83 FR 30080 - Removing Outmoded Regulations Regarding the National Health Service Corps Program

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Federal Register Volume 83, Issue 124 (June 27, 2018)

Page Range		30080-30081
FR Document		2018-13837

This action removes outmoded regulations for the National Health Service Corps (NHSC) Program. The regulations were promulgated to implement Section 338G of the Public Health Service (PHS) Act, relating to private practice loans. The regulations have not been updated since they were issued in 1986. The regulations are no longer relevant or needed as the NHSC has not made private practice loan opportunities available since the 1980s, and does not plan to do so in the foreseeable future. The removal of these regulations will not create any challenges for other programs, as the law and regulations apply solely to NHSC clinicians.

Federal Register, Volume 83 Issue 124 (Wednesday, June 27, 2018)

[Federal Register Volume 83, Number 124 (Wednesday, June 27, 2018)]
[Rules and Regulations]
[Pages 30080-30081]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-13837]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

42 CFR Part 23

RIN 0906-AB15


Removing Outmoded Regulations Regarding the National Health 
Service Corps Program

AGENCY: Health Resources and Services Administration (HRSA), HHS.

ACTION: Final rule.

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

SUMMARY: This action removes outmoded regulations for the National 
Health Service Corps (NHSC) Program. The regulations were promulgated 
to implement Section 338G of the Public Health Service (PHS) Act, 
relating to private practice loans. The regulations have not been 
updated since they were issued in 1986. The regulations are no longer 
relevant or needed as the NHSC has not made private practice loan 
opportunities available since the 1980s, and does not plan to do so in 
the foreseeable future. The removal of these regulations will not 
create any challenges for other programs, as the law and regulations 
apply solely to NHSC clinicians.

DATES: This action is effective July 27, 2018.

FOR FURTHER INFORMATION CONTACT: Sweta Maheshwari J.D., Legislative 
Analyst, Division of Policy and Shortage Designation, Bureau of Health 
Workforce, HRSA, 5600 Fishers Lane, Room 11W21A, Rockville, MD 20857, 
by phone at (301) 945-3527, or by email at smaheshwari@hrsa.gov.

SUPPLEMENTARY INFORMATION: In response to Executive Order 13777 and 
Executive Order 13563, Sec. 6(a), which direct agencies to repeal 
existing regulations that are ``outmoded'' from the Code of Federal 
Regulations (CFR), HHS is removing 42 CFR part 23, subpart B 
(Sec. Sec.  23.21 through 23.35) and subpart C (Sec.  23.41). 
Furthermore, HHS has determined that there is good cause to bypass 
notice and comment and proceed to a final rule, pursuant to 5 U.S.C. 
553(b)(B). The action is non-controversial, as it merely removes 
certain provisions from the CFR that are obsolete. Given the length of 
time (approximately 30 years) since the private practice loan provision 
has been utilized, it is HHS's assessment that the agency is unlikely 
to receive any comments opposing the repeal of these regulations. Thus, 
a comment period prior to finalization of this rule is unnecessary. 
This rule poses no new substantive requirements or burdens on the 
public.

Background

    In 1986, HHS issued implementing regulations, as directed in 
Section 338G of the PHS Act, specifying the interest rate and loan 
repayment terms for private practice special loans to former Corps 
members and interest rate and loan repayment terms for private practice 
start-up loans to NHSC scholarship recipients.
    The provision for Special Loans for Former Corps Members to Enter 
Private Practice authorized the Secretary to make a one-time loan up to 
$25,000 to a Corps member. In exchange, the Corps member reciprocated 
by committing to serve as a full-time private practice provider in a 
Health Professional Shortage Area (HPSA) for a minimum of two years. 
The intent of these regulations was to retain Corps members in HPSAs 
after the completion of their service obligation. The regulation is no 
longer relevant as the NHSC has not made such loan opportunities 
available since the 1980s and, therefore, no longer needs to set 
repayment terms for private practice start-up loans. HRSA does not 
intend to restart this loan program, as the NHSC program currently has 
a retention rate of 88%, making additional incentives unnecessary.
    Section 338G also authorizes Private Start-Up Loans. At the time 
the statute was enacted, only the NHSC Scholarship Program existed. 
Scholars were able to apply for up to $25,000 to purchase or lease the 
equipment and supplies needed for providing health services in their 
private practices. The intention of the program was to offer further 
incentives to recruit health professions students into the program. The 
regulation is no longer relevant since the NHSC has not made such loan 
opportunities available since the 1980s and, therefore, no longer has 
need to set repayment terms for private practice start-up loans. 
Furthermore, the NHSC Scholarship Program is significantly 
oversubscribed, and no further incentives are necessary to recruit 
health professions students.
    Removing these regulations will not have an impact on the NHSC 
program. There is no specific appropriations authority to support 
Section 338G of the PHS Act; the authorization of appropriation at 338H 
supports all the activities under Subpart III (which includes the NHSC 
Loan Repayment and Scholarship Programs). The repeal of these 
regulations will not create any challenges for other programs, as the 
law and regulations apply solely to NHSC clinicians.

Executive Orders 12866, 13563, 13771, and 13777

    Executive Orders 12866 and 13563 direct agencies to assess all 
costs and benefits of available regulatory alternatives and, if 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety effects, distributive impacts, and equity). Executive 
Order 13771 directs agencies to categorize all impacts which generate 
or alleviate costs associated with regulatory burden and to determine 
the actions net incremnatal effect.
    Section 3(f) of Executive Order 12866 defines a ``significant 
regulatory action'' as an action that is likely to result in a rule: 
(1) Having an annual effect on the economy of $100 million or more in 
any 1 year, or adversely and materially affecting a sector of the 
economy, productivity, competition, jobs, the environment, public 
health or safety, or State, local or Tribal governments or communities 
(also referred to as ``economically significant''); (2) creating a 
serious inconsistency or otherwise interfering with an action taken or 
planned by another agency; (3) materially altering the budgetary 
impacts of entitlement grants, user fees, or loan programs or the 
rights and obligations of recipients thereof; or (4) raising novel 
legal or policy issues arising out of legal mandates, the President's 
priorities, or the principles set forth in the Executive Order.
    A regulatory impact analysis (RIA) must be prepared for major rules 
with economically significant effects ($100 million or more in any 1 
year). HHS submits that this final rule is not ``economically 
significant'' as measured by the $100 million threshold, and

[[Page 30081]]

hence not a major rule under the Congressional Review Act. This rule 
has not been designated as a ``significant regulatory action'' under 
Executive Order 12866. Accordingly, this rule has not been reviewed by 
the Office of Management and Budget (OMB).
    Executive Order 13771, titled ``Reducing Regulation and Controlling 
Regulatory Costs,'' was issued on January 30, 2017. HHS identifies this 
final rule as a deregulatory action (removing an obsolete rule from the 
Code of Federal Regulations). For the purposes of Executive Order 
13771, this final rule is not a substantive rule; rather it is 
administrative in nature and provides no cost savings.
    Executive Order 13777, titled ``Enforcing the Regulatory Reform 
Agenda,'' was issued on February 24, 2017. As required by Section 3 of 
this Executive Order, HHS established a Regulatory Reform Task Force 
(HHS Task Force). Pursuant to Section 3(d)(ii), the HHS Task Force 
evaluated this rulemaking and determined that these regulations are 
``outdated, unnecessary, or ineffective.'' Following this finding, the 
HHS Task Force advised the HRSA Administrator to initiate this 
rulemaking to remove the obsolete regulations from the Code of Federal 
Regulations.

Regulatory Flexibility Act

    This action will not have a significant economic impact on a 
substantial number of small entities. Therefore, the regulatory 
flexibility analysis provided for under the Regulatory Flexibility Act 
is not required.

Paperwork Reduction Act

    This action does not affect any information collections.

    Dated: June 4, 2018.
George Sigounas,
Administrator, Health Resources and Services Administration.

    Approved: June 21, 2018.
Alex M. Azar II,
Secretary, Department of Health and Human Services.

List of Subjects in 42 CFR Part 23

    Health, Health professions.

    For reasons set out in the preamble, and under the authority at 5 
U.S.C. 301, HHS amends 42 CFR part 23 as follows:

PART 23--NATIONAL HEALTH SERVICE CORPS

0
1. The authority citation for part 23 continues to read as follows:

    Authority: Secs. 333, 338E(c), and 338C(e)(1), Public Health 
Service Act. 90 Stat. 2272, as amended, 95 Stat. 905, 97 Stat. 1345 
(42 U.S.C. 254f et seq.), 95 Stat. 912 (42 U.S.C. 254p(c)), 95 Stat. 
910 (42 U.S.C. 254n(e)(1)).

Subparts B and C [Removed]

0
2. Remove subpart B, consisting of Sec. Sec.  23.21 through 23.35, and 
subpart C, consisting of Sec.  23.41.

[FR Doc. 2018-13837 Filed 6-26-18; 8:45 am]
BILLING CODE 4165-15-P

30080 Federal Register / Vol. 83, No. 124 / Wednesday, June 27, 2018 / Rules and Regulations

Dated: June 4, 2018. regulations that are ‘‘outmoded’’ from and, therefore, no longer has need to set
George Sigounas, the Code of Federal Regulations (CFR), repayment terms for private practice
Administrator, Health Resources and Services HHS is removing 42 CFR part 23, start-up loans. Furthermore, the NHSC
Administration. subpart B (§§ 23.21 through 23.35) and Scholarship Program is significantly
Approved: June 21, 2018. subpart C (§ 23.41). Furthermore, HHS oversubscribed, and no further
Alex M. Azar II, has determined that there is good cause incentives are necessary to recruit
Secretary, Department of Health and Human to bypass notice and comment and health professions students.
Services. proceed to a final rule, pursuant to 5 Removing these regulations will not
U.S.C. 553(b)(B). The action is non- have an impact on the NHSC program.
List of Subjects in 42 CFR Part 5a controversial, as it merely removes There is no specific appropriations
Health care, Health care professionals, certain provisions from the CFR that are authority to support Section 338G of the
Public health, Rural health. obsolete. Given the length of time PHS Act; the authorization of
(approximately 30 years) since the appropriation at 338H supports all the
PART 5a—[REMOVED] private practice loan provision has been activities under Subpart III (which
utilized, it is HHS’s assessment that the includes the NHSC Loan Repayment
■ For reasons set out in the preamble, agency is unlikely to receive any and Scholarship Programs). The repeal
and under the authority at 5 U.S.C. 301, comments opposing the repeal of these of these regulations will not create any
HHS amends 42 CFR chapter I by regulations. Thus, a comment period challenges for other programs, as the
removing part 5a. prior to finalization of this rule is law and regulations apply solely to
[FR Doc. 2018–13835 Filed 6–26–18; 8:45 am] unnecessary. This rule poses no new NHSC clinicians.
BILLING CODE 4165–15–P substantive requirements or burdens on Executive Orders 12866, 13563, 13771,
the public. and 13777
DEPARTMENT OF HEALTH AND Background Executive Orders 12866 and 13563
HUMAN SERVICES In 1986, HHS issued implementing direct agencies to assess all costs and
regulations, as directed in Section 338G benefits of available regulatory
42 CFR Part 23 of the PHS Act, specifying the interest alternatives and, if regulation is
RIN 0906–AB15 rate and loan repayment terms for necessary, to select regulatory
private practice special loans to former approaches that maximize net benefits
Removing Outmoded Regulations Corps members and interest rate and (including potential economic,
Regarding the National Health Service loan repayment terms for private environmental, public health and safety
Corps Program practice start-up loans to NHSC effects, distributive impacts, and
scholarship recipients. equity). Executive Order 13771 directs
AGENCY: Health Resources and Services The provision for Special Loans for agencies to categorize all impacts which
Administration (HRSA), HHS. Former Corps Members to Enter Private generate or alleviate costs associated
ACTION: Final rule. Practice authorized the Secretary to with regulatory burden and to
SUMMARY: This action removes make a one-time loan up to $25,000 to determine the actions net incremnatal
a Corps member. In exchange, the Corps effect.
outmoded regulations for the National
member reciprocated by committing to Section 3(f) of Executive Order 12866
Health Service Corps (NHSC) Program.
serve as a full-time private practice defines a ‘‘significant regulatory action’’
The regulations were promulgated to as an action that is likely to result in a
provider in a Health Professional
implement Section 338G of the Public rule: (1) Having an annual effect on the
Shortage Area (HPSA) for a minimum of
Health Service (PHS) Act, relating to economy of $100 million or more in any
two years. The intent of these
private practice loans. The regulations 1 year, or adversely and materially
regulations was to retain Corps members
have not been updated since they were affecting a sector of the economy,
in HPSAs after the completion of their
issued in 1986. The regulations are no productivity, competition, jobs, the
service obligation. The regulation is no
longer relevant or needed as the NHSC environment, public health or safety, or
longer relevant as the NHSC has not
has not made private practice loan State, local or Tribal governments or
made such loan opportunities available
opportunities available since the 1980s, since the 1980s and, therefore, no longer communities (also referred to as
and does not plan to do so in the needs to set repayment terms for private ‘‘economically significant’’); (2) creating
foreseeable future. The removal of these practice start-up loans. HRSA does not a serious inconsistency or otherwise
regulations will not create any intend to restart this loan program, as interfering with an action taken or
challenges for other programs, as the the NHSC program currently has a planned by another agency; (3)
law and regulations apply solely to retention rate of 88%, making additional materially altering the budgetary
NHSC clinicians. incentives unnecessary. impacts of entitlement grants, user fees,
DATES: This action is effective July 27, Section 338G also authorizes Private or loan programs or the rights and
2018. Start-Up Loans. At the time the statute obligations of recipients thereof; or (4)
FOR FURTHER INFORMATION CONTACT: was enacted, only the NHSC raising novel legal or policy issues
Sweta Maheshwari J.D., Legislative Scholarship Program existed. Scholars arising out of legal mandates, the
Analyst, Division of Policy and Shortage were able to apply for up to $25,000 to President’s priorities, or the principles
Designation, Bureau of Health purchase or lease the equipment and set forth in the Executive Order.
Workforce, HRSA, 5600 Fishers Lane, supplies needed for providing health A regulatory impact analysis (RIA)
nshattuck on DSK9F9SC42PROD with RULES

Room 11W21A, Rockville, MD 20857, services in their private practices. The must be prepared for major rules with
by phone at (301) 945–3527, or by email intention of the program was to offer economically significant effects ($100
at smaheshwari@hrsa.gov. further incentives to recruit health million or more in any 1 year). HHS
SUPPLEMENTARY INFORMATION: In professions students into the program. submits that this final rule is not
response to Executive Order 13777 and The regulation is no longer relevant ‘‘economically significant’’ as measured
Executive Order 13563, Sec. 6(a), which since the NHSC has not made such loan by the $100 million threshold, and
direct agencies to repeal existing opportunities available since the 1980s hence not a major rule under the

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Federal Register / Vol. 83, No. 124 / Wednesday, June 27, 2018 / Rules and Regulations 30081

Congressional Review Act. This rule has 1345 (42 U.S.C. 254f et seq.), 95 Stat. 912 (42 Relief Fund Program designed to
not been designated as a ‘‘significant U.S.C. 254p(c)), 95 Stat. 910 (42 U.S.C. provide payments to individuals with
regulatory action’’ under Executive 254n(e)(1)). blood-clotting disorders, such as
Order 12866. Accordingly, this rule has hemophilia, who contracted HIV
Subparts B and C [Removed]
not been reviewed by the Office of through the use of antihemophilic factor
Management and Budget (OMB). ■ 2. Remove subpart B, consisting of administered between July 1, 1982, and
Executive Order 13771, titled §§ 23.21 through 23.35, and subpart C, December 31, 1987. The Act also
‘‘Reducing Regulation and Controlling consisting of § 23.41. provided for payments to certain
Regulatory Costs,’’ was issued on persons who contracted HIV from an
[FR Doc. 2018–13837 Filed 6–26–18; 8:45 am]
January 30, 2017. HHS identifies this individual as described above and
BILLING CODE 4165–15–P
final rule as a deregulatory action certain specified survivors.
(removing an obsolete rule from the HHS promulgated 42 CFR part 130 to
Code of Federal Regulations). For the DEPARTMENT OF HEALTH AND establish the proper regulatory
purposes of Executive Order 13771, this HUMAN SERVICES framework for program implementation.
final rule is not a substantive rule; The regulation can be conceptualized as
rather it is administrative in nature and 42 CFR Part 130 four parts: The process for payment, the
provides no cost savings. documentation required to prove
Executive Order 13777, titled RIN 0906–AB13
eligibility, the petition process, and the
‘‘Enforcing the Regulatory Reform reconsideration process. The Ricky Ray
Removing Outmoded Regulations
Agenda,’’ was issued on February 24, Hemophilia Relief Fund was authorized
Regarding the Ricky Ray Hemophilia
2017. As required by Section 3 of this with a directive to pay $100,000 in
Relief Fund Program
Executive Order, HHS established a compensation to eligible individuals. At
Regulatory Reform Task Force (HHS AGENCY: Health Resources and Services that time, however, no funds were
Task Force). Pursuant to Section 3(d)(ii), Administration, HHS. appropriated to implement this statute.
the HHS Task Force evaluated this ACTION: Final rule. In FY 2000, Congress appropriated $75
rulemaking and determined that these million and, in FY 2001, Congress
regulations are ‘‘outdated, unnecessary, SUMMARY: This action removes the appropriated $580 million, for a total of
or ineffective.’’ Following this finding, outmoded regulations for the Ricky Ray $655 million. The appropriated amounts
the HHS Task Force advised the HRSA Hemophilia Relief Fund Program. The provided sufficient funding to make
Administrator to initiate this program and its implementing compassionate payments on all eligible
rulemaking to remove the obsolete regulation have been rendered obsolete petitions received by the program. The
regulations from the Code of Federal by the statutory language in the program received over 6,000 petitions
Regulations. authorizing legislation stating that the resulting in approved payments over
Fund should terminate on the $550 million.
Regulatory Flexibility Act expiration of the 5-year period The statutory language in the
This action will not have a significant beginning on the date of the enactment authorizing legislation stated that the
economic impact on a substantial of the Act. The statute was enacted on ‘‘Fund shall terminate upon the
number of small entities. Therefore, the November 12, 1998; thus, the fund expiration of the 5-year period
regulatory flexibility analysis provided expired on November 12, 2003. beginning on the date of the enactment
for under the Regulatory Flexibility Act DATES: This action is effective July 27, of this Act.’’ The statute was enacted on
is not required. 2018. November 12, 1998; thus, the fund
Paperwork Reduction Act FOR FURTHER INFORMATION CONTACT: expired on November 12, 2003. The
Sweta Maheshwari J.D., Legislative program is no longer in effect or funded.
This action does not affect any
Analyst, Division of Policy and Shortage The repeal of this regulation should not
information collections.
Designation, Bureau of Health create any challenges for other
Dated: June 4, 2018. Workforce, HRSA, 5600 Fishers Lane, programs, as the regulation was strictly
George Sigounas, Room 11W21A, Rockville, MD 20857, for the implementation of the Ricky Ray
Administrator, Health Resources and Services by phone at (301) 945–3527, or by email Hemophilia Relief Fund program, which
Administration. at smaheshwari@hrsa.gov. has not been in operation for almost 14
Approved: June 21, 2018. SUPPLEMENTARY INFORMATION: In years.
Alex M. Azar II, response to Executive Order 13563, Sec. Executive Orders 12866, 13563, 13771,
Secretary, Department of Health and Human 6(a), which urges agencies to repeal and 13777
Services. existing regulations that are outmoded
from the Code of Federal Regulations Executive Orders 12866 and 13563
List of Subjects in 42 CFR Part 23 (CFR), HHS is removing 42 CFR part direct agencies to assess all costs and
Health, Health professions. 130. HHS believes that there is good benefits of available regulatory
For reasons set out in the preamble, cause to bypass notice and comment alternatives and, if regulation is
and under the authority at 5 U.S.C. 301, and proceed to a final rule, pursuant to necessary, to select regulatory
HHS amends 42 CFR part 23 as follows: 5 U.S.C. 553(b)(3)(B). The action is non- approaches that maximize net benefits
controversial, as it merely removes a (including potential economic,
PART 23—NATIONAL HEALTH provision from the CFR that is obsolete. environmental, public health and safety
nshattuck on DSK9F9SC42PROD with RULES

SERVICE CORPS This rule poses no new substantive effects, distributive impacts, and
requirements on the public. equity). Executive Order 13771 directs
■ 1. The authority citation for part 23 agencies to categorize all impacts which
continues to read as follows: Background generate or alleviate costs associated
Authority: Secs. 333, 338E(c), and The Ricky Ray Hemophilia Relief with regulatory burden and to
338C(e)(1), Public Health Service Act. 90 Fund Act of 1998 (Pub. L. 105–369) determine the actions net incremnatal
Stat. 2272, as amended, 95 Stat. 905, 97 Stat. established the Ricky Ray Hemophilia effect.

VerDate Sep<11>2014 14:30 Jun 26, 2018 Jkt 244001 PO 00000 Frm 00051 Fmt 4700 Sfmt 4700 E:\FR\FM\27JNR1.SGM 27JNR1

Document Created: 2018-11-06 09:52:45
Document Modified: 2018-11-06 09:52:45

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Rules and Regulations
Action		Final rule.
Dates		This action is effective July 27, 2018.
Contact		Sweta Maheshwari J.D., Legislative Analyst, Division of Policy and Shortage Designation, Bureau of Health Workforce, HRSA, 5600 Fishers Lane, Room 11W21A, Rockville, MD 20857, by phone at (301) 945-3527, or by email at [email protected]
FR Citation		83 FR 30080
RIN Number		0906-AB15
CFR Associated		Health and Health Professions