[Federal Register Volume 84, Number 225 (Thursday, November 21, 2019)]
[Rules and Regulations]
[Pages 64197-64198]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-25282]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs

20 CFR Part 725

RIN 1240-AA11


Black Lung Benefits Act: Medical Benefit Payments

AGENCY: Office of Workers' Compensation Programs, Labor.

ACTION: Final rule; delay of applicability date.

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SUMMARY: The Office of Workers' Compensation Programs (OWCP) has 
encountered unforeseen delays in implementing a new computer system to 
process payments for professional medical and hospital outpatient 
services made by the Black Lung Disability Trust Fund (Trust Fund) 
under the Black Lung Benefits Act (BLBA). This action delays the 
applicability date of two rules relevant to these payments, which were 
published in the Federal Register on June 14, 2018.

DATES: 
    Effective date: This rule is effective November 21, 2019.
    Applicability date: The applicability date for 20 CFR 725.708(a) 
and (b) and 725.710 is delayed from November 30, 2019 to April 26, 
2020.

FOR FURTHER INFORMATION CONTACT: Michael A. Chance, Director, Division 
of Coal Mine Workers' Compensation, Office of Workers' Compensation 
Programs, U.S. Department of Labor, 200 Constitution Avenue NW, Suite 
N-3520, Washington, DC 20210. Telephone: 1-800-347-2502. This is a 
toll-free number. TTY/TDD callers may dial toll-free 1-800-877-8339 for 
further information.

SUPPLEMENTARY INFORMATION: The Trust Fund pays for covered medical 
services and treatments provided to certain miners who are entitled to 
BLBA disability benefits. See generally 33 U.S.C. 907, as incorporated 
by 30 U.S.C. 932(a); 83 FR 27690 (June 14, 2018). On June 14, 2018, 
OWCP published a final rule revising its regulations governing the 
payment of medical benefits by the Trust Fund. 83 FR 27690-27699. The 
revised rules adopt payment formulas that accurately reflect prevailing 
community rates for authorized treatments and services.
    While the revised regulations became effective on August 31, 2018, 
83 FR 27690, the Department set a separate applicability date for the 
rules governing payments for professional medical and outpatient 
services. Id.; see

[[Page 64198]]

also 20 CFR 725.708(c) and 725.710(d). In adopting this approach, the 
Department explained that payment of these bills ``would require 
extensive modifications to the existing computer processes for full 
implementation. The Department is currently transitioning to a new 
computer system and will realize cost-savings by building the new 
payment methodologies into that system rather than modifying the 
existing one.'' 83 FR 27691.
    The Department has been diligently working toward developing and 
deploying a new computer system to implement the new payment formulas 
but has encountered unforeseen delays. While many of the issues causing 
these delays have been resolved, OWCP cannot complete development of 
the new computer system without shifting significant resources from 
other critical workloads in time to process professional and outpatient 
bills by the current November 30, 2019 applicability date. As an 
alternative, OWCP considered, but rejected, manually processing these 
bills in the interim. Based on black lung program data from FY 2015 
through FY 2017, OWCP estimates it receives an average of approximately 
69,000 requests annually for payment of professional medical services 
alone. OWCP does not have the staff necessary to manually process this 
volume of bills. Thus, without an adequate computer system, it would be 
impractical for OWCP to timely process and pay professional and 
outpatient bills due to the volume. As a result, the Department is 
delaying the applicability date of the rules governing payment of these 
bills until April 26, 2020, the day before the new computer system is 
now scheduled to become operational.
    The Department's implementation of this action without opportunity 
for public comment, effective immediately upon publication, is based on 
the good cause exceptions in the Administrative Procedure Act, 5 U.S.C. 
553(b)(B) and 553(d)(3). Section 553(b)(B) provides that an agency may 
issue a rule without notice and comment when the agency for ``good 
cause'' finds ``that notice and public procedure thereon are 
impracticable, unnecessary, or contrary to the public interest.'' 
Section 553(d) provides that final rules may not become effective less 
than thirty days after publication in the Federal Register ``except . . 
. as otherwise provided by the agency for good cause,'' among other 
exceptions.
    Under these standards, the Department has determined that there is 
good cause for making this rule final without notice and comment 
procedures, and effective immediately upon Federal Register 
publication. As already noted, OWCP does not have the capacity to 
manually process the volume of bills it receives for professional and 
outpatient medical services. Thus, delaying the rule's application is a 
necessity: Without the delay, OWCP would no longer be able to promptly 
pay medical professionals and hospitals who provide treatment services 
to totally disabled coal miners. That result is contrary to the 
interests of miners and medical providers alike. Delaying the rules' 
application also does not impose any additional procedural burdens on 
the treatment providers. They will continue to seek payment in the same 
manner they do now no matter when the rules become applicable. See 
generally 20 CFR 725.714 and 725.715.
    Finally, neither medical professionals nor outpatient services 
providers will be harmed economically by the delay in any significant 
way. The Department summarized its economic impact analysis of the new 
payment formulas in its notice of proposed rulemaking. 82 FR 739, 745-
765 (Jan. 4, 2017). The Department compared payments it actually made 
from the Trust Fund in FY 2014 with payments it would have made if the 
new payment formulas in the proposed (and eventually final) rules 
applied. For both medical professionals and outpatient services, total 
annual Trust Fund payments decreased, in the aggregate, under the new 
payment formulas: $8,493 for professionals and $1,719,543 for 
outpatient services. 82 FR 746-748. Thus, delaying application of the 
new payment formulas will not, in the aggregate, harm the providers of 
either professional or outpatient services.

List of Subjects in 20 CFR Part 725

    Administrative practice and procedure, Black lung benefits, Claims, 
Coal miners' entitlement to benefits, Health care, Reporting and 
recordkeeping requirements, Survivors' entitlement to benefits, Total 
disability due to pneumoconiosis, Vocational rehabilitation, Workers' 
compensation.

    For the reasons set forth in the preamble, the Department of Labor 
amends 20 CFR part 725 as follows:

PART 725--CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE 
FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED

0
1. The authority citation for part 725 continues to read as follows:

     Authority:  5 U.S.C. 301; 28 U.S.C. 2461 note (Federal Civil 
Penalties Inflation Adjustment Act of 1990); Pub. L. 114-74 at sec. 
701; Reorganization Plan No. 6 of 1950, 15 FR 3174; 30 U.S.C. 901 et 
seq., 902(f), 921, 932, 936; 33 U.S.C. 901 et seq.; 42 U.S.C. 405; 
Secretary's Order 10-2009, 74 FR 58834.


Sec.  725.708  [Amended]

0
2. In Sec.  725.708, amend paragraph (c) by removing the date 
``November 30, 2019'' and adding in its place ``April 26, 2020''.


Sec.  725.710  [Amended]

0
3. In Sec.  725.710, amend paragraph (d) by removing the date 
``November 30, 2019'' and adding in its place ``April 26, 2020''.

Julia K. Hearthway,
Director, Office of Workers' Compensation Programs.
[FR Doc. 2019-25282 Filed 11-18-19; 4:15 pm]
 BILLING CODE 4510-CR-P