[Federal Register Volume 74, Number 121 (Thursday, June 25, 2009)]
[Rules and Regulations]
[Pages 30227-30228]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-14966]


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

DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AN07


Foreign Medical Program of the Department of Veterans Affairs--
Hospital Care and Medical Services in Foreign Countries

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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

SUMMARY: This document amends Department of Veterans Affairs (VA) 
medical regulations applicable to VA's Foreign Medical Program, 
Hospital Care and Medical Services in Foreign Countries. This rule is 
intended to change provisions concerning the location for filing 
Foreign Medical Program claims and delegations of authority for 
adjudicating those claims. It also corrects an obsolete regulatory 
citation. These changes are made for accuracy.

DATES: Effective Date: July 27, 2009.

FOR FURTHER INFORMATION CONTACT: Richard M. Trabert, Policy Management 
Division (741/PMD), VA Health Administration Center, P.O. Box 65020, 
Denver, CO 80206-9020; (303) 331-7549. (This is not a toll-free 
number.)

SUPPLEMENTARY INFORMATION: This document amends certain provisions 
concerning VA's Foreign Medical Program (FMP) in VA's medical 
regulations in 38 CFR part 17. The FMP is a VA health benefits program 
designed for a veteran who is residing or traveling outside of the 
United States, if the veteran requires treatment for a VA-rated 
service-connected disability or any disability associated with and 
aggravating a service-connected disability; or if the veteran requires 
care for certain reasons during participation in a rehabilitation 
program under 38 U.S.C. chapter 31.
    This rule amends 38 CFR 17.35, 17.125, and 17.141.
    We are amending Sec.  17.35, ``Hospital care and medical services 
in foreign countries,'' to correct an obsolete reference in Sec.  
17.35(b) to 38 CFR 17.48(j)(2). The reference is corrected to Sec.  
17.47(i)(2) to reflect the redesignation of that paragraph pursuant to 
two earlier final rules (see 61 FR 21964, 21965 (May 13, 1996); 65 FR 
54207, 54218 (Oct. 6, 1999)).
    This rule amends Sec.  17.125, ``Where to file claims,'' to reflect 
a change in the mailing address for FMP claims sent to the Health 
Administration Center in Denver, Colorado. It also amends Sec.  17.125, 
as well as Sec.  17.141, ``Authority to adjudicate foreign 
reimbursement claims,'' to remove provisions that distinguish the 
filing and adjudication of FMP claims for services rendered in Canada 
from those claims for services rendered in other foreign countries. 
Currently, these provisions instruct claimants to file claims for 
services rendered in Canada with the VA Medical Center in White River 
Junction, Vermont, and reflect a delegation of authority to that office 
for adjudication of those claims. Current Sec.  17.125 provides that 
claims for services rendered in other foreign countries (except the 
Philippines) must be mailed to the Denver Health Administration Center 
and Sec.  17.141 reflects a delegation of authority to that office for 
adjudication of those claims. This rule removes the distinction between 
Canada and other foreign countries, thereby requiring claims under the 
FMP for services rendered in Canada to be mailed to and adjudicated by 
the Health Administration Center.

Administrative Procedure Act

    This document merely corrects a citation to a regulatory paragraph 
to reflect that paragraph's redesignation and makes other changes 
pertaining to agency management, organization, and procedure. 
Accordingly, its publication as a final rule is pursuant to 5 U.S.C. 
553, which exempts such a document from the notice-and-comment 
requirements of section 553.

[[Page 30228]]

Regulatory Flexibility Act

    The initial and final regulatory flexibility analyses requirements 
of sections 603 and 604 of the Regulatory Flexibility Act, 5 U.S.C. 
601-612, are not applicable to this rule, because a notice of proposed 
rulemaking is not required for this rule. Even so, the Secretary of 
Veterans Affairs hereby certifies that this 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. Individuals eligible for FMP benefits are widely 
dispersed geographically and any effect on a small entity from the 
provisions of this rule will be miniscule. Therefore, this final rule 
is also exempt pursuant to 5 U.S.C. 605(b) from the initial and final 
regulatory flexibility analyses requirements of section 603 and 604.

Paperwork Reduction Act of 1995

    This document contains no provisions constituting a collection of 
information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-
3521).

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in the expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any year. This rule will have no such effect on State, 
local, and tribal governments, or on the private sector.

Executive Order 12866

    Executive Order 12866 directs agencies to assess all costs and 
benefits of available regulatory alternatives and, when regulation is 
necessary, to select regulatory approaches that maximize net benefits 
(including potential economic, environmental, public health and safety, 
and other advantages; distributive impacts; and equity). The Executive 
Order classifies a regulatory action as a ``significant regulatory 
action,'' requiring review by the Office of Management and Budget (OMB) 
unless OMB waives such review, if it is a regulatory action that is 
likely to result in a rule that may: (1) Have an annual effect on the 
economy of $100 million or more or adversely affect in a material way 
the economy, a sector of the economy, productivity, competition, jobs, 
the environment, public health or safety, or State, local, or tribal 
governments or communities; (2) create a serious inconsistency or 
otherwise interfere with an action taken or planned by another agency; 
(3) materially alter the budgetary impact of entitlements, grants, user 
fees, or loan programs or the rights and obligations of recipients 
thereof; or (4) raise novel legal or policy issues arising out of legal 
mandates, the President's priorities, or the principles set forth in 
the Executive Order.
    The economic, interagency, budgetary, legal, and policy 
implications of this final rule have been examined and it has been 
determined not to be a significant regulatory action under Executive 
Order 12866.

Catalog of Federal Domestic Assistance

    The program that this rule affects has the following Catalog of 
Federal Domestic Assistance number and title: 64.009, Veterans Medical 
Care Benefits.

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: June 10, 2009.
John R. Gingrich,
Chief of Staff, Department of Veterans Affairs.

0
For the reasons stated in the preamble, VA amends 38 CFR part 17 as 
follows:

PART 17--MEDICAL

0
1. Revise the authority citation for part 17 to read as follows:

    Authority:  38 U.S.C. 501, 1721, and as noted in specific 
sections.


Sec.  17.35  [Amended]

0
2. Amend Sec.  17.35(b) by removing ``38 CFR 17.48(j)(2)'' and adding 
in its place ``Sec.  17.47(i)(2)''.


Sec.  17.125  [Amended]

0
3. Amend Sec.  17.125 by:
0
a. In paragraph (a), removing ``, and'' at the end of the paragraph and 
adding in its place ``.''.
0
b. In paragraph (b), removing ``, and'' at the end of the paragraph and 
adding in its place ``.''.
0
c. Removing paragraph (c) and redesignating paragraphs (d) and (e) as 
paragraphs (c) and (d), respectively.
0
d. In newly-redesignated paragraph (c), removing ``P.O. Box 65023, 
Denver, CO 80206-3023'' and adding in its place ``P.O. Box 469063, 
Denver, CO 80246-9063''.


Sec.  17.141  [Amended]

0
4. Amend Sec.  17.141 by removing ``Canada which will be referred to 
the VA Medical Center in White River Junction, VT, and''.

[FR Doc. E9-14966 Filed 6-24-09; 8:45 am]
BILLING CODE P