81 FR 46601 - Prescriptions in Alaska and U.S. Territories and Possessions

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 81, Issue 137 (July 18, 2016)

The Department of Veterans Affairs (VA) is removing 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.

[Federal Register Volume 81, Number 137 (Monday, July 18, 2016)]
[Rules and Regulations]
[Pages 46601-46602]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-16908]


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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: Final rule.

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SUMMARY: The Department of Veterans Affairs (VA) is removing 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.

DATES: This final rule is effective August 17, 2016.

FOR FURTHER INFORMATION CONTACT: Kristin J. Cunningham, Director, 
Business Policy, Chief Business Office (10D), 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: In a document published in the Federal 
Register on February 8, 2016 (81 FR 6479), VA proposed to amend part 17 
of 38 CFR by amending the regulations that govern medication provided 
in Alaska and territories and possessions of the United States. We 
provided a 60-day comment period, which ended on April 8, 2016. We 
received no comments on the proposed rule. 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. 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. 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 and Sec.  17.60d provided that VA 
pharmacies would fill prescriptions for these veterans when they were 
receiving care from a non-VA provider to treat 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).
    Sections 17.60d and 17.60e were renumbered as Sec. Sec.  17.96 and 
17.97, respectively, and relate to the same cohort of veterans for whom 
VA is authorized to provide prescription medication under section 
1712(d). 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 are, therefore, 
removing Sec.  17.97 and marking it as reserved for future use, and are 
also revising Sec.  17.96 to clarify that any non-VA pharmacy under 
contract with VA may be used, not just those non-VA pharmacies in a 
state home under contract with VA for filling prescriptions for 
patients in state homes.
    We are making one edit to the proposed revision of the introductory 
paragraph in Sec.  17.96 for grammatical

[[Page 46602]]

accuracy. No change to the meaning of the proposed regulation text is 
intended by this edit.
    Based on the rationale set forth in the Supplementary Information 
to the proposed rule and in this final rule, VA is adopting the 
proposed rule as a final rule with the edit discussed in this final 
rule.

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 guidance 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 directly affects only individuals and would not 
directly affect small entities. Therefore, pursuant to 5 U.S.C. 605(b), 
this amendment is 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), 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 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://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 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 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. Gina S. 
Farrisee, Deputy Chief of Staff, Department of Veterans Affairs, 
approved this document on June 30, 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: June 30, 2016.
Jeffrey Martin,
Office Program Manager, Office of Regulation Policy & Management, 
Office of the Secretary, Department of Veterans Affairs.

    For the reasons set forth in the preamble, we 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 text 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, including 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 and reserve Sec.  17.97.
[FR Doc. 2016-16908 Filed 7-15-16; 8:45 am]
BILLING CODE 8320-01-P