AD without providing an opportunity 

for public comments prior to adoption. 

The FAA has found that the risk to the 

flying public justifies waiving notice 

and comment prior to adoption of this 

rule because failure to deactivate the 

spoiler control module relays and cap 

and stow associated wiring can result in 

a failure condition that can cause an 

uncommanded spoiler movement 


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Federal Register / Vol. 82, No. 249 / Friday, December 29, 2017 / Rules and Regulations 61677 

resulting in loss of controllability of the 

airplane during the approach phase of 

flight. Therefore, we find good cause 

that notice and opportunity for prior 

public comment are impracticable. In 

addition, for the reason stated above, we 

find that good cause exists for making 

this amendment effective in less than 30 

days. 

Comments Invited 

This AD is a final rule that involves 

requirements affecting flight safety and 

was not preceded by notice and an 

opportunity for public comment. 

However, we invite you to send any 

written data, views, or arguments about 

this final rule. Send your comments to 

an address listed under the ADDRESSES

section. Include the docket number 

FAA–2017–1179 and Product Identifier 

2017–NM–177–AD at the beginning of 

your comments. We specifically invite 

comments on the overall regulatory, 

economic, environmental, and energy 

aspects of this final rule. We will 

consider all comments received by the 

closing date and may amend this final 

rule because of those comments. 

We will post all comments we 

receive, without change, to http://

www.regulations.gov, including any 

personal information you provide. We 

will also post a report summarizing each 

substantive verbal contact we receive 

about this final rule. 

Costs of Compliance 

We estimate that this AD affects 626 

airplanes of U.S. registry. We estimate 

the following costs to comply with this 

AD: 

ESTIMATED COSTS

Action Labor cost Parts cost Cost per 

product 

Cost on U.S. 

operators 

Deactivating spoiler control module relay ....... 14 work-hours × $85 per hour = $1,190 ........ $1,380 $2,570 * 

* Based on our estimate of 169 airplanes that are in compliance with the requirements of AD 2015–08–01 and subject to the deactivation requirements of this AD, the total fleet cost for this AD is approximately $434,330. 

Authority for This Rulemaking 

Title 49 of the United States Code 

specifies the FAA’s authority to issue 

rules on aviation safety. Subtitle I, 

Section 106, describes the authority of 

the FAA Administrator. Subtitle VII, 

Aviation Programs, describes in more 

detail the scope of the Agency’s 

authority. 

We are issuing this rulemaking under 

the authority described in Subtitle VII, 

Part A, Subpart III, Section 44701, 

‘‘General requirements.’’ Under that 

section, Congress charges the FAA with 

promoting safe flight of civil aircraft in 

air commerce by prescribing regulations 

for practices, methods, and procedures 

the Administrator finds necessary for 

safety in air commerce. This regulation 

is within the scope of that authority 

because it addresses an unsafe condition 

that is likely to exist or develop on 

products identified in this rulemaking 

action. 

This AD is issued in accordance with 

authority delegated by the Executive 

Director, Aircraft Certification Service, 

as authorized by FAA Order 8000.51C. 

In accordance with that order, issuance 

of ADs is normally a function of the 

Compliance and Airworthiness 

Division, but during this transition 

period, the Executive Director has 

delegated the authority to issue ADs 

applicable to transport category 

airplanes to the Director of the System 

Oversight Division. 

Regulatory Findings 

We have determined that this AD will 

not have federalism implications under 

Executive Order 13132. This AD will 

not have a substantial direct effect 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. 

For the reasons discussed above, I 

certify that this AD: 

(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), 

(3) Will not affect intrastate aviation 

in Alaska, and 

(4) Will not have a significant 

economic impact, positive or negative, 

on a substantial number of small entities 

under the criteria of the Regulatory 

Flexibility Act. 

List of Subjects in 14 CFR Part 39 

Air transportation, Aircraft, Aviation 

safety, Incorporation by reference, 

Safety. 

Adoption of the Amendment 

Accordingly, under the authority 

delegated to me by the Administrator, 

the FAA amends 14 CFR part 39 as 

follows: 

PART 39—AIRWORTHINESS 

DIRECTIVES 

■ 1. The authority citation for part 39 

continues to read as follows: 

Authority: 49 U.S.C. 106(g), 40113, 44701. 

§ 39.13 [Amended] 

■ 2. The FAA amends § 39.13 by 

removing Airworthiness Directive (AD) 

2015–08–01, Amendment 39–18137 (80 

FR 21645, April 20, 2015), and adding 

the following new AD: 

2017–26–10 The Boeing Company: 

Amendment 39–19141; Docket No. 

FAA–2017–1179; Product Identifier 

2017–NM–177–AD. 

(a) Effective Date 

This AD is effective January 3, 2018. 

(b) Affected ADs 

This AD replaces AD 2015–08–01, 

Amendment 39–18137 (80 FR 21645, April 

20, 2015) (‘‘AD 2015–08–01’’). 

(c) Applicability 

This AD applies to The Boeing Company 

Model 757–200, –200PF, –200CB, and –300 

series airplanes, certificated in any category, 

as identified in Boeing Alert Service Bulletin 

757–27A0157, dated December 18, 2017. 

(d) Subject 

Air Transport Association (ATA) of 

America Code 27, Flight controls. 

(e) Unsafe Condition 

This AD was prompted by a report of a 

momentary uncommanded spoiler movement 

during flap configuration just before landing 

that occurred on an airplane on which the 

actions required by AD 2015–08–01 had been 

done. We are issuing this AD to prevent a 

failure condition that can cause an 

uncommanded spoiler movement resulting in 

loss of controllability of the airplane during 

the approach phase of flight. 

(f) Compliance 

Comply with this AD within the 

compliance times specified, unless already 

done. 

(g) Required Actions 

(1) For airplanes in Configuration 1 in 

Groups 1, 2, and 3, as defined in Boeing Alert 

Service Bulletin 757–27A0157, dated 

December 18, 2017: Within 90 days after the 

effective date of this AD, do all applicable 

actions identified as ‘‘RC’’ (required for 

compliance) in, and in accordance with, the 


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Accomplishment Instructions of Boeing Alert 

Service Bulletin 757–27A0157, dated 

December 18, 2017. 

(2) For airplanes in Configuration 2 in 

Groups 1, 2, and 3, as defined in Boeing Alert 

Service Bulletin 757–27A0157, dated 

December 18, 2017: No work is required by 

this paragraph. 

(h) Prohibited Modification 

As of the effective date of this AD, do not 

accomplish the actions specified in Boeing 

Service Bulletin 757–27A0152 on any 

airplane. 

(i) Alternative Methods of Compliance 

(AMOCs) 

(1) The Manager, Los Angeles ACO Branch, 

FAA, has the authority to approve AMOCs 

for this AD, if requested using the procedures 

found in 14 CFR 39.19. In accordance with 

14 CFR 39.19, send your request to your 

principal inspector or local Flight Standards 

District Office, as appropriate. If sending 

information directly to the manager of the 

certification office, send it to the attention of 

the person identified in paragraph (j) of this 

AD. Information may be emailed to 9-ANMLAACO-AMOC-Requests@faa.gov. 

(2) Before using any approved AMOC, 

notify your appropriate principal inspector, 

or lacking a principal inspector, the manager 

of the local flight standards district office/ 

certificate holding district office. 

(3) An AMOC that provides an acceptable 

level of safety may be used for any repair, 

modification, or alteration required by this 

AD if it is approved by the Boeing 

Commercial Airplanes Organization 

Designation Authorization (ODA) that has 

been authorized by the Manager, Los Angeles 

ACO Branch, to make those findings. To be 

approved, the repair method, modification 

deviation, or alteration deviation must meet 

the certification basis of the airplane, and the 

approval must specifically refer to this AD. 

(4) AMOCs approved previously for AD 

2015–08–01 are not approved as AMOCs for 

any provision in this AD. 

(5) For service information that contains 

steps that are labeled as RC, the provisions 

of paragraphs (i)(5)(i) and (i)(5)(ii) of this AD 

apply. 

(i) The steps labeled as RC, including 

substeps under an RC step and any figures 

identified in an RC step, must be done to 

comply with the AD. If a step or substep is 

labeled ‘‘RC Exempt,’’ then the RC 

requirement is removed from that step or 

substep. An AMOC is required for any 

deviations to RC steps, including substeps 

and identified figures. 

(ii) Steps not labeled as RC may be 

deviated from using accepted methods in 

accordance with the operator’s maintenance 

or inspection program without obtaining 

approval of an AMOC, provided the RC steps, 

including substeps and identified figures, can 

still be done as specified, and the airplane 

can be put back in an airworthy condition. 

(j) Related Information 

For more information about this AD, 

contact Myra Kuck, Aerospace Engineer, 

Cabin Safety, Mechanical & Environmental 

Systems Section, FAA, Los Angeles ACO 

Branch, 3960 Paramount Boulevard, 

Lakewood, CA 90712–4137; phone: 562–627– 

5316; fax: 562–627–5210; email: 

Myra.J.Kuck@faa.gov. 

(k) Material Incorporated by Reference 

(1) The Director of the Federal Register 

approved the incorporation by reference 

(IBR) of the service information listed in this 

paragraph under 5 U.S.C. 552(a) and 1 CFR 

part 51. 

(2) You must use this service information 

as applicable to do the actions required by 

this AD, unless the AD specifies otherwise. 

(i) Boeing Alert Service Bulletin 757– 

27A0157, dated December 18, 2017. 

(ii) Reserved. 

(3) For service information identified in 

this AD, contact Boeing Commercial 

Airplanes, Attention: Contractual & Data 

Services (C&DS), 2600 Westminster Blvd., 

MC 110–SK57, Seal Beach, CA 90740–5600; 

telephone 562–797–1717; internet https://

www.myboeingfleet.com. 

(4) You may view this service information 

at the FAA, Transport Standards Branch, 

1601 Lind Avenue SW, Renton, WA. For 

information on the availability of this 

material at the FAA, call 425–227–1221. 

(5) You may view this service information 

that is incorporated by reference at the 

National Archives and Records 

Administration (NARA). For information on 

the availability of this material at NARA, call 

202–741–6030, or go to: http://

www.archives.gov/federal-register/cfr/ibrlocations.html. 

Issued in Renton, Washington, on 

December 22, 2017. 

John P. Piccola, Jr., 

Acting Director, System Oversight Division, 

Aircraft Certification Service. 

[FR Doc. 2017–28158 Filed 12–28–17; 8:45 am] 

BILLING CODE 4910–13–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[Docket ID: DOD–2012–HA–0146] 

RIN 0720–AB47 

TRICARE; Reimbursement of Long 

Term Care Hospitals and Inpatient 

Rehabilitation Facilities 

AGENCY: Office of the Secretary, 

Department of Defense (DoD). 

ACTION: Final rule. 

SUMMARY: This final rule establishes 

reimbursement rates for Long Term Care 

Hospitals (LTCHs) and Inpatient 

Rehabilitation Facilities (IRFs) in 

accordance with the statutory 

requirement that TRICARE inpatient 

care ‘‘payments shall be determined to 

the extent practicable in accordance 

with the same reimbursement rules as 

apply to payments to providers of 

services of the same type under 

Medicare.’’ This final rule adopts 

Medicare’s reimbursement 

methodologies for inpatient services 

provided by LTCHs and IRFs. Each 

reimbursement methodology will be 

phased in over a 3-year period. This 

final rule also removes the definitions 

for ‘‘hospital, long-term (tuberculosis, 

chronic care, or rehabilitation)’’ and 

‘‘long-term hospital care,’’ and creates 

separate definitions for ‘‘Long Term 

Care Hospital’’ and ‘‘Inpatient 

Rehabilitation Facility’’ adopting 

Centers for Medicare & Medicaid 

Services (CMS) classification criteria. 

This final rule also includes authority 

for a year-end, discretionary General 

Temporary Military Contingency 

Payment Adjustment (GTMCPA) for 

inpatient services in TRICARE network 

IRFs when deemed essential to meet 

military contingency requirements. 

DATES: This rule is effective March 5, 

2018. 

Applicability Date: The regulations 

setting forth the revised reimbursement 

systems shall be applicable for all 

admissions to Long Term Care Hospitals 

and Inpatient Rehabilitation Facilities, 

respectively, commencing on or after 

the first day of the month which is at 

least 120 days after the date of 

publication of this rule in the Federal 

Register. 

FOR FURTHER INFORMATION CONTACT: 

Sharon Seelmeyer, Defense Health 

Agency (DHA), Medical Benefits and 

Reimbursement Branch, telephone (303) 

676–3690. 

SUPPLEMENTARY INFORMATION: 

I. Executive Summary 

A. Purpose of the Final Rule 

1. Long Term Care Hospitals (LTCHs) 

The purpose of this final rule is to 

establish a reimbursement system for 

LTCHs in accordance with the statutory 

provision at title 10, United States Code 

(U.S.C.), section 1079(i)(2). This statute 

requires that TRICARE payment for 

institutional care be determined, to the 

extent practicable, in accordance with 

the same rules as those that apply to 

payments to providers of services of the 

same type under Medicare. Medicare 

pays LTCHs using a LTCH Prospective 

Payment System (PPS) which classifies 

LTCH patients into distinct DiagnosisRelated Groups (DRGs). The patient 

classification system groupings are 

called Medicare Severity Long Term 

Care Diagnosis Related Groups (MS– 

LTC–DRGs), which are the same DRG 

groupings used under the Medicare 

acute hospital inpatient prospective 

payment system (IPPS), but that have 


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