[Federal Register Volume 67, Number 180 (Tuesday, September 17, 2002)]
[Rules and Regulations]
[Pages 58528-58529]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-23312]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AL39


Priorities for Outpatient Medical Services and Inpatient Hospital 
Care

AGENCY: Department of Veterans Affairs.

ACTION: Interim final rule.

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SUMMARY: This document amends VA's medical regulations to establish 
that in scheduling appointments for non-emergency outpatient medical 
services and admissions for inpatient hospital care, VA will give 
priority to veterans with service-connected disabilities rated 50 
percent or greater and veterans needing care for a service-connected 
disability. The Veterans' Eligibility Reform Act of 1996 authorizes VA 
to ensure that these two categories of veterans receive priority access 
to this type of care. The intended effect of this interim final rule is 
to carry out that authority.

DATES: Effective Date: September 17, 2002.
    Comment Date: Comments must be received on or before November 18, 
2002.

ADDRESSES: Mail or hand-deliver written comments to: Director, Office 
of Regulations Management (02D), Department of Veterans Affairs, 810 
Vermont Ave., NW., Room 1154, Washington, DC 20420; or fax comments to 
(202) 273-9289; or e-mail comments to [email protected]. 
Comments should indicate that they are submitted in response to ``RIN 
2900-AL39.'' All comments received will be

[[Page 58529]]

available for public inspection in the Office of Regulations 
Management, Room 1158, between the hours of 8 a.m. and 4:30 p.m., 
Monday through Friday (except holidays).

FOR FURTHER INFORMATION CONTACT: Amy Hertz, Office of Policy and 
Planning (105D), at (202) 273-8934 or Roscoe Butler, Chief Policy & 
Operations, Health Administration Service (10C3), at (202) 273-8302. 
These individuals are in the Veterans Health Administration of the 
Department of Veterans Affairs, and are located at 810 Vermont Avenue, 
NW., Washington, DC 20420.

SUPPLEMENTARY INFORMATION: The Veterans' Eligibility Reform Act of 
1996, Public Law No. 104-262 (Eligibility Reform Act) amended title 38, 
United States Code, to authorize VA to provide needed inpatient 
hospital care and outpatient medical services to most veterans. That 
law also directs VA to establish a national patient enrollment system 
to manage the provision of that care and services. The law directs VA 
to enroll veterans for care in accordance with priorities set forth in 
the statute, and requires that most veterans formally enroll with VA in 
order to receive care from VA.
    However, the law also specifically provides that the Secretary 
shall provide care to certain veterans without their needing to enroll. 
Included are veterans with service-connected disabilities rated 50 
percent or greater and veterans needing care for a service-connected 
disability. Allowing those veterans to receive care without regard to 
enrollment effectively gives them priority over all other veterans. The 
legislative history of the Eligibility Reform Act also includes 
references to Congress' intent that these two groups of veterans, those 
with a very high claim to VA services, should have priority access to 
care.
    VA established an enrollment system through rules promulgated at 38 
CFR 17.36 and 17.37. Those rules provide that veterans with 
disabilities rated 50 percent or greater, and veterans needing care for 
a service-connected disability, need not enroll to receive care from 
VA. The rules do not, however, afford those two groups of veterans with 
special priority access to VA outpatient medical services or inpatient 
hospital care, as authorized by law. This interim final rule rectifies 
that matter and expressly provides for that priority access. Moreover, 
it provides such priority to these veterans regardless of whether they 
are enrolled in the VA health care system.

Administrative Procedure Act

    Since hundreds of thousands of our core constituency veterans are 
currently on waiting lists causing delays in their receiving treatment, 
we have found good cause to dispense with the notice-and-comment and 
delayed effective date provisions of the Administrative Procedure Act 
(5 U.S.C. 553). Compliance with such provisions would be impracticable 
and contrary to the public interest.

Unfunded Mandates

    The Unfunded Mandates Reform Act requires, at 2 U.S.C. 1532, that 
agencies prepare an assessment of anticipated costs and benefits before 
developing any rule that may result in an expenditure by State, local, 
or tribal governments, in the aggregate, or by the private sector of 
$100 million or more in any given year. This rule would have no 
consequential effect on State, local, or tribal governments.

Paperwork Reduction Act

    This document contains no provisions constituting a collection of 
information under the Paperwork Reduction Act (44 U.S.C. 3501-3520).

Executive Order 12866

    This document has been reviewed by the Office of Management and 
Budget under Executive Order 12866.

Regulatory Flexibility Act

    The Secretary hereby certifies that this regulatory amendment would 
not have a significant economic impact on a substantial number of small 
entities as they are defined in the Regulatory Flexibility Act (RFA), 5 
U.S.C. 601-612. This amendment would not directly affect any small 
entities. Only individuals could be directly affected. Therefore, 
pursuant to 5 U.S.C. 605(b), this amendment is exempt from the initial 
and final regulatory flexibility analysis requirements of sections 603 
and 604.

Catalog of Federal Domestic Assistance Numbers

    The Catalog of Federal Domestic Assistance numbers for the programs 
affected by this document are 64.005, 64.007, 64.008, 64.009, 64.010, 
64.011, 64.012, 64.013, 64.014, 64.015, 64.016, 64.018, 64.019, 64.022, 
and 64.025.

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 homes, Philippines, Reporting 
and recordkeeping requirements, Scholarships and fellowships, Travel 
and transportation expenses, Veterans.

    Approved: August 9, 2002.
Anthony J. Principi,
Secretary of Veterans Affairs.

    For the reasons set out in the preamble, 38 CFR part 17 is amended 
as set forth below:

PART 17--MEDICAL

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

    Authority: 38 U.S.C. 501, 1721, unless otherwise noted.


    2. Section 17.49 is revised to read as follows:


Sec.  17.49  Priorities for Outpatient Medical Services and Inpatient 
Hospital Care.

    In scheduling appointments for outpatient medical services and 
admissions for inpatient hospital care, the Under Secretary for Health 
shall give priority to:
    (a) Veterans with service-connected disabilities rated 50 percent 
or greater based on one or more disabilities or unemployability; and
    (b) Veterans needing care for a service-connected disability.

(Authority: 38 U.S.C. 101, 501, 1705, 1710.)


[FR Doc. 02-23312 Filed 9-16-02; 8:45 am]
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