[Federal Register Volume 89, Number 64 (Tuesday, April 2, 2024)]
[Notices]
[Pages 22730-22731]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-06904]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Notice of Purchased/Referred Care Delivery Area Redesignation for 
the Mashantucket Pequot Tribal Nation in the State of Connecticut

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

ACTION: Final notice.

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SUMMARY: Notice is hereby given that the Indian Health Service (IHS) 
has decided to expand the geographic boundaries of the Purchased/
Referred Care Delivery Area (PRCDA) for the Mashantucket Pequot Tribal 
Nation to include the counties of Fairfield, Hartford, Litchfield, 
Middlesex, New Haven, Tolland, and Windham in the State of Connecticut. 
The final PRCDA for the Mashantucket Pequot Tribal Nation now includes 
the Connecticut counties of Fairfield, Hartford, Litchfield, Middlesex, 
New Haven, New London, Tolland, and Windham. The sole purpose of this 
expansion is to authorize additional Mashantucket Pequot Tribal Nation 
members and eligible IHS beneficiaries to receive purchased/referred 
care (PRC) services.

DATES: This expansion is effective as of the publication date of this 
notice.

ADDRESSES: This notice can be found at https://www.federalregister.gov. 
Written requests for information should be delivered to: CAPT John 
Rael, Director, Office of Resource Access and Partnerships, Indian 
Health Service, 5600 Fishers Lane, Mail Stop 10E85C, Rockville, MD 
20857, or by phone at (301) 443-0969 (this is not a toll-free number).

SUPPLEMENTARY INFORMATION: The IHS provides services under regulations 
in effect as of September 15, 1987, and republished at 42 CFR part 136, 
subparts A-C. Subpart C defines a Contract Health Service Delivery Area 
(CHSDA), now referred to as a PRCDA, as the geographic area within 
which PRC will be made available by the IHS to members of an identified 
Indian community who reside in the PRCDA. Residence within a PRCDA by a 
person who is within the scope of the Indian health program, as set 
forth in 42 CFR 136.12, creates no legal entitlement to PRC but only 
potential eligibility for services. Services needed, but not available 
at an IHS/Tribal facility, are provided under the PRC program depending 
on the availability of funds, the relative medical priority of the 
services to be provided, and the actual availability and accessibility 
of alternate resources in accordance with the regulations.
    The regulations at 42 CFR part 136, subpart C provide that, unless 
otherwise designated, a PRCDA shall consist of a county which includes 
all or part of a reservation and any county or counties which have a 
common boundary with the reservation. 42 CFR 136.22(a)(6). The 
regulations also provide that after consultation with the Tribal 
governing body or bodies on those reservations included within the 
PRCDA, the Secretary may from time to time, redesignate areas within 
the United States for inclusion in or exclusion from a PRCDA. 42 CFR 
136.22(b). The regulations require that certain criteria must be 
considered before any

[[Page 22731]]

redesignation is made. The criteria are as follows:
    (1) The number of Indians residing in the area proposed to be so 
included or excluded;
    (2) Whether the Tribal governing body has determined that Indians 
residing in the area near the reservation are socially and economically 
affiliated with the Tribe;
    (3) The geographic proximity to the reservation of the area whose 
inclusion or exclusion is being considered; and
    (4) The level of funding which would be available for the provision 
of PRC.
    Additionally, the regulations require that any redesignation of a 
PRCDA must be made in accordance with the procedures of the 
Administrative Procedure Act (5 U.S.C. 553). 42 CFR 136.22(c). In 
compliance with this requirement, the IHS published a proposed notice 
of redesignation and requested public comments on January 19, 2024 (89 
FR 3669). The IHS did not receive any comments in response to the 
notice of proposed expansion.
    In support of this expansion, the IHS makes the following findings:
    1. By expanding the PRCDA to include Fairfield, Hartford, 
Litchfield, Middlesex, New Haven, Tolland, and Windham Counties, the 
Mashantucket Pequot Tribal Nation's eligible population will increase 
by an estimated 32 Tribal members and AI/AN employees.
    2. The Mashantucket Pequot Tribal Nation has stated that these 32 
individuals are socially and economically affiliated with MPTN.
    3. The expanded PRCDA counties form a contiguous area with the 
existing PRCDA. In addition to their AI/AN employees, MPTN's members 
reside in each of the expansion counties. For these reasons, the IHS 
has determined that the expansion counties are geographically 
proximate, meaning ``on or near'', to the existing PRCDA.
    4. The MPTN will use its existing Federal allocation for PRC funds 
to provide services to the expanded population. No additional financial 
resources will be allocated by the IHS to MPTN to provide services to 
its PRC-eligible population.
    An updated listing of the PRCDAs for all federally-recognized 
Tribes may be accessed via a link on the IHS PRCDA Expansion website 
(https://www.ihs.gov/prc/prcda-expansion).
    Public Comments: The IHS did not receive any comments in response 
to the notice of proposed expansion.

Roselyn Tso,
Director, Indian Health Service.
[FR Doc. 2024-06904 Filed 4-1-24; 8:45 am]
BILLING CODE 4165-16-P