[Federal Register Volume 81, Number 25 (Monday, February 8, 2016)]
[Proposed Rules]
[Pages 6479-6481]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-02350]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AP42


Prescriptions in Alaska and U.S. Territories and Possessions

AGENCY: Department of Veterans Affairs.

ACTION: Proposed rule.

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SUMMARY: The Department of Veterans Affairs (VA) is proposing to remove 
its medical regulation that governs medications provided in Alaska and 
territories and possessions of the United States because this 
regulation is otherwise subsumed by another VA medical regulation 
related to provision of medications that are prescribed by non-VA 
providers.

[[Page 6480]]


DATES: Comments must be received by VA on or before April 8, 2016.

ADDRESSES: Written comments may be submitted: By mail or hand-delivery 
to Director, Regulations Management (02REG), Department of Veterans 
Affairs, 810 Vermont Avenue NW., Room 1068, Washington, DC 20420; by 
fax to (202) 273-9026; or through http://www.Regulations.gov. Comments 
should indicate that they are submitted in response to ``RIN 2900--
[WP2013-04]--Prescriptions in Alaska and U.S. Territories and 
Possessions.'' All comments received will be available for public 
inspection in the Office of Regulation Policy and Management, Room 
1063B, between the hours of 8 a.m. and 4:30 p.m., Monday through Friday 
(except holidays). Call (202) 461-4902 for an appointment. (This is not 
a toll-free number.) In addition during the comment period, comments 
may be viewed online through the Federal Docket Management System at 
http://www.Regulations.gov.

FOR FURTHER INFORMATION CONTACT: Kristin J. Cunningham, Director, 
Business Policy, Chief Business Office (10NB6), Veterans Health 
Administration, Department of Veterans Affairs, 810 Vermont Ave. NW., 
Washington, DC 20420; (202) 382-2508. (This is not a toll-free number.)

SUPPLEMENTARY INFORMATION: Under section 1712(d) of title 38 United 
States Code (U.S.C.), VA must furnish medications to veterans who 
receive increased compensation or pension benefits by reason of being 
permanently housebound or in need of regular aid and attendance, if 
such medications are prescribed for the treatment of any injury or 
illness suffered by such veteran. Section 1712(d) is distinct from the 
more general authority under 38 U.S.C. 1710 to provide medications to 
veterans as hospital care and medical services; veterans under section 
1712(d) do not have to be receiving VA hospital care or medical 
services as a condition of VA furnishing medications to treat their 
injury or illness. VA originally promulgated two regulations on October 
4, 1967, to implement section 1712(d), in title 38 Code of Federal 
Regulations (CFR) 17.60d and 17.60e. See 32 FR 13816. Because section 
1712(d) does not require these certain veterans to be receiving VA 
hospital care or medical services as a condition of receiving 
medications from VA, Sec.  17.60d provided that VA pharmacies would 
fill prescriptions for these veterans if such prescriptions were ``not 
part of authorized Veterans Administration hospital or outpatient 
care,'' and were ``ordered by a private or non-VA'' provider, and if 
the medications were ``prescribed as specific therapy in the treatment 
of any of the veteran's illnesses or injuries.'' See 32 FR 13816 
(October 4, 1967). Section 17.60e, in turn, addressed geographic areas 
that, at the time, did not have VA pharmacies--Sec.  17.60e provided 
that in those areas without VA pharmacies, VA may reimburse the cost of 
prescriptions that otherwise would have been filled under Sec.  17.60d. 
See 32 CFR 13816 (October 4, 1967). The intent of Sec.  17.60e was to 
supplement Sec.  17.60d, to ensure that eligible veterans under section 
1712(d) and Sec.  17.60d were able to have their medications furnished 
by VA, even if such veterans lived in Alaska and territories and 
possessions of the U.S. where there were no VA pharmacies.
    Sections 17.60d and 17.60e were renumbered as Sec. Sec.  17.96 and 
17.97, respectively, and Sec.  17.97 was further revised at that time 
to remove reference to the former Sec.  17.60d and to insert a 
reference to the relevant section 1712 authority. See 61 FR 21964 (May 
13, 1996). Section 17.96 was later revised to permit the filling of 
prescriptions by non-VA pharmacies in state homes under contract with 
VA. 63 FR 37779 (July 14, 1998). Sections 17.96 and 17.97 relate to the 
same cohort of veterans for whom VA is authorized to provide 
prescription medication under section 1712(d), and Sec.  17.97 was 
intended to supplement Sec.  17.96, although the supplementing effect 
of Sec.  17.97 is not as apparent as when these regulations were first 
promulgated as Sec. Sec.  17.60d and 17.60e. Because the same cohort of 
veterans is at issue in Sec. Sec.  17.96 and 17.97, and because Sec.  
17.96 already provides for the filling of prescriptions in non-VA 
pharmacies, a separate Sec.  17.97 to address prescriptions in non-VA 
pharmacies (pharmacies in areas without VA pharmacies) is no longer 
necessary. We would, therefore, remove Sec.  17.97 and mark it reserved 
for future use, and would revise Sec.  17.96 to clarify that any non-VA 
pharmacy under contract with VA may be used, not just those non-VA 
pharmacies in state homes.

Effect of Rulemaking

    The Code of Federal Regulations, as proposed to be revised by this 
rulemaking, would represent the exclusive legal authority on this 
subject. No contrary rules or procedures would be authorized. All VA 
guidance would be read to conform with this proposed rulemaking if 
possible or, if not possible, such guidance would be superseded by this 
rulemaking.

Paperwork Reduction Act

    This proposed rule contains no provisions constituting a collection 
of information under the Paperwork Reduction Act of 1995 (44 U.S.C. 
3501-3521).

Regulatory Flexibility Act

    The Secretary hereby certifies that this proposed rule would not 
have a significant economic impact on a substantial number of small 
entities as they are defined in the Regulatory Flexibility Act, 5 
U.S.C. 601-612. This proposed rule would directly affect only 
individuals and would not directly affect small entities. Therefore, 
pursuant to 5 U.S.C. 605(b), this amendment would be exempt from the 
initial and final regulatory flexibility analysis requirements of 5 
U.S.C. 603 and 604.

Executive Order 12866 and 13563

    Executive Orders 12866 and 13563 direct agencies to assess the 
costs and benefits of available regulatory alternatives and, when 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety effects, and other advantages; distributive impacts; 
and equity). Executive Order 13563 (Improving Regulation and Regulatory 
Review) emphasizes the importance of quantifying both costs and 
benefits, reducing costs, harmonizing rules, and promoting flexibility. 
Executive Order 12866 (Regulatory Planning and Review) defines a 
``significant regulatory action,'' requiring review by the Office of 
Management and Budget (OMB) as ``any regulatory action that is likely 
to result in a rule that may: (1) Have an annual effect on the economy 
of $100 million or more or adversely affect in a material way the 
economy, a sector of the economy, productivity, competition, jobs, the 
environment, public health or safety, or State, local, or tribal 
governments or communities; (2) Create a serious inconsistency or 
otherwise interfere with an action taken or planned by another agency; 
(3) Materially alter the budgetary impact of entitlements, grants, user 
fees, or loan programs or the rights and obligations of recipients 
thereof; or (4) Raise novel legal or policy issues arising out of legal 
mandates, the President's priorities, or the principles set forth in 
this Executive Order.''
    The economic, interagency, budgetary, legal, and policy 
implications of this proposed rule have been examined, and it has been 
determined not to be a significant

[[Page 6481]]

regulatory action under Executive Order 12866. VA's impact analysis can 
be found as a supporting document at http://www.regulations.gov, 
usually within 48 hours after the rulemaking document is published. 
Additionally, a copy of the rulemaking and its impact analysis are 
available on VA's Web site at http://www.va.gov/orpm/, by following the 
link for ``VA Regulations Published From FY 2004 Through Fiscal Year to 
Date.

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in the expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any one year. This proposed rule would have no such 
effect on State, local, and tribal governments, or on the private 
sector.

Catalog of Federal Domestic Assistance

    The Catalog of Federal Domestic Assistance numbers and titles for 
the programs affected by this document are 64.007, Blind Rehabilitation 
Centers; 64.008, Veterans Domiciliary Care; 64.009, Veterans Medical 
Care Benefits; 64.010, Veterans Nursing Home Care; 64.011, Veterans 
Dental Care; 64.012, Veterans Prescription Service; 64.014, Veterans 
State Domiciliary Care; 64.015, Veterans State Nursing Home Care; 
64.018, Sharing Specialized Medical Resources; 64.019, Veterans 
Rehabilitation Alcohol and Drug Dependence; 64.022, Veterans Home Based 
Primary Care; and 64.024, VA Homeless Providers Grant and Per Diem 
Program.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Robert D. 
Snyder, Interim Chief of Staff, Department of Veterans Affairs, 
approved this document on January 29, 2016, for publication.

List of Subjects in 38 CFR Part 17

    Administrative practice and procedure, Alcohol abuse, Alcoholism, 
Claims, Day care, Dental health, Drug abuse, Health care, Health 
facilities, Health professions, Health records, Homeless, Mental health 
programs, Nursing homes, Veterans.

    Dated: February 2, 2016.
William F. Russo,
Director, Office of Regulation Policy & Management, Office of the 
General Counsel, Department of Veterans Affairs.

    For the reasons set forth in the preamble, we propose to amend 38 
CFR part 17 as follows:

PART 17--MEDICAL

0
1. The authority citation for part 17 continues to read as follows:

    Authority:  38 U.S.C. 501, and as noted in specific sections.

0
2. Amend Sec.  17.96 by revising the introductory paragraph to read as 
follows:


Sec.  17.96  Medication prescribed by non-VA physicians.

    Any prescription, which is not part of authorized Department of 
Veterans Affairs hospital or outpatient care, for drugs and medicines 
ordered by a private or non-Department of Veterans Affairs doctor of 
medicine or doctor of osteopathy duly licensed to practice in the 
jurisdiction where the prescription is written, shall be filled by a 
Department of Veterans Affairs pharmacy or a non-VA pharmacy under 
contract with VA, to include non-VA pharmacy in a state home under 
contract with VA for filling prescriptions for patients in state homes, 
provided:
* * * * *


[Sec.  17.97  Removed and Reserved]

0
3. Remove Sec.  17.97 and mark as reserved for future use.

[FR Doc. 2016-02350 Filed 2-5-16; 8:45 am]
 BILLING CODE 8320-01-P