82 FR 21747 - Use of Medicare Procedures To Enter Into Provider Agreements for Extended Care Services

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 82, Issue 89 (May 10, 2017)

The Department of Veterans Affairs (VA) published a notice of proposed rulemaking in the Federal Register on February 13, 2013, that proposed amending its regulations to allow VA to enter into provider agreements to obtain extended care services for Veterans from community providers. Since publication of that proposed rule, further review has led VA to conclude VA cannot achieve the proposal's goals without a statutory change. For this reason, VA withdraws the proposed rule.

[Federal Register Volume 82, Number 89 (Wednesday, May 10, 2017)]
[Proposed Rules]
[Pages 21747-21748]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-09449]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AO15


Use of Medicare Procedures To Enter Into Provider Agreements for 
Extended Care Services

AGENCY: Department of Veterans Affairs.

ACTION: Withdrawal of proposed rule.

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SUMMARY: The Department of Veterans Affairs (VA) published a notice of 
proposed rulemaking in the Federal Register on February 13, 2013, that 
proposed amending its regulations to allow VA to enter into provider 
agreements to obtain extended care services for Veterans from community 
providers. Since publication of that proposed rule, further review has 
led VA to conclude VA cannot achieve the proposal's goals without a 
statutory change. For this reason, VA withdraws the proposed rule.

DATES: This proposed rule is withdrawn as of May 10, 2017.

FOR FURTHER INFORMATION CONTACT: Daniel Schoeps, Office of Geriatrics 
and Extended Care (10P4G), Department of Veterans Affairs, 810 Vermont 
Avenue NW., Washington, DC 20420; (202) 461-6763 (this is not a toll-
free number).

SUPPLEMENTARY INFORMATION: VA published a notice of proposed rulemaking 
in the Federal Register on February 13, 2013, that proposed to allow VA 
to enter into provider agreements to obtain extended care services for 
Veterans from community providers under 38 U.S.C. 1720(c)(1) (see 78 FR 
10117). Since publication of that proposed rule, further review has led 
VA to conclude the goals of this regulation cannot be achieved without 
a statutory change. For this reason, VA withdraws the proposed rule. VA 
has proposed and continues to support legislation that would authorize 
VA to use provider agreements to purchase care in the community.
    After publication of the proposed rule, section 101 of the Veterans 
Access, Choice, and Accountability Act of 2014 (Pub. L. 113-146, 128 
Stat.1754, hereafter referred to as ``the Choice Act'') created the 
Veterans Choice Program, which provides legal authority for VA to enter 
into provider agreements to obtain certain extended care services for 
Veterans. The Veterans Choice Program also has regulations, at 38 CFR 
17.1500, et seq., that are currently operational and have criteria 
similar to those in the proposed rule AO15, including eligibility 
standards for non-

[[Page 21748]]

VA providers and standards for payment rates.
    Although the Choice Act provider agreements are similar in kind, 
and might seem to provide the same authority, they do not. Proposed 
AO15 would have authorized the use of provider agreements to provide 
``extended care services,'' defined as ``geriatric evaluation; nursing 
home care; domiciliary services; adult day-health care; 
noninstitutional palliative care, noninstitutional hospice care, and 
home health care when they are noninstitutional alternatives to nursing 
home care; and respite care'' (see 70 FR 10121 (Feb. 13, 2013)). 
Although the Choice Act provides clear legal authority for VA to enter 
into provider agreements, the authority is limited to care authorized 
under the Veterans Choice Program for eligible Veterans and furnished 
by Choice-eligible providers. Further, the Veterans Choice Program 
covers only hospital care and medical services in VA's medical benefits 
package (see 38 CFR 17.38); this captures some extended care services 
(noninstitutional alternatives to nursing home care like adult day-
health care and respite care) but not the full scope of services 
proposed AO15 would have covered. Finally, the Veterans Choice Program 
will expire when the Choice Fund, established under section 802 of the 
Choice Act, has been exhausted. VA will continue to use provider 
agreements authorized by the Choice Act until the Veterans Choice 
Program expires, but to accomplish the goals of the proposed rule, 
Congress would need to enact a provider agreement provision authorizing 
VA to use provider agreements to purchase care in the community. For 
these reasons, VA withdraws the proposed rule.

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 May 4, 2017, for publication.

List of Subjects in 38 CFR Part 17

    Administrative practice and procedure, Alcohol abuse, Alcoholism, 
Claims, Day care, Dental health, Drug abuse, Foreign relations, 
Government contracts, Grant programs-health, Government programs-
veterans, Health care, Health facilities, Health professions, Health 
records, Homeless, Medical and dental schools, Medical devices, Medical 
research, Mental health programs, Nursing homes, Philippines, Reporting 
and recordkeeping requirements, Scholarships and fellowships, Travel 
and transportation expenses, Veterans.

    Dated: May 5, 2017.
Janet Coleman,
Chief, Office of Regulation Policy & Management, Office of the 
Secretary, Department of Veterans Affairs.
[FR Doc. 2017-09449 Filed 5-9-17; 8:45 am]
 BILLING CODE 8320-01-P