[Federal Register Volume 68, Number 147 (Thursday, July 31, 2003)]
[Proposed Rules]
[Pages 44913-44914]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-19441]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AL60


Sensori-Neural Aids

AGENCY: Department of Veterans Affairs.

ACTION: Proposed rule.

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SUMMARY: This document amends Department of Veterans Affairs (VA) 
medical regulations concerning sensori-neural aids. An existing 
regulation authorizes VA to provide sensori-neural aids (i.e., 
eyeglasses, contact lenses, hearing aids) to seven specific groups of 
veterans identified in the regulation. The first four groups consist of 
veterans with the highest priority for care under VA's enrollment 
system, generally those with compensable service-connected 
disabilities, former prisoners of war, and those receiving increased VA 
pension based on their being housebound or in need of regular aid and 
attendance. Subsequent to promulgating the regulation, Congress changed 
the law to provide that veterans awarded the Purple Heart should have 
priority equal to former prisoners of war under VA's enrollment system. 
To be consistent, VA is proposing to amend the sensori-neural aids 
regulation to allow veterans in receipt of a Purple Heart to also 
receive sensori-neural aids.

DATES: Comments must be received on or before September 29, 2003.

ADDRESSES: Mail or hand-deliver written comments to: Director, 
Regulations Management (00REG1), Department of Veterans Affairs, 810 
Vermont Ave., NW., Room 1064, Washington, DC 20420; or fax comments to 
(202) 273-9026; or e-mail comments to [email protected]. 
Comments should indicate that they are submitted in response to ``RIN 
2900-AL60.'' All comments received will be available for public 
inspection in the Office of Regulation Policy and Management, Room 
1158, between the hours of 8 a.m. and 4:30 p.m., Monday through Friday 
(except holidays). Please call (202) 273-9515 for an appointment.

FOR FURTHER INFORMATION CONTACT: Frederick Downs, Jr., Chief 
Consultant, Prosthetics and Sensory Aids Service Strategic Healthcare 
Group (113), Department of Veterans Affairs, 810 Vermont Avenue, NW., 
Washington, DC 20420, (202) 273-8515. (This is not a toll-free number.)

SUPPLEMENTARY INFORMATION: The ``Veterans' Health Care Eligibility 
Reform Act of 1996,'' Public Law No. 104-262 (Eligibility Reform Act) 
made major changes in the laws governing eligibility for VA health care 
benefits. That law amended 38 U.S.C. 1710, authorizing VA to furnish 
virtually all needed hospital care and medical services (i.e., 
outpatient care) to veterans, including prosthetic devices and similar 
appliances. Prior to enactment of the Eligibility Reform Act, VA was 
generally prohibited from furnishing prosthetic devices and similar 
appliances on an outpatient basis. Although Congress expanded VA's 
authority to furnish veterans with prosthetic devices and similar 
appliances, it expressly provided in the law that with respect to 
sensori-neural aids (i.e., eyeglasses, contact lenses, hearing aids), 
VA could exercise that authority only in accordance with guidelines 
prescribed by the Secretary. 38 U.S.C. 1707(b) (previously codified as 
38 U.S.C. 1701(6)(A)(i)). The purpose of that proviso in the law was to 
permit VA to decide that it would not furnish eyeglasses and hearing 
aids to all veterans. In 1997, VA published an interim final rule 
establishing guidelines for the provision of sensori-neural aids. 62 FR 
30240 (June 3, 1997). The final rule was effective on December 9, 1997 
(62 FR 64722).
    The Eligibility Reform Act also directed VA to establish a system 
of annual patient enrollment (38 U.S.C. 1705). The purpose of the 
enrollment system was to provide a mechanism for prioritizing the 
provision of VA health care if available resources were insufficient to 
provide all needed care to all veterans who sought it. The law 
initially established seven priority categories, although Congress 
subsequently expanded that to eight categories. The eight specific 
categories are enumerated in 38 U.S.C. 1705(a).
    The guidelines that VA promulgated to govern the provision of 
sensori-neural aids specifically listed groups of veterans who could 
receive such devices. Listed were the veterans included in enrollment 
categories 1 through 4, and certain other veterans with unique vision 
and hearing needs. Veterans in enrollment priority categories 1 through 
4, who are also specifically made eligible for sensori-neural aids 
under the guidelines, are veterans with compensable service-connected 
conditions, former prisoners of war, and nonservice-connected veterans 
in receipt of increased pension based on the need for regular aid and 
attendance or by reason of being permanently housebound.
    In 1999, some 2 years after VA promulgated the rule governing 
sensori-neural aids, Congress passed Public Law No. 106-117, the 
``Veterans Millennium Health Care and Benefits Act'' (Millennium Act). 
The Millennium Act amended the law establishing the enrollment priority 
categories. In this Act, Congress added to enrollment priority category 
3, those veterans who were awarded the Purple Heart. Those veterans 
were, in short, given enrollment priority status at the same level as 
service-connected veterans rated 10 percent or 20 percent and former 
POWs. In order to be consistent with that change in law, VA believes it 
appropriate to also provide that those veterans be eligible for 
sensori-neural aids. Accordingly, we propose to amend the guidelines to 
include in Sec.  17.149(b), veterans who received the Purple Heart.

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 proposed amendment would 
have no such effect on State, local, or tribal governments, or the 
private sector.

Executive Order 12866

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

[[Page 44914]]

Paperwork Reduction Act

    This document contains no provisions constituting a collection of 
information under the Paperwork Reduction Act (44 U.S.C. 3501-3521).

Regulatory Flexibility Act

    The Secretary of Veterans Affairs (VA) hereby certifies that this 
proposed regulatory amendment 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. This proposed 
amendment would affect only veterans receiving certain VA benefits and 
does not affect any small entities. Therefore, pursuant to 5 U.S.C. 
605(b), this proposed 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 are 64.009, 
64.010, 64.011, and 64.013.

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, Government 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 fellowships, 
Travel and transportation expenses, Veterans.

    Approved: June 25, 2003.
Anthony J. Principi,
Secretary of Veterans Affairs.

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

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 17.149, is amended by:
    a. Redesignating paragraphs (b)(3) through (b)(7) as paragraphs 
(b)(4) through (b)(8), respectively; and
    b. Adding a new paragraph (b)(3).
    The addition reads as follows:


Sec.  17.149  Sensori-neural aids.

* * * * *
    (b) * * *
    (3) Those awarded a Purple Heart;
* * * * *
[FR Doc. 03-19441 Filed 7-30-03; 8:45 am]
BILLING CODE 8320-01-P