83 FR 31452 - Third Party Billing for Medical Care Provided Under Special Treatment Authorities

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 83, Issue 130 (July 6, 2018)

Page Range		31452-31454
FR Document		2018-14573

The Department of Veterans Affairs (VA) is amending its medical regulations to clarify that VA will not bill third party payers for care and services provided by VA under certain statutory provisions, which we refer to as ``special treatment authorities.'' These special treatment authorities direct VA to provide care and services to veterans based upon discrete exposures or experiences that occurred during active military, naval, or air service. VA is authorized, but not required by law, to recover or collect charges for care and services provided to veterans for non-service-connected disabilities. This rule establishes that VA will not exercise its authority to recover or collect reasonable charges from third party payers for care and services provided under the special treatment authorities.

Federal Register, Volume 83 Issue 130 (Friday, July 6, 2018)

[Federal Register Volume 83, Number 130 (Friday, July 6, 2018)]
[Rules and Regulations]
[Pages 31452-31454]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-14573]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AP20


Third Party Billing for Medical Care Provided Under Special 
Treatment Authorities

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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

SUMMARY: The Department of Veterans Affairs (VA) is amending its 
medical regulations to clarify that VA will not bill third party payers 
for care and services provided by VA under certain statutory 
provisions, which we refer to as ``special treatment authorities.'' 
These special treatment authorities direct VA to provide care and 
services to veterans based upon discrete exposures or experiences that 
occurred during active military, naval, or air service. VA is 
authorized, but not required by law, to recover or collect charges for 
care and services provided to veterans for non-service-connected 
disabilities. This rule establishes that VA will not exercise its 
authority to recover or collect reasonable charges from third party 
payers for care and services provided under the special treatment 
authorities.

DATES: This final rule is effective August 6, 2018.

FOR FURTHER INFORMATION CONTACT: Joseph Duran, Director, Policy and 
Planning, VHA Office of Community Care (10D1A1), Veterans Health 
Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, 
Washington, DC 20420, (303-370-1637). (This is not a toll-free number.)

SUPPLEMENTARY INFORMATION: In a document published in the Federal 
Register on November 22, 2017, VA proposed to amend its regulation 
concerning billing third party payers for

[[Page 31453]]

health care received under its special treatment authorities. 82 FR 
55547.
    VA is authorized by law under 38 U.S.C. 1729 to recover or collect 
reasonable charges from third parties under certain situations for care 
and services provided for non-service-connected disabilities. VA does 
not have authority to recover or collect charges from third parties for 
care or services provided for service-connected disabilities.
    Under the statutes referred to as the special treatment 
authorities, VA provides care and services to veterans for conditions 
and disabilities that are related to certain exposures or experiences 
during active military, naval, or air service, regardless of whether 
such condition or disability is formally adjudicated by the Veterans 
Benefits Administration (VBA) to be service-connected. These 
authorities are codified at 38 U.S.C. 1710(a)(2)(F) and (e), 1720D, and 
1720E. These statutory provisions do not expressly refer to the 
conditions or disabilities resulting from such exposures or experiences 
as service-connected. Therefore, if veterans meet the eligibility 
criteria of these discrete categories in law, they receive the health 
care benefits enumerated in the special treatment authorities. A brief 
description of each of the special treatment authorities follows.
    Subject to the availability of appropriations, the limitations 
found in 38 U.S.C. 1710(e)(2) and (3), and the definitions in 
1710(e)(4), under section 1710(a)(2)(F), VA provides hospital care and 
medical services, and may furnish nursing home care, to veterans who 
were exposed to specified hazards or served under certain circumstances 
as identified in 38 U.S.C. 1710(e). The exposures include herbicide 
exposure, ionizing radiation, and certain chemical and biological 
weapons testing, and circumstances of service include service in the 
Southwest Asia theater during the Persian Gulf War and at Camp Lejeune 
during specified time periods. A more comprehensive list of the 
specific exposures and disabilities is located at 38 U.S.C. 1710(e).
    Under 38 U.S.C. 1720D, VA may provide counseling and appropriate 
care and services to help veterans overcome psychological trauma, which 
in the judgment of a mental health professional employed by VA, 
resulted from a physical assault of a sexual nature, battery of a 
sexual nature, or sexual harassment that occurred while the veteran was 
serving on active duty, active duty for training, or inactive duty 
training.
    Under 38 U.S.C. 1720E, VA is authorized to provide any veteran 
whose service records include documentation of nasopharyngeal radium 
irradiation treatments a medical examination, hospital care, medical 
services, and nursing home care that is needed for the treatment of any 
cancer of the head or neck that the Secretary finds may be associated 
with the veteran's receipt of those treatments in active military, 
naval, or air service. Additionally, notwithstanding the absence of 
such documentation, VA may provide such care to a veteran who served as 
an aviator in the active military, naval, or air service before the end 
of the Korean conflict or a veteran who underwent submarine training in 
active naval service before January 1, 1965.
    The special treatment authorities do not require an adjudication of 
service-connection to establish eligibility for care. These veterans 
are eligible under those authorities for treatment of specific 
conditions, which although not adjudicated as service-connected, are 
treated as the practical equivalent for medical care purposes. 
Therefore, in the proposed rule, we proposed adding a new paragraph 
(a)(9) in Sec.  17.101 to exclude from recovery or collections any 
reasonable charges from third parties for care and services provided 
under the special treatment authorities. VA provided a 60-day comment 
period, which ended on January 22, 2018. We received 2 comments on the 
proposed rule.
    One commenter explained that he was born at Camp Lejeune and that 
he and his family members have illnesses that he believes are related 
to exposures while on the base. He questioned why he was denied 
eligibility for the Camp Lejeune family member program and stated that 
more people should be eligible for the program. While we are 
sympathetic to the commenter, this rulemaking only codifies VA's 
practice of not exercising its discretionary authority in section 1729 
to recover or collect from a third party the cost of care and services 
provided under a special treatment authority, by creating an exception 
to 38 CFR 17.101. This comment is, therefore, beyond the scope of the 
rulemaking and we make no changes based on this comment.
    The other commenter raised concerns about the commenter's claim for 
unspecified benefits and a subsequent court decision that are not 
related to this regulation. The comment is beyond the scope of this 
rulemaking and we make no changes based on this comment.
    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 no changes.

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

    Although this action contains provisions constituting collections 
of information at 38 CFR 17.101, under the Paperwork Reduction Act of 
1995, 44 U.S.C. 3501-3521), no new or proposed collections of 
information are associated with this final rule.
    The information collection requirements for Sec.  17.101 are 
currently approved by the Office of Management and Budget (OMB) and 
have been assigned OMB control number 2900-0606.

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. We are not imposing any new requirements that would have such an 
effect. Our standards almost entirely conform to the existing statutory 
requirements and existing practices in the program. Therefore, pursuant 
to 5 U.S.C. 605(b), this rule is exempt from the initial and final 
regulatory flexibility analysis requirements of sections 603 and 604.

Executive Orders 12866, 13563, and 13771

    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

[[Page 31454]]

Review) defines 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 
this Executive Order.
    The economic, interagency, budgetary, legal, and policy 
implications of this final rule 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 website at 
http://www.va.gov/orpm, by following the link for ``VA Regulations 
Published From FY 2004 Through Fiscal Year To Date.'' This rule is not 
an E.O. 13771 regulatory action because this rule is not significant 
under E.O. 12866

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 an 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 would 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 64.011--Veterans Dental 
Care; 64.012--Veterans Prescription Service; 64.013--Veterans 
Prosthetic Appliances; 64.014--Veterans State Domiciliary Care; 
64.015--Veterans State Nursing Home Care; 64.026--Veterans State Adult 
Day Health Care; 64.029--Purchase Care Program; 64.033--VA Supportive 
Services for Veteran Families Program; 64.034--VA Grants for Adaptive 
Sports Programs for Disabled Veterans and Disabled Members of the Armed 
Forces; 64.035--Veterans Transportation Program; 64.039--CHAMPVA; 
64.040--VHA Inpatient Medicine; 64.041--VHA Outpatient Specialty Care; 
64.042--VHA Inpatient Surgery; 64.043--VHA Mental Health Residential; 
64.044--VHA Home Care; 64.045--VHA Outpatient Ancillary Services; 
64.046--VHA Inpatient Psychiatry; 64.047--VHA Primary Care; 64.048--VHA 
Mental Health clinics; 64.049--VHA Community Living Center; 64.050--VHA 
Diagnostic Care.

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, Grant programs-veterans, 
Health care, Health facilities, Health professions, Health records, 
Homeless, Medical and dental schools, Medical devices, Medical 
research, Mental health programs, Nursing home care, Philippines, 
Reporting and recordkeeping requirements, Scholarships and fellows, 
Travel, Transportation expenses, Veterans.

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. Jacquelyn 
Hayes-Byrd, Acting Chief of Staff, Department of Veterans Affairs, 
approved this document on June 28, 2018, for publication.

    Dated: July 2, 2018.
Consuela Benjamin,
Regulation Development Coordinator, Office of Regulation Policy & 
Management, Office of the Secretary, Department of Veterans Affairs.

    For the reasons set forth in the preamble, VA amends 38 CFR part 17 
as follows:

PART 17--MEDICAL

0
1. The authority citation for part 17 continues to read in part as 
follows:

    Authority:  38 U.S.C. 501, and as noted in specific sections.
* * * * *
0
2. Amend Sec.  17.101 by:
0
a. Adding paragraph (a)(9).
0
b. Revising the authority citation at the end of the section.
    The addition and revision read as follows:


Sec.  17.101   Collection or recovery by VA for medical care or 
services provided or furnished to a veteran for a nonservice-connected 
disability.

    (a) * * *
    (9) Care provided under special treatment authorities. (i) 
Notwithstanding any other provisions in this section, VA will not seek 
recovery or collection of reasonable charges from a third party payer 
for:
    (A) Hospital care, medical services, and nursing home care provided 
by VA or at VA expense under 38 U.S.C. 1710(a)(2)(F) and (e).
    (B) Counseling and appropriate care and services furnished to 
veterans for psychological trauma authorized under 38 U.S.C. 1720D.
    (C) Medical examination, and hospital care, medical services, and 
nursing home care furnished to veteran for cancer of the head or neck 
as authorized under 38 U.S.C. 1720E.
    (ii) VA may continue to exercise its right to recover or collect 
reasonable charges from third parties, pursuant to this section, for 
the cost of care that VA provides to these same veterans for conditions 
and disabilities that VA determines are not covered by any of the 
special treatment authorities.
* * * * *

(Authority: 38 U.S.C. 101, 501, 1701, 1705, 1710, 1720D, 1720E, 
1721, 1722, 1729)


[FR Doc. 2018-14573 Filed 7-5-18; 8:45 am]
 BILLING CODE 8320-01-P

Federal Register / Vol. 83, No. 130 / Friday, July 6, 2018 / Rules and Regulations 31453

health care received under its special whose service records include is adopting the proposed rule as a final
treatment authorities. 82 FR 55547. documentation of nasopharyngeal rule with no changes.
VA is authorized by law under 38 radium irradiation treatments a medical
U.S.C. 1729 to recover or collect Effect of Rulemaking
examination, hospital care, medical
reasonable charges from third parties services, and nursing home care that is Title 38 of the Code of Federal
under certain situations for care and needed for the treatment of any cancer Regulations, as revised by this final
services provided for non-service- of the head or neck that the Secretary rulemaking, represents VA’s
connected disabilities. VA does not finds may be associated with the implementation of its legal authority on
have authority to recover or collect veteran’s receipt of those treatments in this subject. Other than future
charges from third parties for care or active military, naval, or air service. amendments to this regulation or
services provided for service-connected Additionally, notwithstanding the governing statutes, no contrary guidance
disabilities. absence of such documentation, VA or procedures are authorized. All
Under the statutes referred to as the may provide such care to a veteran who existing or subsequent VA guidance
special treatment authorities, VA served as an aviator in the active must be read to conform with this
provides care and services to veterans military, naval, or air service before the rulemaking if possible or, if not
for conditions and disabilities that are end of the Korean conflict or a veteran possible, such guidance is superseded
related to certain exposures or who underwent submarine training in by this rulemaking.
experiences during active military, active naval service before January 1,
naval, or air service, regardless of Paperwork Reduction Act
1965.
whether such condition or disability is The special treatment authorities do Although this action contains
formally adjudicated by the Veterans not require an adjudication of service- provisions constituting collections of
Benefits Administration (VBA) to be connection to establish eligibility for information at 38 CFR 17.101, under the
service-connected. These authorities are care. These veterans are eligible under Paperwork Reduction Act of 1995, 44
codified at 38 U.S.C. 1710(a)(2)(F) and those authorities for treatment of U.S.C. 3501–3521), no new or proposed
(e), 1720D, and 1720E. These statutory specific conditions, which although not collections of information are associated
provisions do not expressly refer to the adjudicated as service-connected, are with this final rule.
conditions or disabilities resulting from The information collection
treated as the practical equivalent for
such exposures or experiences as requirements for § 17.101 are currently
medical care purposes. Therefore, in the
service-connected. Therefore, if veterans approved by the Office of Management
proposed rule, we proposed adding a
meet the eligibility criteria of these and Budget (OMB) and have been
new paragraph (a)(9) in § 17.101 to
discrete categories in law, they receive assigned OMB control number 2900–
exclude from recovery or collections
the health care benefits enumerated in 0606.
any reasonable charges from third
the special treatment authorities. A brief
parties for care and services provided Regulatory Flexibility Act
description of each of the special
under the special treatment authorities. The Secretary hereby certifies that
treatment authorities follows.
Subject to the availability of VA provided a 60-day comment period, this final rule will not have a significant
appropriations, the limitations found in which ended on January 22, 2018. We economic impact on a substantial
38 U.S.C. 1710(e)(2) and (3), and the received 2 comments on the proposed number of small entities as they are
definitions in 1710(e)(4), under section rule. defined in the Regulatory Flexibility
1710(a)(2)(F), VA provides hospital care One commenter explained that he was Act, 5 U.S.C. 601–612. We are not
and medical services, and may furnish born at Camp Lejeune and that he and imposing any new requirements that
nursing home care, to veterans who his family members have illnesses that would have such an effect. Our
were exposed to specified hazards or he believes are related to exposures standards almost entirely conform to the
served under certain circumstances as while on the base. He questioned why existing statutory requirements and
identified in 38 U.S.C. 1710(e). The he was denied eligibility for the Camp existing practices in the program.
exposures include herbicide exposure, Lejeune family member program and Therefore, pursuant to 5 U.S.C. 605(b),
ionizing radiation, and certain chemical stated that more people should be this rule is exempt from the initial and
and biological weapons testing, and eligible for the program. While we are final regulatory flexibility analysis
circumstances of service include service sympathetic to the commenter, this requirements of sections 603 and 604.
in the Southwest Asia theater during the rulemaking only codifies VA’s practice
of not exercising its discretionary Executive Orders 12866, 13563, and
Persian Gulf War and at Camp Lejeune
authority in section 1729 to recover or 13771
during specified time periods. A more
comprehensive list of the specific collect from a third party the cost of care Executive Orders 12866 and 13563
exposures and disabilities is located at and services provided under a special direct agencies to assess the costs and
38 U.S.C. 1710(e). treatment authority, by creating an benefits of available regulatory
Under 38 U.S.C. 1720D, VA may exception to 38 CFR 17.101. This alternatives and, when regulation is
provide counseling and appropriate care comment is, therefore, beyond the scope necessary, to select regulatory
and services to help veterans overcome of the rulemaking and we make no approaches that maximize net benefits
psychological trauma, which in the changes based on this comment. (including potential economic,
judgment of a mental health The other commenter raised concerns environmental, public health and safety
professional employed by VA, resulted about the commenter’s claim for effects, and other advantages;
from a physical assault of a sexual unspecified benefits and a subsequent distributive impacts; and equity).
sradovich on DSK3GMQ082PROD with RULES

nature, battery of a sexual nature, or court decision that are not related to this Executive Order 13563 (Improving
sexual harassment that occurred while regulation. The comment is beyond the Regulation and Regulatory Review)
the veteran was serving on active duty, scope of this rulemaking and we make emphasizes the importance of
active duty for training, or inactive duty no changes based on this comment. quantifying both costs and benefits,
training. Based on the rationale set forth in the reducing costs, harmonizing rules, and
Under 38 U.S.C. 1720E, VA is SUPPLEMENTARY INFORMATION to the promoting flexibility. Executive Order
authorized to provide any veteran proposed rule and in this final rule, VA 12866 (Regulatory Planning and

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31454 Federal Register / Vol. 83, No. 130 / Friday, July 6, 2018 / Rules and Regulations

Review) defines a ‘‘significant Supportive Services for Veteran The addition and revision read as
regulatory action,’’ requiring review by Families Program; 64.034—VA Grants follows:
OMB, unless OMB waives such review, for Adaptive Sports Programs for
as any regulatory action that is likely to Disabled Veterans and Disabled § 17.101 Collection or recovery by VA for
medical care or services provided or
result in a rule that may: (1) Have an Members of the Armed Forces; 64.035— furnished to a veteran for a nonservice-
annual effect on the economy of $100 Veterans Transportation Program; connected disability.
million or more or adversely affect in a 64.039—CHAMPVA; 64.040—VHA
(a) * * *
material way the economy, a sector of Inpatient Medicine; 64.041—VHA (9) Care provided under special
the economy, productivity, competition, Outpatient Specialty Care; 64.042— treatment authorities. (i)
jobs, the environment, public health or VHA Inpatient Surgery; 64.043—VHA
Notwithstanding any other provisions in
safety, or State, local, or tribal Mental Health Residential; 64.044—
this section, VA will not seek recovery
governments or communities; (2) Create VHA Home Care; 64.045—VHA
or collection of reasonable charges from
a serious inconsistency or otherwise Outpatient Ancillary Services; 64.046—
a third party payer for:
interfere with an action taken or VHA Inpatient Psychiatry; 64.047— (A) Hospital care, medical services,
planned by another agency; (3) VHA Primary Care; 64.048—VHA and nursing home care provided by VA
Materially alter the budgetary impact of Mental Health clinics; 64.049—VHA
or at VA expense under 38 U.S.C.
entitlements, grants, user fees, or loan Community Living Center; 64.050—
1710(a)(2)(F) and (e).
programs or the rights and obligations of VHA Diagnostic Care. (B) Counseling and appropriate care
recipients thereof; or (4) Raise novel and services furnished to veterans for
List of Subjects in 38 CFR Part 17
legal or policy issues arising out of legal psychological trauma authorized under
mandates, the President’s priorities, or Administrative practice and
procedure, Alcohol abuse, Alcoholism, 38 U.S.C. 1720D.
the principles set forth in this Executive (C) Medical examination, and hospital
Order. Claims, Day care, Dental health, Drug
abuse, Foreign relations, Government care, medical services, and nursing
The economic, interagency,
contracts, Grant programs-health, Grant home care furnished to veteran for
budgetary, legal, and policy
programs-veterans, Health care, Health cancer of the head or neck as authorized
implications of this final rule have been
facilities, Health professions, Health under 38 U.S.C. 1720E.
examined, and it has been determined (ii) VA may continue to exercise its
not to be a significant regulatory action records, Homeless, Medical and dental
schools, Medical devices, Medical right to recover or collect reasonable
under Executive Order 12866. VA’s
research, Mental health programs, charges from third parties, pursuant to
impact analysis can be found as a
Nursing home care, Philippines, this section, for the cost of care that VA
supporting document at http://
Reporting and recordkeeping provides to these same veterans for
www.regulations.gov, usually within 48
requirements, Scholarships and fellows, conditions and disabilities that VA
hours after the rulemaking document is
Travel, Transportation expenses, determines are not covered by any of the
published. Additionally, a copy of the
Veterans. special treatment authorities.
rulemaking and its impact analysis are
available on VA’s website at http:// * * * * *
Signing Authority
www.va.gov/orpm, by following the link (Authority: 38 U.S.C. 101, 501, 1701, 1705,
for ‘‘VA Regulations Published From FY The Secretary of Veterans Affairs, or 1710, 1720D, 1720E, 1721, 1722, 1729)
2004 Through Fiscal Year To Date.’’ designee, approved this document and [FR Doc. 2018–14573 Filed 7–5–18; 8:45 am]
This rule is not an E.O. 13771 regulatory authorized the undersigned to sign and
BILLING CODE 8320–01–P
action because this rule is not submit the document to the Office of the
significant under E.O. 12866 Federal Register for publication
electronically as an official document of
Unfunded Mandates the Department of Veterans Affairs. ENVIRONMENTAL PROTECTION
Jacquelyn Hayes-Byrd, Acting Chief of AGENCY
The Unfunded Mandates Reform Act
of 1995 requires, at 2 U.S.C. 1532, that Staff, Department of Veterans Affairs,
40 CFR Part 52
agencies prepare an assessment of approved this document on June 28,
anticipated costs and benefits before 2018, for publication. [EPA–R04–OAR–2017–0642; FRL–9980–
issuing any rule that may result in an 50—Region 4]
Dated: July 2, 2018.
expenditure by State, local, and tribal Consuela Benjamin, Air Plan Approval; AL; Section 128
governments, in the aggregate, or by the Regulation Development Coordinator, Office Board Requirements for Infrastructure
private sector, of $100 million or more of Regulation Policy & Management, Office SIPs
(adjusted annually for inflation) in any of the Secretary, Department of Veterans
one year. This final rule would have no Affairs. AGENCY: Environmental Protection
such effect on State, local, and tribal For the reasons set forth in the Agency (EPA).
governments, or on the private sector. preamble, VA amends 38 CFR part 17 as ACTION: Final rule.
Catalog of Federal Domestic Assistance follows:
SUMMARY: The Environmental Protection
The Catalog of Federal Domestic PART 17—MEDICAL Agency (EPA) is taking final action to
Assistance numbers and titles for the approve a State Implementation Plan
programs affected by this document are ■ 1. The authority citation for part 17 (SIP) submission, submitted by the State
64.011—Veterans Dental Care; 64.012— continues to read in part as follows: of Alabama, through the Alabama
sradovich on DSK3GMQ082PROD with RULES

Veterans Prescription Service; 64.013— Authority: 38 U.S.C. 501, and as noted in Department of Environmental
Veterans Prosthetic Appliances; specific sections. Management (ADEM), on October 24,
64.014—Veterans State Domiciliary * * * * * 2017, and a portion of a December 9,
Care; 64.015—Veterans State Nursing ■ 2. Amend § 17.101 by: 2015, infrastructure SIP submission.
Home Care; 64.026—Veterans State ■ a. Adding paragraph (a)(9). The October 24, 2017 submission
Adult Day Health Care; 64.029— ■ b. Revising the authority citation at addresses the general Clean Air Act
Purchase Care Program; 64.033—VA the end of the section. (CAA or Act) conflict of interest

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Document Created: 2018-07-06 00:46:23
Document Modified: 2018-07-06 00:46:23

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 final rule is effective August 6, 2018.
Contact		Joseph Duran, Director, Policy and Planning, VHA Office of Community Care (10D1A1), Veterans Health Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (303-370-1637). (This is not a toll-free number.)
FR Citation		83 FR 31452
RIN Number		2900-AP20
CFR Associated		Administrative Practice and Procedure; Alcohol Abuse; Alcoholism; Claims; Day Care; Dental Health; Drug Abuse; Foreign Relations; Government Contracts; Grant Programs-Health; Grant Programs-Veterans; Health Care; Health Facilities; Health Professions; Health Records; Homeless; Medical and Dental Schools; Medical Devices; Medical Research; Mental Health Programs; Nursing Home Care; Philippines; Reporting and Recordkeeping Requirements; Scholarships and Fellows; Travel; Transportation Expenses and Veterans