Federal Register / Vol. 70, No. 182 / Wednesday, September 21, 2005 / Rules and Regulations 55251 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

RIN 0720–AA93 

TRICARE; Changes Included in the 

National Defense Authorization Act for 

Fiscal Year 2005; TRICARE Dental 

Program 

AGENCY: Office of the Secretary. DoD. 

ACTION: Interim final rule. 

SUMMARY: The Department is publishing 

this interim final rule to implement 

sections 711 and 715 of the Ronald W. 

Reagan National Defense Authorization 

Act for Fiscal Year 2005 (NDAA–05), 

Public Law 108–375. Specifically, that 

legislation makes young dependents of 

deceased Service members eligible for 

enrollment in the TRICARE Dental 

Program when the child was not 

previously enrolled because of age, and 

authorizes post-graduate dental 

residents in a dental treatment facility of 

the uniformed services under a graduate 

dental education program accredited by 

the American Dental Association to 

provide dental treatment to dependents 

who are 12 years of age or younger and 

who are covered by a dental plan 

established under 10 U.S.C. 1076a. This 

rule also corrects certain references in 

32 CFR 199.13. The rule is being 

published as an interim final rule with 

comment period in order to comply 

with statutory effective dates. Public 

comments are invited and will be 

considered for possible revisions to the 

final rule. 

DATES: This rule is effective November 

21, 2005. 

Comments: Written comments 

received at the address indicated below 

by November 21, 2005 will be accepted. 

Because of staff and resource 

limitations, we can only accept 

comments by mail or electronic mail (email). We are unable to accept 

comments by facsimile (FAX) 

transmission. Send e-mail comments to 

TDP.rule@tma.osd.mil Mail written 

comments to the following address only: 

TRICARE Management Activity, 

TRICARE Operation/Dental Division, 

Skyline 5, Suite 810, 5111 Leesburg 

Pike, Falls Church, VA 22041–3206; 

Attention: Col. Gary C. Martin, Director. 

Please allow sufficient time for mailed 

comments to be timely received in the 

event of delivery delays. 

FOR FURTHER INFORMATION CONTACT: Col. 

Gary C. Martin, Office of the Assistant 

Secretary of Defense (Health Affairs), 

TRICARE Management Activity, 

telephone (703) 681–0039. Questions 

regarding payment of specific claims 

should be addressed to the appropriate 

TRICARE contractor. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Opportunity for Young Child Dependent 

of Decease Member To Become Eligible 

for Enrollment in a TRICARE Dental 

Plan 

Currently, military members may 

enroll dependent children of any age in 

the TRICARE Dental Progam (TDP), but 

many members choose not to enroll 

young children until they are 

automatically enrolled at four years of 

age. Unfortunately, when a member on 

active duty for a period of more than 

thirty days or a member of the Ready 

Reserve (i.e., Selected Reserve and 

Individual Ready Reserve) dies, 

dependent children less than four years 

of age who are not enrolled in the TDP 

at the time of the member’s death are 

ineligible for enrollment for the threeyear TDP survivor’s benefit. The NDAA 

for FY05 corrects this inequity by giving 

young dependent children of deceased 

Service members the opportunity to 

become eligible for enrollment in the 

TDP although they were not previously 

enrolled due to their age. 

Professional Accreditation of Military 

Dentists 

Currently, section 199.13(a)(2)(iii) of 

this Part excludes dependents of active 

duty, Selected Reserve and individual 

Ready Reserve members enrolled in the 

TRICARE Dental Program (TDP) from 

obtaining benefit services provided by 

the TDP in military dental care facilities 

except for emergency treatment, dental 

care provided outside the United States, 

and services incidental to non-covered 

services. Due to insufficient numbers of 

pediatric patients available for treatment 

in DoD’s training facilities, the 

uniformed services faced significant 

problems with program accreditation 

and pediatric dental training. The 

Services had difficulty maintaining 

accreditation of post-graduate training 

programs because of a lack of pediatric 

dental patients with the proper dental 

case mix required for training. in 

addition, without adequate case 

numbers and case complexity, residents 

who at completion of their training were 

assigned overseas were not always fully 

trained to manage and treat pediatric 

dental patients. 

Therefore, section 715 of the NDAA 

FY 05 provides the uniformed services 

with authority to maintain American 

Dental Association accreditation 

standards for certain military dental 

specialty training programs that require 

treatment of pediatric patients and to 

provide pediatric training to meet 

requirements for the delivery of 

authorized dental care to children 

accompanying sponsors at OCONUS 

locations. The statute authorizes the 

Services to treat in their facilities a 

limited number of pediatric dental 

patients enrolled in the TDP. The 

Services have estimated their pediatric 

patient load requirements to sustain 

training facilities at 500–600 patients 

annually per Service. only those 

patients age 12 years or younger meeting 

training needs and accepted for care in 

DoD’s training programs will be treated 

in those programs to the maximum of 

2,000 patients annually across DoD. To 

ensure strict compliance with the 

amended statute, Health Affairs will 

allocate specific numbers of patient 

training cases to each Service POC. 

Service POCs will implement registries 

to track the number of patients served 

on a daily basis to ensure that the 

respective patient case caps are not 

exceeded. Each Service will forward a 

semi-annual report to the Dental Care 

Division, TRICARE Management 

Activity. An annual report will be 

submitted at the end of each fiscal year 

to the Assistant Secretary of Defense for 

Health Affairs. 

II. Regulatory Procedures 

Executive Order (EO) 12866 

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 rule is 

not an economically significant 

regulatory action and will not have a 

significant impact on a substantial 

number of small entities for purposes of 

the RFA, thus this interim final rule is 

not subject to any of these requirements. 

This rule, although not economically 

significant under Executive Order 

12866, is a significant rule under 

Executive Order 12866 and has been 

reviewed by the Office of Management 

and Budget. This rule is being issued as 

an interim final rule, with comment 

period, as an exception to our standard 

practice of soliciting public comments 

55252 Federal Register / Vol. 70, No. 182 / Wednesday, September 21, 2005 / Rules and Regulations 

prior to issuance. This is because the 

effective date of the changes to these 

statutes was October 28, 2004. The rule 

changes the regulation to conform to the 

new statutory entitlement. Based on 

these statutory requirements, the 

Assistant Secretary of Defense (Health 

Affairs) has determined that following 

the standard practice in this case would 

be unnecessary, impractical and 

contrary to the public interest. Public 

comments are invited. All comments 

will be carefully considered. A 

discussion of the major issues received 

by public comments will be included 

with the issuance of the final rule. 

Paperwork Reduction Act 

This rule will not impose additional 

information collection requirements on 

the public under the Paperwork 

Reduction Act of 1995 (44 U.S.C. 3501–

3511). 

List of Subjects in 32 CFR Part 199 

Claims, Dental Program, Dental 

Health, Health care, Health insurance, 

Military personnel. 

■ For the reasons set out in the 

preamble, the Department of Defense 

amends 32 CFR part 199 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 199.13 is amended by 

revising paragraphs (a)(2)(iii), 

(c)(2)(i)(a)(2) and (c)(3)(ii)(E)(2), and 

adding paragraphs (a)(2)(iv) and (i) to 

read as follows: 

§ 199.13 TRICARE Dental Program. 

(a) * * * 

(2) * * * 

(iii) Exclusion of benefit services 

performed in military dental care 

facilities. Except for emergency 

treatment, dental care provided outside 

the United States, services incidental to 

noncovered services, and services 

provided under paragraph (a)(2)(iv), 

dependents of active duty, Selected 

Reserve and Individual Ready Reserve 

members enrolled in the TDP may not 

obtain those services that are benefits of 

the TDP in military dental care 

facilities, as long as those covered 

benefits are available for cost-sharing 

under the TDP. Enrolled dependents of 

active duty, Selected Reserve and 

Individual Ready Reserve members may 

continue to obtain noncovered services 

from military dental care facilities 

subject to the provisions for space 

available care. 

(iv) Exception to the exclusion of 

services performed in military dental 

care facilities. 

(A) Dependents who are 12 years of 

age or younger and are covered by a 

dental plan established under this 

section may be treated by postgraduate 

dental residents in a dental treatment 

facility of the uniformed services under 

a graduate dental education program 

accredited by the American Dental 

Association if 

(1) Treatment of pediatric dental 

patients is necessary in order to satisfy 

an accreditation standard of the 

American Dental Association that is 

applicable to such program, or training 

in pediatric dental care is necessary for 

the residents to be professionally 

qualified to provide dental care for 

dependent children accompanying 

members of the uniformed services 

outside the United States; and 

(2) The number of pediatric patients 

at such facility is insufficient to support 

satisfaction of the accreditation or 

professional requirements in pediatric 

dental care that apply to such programs 

or students. 

(B) The total number of dependents 

treated in all facilities of the uniformed 

services under paragraph (a)(2)(iv) in a 

fiscal year may not exceed 2,000. 

* * * * * 

(c) * * * 

(2) * * * 

(i) * * * 

(A) * * * 

(2) Child. To be eligible, the child 

must be unmarried and meet one of the 

requirements set forth in section 

199.3(b)(2)(ii)(A)–(F) or 

199.3(b)(2)(ii)(H). 

* * * * * 

(c) * * * 

(3) * * * 

(ii) * * * 

(E) * * * 

(2) Continuation of eligibility. Eligible 

dependents of active duty members 

while on active duty for a period of 

more than 30 days and eligible 

dependents of members of the Ready 

Reserve (i.e., Selected Reserve or 

Individual Ready Reserve, as specified 

in 10 U.S.C. 10143 and 10144(b) 

respectively), shall be eligible for 

continued enrollment in the TDP for up 

to three (3) years from the date of the 

member’s death, if, on the date of the 

death of the member, the dependent is 

enrolled in the TDP, or is not enrolled 

by reason of discontinuance of a former 

enrollment under paragraphs 

(e)(3)(ii)(E)(4)(ii) and (c)(3)(ii)(E)(4)(iii) 

of this section, or is not enrolled 

because the dependent was under the 

minimum age for enrollment at the time 

of the member’s death. This continued 

enrollment is not contingent on the 

Selected Reserve or Individual Ready 

Reserve member’s own enrollment in 

the TDP. During the three-year period of 

continuous enrollment, the government 

will pay both the Government and the 

beneficiary’s portion of the premium 

share. 

* * * * * 

(i) Implementing Instructions. The 

Director, TRICARE Management 

Activity or designee may issue 

TRICARE Dental Program policies, 

standards, and criteria as may be 

necessary to implement the intent of 

this section. 

* * * * * 

Dated: September 14, 2005. 

L.M. Bynum, 

Alternate OSD Federal Register Liaison 

Officer, Department of Defense. 

[FR Doc. 05–18753 Filed 9–20–05; 8:45 am] 

BILLING CODE 5001–06–M 

DEPARTMENT OF HOMELAND 

SECURITY 

Coast Guard 

33 CFR Part 165 

[USCG–2005–22429] 

RIN 1625–AA11 

Safety Zones; Sector New Orleans; 

Barges 

AGENCY: Coast Guard, DHS. 

ACTION: Temporary final rule. 

SUMMARY: The Coast Guard is 

establishing safety zones on the 

navigable waters of Sector New Orleans 

surrounding barges that have sustained 

damage requiring salvage operations 

during Hurricane Katrina. This action is 

necessary to provide for the safety of life 

and property during salvage operations, 

as well as to minimize effects on the 

navigable waters of Sector New Orleans. 

DATES: This rule is effective from 

September 19, 2005 through December 

31, 2005. 

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–2005–22429 and are 

available for inspection or copying at 

the Docket Management Facility, U.S. 

Department of Transportation, room PL–

401, 400 Seventh Street, SW., 

Washington, DC, between 9 a.m. and 5 

p.m., Monday through Friday, except 

Federal holidays. You may also find this