[Federal Register Volume 64, Number 55 (Tuesday, March 23, 1999)]
[Rules and Regulations]
[Pages 13912-13913]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-7034]


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DEPARTMENT OF DEFENSE

Office of the Secretary

32 CFR Part 199

RIN 0720-AA48


Civilian Health and Medical Program of the Uniformed Services 
(CHAMPUS); TRICARE Prime Enrollment Procedures

AGENCY: Office of the Secretary, DoD.

ACTION: Final rule.

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SUMMARY: This final rule modifies the TRICARE Prime enrollment 
procedures for active duty families by specifying that enrollment will 
be automatically renewed upon the expiration of the annual enrollment 
period, unless the renewal is declined. It also allows for monthly 
installment payments of enrollment fees via allotment or electronic 
funds transfer for those beneficiaries required to pay an annual 
TRICARE Prime enrollment fee.

EFFECTIVE DATE: April 22, 1999.

ADDRESSES: TRICARE Management Activity, Program Development Branch, 
Aurora, CO 80045-6900.

FOR FURTHER INFORMATION CONTACT: Kathleen Larkin, Office of the 
Assistant Secretary of Defense (Health Affairs)/TRICARE Management 
Activity, telephone (703) 681-1745.

SUPPLEMENTARY INFORMATION:

Introduction and Background

A. Congressional Action

    This final rule implements section 712 of the FY 1999 National 
Defense Authorization Act, which modified 10 U.S.C. 1097a to provide 
for automatic renewal of TRICARE Prime enrollments and additional 
payment options for retirees.

B. Public Comments

    The proposed rule was published in the Federal Register on July 7, 
1998 (63 FR 36651). We received no public comments.

II. Provisions of the Rule

1. TRICARE Prime Enrollment Renewals (revision to section 199.17(o)(2))

Provisions of the Proposed Rule
    This paragraph explained that we proposed a change to the TRICARE 
Prime enrollment period from a 12-month enrollment period to continuous 
enrollment until such time as the enrollee opted to disenroll from 
TRICARE Prime. TRICARE Prime was originally designed so that enrollees 
would be required to take positive action to continue their enrollment 
in TRICARE Prime at or before their 12-month anniversary date. Positive 
action to reenroll was required because TRICARE implementation was not 
available in all regions of the country and overseas locations. 
Subsequent to our notice of proposed rulemaking, section 712 of the FY 
1999 National Defense Authorization Act modified 10 U.S.C. 1097a to 
require annual enrollment periods but required that TRICARE Prime 
enrollment be automatically renewed upon the expiration of the 
enrollment unless the renewal is declined. The Act also requires that 
the enrollee, or the sponsor in the case of an enrolled family member, 
be notified in writing no later than 15 days before the enrollment 
expiration date and afforded the opportunity to decline enrollment.
Provisions of the Final Rule
    The final rule has been modified to implement the statutory 
direction given in the FY 1999 National Defense Authorization Act.

2. Changes to Installment Payments of Enrollment Fees (revision to 
section 199.17(o)(3))

Provisions of the Proposed Rule
    When we first instituted the requirement for annual TRICARE Prime 
enrollment fees for certain beneficiary categories, we allowed for 
quarterly installment payments of the enrollment fees. In keeping with 
the nature of a more continuous enrollment process, we proposed that 
retirees, their families, and other beneficiaries required to pay an 
annual enrollment fee would be

[[Page 13913]]

offered additional flexibility in fee payment by allowing for monthly 
or quarterly installment payments of enrollment fees. Subsequent to our 
notice of proposed rulemaking, section 712 of the FY 1999 National 
Defense Authorization Act modified 10 U.S.C. 1097a to expand payment 
options to include monthly payment of enrollment fees via an allotment 
from retired or retainer pay, or monthly payment via electronic funds 
transfer from a financial institution.
Provisions of the Final Rule
    The final rule has been modified to implement the statutory 
direction given in the FY 1999 National Defense Authorization Act.

III. Regulatory Procedures

    Executive Order 12866 requires certain regulatory assessments for 
any significant regulatory action, defined as one which would result in 
an annual effect on the economy of $100 million or more, or have other 
substantial impacts.
    The Regulatory Flexibility Act (RFA) requires that each Federal 
agency prepare, and make available for public comment, a regulatory 
flexibility analysis when the agency issues a regulation which would 
have a significant impact on a substantial number of small entities.
    This is not a significant regulatory action under the provisions of 
Executive Order 12866, and it would not have a significant impact on a 
substantial number of small entities.
    The final rule will not impose additional information collection 
requirements on the public under the Paperwork Reduction Act of 1995 
(44 U.S.C. Chapter 55).

List of Subjects in 32 CFR Part 199

    Claims, Health insurance, Individuals and disabilities, Military 
personnel, Reporting and recordkeeping requirements.
    Accordingly, 32 CFR Part 199 is amended as follows:

PART 199--[AMENDED]

    1. The authority citation for part 199 continues to read as 
follows:

    Authority: 5 U.S.C. 301, 10 U.S.C. Chapter 55.

    2. Section 199.17 is amended by revising paragraphs (o)(2) and 
(o)(3), redesignating paragraphs (o)(4) and (o)(5) and (o)(5) and 
(o)(6), and adding new paragraph (o)(4), to read as follows:


Sec. 199.17  TRICARE Program.

* * * * *
    (o) * * *
    (2) Enrollment period. Beneficiaries who select the TRICARE Prime 
option remain enrolled for 12 month increments until: they take action 
to disenroll; they are no longer eligible for enrollment in TRICARE 
Prime; or they are disenrolled for failure to pay required enrollment 
fees. For those who remain eligible for TRICAREPrime enrollment, no 
later than 15 days before the expiration date of an enrollment, the 
sponsor will be sent a written notification of the pending expiration 
and renewal of the TRICARE Prime enrollment. TRICARE Prime enrollments 
shall be automatically renewed upon the expiration of the enrollment 
unless the renewal is declined by the sponsor. Termination of 
enrollment for failure to pay enrollment fees is addressed in paragraph 
(o)(3) of this section.
    (3) Installment payments of enrollment fee. The enrollment fee 
required by Sec. 199.18(c) may be paid in monthly or quarterly 
installments. Monthly fees may be payable by an allotment from retired 
or retainer pay, or paid from a financial institution through an 
electronic transfer of funds. For beneficiaries paying enrollment fees 
on an installment basis, failure to make a required installment payment 
on a timely basis [including a grace period, as determined by the 
Assistant Secretary of Defense (Health Affairs)] will result in 
termination of the beneficiary's enrollment in Prime and 
disqualification from future enrollment in Prime for a period of one 
year.
    (4) Voluntary disenrollment. Any beneficiary for whom enrollment in 
Prime is voluntary may disenroll at any time. Disenrollment will take 
effect in accordance with administrative procedures established by the 
Assistant Secretary of Defense (Health Affairs). Beneficiaries who 
disenroll prior to their annual enrollment renewal date will not be 
eligible to reenroll in Prime for a one-year period from the effective 
date of the disenrollment. This one year exclusion may be waived by the 
Assistant Secretary of Defense (Health Affairs) based on extraordinary 
circumstances.
* * * * *
    Dated: March 17, 1999.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 99-7034 Filed 3-22-99; 8:45 am]
BILLING CODE 5000-04-M