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Federal Register / Vol. 84, No. 148 / Thursday, August 1, 2019 / Rules and Regulations 37587 

EPA APPROVED OKLAHOMA REGULATIONS—Continued 

State citation Title/subject State effective date EPA approval date Explanation 

* * * * * * * 

* * * * * 

[FR Doc. 2019–16229 Filed 7–31–19; 8:45 am] 

BILLING CODE 6560–50–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

42 CFR Part 81 

[Docket Number CDC–2019–0050; NIOSH– 

329] 

RIN 0920–AA74 

Guidelines for Determining the 

Probability of Causation Under the 

Energy Employees Occupational 

Illness Compensation Program Act of 

2000; Technical Amendments 

AGENCY: Centers for Disease Control and 

Prevention, HHS. 

ACTION: Interim final rule. 

SUMMARY: The Department of Health and 

Human Services (HHS) is revising its 

regulations to update references to the 

International Classification of Disease 

(ICD) codes from ICD–9–CM to ICD–10– 

CM, and remove outdated references to 

chronic lymphocytic leukemia from 

Energy Employees Occupational Illness 

Compensation Program regulations. 

These technical amendments have no 

effect on the cancer eligibility 

requirement under the Program because 

all cancer types are eligible to receive a 

dose reconstruction from NIOSH. Thus, 

no eligible claimant will be adversely 

impacted by this rulemaking. 

DATES: This rule is effective on August 

1, 2019. Comments must be received by 

September 30, 2019. 

ADDRESSES: You may submit comments, 

identified by ‘‘RIN 0920–AA74,’’ by any 

of the following methods: 

• Internet: Access the Federal erulemaking portal at http:// 

www.regulations.gov. Follow the 

instructions for submitting comments to 

docket CDC–2019–0050. 

• Mail: NIOSH Docket Office, 1090 

Tusculum Avenue, MS C–34, 

Cincinnati, OH 45226–1998. 

Instructions: All submissions received 

must include the agency name and 

docket number or Regulation Identifier 

Number (RIN) for this rulemaking. For 

detailed instructions on submitting 

comments and additional information 

on the rulemaking process, see the 

‘‘Public Participation’’ heading of the 

SUPPLEMENTARY INFORMATION section of 

this document. 

Docket: For access to the docket to 

read background documents or 

comments received, go to http:// 

www.regulations.gov and search for 

CDC–2019–0050. 

FOR FURTHER INFORMATION CONTACT: 

Rachel Weiss, Program Analyst; 1090 

Tusculum Ave., MS: C–48, Cincinnati, 

OH 45226; telephone (855) 818–1629 

(this is a toll-free number); email 

NIOSHregs@cdc.gov. 

SUPPLEMENTARY INFORMATION: 

Table of Contents 

I. Public Participation 

II. Background 

III. Issuance of an Interim Final Rule With 

Immediate Effective Date 

IV. Technical Review by the Advisory Board 

on Radiation and Worker Health 

V. Summary of Interim Final Rule 

VI. Regulatory Assessment Requirements 

A. Executive Orders 12866 (Regulatory 

Planning and Review) and 13563 

(Improving Regulation and Regulatory 

Review) 

B. Executive Order 13771 (Reducing 

Regulation and Controlling Regulatory 

Costs) 

C. Regulatory Flexibility Act 

D. Paperwork Reduction Act 

E. Small Business Regulatory Enforcement 

Fairness Act 

F. Unfunded Mandates Reform Act of 1995 

G. Executive Order 12988 (Civil Justice) 

H. Executive Order 13132 (Federalism) 

I. Executive Order 13045 (Protection of 

Children From Environmental Health 

Risks and Safety Risks) 

J. Executive Order 13211 (Actions 

Concerning Regulations That 

Significantly Affect Energy Supply, 

Distribution, or Use) 

K. Plain Writing Act of 2010 

I. Public Participation 

Interested persons or organizations 

are invited to participate in this 

rulemaking by submitting written views, 

arguments, recommendations, and data. 

Comments are invited on any topic 

related to this rulemaking. 

All relevant comments submitted will 

be available for examination in the 

docket for this rulemaking both before 

and after the closing date for comments. 

All relevant comments will be posted 

without change to Docket CDC–2019– 

0050 at http://www.regulations.gov 

including any personal information 

provided. 

All relevant communications received 

on or before the closing date for 

comments will be fully considered by 

HHS. 

II. Background 

The Energy Employees Occupational 

Illness Compensation Program Act of 

2000 (EEOICPA) 1 was established to 

provide financial compensation and 

prospective medical benefits to 

employees for illness caused by 

exposure to radiation, beryllium, silica, 

and toxic substances during their 

employment at facilities of the 

Department of Energy, its predecessor 

agencies, and certain of its contractors 

and vendors. It is administered by the 

Department of Labor’s Office of 

Workers’ Compensation Programs 

(OWCP) with radiation dose 

reconstructions for claims involving 

radiogenic cancers provided by CDC’s 

National Institute for Occupational 

Safety and Health (NIOSH). For these 

radiogenic cancer claims, OWCP is 

responsible for developing a claim file 

upon receipt of an application for 

benefits under EEOICPA from a 

claimant. The claim file includes, 

among other things, employment history 

and an International Classification of 

Disease (ICD) diagnosis code(s) 

indicating the type and location of a 

radiogenic cancer for the claimant. After 

a claim file is developed, OWCP then 

transmits the claim file to NIOSH, 

which uses that information to estimate 

the amount of radiation (radiation 

‘‘dose’’) the worker might have received 

during covered employment. OWCP 

then makes determinations regarding 

the likelihood that an individual’s 

cancer is associated with workplace 

radiation exposures using a number of 

factors, including the radiation doses 

estimated by NIOSH. Existing HHS 

regulations in 42 CFR part 81 require 

the use of International Classification of 

Disease, 9th Revision, Clinical 

Modification (ICD–9–CM) codes to 

identify specific cancer types used in 

making these determinations. 

The World Health Organization 

(WHO) develops diagnostic codes for 

the identification of health conditions; 

these ICD codes are periodically 

updated to reflect advances in health 

and medicine. WHO developed the 10th 

1 42 U.S.C. 7384n(c). 

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37588 Federal Register / Vol. 84, No. 148 / Thursday, August 1, 2019 / Rules and Regulations 

version (ICD–10) to replace the 9th in 

1999. CDC’s National Center for Health 

Statistics developed the ICD–10–CM 

classification, which is a ‘‘clinical 

modification’’ of WHO’s ICD–10 codes, 

for use in coding and classifying disease 

in the clinical setting. Since the 

development of the ICD–10–CM codes, 

health facilities and other organizations, 

including OWCP, have relied on HHS’ 

Centers for Medicare & Medicaid 

Services (CMS) to provide ‘‘general 

equivalence mapping’’ between ICD–9– 

CM codes and ICD–10–CM codes. 

However, CMS will discontinue that 

service on September 30, 2019.2 

Accordingly, OWCP informed NIOSH in 

January 2019 that it will be unable to 

continue providing both ICD–9–CM and 

ICD–10–CM codes in the claim files 

without potentially causing delay to 

claim processing. Therefore, the ICD–9– 

CM codes in part 81 must be replaced 

with ICD–10–CM codes to bring the 

regulations up to date and allow NIOSH 

to efficiently develop dose estimates 

and improve the overall efficiency in 

claim processing. 

Updating the ICD codes and 

references in part 81 will inform the 

claimant population of the current 

diagnosis codes used in the 

compensation program and the dose 

reconstruction process. This rulemaking 

will benefit the population of energy 

workers who submit claims to OWCP 

for benefits under EEOICPA by allowing 

NIOSH to complete radiation dose 

reconstructions in support of OWCP’s 

adjudication of the claims in a timely 

manner. This technical amendment has 

no effect on the cancer eligibility 

requirement under the dose 

reconstruction program (Program) 

because all cancer types are eligible to 

receive a dose reconstruction from 

NIOSH. Thus, no eligible claimant will 

be adversely impacted by this 

rulemaking. 

In addition to updating the ICD codes, 

NIOSH will also remove outdated 

references to chronic lymphocytic 

leukemia (CLL) from part 81. Until 

promulgation of a final rule in 2012,3 

CLL was not covered under the 

EEOICPA program. The 2012 final rule 

removed 42 CFR 81.30, which excluded 

this cancer, thereby allowing claimants 

to seek compensation through the dose 

reconstruction process. That rulemaking 

mistakenly did not remove other 

2 See https://www.cms.gov/Medicare/Coding/ 

ICD10/2019-ICD-10-CM.html. 

3 Final Rule; Guidelines for Determining 

Probability of Causation Under the Energy 

Employees Occupational Illness Compensation 

Program Act of 2000; Revision of Guidelines on 

Non-Radiogenic Cancers, February 6, 2012 (77 FR 

5711). 

references to this provision found 

elsewhere in part 81. 

Finally, a recent Department of Labor 

rulemaking renumbered a CFR section 

that defines the term ‘‘specified cancer’’ 

used in that part. Because that term is 

referenced in HHS’ rules in part 81, the 

citation to the Department of Labor 

regulations is no longer accurate and 

should be updated. 

III. Issuance of an Interim Final Rule

With Immediate Effective Date

Rulemaking under the Administrative 

Procedure Act (APA) generally requires 

a public notice and comment period and 

consideration of the submitted 

comments prior to promulgation of a 

final rule (5 U.S.C. 553). However, the 

APA provides for exceptions to its 

notice and comment procedures when 

an agency finds that there is good cause 

for dispensing with such procedures on 

the basis that they are impracticable, 

unnecessary, or contrary to the public 

interest. In accordance with the 

provisions in 5 U.S.C. 553(b)(3)(B), HHS 

finds good cause to waive the use of 

prior notice and comment procedures 

when issuing this IFR and to make 

updates to references and ICD codes in 

42 CFR part 81 effective immediately. 

This IFR amends 42 CFR part 81 to 

update references and ICD codes. HHS 

has determined that it is unnecessary to 

use prior notice and comment 

procedures for this IFR because HHS 

has already issued through notice-andcomment rulemaking a requirement that 

covered entities, such as physicians and 

hospitals, use ICD–10–CM for covered 

transactions.4 Updating the ICD codes is 

a technical amendment in which CDC 

exercises little discretion. Soliciting 

public comment prior to promulgation 

of this rulemaking would be 

unnecessary since mapping between 

ICD–9 and –10 codes is straightforward 

and all cancer types are eligible to 

receive a dose reconstruction from 

NIOSH. Moreover, notice and comment 

rulemaking would be impracticable and 

contrary to the public interest because 

the rulemaking process may take up to 

2 years to complete, resulting in the 

public not being provided timely 

information about the updated diagnosis 

codes as well as a lack of transparency 

in NIOSH’s dose reconstruction process. 

NIOSH was not notified until January 

2019 that OWCP will no longer provide 

both sets of ICD codes when CMS 

phases out the general equivalence 

mapping in September 2019. Thus, 

there is limited time in which to 

promulgate this regulation. For similar 

reasons, HHS has also determined that 

4 45 CFR 162.1002(c)(2). 

the need for immediate implementation 

of the proposed updates to ensure 

transparency and expediency in the 

NIOSH dose reconstruction process 

outweighs the fairness consideration 

and any need of potential stakeholders 

to adjust to the use of ICD–10–CM 

codes. Accordingly, HHS is waiving the 

prior notice and comment procedures in 

the interest of regulatory compliance 

and administrative efficiency. 

Under 5 U.S.C. 553(d)(3), HHS finds 

good cause to make this IFR effective 

immediately. As stated above, in order 

to facilitate the complete transition of 

the Program from ICD–9–CM to ICD–10– 

CM, it is necessary that HHS act quickly 

to amend 42 CFR part 81 to allow 

NIOSH to replace all references to ICD– 

9–CM codes with ICD–10–CM codes. 

While amendments to 42 CFR part 81 

are effective on the date of publication 

of this IFR, they are interim and a final 

rule will be published following the 

receipt and consideration of any 

substantive public comments. 

IV. Technical Review by the Advisory

Board on Radiation and Worker Health

EEOICPA requires that HHS obtain a 

technical review by the Advisory Board 

on Radiation and Worker Health (the 

Board) prior to establishing the 

probability of causation guidelines to be 

amended through this rulemaking.5 

HHS interprets this requirement also to 

apply to any revisions HHS would make 

to these guidelines. Hence, HHS will 

obtain a technical review by the Board 

and consider the findings of this review 

in promulgating the final regulation. 

V. Summary of Interim Final Rule

This interim final rule amends 42 CFR

part 81 to allow NIOSH to update 

references and ICD codes. No 

substantive changes are being made to 

part 81. 

In the existing definitions section, 

§ 81.4, the term ‘‘specified cancer’’

includes a reference to a corresponding

DOL regulation (i.e., 20 CFR 30.5(dd)).

DOL has recently conducted a

rulemaking to revise 20 CFR part 30 that

resulted in the reordering of this

reference from 20 CFR 30.5(dd) to 20

CFR 30.5(gg).6 Therefore, in § 81.4, HHS

is revising the reference to ‘‘20 CFR

30.5(gg).’’ In addition, the definition of

the term ‘‘non-radiogenic cancer’’ is

removed because all cancers are

considered radiogenic and there are no

longer any non-radiogenic cancers

ineligible for receiving a dose

reconstruction from NIOSH. Finally,

§ 81.4 is revised by adding a new

5 42 U.S.C. 7384n(c). 

6 84 FR 3026 (February 8, 2019). 

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Federal Register / Vol. 84, No. 148 / Thursday, August 1, 2019 / Rules and Regulations 37589 

definition of ‘‘ICD–10–CM,’’ to include 

a reference and web link. 

In existing § 81.5(b), the term ‘‘ICD–9’’ 

is replaced with ‘‘ICD–10–CM.’’ In 

§§ 81.21, 81.23, and 81.24, all references 

to ICD–9 codes are changed to ICD–10– 

CM codes. In §§ 81.21(a) and 81.24(a), 

outdated references to CLL are also 

removed. Finally, Appendix A is 

removed in its entirety because it is a 

glossary of ICD–9 codes and their cancer 

descriptions, and such reference tables, 

including tables of ICD–10 codes and 

their cancer descriptions, are readily 

available online. 

VI. Regulatory Assessment 

Requirements 

A. Executive Orders 12866 (Regulatory 

Planning and Review) and 13563 

(Improving Regulation and Regulatory 

Review) 

Executive Orders 12866 and 13563 

direct agencies to assess all costs and 

benefits of available regulatory 

alternatives and, if regulation is 

necessary, to select regulatory 

approaches that maximize net benefits 

(including potential economic, 

environmental, public health and safety 

effects, distributive impacts, and 

equity). E.O. 13563 emphasizes the 

importance of quantifying both costs 

and benefits, of reducing costs, of 

harmonizing rules, and of promoting 

flexibility. 

This interim final rule is not being 

treated as a ‘‘significant’’ action under 

E.O. 12866. It updates references and 

ICD codes in existing 42 CFR part 81 to 

allow better administrative efficiency in 

the processing of dose reconstruction 

claims. The rule does not result in costs 

to the Program, claimants, or any other 

interested parties. Accordingly, HHS 

has not prepared an economic analysis 

and the Office of Management and 

Budget (OMB) has not reviewed this 

rulemaking. 

The rule does not interfere with State, 

local, or tribal governments in the 

exercise of their governmental 

functions. 

B. Executive Order 13771 (Reducing 

Regulation and Controlling Regulatory 

Costs) 

Executive Order 13771 requires 

executive departments and agencies to 

eliminate at least two existing 

regulations for every new significant 

regulation that imposes costs. HHS has 

determined that this rulemaking is costneutral because it does not require any 

new action by stakeholders. The 

rulemaking ensures that the dose 

reconstructions developed by the 

Program can be conducted efficiently. 

Because OMB has determined that this 

rulemaking is not significant, pursuant 

to E.O. 12866, and because it does not 

impose costs, OMB has determined that 

this rulemaking is exempt from the 

requirements of E.O. 13771. Thus it has 

not been reviewed by OMB. 

C. Regulatory Flexibility Act 

The Regulatory Flexibility Act, 5 

U.S.C. 601 et seq., requires each agency 

to consider the potential impact of its 

regulations on small entities including 

small businesses, small governmental 

units, and small not-for-profit 

organizations. The rule affects only 

Federal agencies and certain individuals 

covered by EEOICPA. Therefore, HHS 

certifies that this interim final rule will 

not have a significant economic impact 

on a substantial number of small 

entities. 

D. Paperwork Reduction Act 

The Paperwork Reduction Act, 44 

U.S.C. 3501 et seq., requires an agency 

to invite public comment on and to 

obtain OMB approval of any rule of 

general applicability that requires 

recordkeeping, reporting, or disclosure 

requirements. 

NIOSH has obtained approval from 

OMB to collect information from 

claimants under ‘‘Energy Employees 

Occupational Illness Compensation 

Program Act Dose Reconstruction 

Interviews and Forms (EEOICPA)’’ 

(OMB Control No. 0920–0530, exp. 

January 31, 2022), which covers 

information collected under 42 CFR part 

81. This rulemaking does not change the 

reporting burden on any respondents. 

E. Small Business Regulatory 

Enforcement Fairness Act 

As required by Congress under the 

Small Business Regulatory Enforcement 

Fairness Act of 1996 (5 U.S.C. 801 et 

seq.), the Department will report the 

promulgation of this rule to Congress 

prior to its effective date. The report 

will state that the Department has 

concluded that this rule is not a ‘‘major 

rule’’ because it is not likely to result in 

an annual effect on the economy of $100 

million or more. 

F. Unfunded Mandates Reform Act of 

1995 

Title II of the Unfunded Mandates 

Reform Act of 1995 (2 U.S.C. 1531 et 

seq.) directs agencies to assess the 

effects of Federal regulatory actions on 

State, local, and tribal governments, and 

the private sector ‘‘other than to the 

extent that such regulations incorporate 

requirements specifically set forth in 

law.’’ For purposes of the Unfunded 

Mandates Reform Act, this rule does not 

include any Federal mandate that may 

result in increased annual expenditures 

in excess of $100 million by State, local 

or tribal governments in the aggregate, 

or by the private sector. 

G. Executive Order 12988 (Civil Justice) 

This rule has been drafted and 

reviewed in accordance with Executive 

Order 12988, ‘‘Civil Justice Reform,’’ 

and will not unduly burden the Federal 

court system. This rule has been 

reviewed carefully to eliminate drafting 

errors and ambiguities. 

H. Executive Order 13132 (Federalism) 

The Department has reviewed this 

rule in accordance with Executive Order 

13132 regarding federalism, and has 

determined that it does not have 

‘‘federalism implications.’’ The rule 

does not ‘‘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.’’ 

I. Executive Order 13045 (Protection of 

Children From Environmental Health 

Risks and Safety Risks) 

In accordance with Executive Order 

13045, HHS has evaluated the 

environmental health and safety effects 

of this rule on children. HHS has 

determined that the rule would have no 

effect on children. 

J. Executive Order 13211 (Actions 

Concerning Regulations That 

Significantly Affect Energy Supply, 

Distribution, or Use) 

In accordance with Executive Order 

13211, HHS has evaluated the effects of 

this rule on energy supply, distribution 

or use, and has determined that the rule 

will not have a significant adverse 

effect. 

K. Plain Writing Act of 2010 

Under Public Law 111–274 (October 

13, 2010), executive Departments and 

Agencies are required to use plain 

language in documents that explain to 

the public how to comply with a 

requirement the Federal Government 

administers or enforces. HHS has 

attempted to use plain language in 

promulgating the interim final rule 

consistent with the Federal Plain 

Writing Act guidelines. 

List of Subjects in 42 CFR Part 81 

Cancer, Government employees, 

Nuclear materials, Occupational safety 

and health, Radiation protection, 

Radioactive materials, Workers’ 

compensation. 

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37590 Federal Register / Vol. 84, No. 148 / Thursday, August 1, 2019 / Rules and Regulations 

Interim Final Rule 

For the reasons discussed in the 

preamble, the Department of Health and 

Human Services amends 42 CFR part 81 

as follows: 

PART 81—GUIDELINES FOR 

DETERMINING PROBABILITY OF 

CAUSATION UNDER THE ENERGY 

EMPLOYEES OCCUPATIONAL 

ILLNESS COMPENSATION PROGRAM 

ACT OF 2000 

■ 1. The authority citation for part 81 

continues to read as follows: 

Authority: 42 U.S.C. 7384n(c); E.O. 13179, 

65 FR 77487, 3 CFR, 2000 Comp., p. 321. 

■ 2. Amend § 81.4 as follows: 

■ a. Remove paragraph (l); 

■ b. Redesignate paragraphs (g) through 

(k) as paragraphs (h) through (l), 

respectively; 

■ c. Add a new paragraph (g); 

■ d. In paragraph (s), remove the 

reference ‘‘20 CFR 30.5(dd)’’ and add in 

its place ‘‘20 CFR 30.5(gg)’’. 

The addition reads as follows: 

§ 81.4 Definition of terms used in this part. 

* * * * * 

(g) ICD–10–CM means the 

International Statistical Classification of 

Diseases and Related Health Problems, 

Tenth Revision, Clinical Modification, 

https://www.cdc.gov/nchs/icd/ 

icd10cm.htm. 

* * * * * 

■ 3. Amend § 81.5 as follows: 

■ a. Add a period at the end of 

paragraph (a); 

■ b. Revise paragraph (b); and 

■ c. Add periods at the ends of 

paragraphs (c) through (f). 

The revision reads as follows: 

§ 81.5 Use of personal and medical 

information. 

* * * * * 

(b) Cancer diagnosis (by ICD–10–CM 

code) for primary and secondary 

cancers. 

* * * * * 

■ 4. Revise § 81.21 to read as follows: 

§ 81.21 Cancers requiring the use of 

NIOSH–IREP. 

(a) DOL will calculate probability of 

causation for all cancers using NIOSH– 

IREP. 

(b) Carcinoma in situ (ICD–10–CM 

codes D00–D09), neoplasms of 

uncertain behavior (ICD–10–CM codes 

D37–D44 and D48), and neoplasms of 

unspecified nature (ICD–10–CM code 

D49) are assumed to be malignant, for 

purposes of estimating probability of 

causation. 

(c) All secondary and unspecified 

cancers of the lymph node (ICD–10–CM 

codes C77 and C7B.01) shall be 

considered secondary cancers (cancers 

resulting from metastasis of cancer from 

a primary site). For claims identifying 

cancers of the lymph node, Table 1 in 

§ 81.23(a) provides guidance for 

assigning a primary site and calculating 

probability of causation using NIOSH– 

IREP. 

■ 5. Amend § 81.23 by revising 

paragraph (a) to read as follows: 

§ 81.23 Guidelines for cancers for which 

primary site is unknown. 

(a) In claims for which the primary 

cancer site cannot be determined, but a 

site of metastasis is known, DOL will 

calculate probability of causation 

estimates for various likely primary 

sites. Table 1 of this paragraph (a) 

indicates the primary cancer site(s) DOL 

will use in NIOSH–IREP when the 

primary cancer site is unknown. 

Table 1 to Paragraph (a) 

Primary cancers (ICD–10–CM codes) for 

which probability of causation is to be 

calculated, if only a secondary cancer 

site is known. ‘‘M’’ indicates cancer site 

should be used for males only, and ‘‘F’’ 

indicates the cancer site should be used 

for females only. 

Secondary cancer 

(ICD–10–CM code) 

Lymph nodes of head, face and neck (C77.0) ........................................ 

Intrathoracic lymph nodes (C77.1) ........................................................... 

Intra-abdominal lymph nodes (C77.2) ...................................................... 

Lymph nodes of axilla and upper limb (C77.3) ........................................ 

Inguinal and lower limb lymph nodes (C77.4) ......................................... 

Intrapelvic lymph nodes (C77.5) .............................................................. 

Lymph nodes of multiple sites (C77.8) .................................................... 

Lymph nodes, site unspecified (C77.9) ....................................................

Lung (C78.0) ............................................................................................. 

Mediastinum (C78.1) ................................................................................ 

Pleura (C78.2) .......................................................................................... 

Other respiratory organs (C78.3) ............................................................. 

Small intestine, including duodenum (C78.4) ..........................................

Large intestine and rectum (C78.5) ......................................................... 

Retroperitoneum and peritoneum (C78.6) ............................................... 

Liver, specified as secondary (C78.7) ......................................................

Other digestive organs (C78.8) ................................................................ 

Kidney (C79.0) .......................................................................................... 

Other urinary organs (C79.1) ................................................................... 

Skin (C79.2) .............................................................................................. 

Brain and spinal cord (C79.3) .................................................................. 

ICD–10–CM code of likely primary cancers 

C01, C02, C07(M), C08(M), C09(M), C10(M), C14(F), C32(M), C33, 

C34, C43, C44, C50(F), C73(F), D03. 

C15(M), C33, C34, C50(F). 

C15(M), C16(M), C18, C25(F), C33, C34, C50(F), C53(F), C61(M), 

C64, C65, C66, C68, C82(F), C84(F) (excluding C84.6, C84.7), 

C85(F), C86(F) (excluding C86.5, C86.6), C91.4(F), C96(F). 

C33, C34, C43, C50(F) , D03. 

C19(M), C20(M), C21(M), C33, C34, C43, C44(F), C60(M), C63(M), 

D03. 

C18(M), C19(F), C20(F), C21(F), C33(M), C34(M), C53(F), C54(F), 

C61(M), C67. 

C15(M), C16(M), C18(M), C33, C34, C50(F). 

C15(M), C16, C18, C33, C34, C43, C50(F), C61(M), D03. 

C18, C33, C34, C43(M), C50(F), C61(M), C67(M), C64, C65, C66,

C68, D03(M). 

C15(M), C33, C34, C50(F). 

C15(M), C18(M), C33, C34, C50(F), C56(F), C57(F), C61(M), C64(M), 

C65(M), C66(M), C68(M). 

C15, C18(M), C32, C33, C34, C44(M), C50(F), C61(M), C73(F). 

C17, C18, C25, C33, C34, C49, C43(M), C50(F), C56(F), C57(F), 

C64(M), C65(M), C66(M), C68(M), D03(M). 

C18, C19, C20, C21, C33, C34, C50(F), C56(F), C57(F), C61(M). 

C16, C18, C19(M), C20(M), C21(M), C25, C33(M), C34(M), C49, 

C50(F), C54(F), C56(F), C57(F). 

C16(M), C18, C19(M), C20(M), C21(M), C25, C33, C34, C50(F). 

C15(M), C16, C18, C25, C33, C34, C50(F), C61(M). 

C18, C33, C34, C50(F), C53(F), C61(M), C67, C64, C65, C66, C68, 

C82(F), C84(F) (excluding C84.6, C84.7), C85(F), C86(F) (excluding 

C86.5, C86.6), C91.4(F), C96(F). 

C18, C50(F), C53(F), C56(F), C57(F), C61(M), C67, C64(F), C65(F), 

C66(F), C68(F). 

C18, C33, C34, C49(M), C43, C44(M), C50(F), C64(M), C65(M), 

C66(M), C68(M), D03. 

C33, C34, C43(M), C50(F), D03(M). 

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Federal Register / Vol. 84, No. 148 / Thursday, August 1, 2019 / Rules and Regulations 37591 

Secondary cancer 

(ICD–10–CM code) 

Other parts of nervous system (C79.4) .................................................... 

Bone and bone marrow (C79.5) ............................................................... 

Ovary (C79.6) ........................................................................................... 

Adrenal gland (C79.7) .............................................................................. 

Other specified sites (C79.8) .................................................................... 

Unspecified sites (C79.9) ......................................................................... 

Carcinoid tumor of distant lymph nodes (C7B.01) ................................... 

Carcinoid tumor of liver (C7B.02) ............................................................. 

Carcinoid tumor of bone (C7B.03) ........................................................... 

Carcinoid tumor of peritoneum (C7B.04) ................................................. 

Merkel cell carcinoma (C7B.1) ................................................................. 

ICD–10–CM code of likely primary cancers 

C33, C34, C43(M), C50(F), C61(M), C82, C84 (excluding C84.6, 

C84.7), C85, C86 (excluding C86.5, C86.6), C91.4, C96, D03(M). 

C33, C34, C50(F), C61(M). 

C18(F), C50(F), C56(F), C57(F). 

C18(F), C33, C34, C50(F). 

C18, C33, C34, C43(M), C50(F), C56(F), C57(F), C61(M), C67(M), 

D03(M). 

C18, C33, C34, C43(M), C50(F), C56(F), C57(F), C61(M), C67(M), 

D03(M). 

C15(M), C16, C18, C33, C34, C43, C50(F),C61(M), D03. 

C16(M), C18, C19(M), C20(M), C21(M), C25, C33, C34, C50(F). 

C33, C34, C50(F), C61(M). 

C16, C18, C19(M), C20(M), C21(M), C25, C33(M), C34(M), C49, 

C50(F), C54(F), C56(F), C57(F). 

C18, C33, C34, C49(M), C43, C44(M), C50(F), C64(M), C65(M), 

C66(M), C68(M), D03. 

* * * * * 

■ 6. Amend § 81.24 by revising 

paragraph (a) to read as follows:

§ 81.24 Guidelines for leukemia.

(a) For claims involving leukemia,

DOL will calculate one or more 

probability of causation estimates from 

up to three of the four alternate 

leukemia risk models included in 

NIOSH–IREP, as specified in the 

NIOSH–IREP Operating Guide. These 

include: ‘‘Leukemia, all types’’ (ICD–10– 

CM codes C91–C95), ‘‘acute 

lymphocytic leukemia’’ (ICD–10–CM 

code C91.0), and ‘‘acute myelogenous 

leukemia’’ (ICD–10–CM codes C92.6 

and C92.A). 

* * * * * 

§ 81.25 [Amended]

■ 7. Amend § 81.25 by redesignating 

footnote 4 as footnote 3.

Dated: July 25, 2019. 

Alex M. Azar II, 

Secretary, Department of Health and Human 

Services. 

[FR Doc. 2019–16347 Filed 7–31–19; 8:45 am] 

BILLING CODE 4163–18–P 

FEDERAL COMMUNICATIONS 

COMMISSION 

47 CFR Part 20 

[WT Docket No. 17–228, FCC 18–167] 

Revisions to Reporting Requirements 

Governing Hearing Aid-Compatible 

Handsets 

AGENCY: Federal Communications 

Commission. 

ACTION: Final rule; announcement of 

compliance dates. 

SUMMARY: The Wireless 

Telecommunications Bureau (WTB or 

the Bureau) announces that the Office of 

Management and Budget (OMB) has 

approved the information-collection and 

recordkeeping requirements associated 

with the recently amended hearing aid 

compatibility provisions addressing 

wireless service provider record 

retention, website posting, and 

certification filing requirements and 

announces the date by which service 

providers must be in compliance with 

these provisions. 

DATES: Effective August 1, 2019. 

Compliance Dates: Compliance with 

47 CFR 20.19(e), (h) and (i) is required 

as of September 3, 2019. The § 20.19(i) 

service provider certification filing 

requirement must be completed 

between the compliance date and no 

later than 30 days after the compliance 

date. 

FOR FURTHER INFORMATION CONTACT: 

Susannah Larson, Wireless 

Telecommunications Bureau, at (202) 

418–1883 or via email: 

. For additional 

information concerning the Paperwork 

Reduction Act information collection 

requirements contact Cathy Williams at 

. 

SUPPLEMENTARY INFORMATION: This 

document announces that OMB 

approved the information collection 

requirements in revised §§ 20.19(e), (h), 

and (i) on June 25, 2019. Revised 

§ 20.19(e) addresses the reporting and

certification requirements applicable to

de minimis wireless service providers.

Revised § 20.19(h) sets forth service

provider website posting and record

retention obligations and revised

§ 20.19(i) sets forth service provider

annual certification requirements. The

Commission adopted these revised rules

in the following Report and Order

susannah.larson@fcc.gov

(202) 418–2918 or via email:

cathy.williams@fcc.gov

Revisions to Reporting Requirements

Governing Hearing Aid-Compatible

Mobile Handsets, FCC 18–167, 

published at 83 FR 63098 on December 

7, 2018 (Report and Order). 

The Report and Order provides that 

the Bureau will publish a document in 

the Federal Register announcing 

compliance dates for revised §§ 20.19(e), 

(h), and (i) once OMB approval is 

obtained for the paperwork burden 

associated with these sections. Further, 

the Report and Order states that the 

Bureau will revise § 20.19(m) once OMB 

approval is obtained for §§ 20.19(e), (h), 

and (i) and a compliance date for these 

sections is established. Section 20.19(m) 

states that compliance with the 

paperwork obligations of §§ 20.19(e), 

(h), and (i) is not required until OMB 

approval is obtained and a compliance 

date is established. The other rule 

amendments that the Commission 

adopted in the Report and Order did not 

require OMB approval and compliance 

with those rule sections was required as 

of January 7, 2019. See Report and 

Order at 83 FR 63098 (Dec. 7, 2018). 

With respect to §§ 20.19(e) and (h), 

service providers must be in compliance 

with these sections by the compliance 

date set out above, except to the extent 

that these sections reference the 

§ 20.19(i) certification requirement.

With respect to the § 20.19(i) 

certification requirement, service 

providers may begin filing their 

certifications on the compliance date 

announced above and must have their 

certifications filed with the Commission 

within 30 days of that date. Service 

providers will be using new electronic 

FCC Form 855 to make their 

certifications. The OMB approved 

instructions for how to fill out and file 

the electronic FCC Form 855 

certification will be available on the 

hearing aid compatibility section of the 

FCC website starting on the compliance 

date listed above. We remind service 

providers that the initial certifications