Source: https://www.federalregister.gov/documents/2008/06/30/E8-14722/beneficiary-travel-under-38-usc-111-within-the-united-states
Timestamp: 2017-09-20 15:59:43
Document Index: 633803008

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A Rule by the Veterans Affairs Department on 06/30/2008
73 FR 36796
36796-36802 (7 pages)
E8-14722
https://www.federalregister.gov/d/E8-14722 https://www.federalregister.gov/d/E8-14722
This document amends the beneficiary travel regulations of the Department of Veterans Affairs (VA) that provide a mechanism for payment of travel expenses within the United States under 38 U.S.C. 111 to help veterans and other persons obtain care and services from VA's Veterans Health Administration (VHA). The amended regulations more fully implement the statutory provisions governing such payments.
Effective Date: This final rule is effective July 30, 2008.
This document revises the beneficiary travel regulations that were previously captioned “Transportation of Claimants and Beneficiaries.” The revised regulations, set forth at 38 CFR part 70, provide a mechanism for payment of travel expenses within the United States under 38 U.S.C. 111 to help veterans and other persons obtain care and services from VHA, a subunit within VA.
This final rule adopts, with changes discussed below, the provisions of the corresponding proposed rule published in the Federal Register on July 23, 2007 (72 FR 40096), based on the rationale set forth in the proposed rule and this document.
The proposed rule provided for a 60-day comment period which ended September 21, 2007. We received comments from one commenter. We discuss below issues raised by the commenter.
The commenter asserted that the revised regulations should cover those aspects of beneficiary travel administered by the Veterans Benefit Administration (VBA), one of the Administrations within VA, and that we should add a definition of VBA. We made no changes based on these comments. These regulations properly concern, insofar as they apply to the VBA programs discussed in this comment, the beneficiary travel program administered by VHA under 38 U.S.C. 111 for eligible beneficiaries traveling to and from a Department facility in connection with vocational rehabilitation or incident to a scheduled Compensation and Pension examination. Additional transportation benefits available to vocational rehabilitation participants are, however, administered by VBA in accordance with chapter 31 of title 38, United States Code. As such, they are beyond the travel benefits authorized by section 111 and are properly administered pursuant to separate regulations (see, e.g., 38 CFR 21.154).
The commenter asserted that we should add a definition of “beneficiary” to read: “Beneficiary means a person determined eligible for VHA benefits and who, subject to these regulations, is engaged in official business for the Government and authorized to travel at Government expense.” We made no changes based on this comment. Such a definition would not be correct. A covered beneficiary's travel must be for the limited purpose of obtaining a specific VA benefit or another purpose that qualifies under this rule. Such travel is not undertaken in connection with the conduct of official business on behalf of the Government.
The commenter asserted that we should amend the regulations to provide that any recipient of benefits under 38 U.S.C. chapter 18 who travels to or from a VA facility or VA-authorized health care facility for care or services is eligible to receive beneficiary travel benefits under section 111. We made no changes based on this comment. For purposes of chapter 18, the definition of “health care” includes, among other things, direct transportation costs to and from approved sources of health care. The authority for travel benefits under chapter 18 is 38 U.S.C. 1803(c) and 1813(c), not section 111. These travel benefits are administered separately by VA's Health Administration Center, pursuant to 38 CFR 17.900 et seq.
The proposed rule explained that beneficiaries of the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) had previously been included in error among the groups eligible for beneficiary travel benefits under section 111. The commenter responded that this change should enable VA to have more funds available for those who are in fact eligible for beneficiary travel benefits, permitting VA to increase its reimbursement rates. However, funds allocated for the payment of beneficiary travel benefits under 38 U.S.C. 111 have not been used to pay for CHAMPVA beneficiaries' travel claims. Instead, those claims have been paid with funds allocated to the Health Administration Center, which administers the CHAMPVA program. Consequently, the amendment does not adjust the funding amounts available for the beneficiary travel program and is for clarification only.
Under the provisions of § 70.30(a)(1) as proposed, the Secretary would be authorized to establish a per mile rate for travel by a privately owned vehicle. Further, proposed § 70.30(a)(1)(iv) explained how VA would comply with the statutory provisions of 38 U.S.C. 111(g)(1), which require the Secretary, in consultation with the Administrator of General Services, the Secretary of Transportation, the Comptroller General of the United States, and representatives of veterans' service organizations, to conduct periodic investigations and other investigations required by that section on the actual cost of travel incurred by VA beneficiaries traveling to and from a Department facility for a covered purpose. Those provisions further explained how VA would provide notification of current mileage reimbursement rates. The commenter responded that the Secretary should be bound by the costs identified during such investigations, when determining VA's reimbursement rates. The commenter further stated that any rate that is less than that prescribed for Federal employee travel should be required to be fully justified in the Federal Register. We made no changes based on these comments.
Although the Secretary, when conducting investigations and determining rates under section 111, is required to take into consideration the actual cost of travel, along with other factors specified in the law, it is vital that the Secretary also be able to take into consideration the ramifications of diverting funds from direct medical care for the purpose of increasing mileage Start Printed Page 36797reimbursement rates for the few categories of veterans eligible for beneficiary travel benefits. Indeed, in our view, by not tying the rates payable under section 111 to any other Federal travel program or otherwise mandating the reimbursement level, Congress implicitly recognized the need for this flexibility. Since the process and public notice provided for in § 70.31(a)(1) are appropriate under the applicable statutory provisions, we believe that there is no need for change based on the commenter's suggestions.
As we discuss below, this final rule makes a number of changes from the proposed rule in § 70.31, Deductibles. The proposed rule provided that VA will publish a notice of any change in the rates in the Federal Register and make current rates available on the Internet. In this final rule, we provide the correct Internet address for the rates in § 70.31(a)(2).
Proposed § 70.31(a) had stated, concerning reimbursement for travel to and from VA or VA-authorized health care, that VA shall deduct an amount established by the Secretary for each one-way trip from the amount otherwise payable under part 70 for such one-way trip except in limited circumstances, and had referred in parentheses to the then-current deductible. This final rule removes that parenthetical, which no longer is accurate, and provides a means for access to what the actual deductibles are. The Secretary raised the mileage reimbursement rate for travel under 38 U.S.C. 111 from 11 cents per mile to 28.5 cents per mile effective February 1, 2008, for the reasons stated in a Notice published in the Federal Register on February 1, 2008 (73 FR 6291), which referred to the authority in 38 U.S.C. 111 and the provision in the 2008 Appropriations Act funding an increase in the beneficiary travel mileage reimbursement rate to 28.5 cents per mile. The law requires that whenever the mileage reimbursement rates are increased, there must be a proportionate increase in the deductible amount. Accordingly, that notice announced an increase in the deductible, which for a one-way trip is $7.77. This final rule reflects in § 70.31(a) a Web site and offices at which the public can obtain this and any future change to the deductible amounts.
The Secretary is authorized to waive the deductible requirements when the imposition of the deductible would cause the beneficiary severe financial hardship. Proposed § 70.31(c) concerned implementation of this waiver authority. We are aware that, in general, deductibles and other similar cost sharing requirements constitute a barrier to access to care for those with limited income. Given the significant increase in the deductible and increasing fuel costs, many veterans will now experience financial hardship in meeting the increased deductible requirement. Therefore, the Secretary, acting within his discretionary authority, has concluded it is necessary to expand the categories of beneficiaries who are exempt from the deductible requirement to ensure their continued access to VA health care.
Thus, § 70.31 provides that the following three circumstances will constitute evidence of severe financial hardship for purposes of this section: (1) The beneficiary is in receipt of a VA pension; (2) the beneficiary has income for the year prior to the year of application made pursuant to § 70.20 that does not exceed the household income threshold determined under 38 U.S.C. 1722(a); or (3) the beneficiary's projected income for the year of application does not exceed the household income threshold determined under 38 U.S.C. 1722(a).
In addition, we have added in the final rule a provision to clarify the length of time for which a waiver granted under this section will be valid and effective. While implicit in both the current provisions in 38 CFR part 17 and in the proposed rule, we believe it preferable from a notice perspective to include this in the actual text of the regulation. Under the provisions of § 70.31(d) in this final rule, waivers granted under § 70.31(c) will be in effect: (1) To the end of the calendar year of the application; or (2) until there is a change in the beneficiary's household income status during the calendar year of application that results in the beneficiary no longer meeting the provisions of § 70.31(c) concerning severe financial hardship.
We have also changed § 70.31 by adding paragraph (e), which requires beneficiaries granted a waiver to promptly inform VA of any household income changes during the waiver period that result in their no longer meeting the severe financial hardship provisions of § 70.31(c). This is intended to ensure that those beneficiaries receiving a waiver of the deductible requirement meet eligibility criteria for it.
We are, where applicable, making changes in the final rule to display the approved information collection control numbers that have been assigned by the Office of Management and Budget (OMB). This final rule also makes changes from the proposed rule by making a number of minor clarifications and punctuation corrections.
Based on the rationale set forth in the proposed rule and in this document, we are adopting the provisions of the proposed rule as a final rule without change, except as stated above.
Executive Order 12866 directs agencies to assess all 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, and other advantages; distributive impacts; and equity). The Executive Order classifies a “significant regulatory action,” requiring review by 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 the principles set forth in the Executive Order.
The economic, interagency, budgetary, legal, and policy implications of this rule have been examined and it has been determined to be a significant regulatory action under the Executive Order because it is likely to result in a rule that may raise novel legal or policy issues arising out of legal mandates, the President's priorities, or the principles set forth in the Executive Order and/or materially alter the budgetary impact of entitlements, grants, user fees, or loan programs or the rights and obligations of recipients thereof.
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 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 given year. This rule would have no such effect on State, local, and tribal governments, or on the private sector. Start Printed Page 36798
This final rule contains provisions that constitute collections of information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3521). OMB has approved those collections under control numbers 2900-0080 and 2900-0091. (We determined that it was not necessary to obtain OMB approval for the proposed information collection that was inadvertently described in the preamble of the proposed rule as requiring OMB approval. We did not receive any comments concerning that proposed information collection.) We display the control number under the applicable sections of the regulations in this final rule. OMB assigns a control number for each collection of information it approves. VA may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.
VA hereby certifies that the provisions of the 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. 601-602. This rule primarily affects individuals and any effects on small businesses would be inconsequential. Therefore, pursuant to 5 U.S.C. 605(b), this rule is exempt from the initial and final regulatory flexibility analysis requirement of sections 603 and 604.
Approved: March 31, 2008.
For the reasons set forth in the preamble, the Department of Veterans Affairs amends 38 CFR chapter I as follows:
United States means each of the several States, Territories, and Start Printed Page 36799possessions of the United States, the District of Columbia, and the Commonwealth of Puerto Rico.
(a) A claimant may apply for beneficiary travel orally or in writing but must provide VA the receipt for each expense other than for mileage. Start Printed Page 36800
(d) Notwithstanding other provisions of this section, for travel that includes meals and/or lodging, a claimant must apply for and receive approval prior to obtaining the meals and/or lodging in order to receive payment in accordance with § 70.30(a)(3) for the meals and/or lodging.
(The Office of Management and Budget has approved the information collection provisions in this section under control number 2900-0080.)
(iv) As required by law, each time the Federal government makes a change in mileage rates payable under 5 U.S.C. 5702 and 5704 for Federal employee travel by privately owned vehicle, but not less frequently than annually, the Secretary shall conduct an investigation of the actual costs of travel, including lodging and subsistence. In conducting the investigation, the Secretary shall consult with the Administrator of the General Services Administration, the Secretary of Transportation, the Comptroller General of the United States, and veterans' service organizations. As part of the investigation, the Secretary shall review and consider various factors including vehicle depreciation, State and Federal vehicle taxes and the costs of gasoline, oil, maintenance, accessories, parts, tires, and insurance. However, to the extent that the Administrator of General Services has, within a reasonable period of time, conducted an investigation of travel costs that included the factors described in this paragraph, the Secretary may consider that investigation in lieu of conducting a separate investigation with respect to the findings of those individual factors. The Secretary is not obligated to accept or rely on any conclusions of the Administrator's investigation. Based on the investigation required by this subsection, VA shall determine whether there is a need to change the mileage rates payable under paragraph (a) of this section. If a determination is made that a change is warranted the new rate(s) will be published in the notices section of the Federal Register. Current rate(s) can be found at http://www.va.gov/​healtheligibility/​Library/​pubs/​BeneficiaryTravel/​BeneficiaryTravel.pdf or by contacting the Beneficiary Travel office at the closest VA health care facility.
(2) The actual cost of ferry fares, bridge tolls, road tolls, and tunnel tolls (supported by receipts for such expenses as required by § 70.20(a)).
(3) Payment may be made for travel from or to a place where the beneficiary is staying (if the beneficiary is not staying at the beneficiary's residence) but the payment may not exceed the amount that would be payable for travel Start Printed Page 36801under paragraph (b)(1) or (b)(2) of this section, as applicable.
(2) Whenever the Secretary adjusts the mileage rates as a result of the investigation described in § 70.30(a)(1)(iv), the Secretary shall, effective on the date such mileage rate change should occur, adjust proportionally the deductible amount in effect at the time of the adjustment. If a determination is made that a change is warranted, the new deductible(s) will be published in the notice section of the Federal Register. Current deductible(s) can be found at http://www.va.gov/​healtheligibility/​Library/​pubs/​BeneficiaryTravel/​BeneficiaryTravel.pdf or by contacting the Beneficiary Travel office at the closest VA health care facility.
(2) Has income for the year prior to the year in which application is made pursuant to § 70.20 that does not exceed the household income threshold determined under 38 U.S.C. 1722(a) (the current income thresholds can be found at http://www.va.gov/​healtheligibility/​Library/​pubs/​VAIncomeThresholds/​VAIncomeThresholds.pdf); or
(3) Has circumstances in the year the application is made pursuant to § 70.20 that cause his or her projected income not to exceed the household income threshold determined under 38 U.S.C. 1722(a).
(1) Through the end of the calendar year of the application made pursuant to § 70.20; or
(2) Until there is a change in the beneficiary's household income during the calendar year of the application made pursuant to § 70.20 that results in the beneficiary no longer meeting the terms of paragraph (c) of this section.
(The Office of Management and Budget has approved the information collection provisions in this section under control number 2900-0091.)
[FR Doc. E8-14722 Filed 6-27-08; 8:45 am]