[Federal Register Volume 83, Number 124 (Wednesday, June 27, 2018)]
[Rules and Regulations]
[Pages 30080-30081]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-13837]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

42 CFR Part 23

RIN 0906-AB15


Removing Outmoded Regulations Regarding the National Health 
Service Corps Program

AGENCY: Health Resources and Services Administration (HRSA), HHS.

ACTION: Final rule.

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SUMMARY: This action removes outmoded regulations for the National 
Health Service Corps (NHSC) Program. The regulations were promulgated 
to implement Section 338G of the Public Health Service (PHS) Act, 
relating to private practice loans. The regulations have not been 
updated since they were issued in 1986. The regulations are no longer 
relevant or needed as the NHSC has not made private practice loan 
opportunities available since the 1980s, and does not plan to do so in 
the foreseeable future. The removal of these regulations will not 
create any challenges for other programs, as the law and regulations 
apply solely to NHSC clinicians.

DATES: This action is effective July 27, 2018.

FOR FURTHER INFORMATION CONTACT: Sweta Maheshwari J.D., Legislative 
Analyst, Division of Policy and Shortage Designation, Bureau of Health 
Workforce, HRSA, 5600 Fishers Lane, Room 11W21A, Rockville, MD 20857, 
by phone at (301) 945-3527, or by email at [email protected].

SUPPLEMENTARY INFORMATION: In response to Executive Order 13777 and 
Executive Order 13563, Sec. 6(a), which direct agencies to repeal 
existing regulations that are ``outmoded'' from the Code of Federal 
Regulations (CFR), HHS is removing 42 CFR part 23, subpart B 
(Sec. Sec.  23.21 through 23.35) and subpart C (Sec.  23.41). 
Furthermore, HHS has determined that there is good cause to bypass 
notice and comment and proceed to a final rule, pursuant to 5 U.S.C. 
553(b)(B). The action is non-controversial, as it merely removes 
certain provisions from the CFR that are obsolete. Given the length of 
time (approximately 30 years) since the private practice loan provision 
has been utilized, it is HHS's assessment that the agency is unlikely 
to receive any comments opposing the repeal of these regulations. Thus, 
a comment period prior to finalization of this rule is unnecessary. 
This rule poses no new substantive requirements or burdens on the 
public.

Background

    In 1986, HHS issued implementing regulations, as directed in 
Section 338G of the PHS Act, specifying the interest rate and loan 
repayment terms for private practice special loans to former Corps 
members and interest rate and loan repayment terms for private practice 
start-up loans to NHSC scholarship recipients.
    The provision for Special Loans for Former Corps Members to Enter 
Private Practice authorized the Secretary to make a one-time loan up to 
$25,000 to a Corps member. In exchange, the Corps member reciprocated 
by committing to serve as a full-time private practice provider in a 
Health Professional Shortage Area (HPSA) for a minimum of two years. 
The intent of these regulations was to retain Corps members in HPSAs 
after the completion of their service obligation. The regulation is no 
longer relevant as the NHSC has not made such loan opportunities 
available since the 1980s and, therefore, no longer needs to set 
repayment terms for private practice start-up loans. HRSA does not 
intend to restart this loan program, as the NHSC program currently has 
a retention rate of 88%, making additional incentives unnecessary.
    Section 338G also authorizes Private Start-Up Loans. At the time 
the statute was enacted, only the NHSC Scholarship Program existed. 
Scholars were able to apply for up to $25,000 to purchase or lease the 
equipment and supplies needed for providing health services in their 
private practices. The intention of the program was to offer further 
incentives to recruit health professions students into the program. The 
regulation is no longer relevant since the NHSC has not made such loan 
opportunities available since the 1980s and, therefore, no longer has 
need to set repayment terms for private practice start-up loans. 
Furthermore, the NHSC Scholarship Program is significantly 
oversubscribed, and no further incentives are necessary to recruit 
health professions students.
    Removing these regulations will not have an impact on the NHSC 
program. There is no specific appropriations authority to support 
Section 338G of the PHS Act; the authorization of appropriation at 338H 
supports all the activities under Subpart III (which includes the NHSC 
Loan Repayment and Scholarship Programs). The repeal of these 
regulations will not create any challenges for other programs, as the 
law and regulations apply solely to NHSC clinicians.

Executive Orders 12866, 13563, 13771, and 13777

    Executive Orders 12866 and 13563 direct 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). Executive 
Order 13771 directs agencies to categorize all impacts which generate 
or alleviate costs associated with regulatory burden and to determine 
the actions net incremnatal effect.
    Section 3(f) of Executive Order 12866 defines a ``significant 
regulatory action'' as an action that is likely to result in a rule: 
(1) Having an annual effect on the economy of $100 million or more in 
any 1 year, or adversely and materially affecting a sector of the 
economy, productivity, competition, jobs, the environment, public 
health or safety, or State, local or Tribal governments or communities 
(also referred to as ``economically significant''); (2) creating a 
serious inconsistency or otherwise interfering with an action taken or 
planned by another agency; (3) materially altering the budgetary 
impacts of entitlement grants, user fees, or loan programs or the 
rights and obligations of recipients thereof; or (4) raising novel 
legal or policy issues arising out of legal mandates, the President's 
priorities, or the principles set forth in the Executive Order.
    A regulatory impact analysis (RIA) must be prepared for major rules 
with economically significant effects ($100 million or more in any 1 
year). HHS submits that this final rule is not ``economically 
significant'' as measured by the $100 million threshold, and

[[Page 30081]]

hence not a major rule under the Congressional Review Act. This rule 
has not been designated as a ``significant regulatory action'' under 
Executive Order 12866. Accordingly, this rule has not been reviewed by 
the Office of Management and Budget (OMB).
    Executive Order 13771, titled ``Reducing Regulation and Controlling 
Regulatory Costs,'' was issued on January 30, 2017. HHS identifies this 
final rule as a deregulatory action (removing an obsolete rule from the 
Code of Federal Regulations). For the purposes of Executive Order 
13771, this final rule is not a substantive rule; rather it is 
administrative in nature and provides no cost savings.
    Executive Order 13777, titled ``Enforcing the Regulatory Reform 
Agenda,'' was issued on February 24, 2017. As required by Section 3 of 
this Executive Order, HHS established a Regulatory Reform Task Force 
(HHS Task Force). Pursuant to Section 3(d)(ii), the HHS Task Force 
evaluated this rulemaking and determined that these regulations are 
``outdated, unnecessary, or ineffective.'' Following this finding, the 
HHS Task Force advised the HRSA Administrator to initiate this 
rulemaking to remove the obsolete regulations from the Code of Federal 
Regulations.

Regulatory Flexibility Act

    This action will not have a significant economic impact on a 
substantial number of small entities. Therefore, the regulatory 
flexibility analysis provided for under the Regulatory Flexibility Act 
is not required.

Paperwork Reduction Act

    This action does not affect any information collections.

    Dated: June 4, 2018.
George Sigounas,
Administrator, Health Resources and Services Administration.

    Approved: June 21, 2018.
Alex M. Azar II,
Secretary, Department of Health and Human Services.

List of Subjects in 42 CFR Part 23

    Health, Health professions.

    For reasons set out in the preamble, and under the authority at 5 
U.S.C. 301, HHS amends 42 CFR part 23 as follows:

PART 23--NATIONAL HEALTH SERVICE CORPS

0
1. The authority citation for part 23 continues to read as follows:

    Authority: Secs. 333, 338E(c), and 338C(e)(1), Public Health 
Service Act. 90 Stat. 2272, as amended, 95 Stat. 905, 97 Stat. 1345 
(42 U.S.C. 254f et seq.), 95 Stat. 912 (42 U.S.C. 254p(c)), 95 Stat. 
910 (42 U.S.C. 254n(e)(1)).

Subparts B and C [Removed]

0
2. Remove subpart B, consisting of Sec. Sec.  23.21 through 23.35, and 
subpart C, consisting of Sec.  23.41.

[FR Doc. 2018-13837 Filed 6-26-18; 8:45 am]
BILLING CODE 4165-15-P