[Federal Register Volume 65, Number 125 (Wednesday, June 28, 2000)]
[Rules and Regulations]
[Pages 39804-39806]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-16263]


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DEPARTMENT OF DEFENSE

Office of the Secretary

32 CFR Part 199


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

AGENCY: Office of the Secretary, DOD.

ACTION: Interim final rule.

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SUMMARY: This interim final rule provides for automatic enrollment of 
certain family members of E-4 and below in TRICARE Prime. When affected 
family members reside in a catchment area of a military medical 
treatment facility offering TRICARE Prime, the family members will be 
automatically enrolled in TRICARE Prime and will choose or be assigned 
a Primary Care Manager located in the military medical treatment 
facility. Such automatic enrollment may be terminated at any time.

DATES: This rule is effective July 28, 2000. Public comments must be 
received by August 28, 2000.

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

FOR FURTHER INFORMATION CONTACT: Lt Col Kathleen Larkin, Office of the 
Assistant Secretary of Defense (Health Affairs)/TRICARE Management 
Activity, telephone (703) 681-3628.
    Questions regarding payment of specific claims under the CHAMPUS 
allowable charge method should be addressed to the appropriate TRICARE/
CHAMPUS contractor.

SUPPLEMENTARY INFORMATION:

[[Page 39805]]

I. Overview of the Rule

    This interim final rule implements section 712 of the National 
Defense Authorization Act for Fiscal Year 1999 which modified chapter 
55 of title 10, United States Code by adding a new section 1079a which 
provides for automatic TRICARE Prime enrollment for active duty 
families of E-4 and below in certain circumstances. Owing to the small 
number of family members of E-4 and below who are not already enrolled 
in TRICARE Prime, and the restrictive nature of TRICARE Prime 
enrollment, military medical treatment facility commanders will 
identify those individuals residing in their catchment area who should 
be automatically enrolled but are not. At that time, the family members 
will be informed of their enrollment and be given the opportunity to 
select or be assigned a primary care manager, or to disenroll from 
TRICARE Prime. The choice of whether to remain enrolled in TRICARE 
Prime, or to decline enrollment to participate in TRICARE Extra or 
Standard remains completely voluntary.

II. Rulemaking 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 interim 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).
    This rule is being issued as an interim final rule, with comment 
period, as an exception to our standard practice of soliciting public 
comments prior to issuance. The Assistant Secretary of Defense (Health 
Affairs) has determined that following the standard practice in this 
case would be impracticable, unnecessary, and contrary to the public 
interest. This determination is based on several factors. First, this 
change directly implements a statutory amendment enacted by Congress 
expressly for this purpose. Second, for the most part this rule simply 
implements the unambiguous Congressional policy of automatically 
enrolling family members of active duty members of E-4 and below who 
reside in areas where TRICARE Prime is offered through a military 
medical treatment facility. Third, TRICARE Prime is a major ``quality 
of life'' program of the Department of Defense. Its success is of great 
importance to maintaining adequate retention rates of military 
personnel and, thus, the conduct of the military affairs function of 
the United States. Public comments are invited. All comments will be 
carefully considered. A discussion of the major issues received by 
public comments will be included with the issuance of the permanent 
final rule, anticipated approximately 60 days after the end of the 
comment period.

List of Subjects in 32 CFR Part 199

    Administrative practice and procedure, Claims, Health care, Health 
insurance, Individuals with disabilities, Military personnel.

    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 as follows:
    a. Revising paragraph (a)(6)(ii)(A),
    b. Adding a new paragraph (b)(3),
    c. Revising paragraphs (c)(2)(i) and (n)(1), and
    d. Adding a new paragraph (o)(7).
    The revisions and additions read as follows:


Sec. 199.17  TRICARE Program.

    (a) * * *
    (6) * * *
    (ii) * * *
    (A) Beneficiaries may enroll, or be enrolled, in the ``TRICARE 
Prime Plan,'' which features use of military treatment facilities and 
substantially reduced out-of-pocket costs for CHAMPUS care. 
Beneficiaries generally agree to use military treatment facilities and 
designated civilian provider networks, in accordance with enrollment 
provisions.
* * * * *
    (b) * * *
    (3) Automatic enrollment of certain dependents. Under 10 U.S.C. 
1079a, in the case of dependents of active duty members in the grade of 
E-1 to E-4, such dependents who reside in catchment areas of military 
hospitals shall be automatically enrolled in TRICARE Prime consistent 
with procedures established under paragraph (o)(7) of this section. 
Voluntary choice shall be preserved by the right of such dependents to 
disenroll at any time.
* * * * *
    (c) * * *
    (2) * * *
    (i) In the case of dependents of active duty members in the grade 
of E-1 to E-4, such dependents who reside in catchment areas of 
military hospitals will be automatically enrolled in TRICARE Prime 
consistent with procedures established under paragraph (o)(7) of this 
section. Other dependents of active duty members are eligible to enroll 
in Prime. After all active duty members, and those dependents 
automatically enrolled, all other dependents of active duty members 
will have second priority for enrollment .
* * * * *
    (n) * * *
    (1) Primary care manager. All active duty members and Prime 
enrollees will be assigned or allowed to select a primary care manager 
pursuant to a system established by the MTF Commander or other 
authorized official. Active duty members and dependents of E-4 and 
below who are automatically enrolled in TRICARE Prime shall choose or 
be assigned a primary care manager who is part of the MTF. The primary 
care manager may be an individual physician, a group practice, a 
clinic, a treatment site, or other designation. For those who are not 
automatically enrolled in Prime, the primary care manager may be part 
of the MTF or the Prime civilian network. The enrollee will be given 
the opportunity to register a preference for primary care manager from 
a list of choices provided by the MTF commander. Preference requests 
will be honored subject to availability, under the MTF beneficiary 
category priority system and other operational requirements established 
by the commander or other authorized person).
* * * * *
    (o) * * *
    (6) Special procedures for certain dependents of active duty 
members in pay grades E-1 to E-4. As an exception to other procedures 
in paragraph (o) of this section, dependents of active duty members in 
pay grades E-1 to E-4, if such dependents reside in a catchment area of 
a military hospital, are automatically enrolled in TRICARE Prime. The 
applicable military hospital shall provide written notice of the 
automatic enrollment to the member

[[Page 39806]]

and the affected dependents. The effective date of such automatic 
enrollment shall be the date of the written notice, unless an earlier 
effective date is requested by the member or affected dependents, so 
long as the affected dependents were as of the effective date 
dependents of an active duty member in pay grades E-1 to E-4 and 
residents in a catchment area of a military hospital. Dependents who 
are automatically enrolled under this paragraph may disenroll at any 
time. Such disenrollment shall remain in effect until such dependents 
take specific action to reenroll which such dependents may do at any 
time.
* * * * *

    Dated: June 22, 2000.
L. M. Bynum,
Alternate Federal Register Notice Liaison Officer, Department of 
Defense.
[FR Doc. 00-16263 Filed 6-27-00; 8:45 am]
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