[Federal Register Volume 67, Number 75 (Thursday, April 18, 2002)]
[Proposed Rules]
[Pages 19141-19142]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-9244]


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

DEPARTMENT OF DEFENSE

Office of the Secretary

32 CFR Part 199

[RIN 0720-AA72]


TRICARE; Waiver of Certain TRICARE Deductibles; Clarification of 
TRICARE Prime Enrollment Period

AGENCY: Office of the Secretary, DoD.

ACTION: Proposed rule.

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

SUMMARY: This proposed rule implements section 714 of the National 
Defense Authorization Act for Fiscal Year 2000 which authorizes the 
Secretary of Defense to waive the TRICARE deductible in certain cases 
for care provided to a dependent of a member of a Reserve Component or 
the National Guard who is called to active duty for more than 30 days 
but less than one year. In implementing this rule, we are limiting this 
to Reserve Component and National Guard members called to active duty 
in support of a contingency operations. The term ``contingency 
operations'' is defined at 10 U.S.C. 101(a)(13). This proposed rule 
also establishes circumstances under which eligible beneficiaries may 
enroll in TRICARE Prime for a period of less than one year.

DATES: Public comments must be received by June 17, 2002.

ADDRESSES: Forward comments to: TRICARE Management Activity (TMA), 
Medical Benefits and Reimbursement Systems, 16401 East Centretech 
Parkway, Aurora, CO 80011-9043.

FOR FURTHER INFORMATION CONTACT: Stephen E. Isaacson, Medical Benefits 
and Reimbursement Systems, TMA, (303) 676-3572.

SUPPLEMENTARY INFORMATION:

Waiver of Certain TRICARE Deductibles

    Often a call to active duty for a member of a Reserve Component or 
of the National Guard presents certain financial hardships. Dependents 
of these individuals become eligible for TRICARE Standard if the member 
is called to active duty for a period of more than 30 days. However, 
since they are not covered by TRICARE prior to the member's call to 
active duty, they generally are covered by some other health plan under 
which they probably have been required to pay a deductible.
    In order to mitigate the hardship of having to meet a second 
deductible for active duty service that often is less than a year, the 
TRICARE deductible has been reduced or waived on two previous 
occasions. For dependents of active duty members of pay grade E-5 or 
above who served in connection with Operation Desert Shield or 
Operation Desert Storm, the TRICARE deductible was reduced to the 
lesser amounts required for active duty members of pay grade E-4 or 
below. For dependents of certain reserve members who were called to 
active duty for more than 30 days in support of Operation Joint 
Endeavor, the TRICARE deductible was waived.
    Section 714 of the National Defense Authorization Act for Fiscal 
Year 2000 (Pub. L. 106-65) gives the Secretary of Defense authority to 
waive the TRICARE deductible for certain beneficiaries in circumstances 
similar to those when it was previously waived. Specifically the 
Secretary may waive the deductible for care provided to a dependent of: 
(1) A member of a Reserve Component who is called or ordered to active 
duty in support of a contingency operation for a period of more than 30 
days but less than one year; or (2) a member of the National Guard who 
is called or ordered to full-time National Guard duty for a period of 
more than 30 days but less than one year. The proposed rule allows the 
family members of a Reservist or National Guard member an immediate 
opportunity to participate in the TRICARE program without the barrier 
of deductibles when the period of recall is in support of a contingency 
operation for more than 30 days but less than one year. Because of the 
nature of rapid deployments for an unspecified period of time, this 
change provides family-friendly coverage when we need family 
cooperation to respond effectively to the deployment situation. For 
purposes of this provision, a dependent is limited to a spouse (but not 
a former spouse) of the member and a child who is dependent upon the 
member for over one-half of the child's support as defined in 
Secs. 199.3(b)(2)(ii)(A) through (b)(2)(ii)(F) and (b)(2)(ii)(H)(1), 
(b)(2)(ii)(H)(2) and (b)(2)(ii)(H)(4).

Enrollment in TRICARE Prime

    Enrollment in TRICARE Prime normally must be for a period of one 
year. Section 199.17(v), provides for the establishment of 
administrative requirements and procedures to ensure reasonable 
implementation and operation of the TRICARE program. Under this 
authority, an exception to the one-year Prime enrollment requirement 
has been provided for Reservists and members of the National Guard who 
are called or ordered to active duty for a period of 179 days or more. 
A second exception has been established for those beneficiaries who are 
eligible to enroll in Prime but have less than one year of TRICARE 
eligibility remaining. For example, the dependents of an active duty 
member may enroll in Prime even though the member has less than one 
year of active duty service remaining, and the member will not be 
eligible for retirement at the end of the member's active duty service.
    This proposed rule establishes specific regulatory authority for 
these exceptions.

Regulatory Procedures

    Executive Order (EO) 12866 requires that a comprehensive regulatory 
impact analysis be performed on any economically significant regulatory 
action, defined as one which would result in an annual effect of $100 
million or more on the national economy or which would 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

[[Page 19142]]

number of small entities. We certify that this proposed rule would not 
significantly affect a substantial number of small entities.
    This rule has been designated as significant and has been reviewed 
by the Office Management and Budget as required under the provisions of 
E.O. 12866.

Paperwork Reduction Act

    This rule imposes no burden as defined by the Paperwork Reduction 
Act of 1995.

List of Subjects in 32 CFR Part 199

    Claims, Handicapped, Health insurance, and 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 199.4 is proposed to be amended by adding a new 
paragraph (f)(2)(i)(H) to read as follows.


Sec. 199.4  Basic program benefits.

* * * * *
    (f) * * *
    (2) * * *
    (i) * * *
    (H) The Secretary of Defense, or a designee, may waive the annual 
fiscal year deductible for a dependent of a member of a Reserve 
Component who is called or ordered to active duty for a period of more 
than 30 days but less than one year or a member of the National Guard 
who is called or ordered to full-time National Guard duty for a period 
of more than 30 days but less than one year, in support of a 
contingency operation (as defined in 10 U.S.C. 101(a)(13)) for care 
received on or since October 5, 1999. For purposes of this paragraph, a 
dependent is a spouse (but not a former spouse) of the member and a 
child who is dependent upon the member for over one-half of the child's 
support as defined in Sec. 199.3 (b)(2)(ii)(A) through (b)(2)(ii)(F) 
and (b)(2)(ii)(H)(1), (b)(2)(ii)(H)(2) and (b)(2)(ii)(H)(4).
* * * * *
    3. Section 199.17 is proposed to be amended by revising paragraph 
(o)(2) to read as follows:


Sec. 199.17  TRICARE program.

* * * * *
    (o) * * *
    (2) Enrollment period.
    (i) 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 TRICARE Prime 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.
    (ii) Exceptions to the 12-month enrollment period.
    (A) Beneficiaries who are eligible to enroll in TRICARE Prime but 
have less than one year of TRICARE eligibility remaining may enroll.
    (B) The dependents of a reservist or of a member of the National 
Guard who is called to active duty for a period of 179 days or more may 
enroll in TRICARE Prime.
* * * * *

    Dated: April 11, 2002.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 02-9244 Filed 4-17-02; 8:45 am]
BILLING CODE 5001-08-P