[Federal Register Volume 78, Number 229 (Wednesday, November 27, 2013)]
[Rules and Regulations]
[Pages 70863-70864]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-28436]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AO59


Copayment for Extended Care Services

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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SUMMARY: This document promulgates Department of Veterans Affairs (VA) 
final regulations amending the definition of ``spousal resource 
protection amount'' to reference the Maximum Community Spouse Resource 
Standard, which is adjusted and published each year by the Centers for 
Medicare and Medicaid Services (CMS). This change has the immediate 
effect of increasing the spousal resource protection amount from 
$89,280 to $115,920, and ensures that the spousal resource protection 
amount will stay consistent with the comparable protection for the 
spouses of Medicaid recipients.

DATES: Effective Date: This rule is effective December 27, 2013.

FOR FURTHER INFORMATION CONTACT: Kristin J. Cunningham, Director 
Business Policy, Chief Business Office, Department of Veterans Affairs, 
810 Vermont Avenue NW., Washington, DC 20420; (202) 461-1599. (This is 
not a toll-free number.)

SUPPLEMENTARY INFORMATION: On April 22, 2013, VA published in the 
Federal Register (78 FR 23702) a proposal to amend the definition of 
``spousal resource protection amount'' found at 38 CFR 
17.111(d)(2)(vi). The spousal resource protection amount is the amount 
of liquid assets of a veteran and community (i.e., not 
institutionalized) spouse that is considered unavailable when 
calculating the veteran's maximum monthly copayment obligation for 
extended care services longer than 180 days. We proposed to define the 
``spousal resource protection amount'' by reference to the Maximum 
Community Spouse Resource Standard, which is published each year by the 
Centers for Medicare and Medicaid Services (CMS) and is adjusted 
annually based on the Consumer Price Index. Previously, the spousal 
resource protection amount used by VA was set at $89,280 and did not 
adjust annually. Under the proposed change, this amount would 
immediately increase to the current CMS standard of $115,920, and would 
automatically adjust on an annual basis consistent with the comparable 
protection for the spouses of Medicaid recipients.
    In addition, we proposed to remove Sec.  17.111(g), which consists 
entirely of a copy of VA Form 10-10EC, Application for Extended Care 
Services.
    Interested persons were invited to submit comments to the proposed 
rule on or before June 21, 2013. We received one comment advocating for 
increased funding for medical services provided to military spouses, 
which is beyond the scope of this rulemaking. We received no 
substantive comments addressing the substance of the proposed rule or 
suggesting any changes. Therefore, based on the rationale set forth in 
the proposed rule, VA is adopting the provisions of the proposed rule 
as a final rule with no changes.

Effect of Rulemaking

    Title 38 of the Code of Federal Regulations, as revised by this 
final rulemaking, represents VA's implementation of its legal authority 
on this subject. Other than future amendments to this regulation or 
governing statutes, no contrary guidance or procedures are authorized. 
All existing or subsequent VA guidance must be read to conform with 
this rulemaking if possible or, if not possible, such guidance is 
superseded by this rulemaking.

Paperwork Reduction Act

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

Regulatory Flexibility Act

    The Secretary hereby certifies that this final rule 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 final rule will directly affect only individuals and will not 
directly affect small entities. Therefore, pursuant to 5 U.S.C. 605(b), 
this rulemaking is exempt from the initial and final regulatory 
flexibility analysis requirements of 5 U.S.C. 603 and 604.

Executive Orders 12866 and 13563

    Executive Orders 12866 and 13563 direct agencies to assess the 
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 effects, and other advantages; distributive impacts; 
and equity). Executive Order 13563 (Improving Regulation and Regulatory 
Review) emphasizes the importance of quantifying both costs and 
benefits, reducing costs, harmonizing rules, and promoting flexibility. 
Executive Order 12866 (Regulatory Planning and Review) defines a 
``significant regulatory action'' requiring review by the Office of 
Management and Budget (OMB), unless OMB waives such review, as ``any 
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 this 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. VA's impact analysis can be found as a supporting document 
at http://www.regulations.gov, usually within 48 hours after the 
rulemaking document is published. Additionally, a copy of the 
rulemaking and its impact analysis are available on VA's Web site at 
http://www1.va.gov/orpm/, by following the link for ``VA Regulations 
Published.''

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that

[[Page 70864]]

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 one year. 
This final rule will have no such effect on State, local, and tribal 
governments, or on the private sector.

Catalog of Federal Domestic Assistance

    The Catalog of Federal Domestic Assistance numbers and titles for 
the programs affected by this document are 64.007, Blind Rehabilitation 
Centers; 64.008, Veterans Domiciliary Care; 64.009, Veterans Medical 
Care Benefits; 64.010, Veterans Nursing Home Care; 64.014, Veterans 
State Domiciliary Care; 64.015, Veterans State Nursing Home Care; 
64.016, Veterans State Hospital Care; 64.018, Sharing Specialized 
Medical Resources; 64.019, Veterans Rehabilitation Alcohol and Drug 
Dependence; 64.022, Veterans Home Based Primary Care; and 64.024, VA 
Homeless Providers Grant and Per Diem Program.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Jose D. 
Riojas, Chief of Staff, Department of Veterans Affairs, approved this 
document on November 21, 2013, for publication.

List of Subjects in 38 CFR Part 17

    Administrative practice and procedure, Alcohol abuse, Alcoholism, 
Claims, Day care, Dental health, Drug abuse, 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, Reporting and recordkeeping requirements, 
Travel and transportation expenses, Veterans.

    Dated: November 22, 2013.
Robert C. McFetridge,
Director, Regulation Policy and Management, Office of the General 
Counsel, Department of Veterans Affairs.

    For the reasons stated in the preamble, the Department of Veterans 
Affairs amends 38 CFR part 17 as set forth below:

PART 17--MEDICAL

0
1. The authority citation for part 17 continues to read as follows:

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

0
2. Amend Sec.  17.111 by:
0
a. Revising paragraph (d)(2)(vi).
0
b. Removing paragraph (g).
    The revision reads as follows:


Sec.  17.111  Copayments for extended care services.

* * * * *
    (d) * * *
    (2) * * *
    (vi) Spousal resource protection amount means the value of liquid 
assets equal to the Maximum Community Spouse Resource Standard 
published by the Centers for Medicare and Medicaid Services (CMS) as of 
January 1 of the current calendar year if the spouse is residing in the 
community (not institutionalized).
* * * * *
[FR Doc. 2013-28436 Filed 11-26-13; 8:45 am]
BILLING CODE 8320-01-P