82_FR_21836 82 FR 21747 - Use of Medicare Procedures To Enter Into Provider Agreements for Extended Care Services

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)

Page Range21747-21748
FR Document2017-09449

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 Issue 89 (Wednesday, May 10, 2017) 
[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]


=======================================================================
-----------------------------------------------------------------------

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.

-----------------------------------------------------------------------

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DATES: This proposed rule is withdrawn as of May 10, 2017.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

Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules 21747 comments or information that may lead PART 165—REGULATED NAVIGATION DEPARTMENT OF VETERANS to the discovery of a significant AREAS AND LIMITED ACCESS AREAS AFFAIRS environmental impact from this proposed rule. ■ 1. The authority citation for part 165 38 CFR Part 17 G. Protest Activities continues to read as follows: RIN 2900–AO15 The Coast Guard respects the First Authority: 33 U.S.C. 1231; 50 U.S.C. 191; 33 CFR 1.05–1, 6.04–1, 6.04–6, and 160.5; Use of Medicare Procedures To Enter Amendment rights of protesters. Into Provider Agreements for Extended Department of Homeland Security Delegation Protesters are asked to contact the No. 0170.1. Care Services person listed in the FOR FURTHER INFORMATION CONTACT section to ■ 2. Add § 165.T09–0275 to read as AGENCY: Department of Veterans Affairs. coordinate protest activities so that your follows: ACTION: Withdrawal of proposed rule. message can be received without jeopardizing the safety or security of § 165.T09–0275 Safety Zone; Hope Chest The Department of Veterans SUMMARY: Buffalo Niagara Dragon Boat Festival, Affairs (VA) published a notice of people, places, or vessels. Buffalo River, Buffalo, NY proposed rulemaking in the Federal V. Public Participation and Request for (a) Location. This zone will cover all Register on February 13, 2013, that Comments navigable waters of the Buffalo River; proposed amending its regulations to We view public participation as Buffalo, NY starting at position allow VA to enter into provider essential to effective rulemaking, and 42°52′12.60″ N. and 078°52′17.64″ W. agreements to obtain extended care will consider all comments and material then Southeast to 42°52′3.17″ N. and services for Veterans from community received during the comment period. 078°52′12.43″ W. then East to providers. Since publication of that Your comment can help shape the 42°52′3.68″ N. and 078°52′10.35″ W. proposed rule, further review has led outcome of this rulemaking. If you then Northwest to 42°52′13.41″ N. and VA to conclude VA cannot achieve the submit a comment, please include the 078°52′16.57″ W. then returning to the proposal’s goals without a statutory docket number for this rulemaking, point of origin. change. For this reason, VA withdraws indicate the specific section of this (b) Enforcement Period. This the proposed rule. document to which each comment regulation will be enforced DATES: This proposed rule is withdrawn applies, and provide a reason for each intermittently on June 17, 2017 from as of May 10, 2017. suggestion or recommendation. 7:45 a.m. until 5:15 p.m. FOR FURTHER INFORMATION CONTACT: We encourage you to submit (c) Regulations. (1) In accordance with Daniel Schoeps, Office of Geriatrics and comments through the Federal the general regulations in § 165.23 of Extended Care (10P4G), Department of eRulemaking Portal at http:// this part, entry into, transiting, or Veterans Affairs, 810 Vermont Avenue www.regulations.gov. If your material anchoring within this safety zone is NW., Washington, DC 20420; (202) 461– cannot be submitted using http:// prohibited unless authorized by the 6763 (this is not a toll-free number). www.regulations.gov, contact the person Captain of the Port Buffalo or his SUPPLEMENTARY INFORMATION: VA in the FOR FURTHER INFORMATION designated on-scene representative. published a notice of proposed CONTACT section of this document for alternate instructions. (2) This safety zone is closed to all rulemaking in the Federal Register on We accept anonymous comments. All vessel traffic, except as may be February 13, 2013, that proposed to comments received will be posted permitted by the Captain of the Port allow VA to enter into provider without change to http:// Buffalo or his designated on-scene agreements to obtain extended care www.regulations.gov and will include representative. services for Veterans from community any personal information you have (3) The ‘‘on-scene representative’’ of providers under 38 U.S.C. 1720(c)(1) provided. For more about privacy and the Captain of the Port Buffalo is any (see 78 FR 10117). Since publication of the docket, you may review a Privacy Coast Guard commissioned, warrant or that proposed rule, further review has Act notice regarding the Federal Docket petty officer who has been designated led VA to conclude the goals of this Management System in the March 24, by the Captain of the Port Buffalo to act regulation cannot be achieved without a 2005, issue of the Federal Register (70 on his behalf. statutory change. For this reason, VA FR 15086). (4) Vessel operators desiring to enter withdraws the proposed rule. VA has Documents mentioned in this NPRM or operate within the safety zone must proposed and continues to support as being available in the docket, and all contact the Captain of the Port Buffalo legislation that would authorize VA to public comments, will be in our online or his on-scene representative to obtain use provider agreements to purchase docket at http://www.regulations.gov permission to do so. The Captain of the care in the community. and can be viewed by following that Port Buffalo or his on-scene After publication of the proposed Web site’s instructions. Additionally, if representative may be contacted via rule, section 101 of the Veterans Access, you go to the online docket and sign up VHF Channel 16. Vessel operators given Choice, and Accountability Act of 2014 for email alerts, you will be notified permission to enter or operate in the (Pub. L. 113–146, 128 Stat.1754, when comments are posted or a final safety zone must comply with all hereafter referred to as ‘‘the Choice rule is published. directions given to them by the Captain Act’’) created the Veterans Choice Program, which provides legal authority jstallworth on DSK7TPTVN1PROD with PROPOSALS List of Subjects in 33 CFR Part 165 of the Port Buffalo, or his on-scene representative. for VA to enter into provider agreements Harbors, Marine safety, Navigation to obtain certain extended care services (water), Reporting and recordkeeping Dated: May 4, 2017. for Veterans. The Veterans Choice requirements, Security measures, J.S. Dufresne, Program also has regulations, at 38 CFR Waterways. Captain, U.S. Coast Guard, Captain of the 17.1500, et seq., that are currently For the reasons discussed in the Port Buffalo. operational and have criteria similar to preamble, the Coast Guard proposes to [FR Doc. 2017–09483 Filed 5–9–17; 8:45 am] those in the proposed rule AO15, amend 33 CFR part 165 as follows: BILLING CODE 9110–04–P including eligibility standards for non- VerDate Sep<11>2014 15:10 May 09, 2017 Jkt 241001 PO 00000 Frm 00006 Fmt 4702 Sfmt 4702 E:\FR\FM\10MYP1.SGM 10MYP1

21748 Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules VA providers and standards for Medical and dental schools, Medical comment received to its public docket. payment rates. devices, Medical research, Mental Do not submit electronically any Although the Choice Act provider health programs, Nursing homes, information you consider to be agreements are similar in kind, and Philippines, Reporting and Confidential Business Information (CBI) might seem to provide the same recordkeeping requirements, or other information whose disclosure is authority, they do not. Proposed AO15 Scholarships and fellowships, Travel restricted by statute. Multimedia would have authorized the use of and transportation expenses, Veterans. submissions (audio, video, etc.) must be provider agreements to provide Dated: May 5, 2017. accompanied by a written comment. ‘‘extended care services,’’ defined as Janet Coleman, The written comment is considered the ‘‘geriatric evaluation; nursing home Chief, Office of Regulation Policy & official comment and should include care; domiciliary services; adult day- health care; noninstitutional palliative Management, Office of the Secretary, discussion of all points you wish to Department of Veterans Affairs. make. EPA will generally not consider care, noninstitutional hospice care, and home health care when they are [FR Doc. 2017–09449 Filed 5–9–17; 8:45 am] comments or comment contents located noninstitutional alternatives to nursing BILLING CODE 8320–01–P outside of the primary submission (i.e. home care; and respite care’’ (see 70 FR on the web, cloud, or other file sharing 10121 (Feb. 13, 2013)). Although the system). For additional submission Choice Act provides clear legal ENVIRONMENTAL PROTECTION methods, please contact the person authority for VA to enter into provider AGENCY identified in the FOR FURTHER agreements, the authority is limited to INFORMATION CONTACT section. For the care authorized under the Veterans 40 CFR Part 52 full EPA public comment policy, Choice Program for eligible Veterans [EPA–R05–OAR–2016–0645 FRL–9962–10- information about CBI or multimedia and furnished by Choice-eligible Region 5] submissions, and general guidance on providers. Further, the Veterans Choice making effective comments, please visit Program covers only hospital care and Air Plan Approval; Indiana; http://www2.epa.gov/dockets/ medical services in VA’s medical Commissioner’s Orders for SABIC commenting-epa-dockets. benefits package (see 38 CFR 17.38); this Innovative Plastics captures some extended care services FOR FURTHER INFORMATION CONTACT: AGENCY: Environmental Protection (noninstitutional alternatives to nursing Joseph Ko, Environmental Engineer, Agency (EPA). home care like adult day-health care Attainment Planning and Maintenance ACTION: Proposed rule. and respite care) but not the full scope Section, Air Programs Branch (AR–18J), of services proposed AO15 would have SUMMARY: The Environmental Protection Environmental Protection Agency, covered. Finally, the Veterans Choice Agency (EPA) is proposing to approve Region 5, 77 West Jackson Boulevard, Program will expire when the Choice as a revision to the Indiana State Chicago, Illinois 60604, (312) 886–7947, Fund, established under section 802 of Implementation Plan (SIP) a submittal ko.joseph@epa.gov. the Choice Act, has been exhausted. VA from the Indiana Department of will continue to use provider SUPPLEMENTARY INFORMATION: In the Environmental Management (IDEM) to Final Rules section of this Federal agreements authorized by the Choice EPA, dated December 5, 2016. The Act until the Veterans Choice Program Register, EPA is approving the State’s submittal consists of an order issued by expires, but to accomplish the goals of SIP submittal as a direct final rule the Commissioner of IDEM that the proposed rule, Congress would need without prior proposal because the establishes permanent and enforceable to enact a provider agreement provision sulfur dioxide (SO2) emission limits for Agency views this as a noncontroversial authorizing VA to use provider SABIC Innovative Plastics (SABIC). submittal and anticipates no adverse agreements to purchase care in the IDEM submitted this order so the area comments. A detailed rationale for the community. For these reasons, VA near SABIC can be designated approval is set forth in the direct final withdraws the proposed rule. ‘‘attainment’’ of the 2010 primary SO2 rule. If no adverse comments are Signing Authority National Ambient Air Quality received in response to this rule, no Standards, a matter that will be further activity is contemplated. If EPA The Secretary of Veterans Affairs, or receives adverse comments, the direct addressed in a separate future designee, approved this document and final rule will be withdrawn and all rulemaking. EPA’s approval of this authorized the undersigned to sign and public comments received will be order would make these SO2 emission submit the document to the Office of the limits and applicable reporting, addressed in a subsequent final rule Federal Register for publication recordkeeping, and compliance based on this proposed rule. EPA will electronically as an official document of demonstration requirements part of the not institute a second comment period. the Department of Veterans Affairs. Gina federally enforceable Indiana SIP. Any parties interested in commenting S. Farrisee, Deputy Chief of Staff, Department of Veterans Affairs, DATES: Comments must be received on on this action should do so at this time. approved this document on May 4, or before June 9, 2017. Please note that if EPA receives adverse 2017, for publication. ADDRESSES: Submit your comments, comment on an amendment, paragraph, identified by Docket ID No. EPA–R05– or section of this rule and if that List of Subjects in 38 CFR Part 17 OAR–2016–0645 at http:// provision may be severed from the jstallworth on DSK7TPTVN1PROD with PROPOSALS Administrative practice and www.regulations.gov or via email to remainder of the rule, EPA may adopt procedure, Alcohol abuse, Alcoholism, aburano.douglas@epa.gov. For as final those provisions of the rule that Claims, Day care, Dental health, Drug comments submitted at Regulations.gov, are not the subject of an adverse abuse, Foreign relations, Government follow the online instructions for comment. For additional information, contracts, Grant programs-health, submitting comments. Once submitted, see the direct final rule which is located Government programs-veterans, Health comments cannot be edited or removed in the Rules section of this Federal care, Health facilities, Health from Regulations.gov. For either manner Register. professions, Health records, Homeless, of submission, EPA may publish any VerDate Sep<11>2014 15:10 May 09, 2017 Jkt 241001 PO 00000 Frm 00007 Fmt 4702 Sfmt 4702 E:\FR\FM\10MYP1.SGM 10MYP1


Document Created: 2017-05-10 00:00:45
Document Modified: 2017-05-10 00:00:45
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionProposed Rules
ActionWithdrawal of proposed rule.
DatesThis proposed rule is withdrawn as of May 10, 2017.
ContactDaniel 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).
FR Citation82 FR 21747 
RIN Number2900-AO15
CFR AssociatedAdministrative 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 and Veterans
2025 Federal Register | Disclaimer | Privacy Policy
USC | CFR | eCFR