[Federal Register Volume 79, Number 220 (Friday, November 14, 2014)]
[Rules and Regulations]
[Pages 68130-68131]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-26954]



[[Page 68130]]

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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AO93


Technical Corrections to Medical Regulations Based on Veterans' 
Health Care Eligibility Reform Act of 1996

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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SUMMARY: The Department of Veterans Affairs (VA) is amending its 
medical regulations by making technical corrections to conform to the 
Veterans' Health Care Eligibility Reform Act of 1996 (Act of 1996). 
Currently VA regulations read that veterans receive only VA hospital 
care to treat medical conditions of eligible veterans. We are amending 
our regulation to clarify that VA provides hospital care and medical 
services to eligible veterans.

DATES: This final rule is effective November 14, 2014.

FOR FURTHER INFORMATION CONTACT: Kristin J. Cunningham, Director, 
Business Policy, Chief Business Office, Veterans Health Administration, 
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 
20420; (202) 461-1599. (This is not a toll-free number.)

SUPPLEMENTARY INFORMATION: The Veterans' Health Care Eligibility Reform 
Act of 1996 (Act of 1996) significantly changed the provision of care 
to eligible veterans by establishing an enrollment system of care that 
gives priority for VA medical care to veterans whose disabilities are 
connected to military service. Section 101, Public Law 104-262, 103 
Stat. 3177. The general enrollment regulations are set forth in 38 CFR 
17.36 through 17.38, which are not being amended by this rulemaking. 
The Act of 1996 clarified that not only does VA provide hospital care, 
but VA also provides medical services to eligible veterans. Section 
1701 of 38 U.S.C. defines the term medical services, which include, 
among other things, medical examinations, treatment, and rehabilitative 
services. Since VA has been providing hospital care and medical 
services to eligible veterans as required by the Act of 1996, VA is 
updating Sec.  17.47 accordingly. Current Sec.  17.47 refers only to 
VA's provision of hospital care to eligible veterans when, in fact, VA 
provides hospital care and medical services to such veterans.
    The title of Sec.  17.47 is amended to reflect the scope of the 
section. The title of the section is changed from ``Considerations 
applicable in determining eligibility for hospital, nursing home or 
domiciliary care'' to read ``Considerations applicable in determining 
eligibility for hospital care, medical services, nursing home care or 
domiciliary care.''
    We are editing Sec.  17.47 to add the term ``medical services'' 
where appropriate. For example, the first sentence of paragraph (a)(1) 
reads, ``For applicants discharged or released for disability incurred 
or aggravated in line of duty and who are not in receipt of 
compensation for service-connected or service-aggravated disability, 
the official records of the Armed Forces relative to findings of line 
of duty for its purposes will be accepted in determining eligibility 
for hospital care.'' We are amending this sentence by adding ``or 
medical services'' immediately after ``hospital care''. Because VA does 
not limit its services to hospital care only, the addition reflects the 
types of care available to veterans. The other amendments in paragraph 
(a)(1) and in paragraphs (a)(2), (c), (d)(1), (d)(2), (f), (g)(1) and 
(g)(2) are made for the same purpose.
    For this same reason, we are replacing the term ``admission'' in 
paragraph (a)(1) with the term ``such care or services''. The term 
``admission'' is too narrow, as it applies only to hospital admission 
and not outpatient medical services. We are also replacing the term 
``hospitalization'' in paragraph (a)(1) with ``hospital care or medical 
services''. We are making similar edits in paragraph (a)(2).
    We are making a technical edit to Sec.  17.47(j) by correcting the 
spelling of ``cytomegalovirus.''

Administrative Procedure Act

    The Secretary of Veterans Affairs (Secretary) finds good cause 
under the provisions of 5 U.S.C. 553(b)(B) to publish this rule without 
prior opportunity for public comment. This amendment merely revises 
VA's regulation to comply with a statutory mandate that VA provide 
hospital care and medical services to eligible veterans. Therefore, a 
prior opportunity for notice and comment is unnecessary. Additionally, 
for the reason previously stated, the Secretary finds good cause to 
dispense with the delayed-effective-date requirement of 5 U.S.C. 
553(d).

Effect of Rulemaking

    Title 38 of the Code of Federal Regulations, as revised by this 
final rulemaking, represents VA's implementation of its legal authority 
on this subject. Other than future amendments to this regulation or 
governing statutes, no contrary rules or procedures are authorized. All 
existing or subsequent VA guidance must be read to conform with this 
rulemaking if possible or, if not possible, such guidance is superseded 
by this rulemaking.

Paperwork Reduction Act

    This final 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 final rule will 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 final rule will directly affect only individuals and will 
not directly affect small entities. Therefore, pursuant to 5 U.S.C. 
605(b), this rulemaking is exempt from the initial and final regulatory 
flexibility analysis requirements of 5 U.S.C. 603 and 604.

Executive Orders 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), unless OMB waives such review, 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

[[Page 68131]]

the principles set forth in this Executive Order.''
    The economic, interagency, budgetary, legal, and policy 
implications of this regulatory action have been examined, and it has 
been determined not to be a significant 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://www1.va.gov/orpm/, by following the link for VA 
Regulations Published from FY 2004 through FYTD.

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 1 year. This final rule will 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 final rule 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; 
64.013, Veterans Prosthetic Appliances; 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. Jose D. 
Riojas, Chief of Staff, Department of Veterans Affairs, approved this 
document on November 6, 2014, for publication.

List of Subjects in 38 CFR Part 17

    Administrative practice and procedure, Alcohol abuse; Alcoholism, 
Claims, Day care, Dental health, Drug abuse, Government contracts, 
Grant programs--health, Grant programs--veterans, Health care, Health 
facilities, Health professions, Health records, Homeless, Mental health 
programs, Nursing homes, Philippines, Veterans.

    Dated: November 10, 2014.
Janet Coleman,
Chief, Regulations Development, Tracking, and Control, Office of 
Regulation Policy & Management, Office of the General Counsel, U.S. 
Department of Veterans Affairs.

    For the reasons set out in the preamble, VA amends 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.


Sec.  17.47  [Amended]

0
2. Amend Sec.  17.47 by:
0
a. Removing from the section heading ``hospital, nursing home or 
domiciliary care'' and adding in its place ``hospital care, medical 
services, nursing home care, or domiciliary care''.
0
b. In paragraph (a)(1) by:
0
i. Removing all references to ``hospital care'' and adding in each 
place ``hospital care or medical services'';
0
ii. Removing ``admission,'' and adding in its place ``such care or 
services,''; and
0
iii. Removing ``hospitalization,'' and adding in its place ``hospital 
care or medical services,''.
0
c. In paragraph (a)(2), by removing ``admission of the applicant for 
hospital care,'' and adding in its place ``hospital care or medical 
services,''.
0
d. In paragraph (c), removing all references to ``hospital care'' and 
adding in each place ``hospital care or medical services''.
0
e. In paragraphs (d)(1) introductory text and (d)(2), removing all 
references to ``hospital or nursing home care'' and adding in each 
place ``hospital care, medical services, or nursing home care''.
0
f. In paragraph (f), removing ``hospital, nursing home, or outpatient 
care under 38 U.S.C. 1710(a)(3) by virtue of the veteran's eligibility 
for hospital care'' and adding in its place ``hospital care, medical 
services, nursing home care, or outpatient care under 38 U.S.C. 
1710(a)(3) by virtue of the veteran's eligibility for hospital care and 
medical services ''.
0
g. In the first sentences of paragraphs (g)(1) and (2), adding ``and/or 
receiving medical services'' immediately following ``hospitalized''.
0
h. In paragraph (j), removing ``cytemegalovirus'' and adding in its 
place ``cytomegalovirus''.

[FR Doc. 2014-26954 Filed 11-13-14; 8:45 am]
BILLING CODE 8320-01-P