Civilian health and medical program of uniformed services (CHAMPUS): State victims of crime compensation programs and voice prostheses benefit establishment,

[Federal Register: November 3, 1998 (Volume 63, Number 212)]

[Rules and Regulations]

[Page 59231-59232]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr03no98-9]

DEPARTMENT OF DEFENSE

Office of the Secretary

32 CFR Part 199

RIN 0720-AA42

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); State Victims of Crime Compensation Programs; Voice Prostheses

AGENCY: Office of the Secretary, DoD.

ACTION: Final rule.

SUMMARY: This final rule establishes CHAMPUS as primary payer to State Victims of Crime Compensation Programs; and voice prostheses as a CHAMPUS benefit.

EFFECTIVE DATES: Amendments to Secs. 199.2 and 199.8 are effective

[[Page 59232]]

September 13, 1994 and Sec. 199.4(g)(48) is effective October 5, 1994.

FOR FURTHER INFORMATION CONTACT: Connie Kiese, TRICARE Management Activity, Office of Medical Benefits and Reimbursement Systems (303) 676-3578.

SUPPLEMENTARY INFORMATION: On October 20, 1997, DoD published an interim rule with a public comment period; however, no comments were received. Therefore, the interim final rule is being adopted as the final rule.

Under 10 U.S.C. 1079(j)(1), no CHAMPUS benefits shall be available for the payment for any service or supply for persons enrolled in any other insurance, medical service, or health plan to the extent that the service or supply is a benefit under the other plan, except in the case of those plans administered under title XIX of the Social Security Act (Medicaid), (51 FR 24008). Therefore, in all double coverage situations, and for all classes of beneficiaries, CHAMPUS shall be secondary payer except when the other medical coverage is provided through Medicaid.

However, on September 13, 1994, Public Law 103-322 was signed into law. Section 230202 of that law states that notwithstanding any other law, if the compensation paid by an eligible crime victim compensation plan would cover costs that a Federal program or a federally financed State or local program would otherwise pay, the crime compensation program shall not pay that compensation; and the other program shall make its payments without regard to the existence of the crime victim compensation program.

This provision mandates, as an exception to 10 U.S.C. 1079(j)(1), that CHAMPUS assume primary payer status to State Victims of Crime Compensation Programs. Benefits will be granted retroactively effective September 13, 1994.

Public Law 103-337, Section 705, October 5, 1994, added voice prostheses to the benefits available under CHAMPUS. Benefits will be granted retroactively effective October 5, 1994.

Regulatory Procedures

The Regulatory Flexibility Act (RFA) requires that each federal agency prepare, and make available for public comment, a regulatory flexibility analysis when the agency issues a regulation which would have a significant impact on a substantial number of small entities.

This is not such a regulation. Nor is this final rule a significant regulatory action under Executive Order 12866. The changes set forth in this final rule are minor revisions to the existing regulation. In addition, this final rule does not impose new information collection requirements for purposes of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3511).

List of Subjects in 32 CFR Part 199

Claims, Handicapped, Health Insurance, Military personnel.

PART 199--[AMENDED]

Accordingly, 32 CFR part 199 is amended as follows:

1. The authority citation for part 199 continues to read as follows:

   Authority: 5 U.S.C. 301; 10 U.S.C. Chapter 55.

2. Section 199.2(b) is amended by revising the definition ``State Victims of Crime Compensation Programs'' to read as follows:

   Sec. 199.2 Definitions

   * * * * *

   (b) * * *

   State victims of crime compensation programs. Benefits available to victims of crime under the Violent Crime Control and Law Enforcement Act. * * * * *

3. Section 199.4 is amended by revising paragraph (g)(48) to read as follows:

   Sec. 199.4 Basic program benefits

   * * * * *

   (g) * * *

   (48) Prosthetic devices. Prostheses, except artificial limbs, voice prostheses, eyes, or if an item is inserted surgically in the body as an integral part of a surgical procedure. All dental prostheses are excluded, except for those specially required in connection with otherwise covered orthodontia directly related to the surgical correction of a cleft palate anomaly. * * * * *

4. Section 199.8 is amended by revising paragraphs (b)(3)(iii), (b) (3)(iv) and (b)(3)(v) to read as follows:

   Sec. 199.8 Double coverage.

   * * * * *

   (b) * * *

   (3) * * *

   (iii) Entitlement to receive care from Uniformed Services medical care facilities;

   (iv) Certain Federal Government programs, as prescribed by the Director, OCHAMPUS, that are designed to provide benefits to a distinct beneficiary population and for which entitlement does not derive from either premium payment of monetary contribution (for example, the Indian Health Service); or

   (v) State Victims of Crime Compensation Programs. * * * * *

   Dated: October 19, 1998. L.M. Bynum, Alternate OSD Federal Register Liaison Officer, Department of Defense.

   [FR Doc. 98-28414Filed11-2-98; 8:45 am]

   BILLING CODE 5000-04-M