[Federal Register Volume 85, Number 115 (Monday, June 15, 2020)]
[Proposed Rules]
[Pages 36182-36183]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-12749]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

42 CFR Part 136

[Docket No. IHS-FRDOC-0001]
RIN 0917-AA14


Removal of Obsolete Portion of Regulation Relating to Care and 
Treatment of Ineligible Individuals

AGENCY: Indian Health Service, Department of Health and Human Services.

ACTION: Notice of proposed rulemaking.

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

SUMMARY: The Indian Health Service (IHS) of the Department of Health 
and Human Services (HHS or ``the Department'') is issuing this Notice 
of Proposed Rulemaking (NPRM) to remove obsolete language appearing in 
the Code of Federal Regulations, regarding the rates charged for the 
provision of IHS services to ineligible individuals.

DATES: Comments due on or before August 14, 2020.

ADDRESSES: You may submit comments to this proposed rule, identified by 
RIN 0917-AA14 by any of the following methods:
     Federal eRulemaking Portal. You may submit electronic 
comments at http://www.regulations.gov by searching for the Docket ID 
number IHS-FRDOC-0001. Follow the instructions http://www.regulations.gov online for submitting comments through this method.
     Regular, Express, or Overnight Mail: You may mail comments 
to Indian Health Service, Attention: Evonne Bennett, Acting Director, 
NPRM, RIN 0917-AA14, Division of Regulatory and Policy Coordination, 
Office of Management Services, Indian Health Service, 5600 Fishers 
Lane, Mailstop: 09E70, Rockville, Maryland 20857.
    All comments received by the methods and due date specified above 
will be posted without change to content to http://www.regulations.gov, 
including any personal information provided about the commenter, and 
such posting may occur before or after the closing of the comment 
period.
    Docket: For complete access to background documents or posted 
comments, go to http://www.regulations.gov and search for Docket ID 
number IHS-FRDOC-0001.

FOR FURTHER INFORMATION CONTACT: Evonne Bennett, Acting Director, 
Division of Regulatory and Policy Coordination, Office of Management 
Services, IHS, 5600 Fishers Lane, Rockville, MD 20857, Mail Stop: 
09E70. Telephone (301) 443-1116 (This is not a toll-free number).

SUPPLEMENTARY INFORMATION: In response to Executive Order 13777, Sec. 
3(d), which directs agencies to repeal existing regulations that are 
``outdated, unnecessary or ineffective'' from the CFR, HHS proposes to 
remove outdated language appearing in the CFR at 42 CFR 136.14. The 
regulations in this part establish general principles and program 
requirements for carrying out Indian health programs. Regarding the 
provision of IHS services to ineligible individuals, Sec.  136.14(b) 
provides that such individuals should be charged ``rates approved by 
the Assistant Secretary for Health and Surgeon

[[Page 36183]]

General published in the Federal Register.'' The Assistant Secretary 
for Health and the Surgeon General no longer approve or publish such 
rates. The Agency therefore proposes the removal of this unnecessary 
language. If the outdated language of Sec.  136.14(b) were to be 
removed as proposed, Sec.  136.14 in its entirety would read: ``(a) In 
case of an emergency, as an act of humanity, individuals not eligible 
under Sec.  136.12 may be provided temporary care and treatment in 
Service facilities; (b) Charging ineligible individuals. Where the 
Service Unit Director determines that an ineligible individual is able 
to defray the cost of care and treatment, the individual shall be 
charged. Reimbursement from third-party payors may be arranged by the 
patient or by the Service on behalf of the patient.''

Executive Orders 12866, 13563, 13771, and 13777

    Executive Orders 12866 and 13563 direct agencies to assess all 
costs and benefits of available regulatory alternatives. 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 proposed rule is not ``economically significant'' as measured 
by the $100 million threshold, and 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. 
Executive Order 13771 directs agencies to categorize all impacts which 
generate or alleviate costs associated with regulatory burden and to 
determine the actions net incremental effect. HHS identifies this 
proposed rule as a deregulatory action (removing an obsolete rule from 
the CFR) that 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 IHS to initiate this rulemaking to remove the 
unnecessary regulation from the CFR.

Regulatory Flexibility Act

    This action will not have a significant economic impact on Indian 
health programs. 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.

List of Subjects in 42 CFR 136

    Care and treatment of ineligible individuals.

    For the reasons set forth above, the Department of Health and Human 
Services proposes to amend 42 CFR 136.14 as follows:

PART 136--INDIAN HEALTH

0
1. The authority citation for part 136 continues to read as follows:

    Authority: 25 U.S.C. 13; sec. 3, 68 Stat. 674 (42 U.S.C. 2001, 
2003); Sec. 1, 42 Stat. 208 (25 U.S.C. 13); 42 U.S.C. 2001.

0
2. Amend Sec.  [thinsp]136.14 by revising paragraph (b) to read as 
follows:


Sec.  136.14  Care and treatment of ineligible individuals.

* * * * *
    (b) Charging ineligible individuals. Where the Service Unit 
Director determines that an ineligible individual is able to defray the 
cost of care and treatment, the individual shall be charged. 
Reimbursement from third-party payors may be arranged by the patient or 
by the Service on behalf of the patient.
* * * * *

    Dated: March 13, 2020.
Michael D. Weahkee,
RADM, Assistant Surgeon General, U.S. Public Health Service, Principal 
Deputy Director, Indian Health Service.
    Approved: April 9, 2020.
Alex M. Azar II,
Secretary, Department of Health and Human Services.
[FR Doc. 2020-12749 Filed 6-12-20; 8:45 am]
BILLING CODE 4165-16-P