[Federal Register Volume 79, Number 242 (Wednesday, December 17, 2014)]
[Rules and Regulations]
[Pages 75043-75044]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-29554]



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 Rules and Regulations
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  Federal Register / Vol. 79, No. 242 / Wednesday, December 17, 2014 / 
Rules and Regulations  

[[Page 75043]]



OFFICE OF PERSONNEL MANAGEMENT

5 CFR Part 890

RIN 3206-AN03


Federal Employees Health Benefits Program Miscellaneous Changes: 
Medically Underserved Areas

AGENCY: U.S. Office of Personnel Management.

ACTION: Direct final rule.

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SUMMARY: The U.S. Office of Personnel Management (OPM) is issuing a 
direct final rule to discontinue the annual determination of the 
Medically Underserved Areas (MUAs) for the Federal Employees Health 
Benefits (FEHB) Program.

DATES: Effective January 1, 2015. Comments due February 17, 2015.

ADDRESSES: Send written comments to Lynelle T. Frye, Policy Analyst, 
Planning and Policy Analysis, U.S. Office of Personnel Management, Room 
4312, 1900 E Street NW., Washington, DC; or FAX to (202) 606-4640 Attn: 
Lynelle T. Frye. You may also submit comments using the Federal 
eRulemaking Portal: http://www.regulations.gov. Follow the instructions 
for submitting comments.

FOR FURTHER INFORMATION CONTACT: Lynelle T. Frye, Policy Analyst, at 
(202) 606-0004 or email: [email protected].

SUPPLEMENTARY INFORMATION: Due to the enactment of Section 2706(a) of 
the Public Health Service Act (PHSA), OPM has concluded that the annual 
determination of Medically Underserved Areas (MUAs) for the FEHB 
Program is no longer required. Section 2706(a) of the PHSA requires 
that a health insurance issuer or group health plan offering coverage 
shall not discriminate with respect to coverage against any health care 
provider who performs covered services when acting within the scope of 
their license or certification under applicable state law in any area 
of a state.

Background

    The Federal Employees Health Benefits (FEHB) law (5 U.S.C. 
8902(m)(2)) requires that a State be designated as a Medically 
Underserved Area if 25% or more of the population lives in an area 
identified by the Department of Health and Human Services (HHS) as a 
primary medical care manpower shortage area.
    It is intended to provide special consideration for enrollees who 
obtain health services in states with critical shortages of primary 
care physicians. As such, FEHB fee-for-service plans are required to 
provide benefits for covered services (subject to their contract terms) 
provided by any licensed provider practicing within the scope of his/
her license, such as physician assistants or nurse midwives, which 
otherwise may not be considered as covered providers by the fee-for-
service plan.
    After the enactment of Section 2706(a) of the Public Health Service 
Act (PHSA) the Department of Labor offered guidance to health plans and 
health insurance issuers that, to the extent an item or service is a 
covered benefit under the plan or coverage, and consistent with 
reasonable medical management techniques specified under the plan with 
respect to the frequency, method, treatment or setting for an item or 
service, a plan or issuer shall not discriminate based on a provider's 
license or certification, to the extent the provider is acting within 
the scope of the provider's license or certification under applicable 
state law. This provision does not require plans or issuers to accept 
all types of providers into a network. This provision also does not 
govern provider reimbursement rates, which may be subject to quality, 
performance, or market standards and considerations.
    The effect of Section 2706(a) of the PHSA is to expand the 
geographic area of coverage for all licensed providers offering covered 
services within the scope of their license to all areas of all States 
rather than the only those areas designated as Medically Underserved 
under 5 U.S.C. 8902(m)(2).
    OPM has concluded that Section 2706(a) of the PHSA renders the 
annual determination of the MUAs for FEHB no longer required. It serves 
a similar purpose, since this Section is to expand the geographic area 
of coverage for all licensed providers offering covered services within 
the scope of their license to all areas of all States rather than the 
only those areas designated as Medically Underserved under 5 U.S.C. 
8902(m)(2).
    With this change, we are not seeking a comment period since we feel 
it serves the same purpose as MUA.

Regulatory Impact Analysis

    OPM has examined the impact of this proposed rule as required by 
Executive Order 12866 and Executive Order 13563, which directs agencies 
to assess all costs and benefits of available regulatory alternatives 
and, if regulation is necessary, to select regulatory approaches that 
maximize net benefits (including potential economic, environmental, 
public, health, and safety effects, distributive impacts, and equity). 
A regulatory impact analysis must be prepared for major rules with 
economically significant effects of $100 million or more in any one 
year. This rule is not considered a major rule because there will be a 
minimal impact on costs to Federal agencies.

Regulatory Flexibility Act

    I certify that this regulation will not have a significant economic 
impact on a substantial number of small entities because the regulation 
only affects health insurance benefits of Federal employees and 
annuitants.

Regulatory Review

    This rule has been reviewed by the Office of Management and Budget 
in accordance with Executive Order 12866.

Federalism

    We have examined this rule in accordance with Executive Order 
13132, Federalism, and have determined that this rule will not have any 
negative impact on the rights, roles, and responsibilities of State, 
local, or Tribal governments.

Paperwork Reduction Act

    The Paperwork Reduction Act of 1995 (44 U.S.C. chapter 35; see 5 
CFR part 1320) requires that the U.S. Office of Management and Budget 
(OMB) approve all collections of information by a Federal agency from 
the public before they can be implemented.

[[Page 75044]]

Respondents are not required to respond to any collection of 
information unless it displays a current valid OMB control number. OPM 
is not proposing any additional collections in this rule.

List of Subjects in 5 CFR Part 890

    Administrative practice and procedure; Government employees; Health 
facilities; Health insurance; Health professions; Hostages; Iraq; 
Kuwait; Lebanon; Military personnel; Reporting and recordkeeping 
requirements; Retirement.

    U.S. Office of Personnel Management.
Kathleen Archuleta,
Director.
    Accordingly, OPM is amending 5 CFR part 890 as follows:

PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM

0
1. The authority citation for part 890 continues to read as follows:

    Authority: 5 U.S.C. 8913; Sec. 890.301 also issued under sec. 
311 of Pub. L. 111-03, 123 Stat. 64; Sec. 890.111 also issued under 
section 1622(b) of Pub. L. 104-106, 110 Stat. 521; Sec. 890.112 also 
issued under section 1 of Pub. L. 110-279, 122 Stat. 2604; 5 U.S.C. 
8913; Sec. 890.803 also issued under 50 U.S.C. 403p, 22 U.S.C. 4069c 
and 4069c-1; subpart L also issued under sec. 599C of Pub. L. 101-
513, 104 Stat. 2064, as amended; Sec. 890.102 also issued under 
sections 11202(f), 11232(e), 11246 (b) and (c) of Pub. L. 105-33, 
111 Stat. 251; and section 721 of Pub. L. 105-261, 112 Stat. 2061; 
Pub. L. 111-148, as amended by Pub. L. 111-152.

Subpart G--[Removed and Reserved]

0
1. Remove and Reserve subpart G, consisting of Sec. Sec.  890.701 and 
890.702.
[FR Doc. 2014-29554 Filed 12-16-14; 8:45 am]
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