Civilian health and medical program of uniformed services (CHAMPUS): TRICARE Prime enrollment procedures,
[Federal Register: March 23, 1999 (Volume 64, Number 55)]
[Rules and Regulations]
[Page 13912-13913]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr23mr99-10]
DEPARTMENT OF DEFENSE
Office of the Secretary
32 CFR Part 199
RIN 0720-AA48
Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Prime Enrollment Procedures
AGENCY: Office of the Secretary, DoD.
ACTION: Final rule.
SUMMARY: This final rule modifies the TRICARE Prime enrollment procedures for active duty families by specifying that enrollment will be automatically renewed upon the expiration of the annual enrollment period, unless the renewal is declined. It also allows for monthly installment payments of enrollment fees via allotment or electronic funds transfer for those beneficiaries required to pay an annual TRICARE Prime enrollment fee.
EFFECTIVE DATE: April 22, 1999.
ADDRESSES: TRICARE Management Activity, Program Development Branch, Aurora, CO 80045-6900.
FOR FURTHER INFORMATION CONTACT: Kathleen Larkin, Office of the Assistant Secretary of Defense (Health Affairs)/TRICARE Management Activity, telephone (703) 681-1745.
SUPPLEMENTARY INFORMATION:
Introduction and Background
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Congressional Action
This final rule implements section 712 of the FY 1999 National Defense Authorization Act, which modified 10 U.S.C. 1097a to provide for automatic renewal of TRICARE Prime enrollments and additional payment options for retirees.
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Public Comments
The proposed rule was published in the Federal Register on July 7, 1998 (63 FR 36651). We received no public comments.
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Provisions of the Rule
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TRICARE Prime Enrollment Renewals (revision to section 199.17(o)(2))
Provisions of the Proposed Rule
This paragraph explained that we proposed a change to the TRICARE Prime enrollment period from a 12-month enrollment period to continuous enrollment until such time as the enrollee opted to disenroll from TRICARE Prime. TRICARE Prime was originally designed so that enrollees would be required to take positive action to continue their enrollment in TRICARE Prime at or before their 12-month anniversary date. Positive action to reenroll was required because TRICARE implementation was not available in all regions of the country and overseas locations. Subsequent to our notice of proposed rulemaking, section 712 of the FY 1999 National Defense Authorization Act modified 10 U.S.C. 1097a to require annual enrollment periods but required that TRICARE Prime enrollment be automatically renewed upon the expiration of the enrollment unless the renewal is declined. The Act also requires that the enrollee, or the sponsor in the case of an enrolled family member, be notified in writing no later than 15 days before the enrollment expiration date and afforded the opportunity to decline enrollment. Provisions of the Final Rule
The final rule has been modified to implement the statutory direction given in the FY 1999 National Defense Authorization Act.
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Changes to Installment Payments of Enrollment Fees (revision to section 199.17(o)(3))
Provisions of the Proposed Rule
When we first instituted the requirement for annual TRICARE Prime enrollment fees for certain beneficiary categories, we allowed for quarterly installment payments of the enrollment fees. In keeping with the nature of a more continuous enrollment process, we proposed that retirees, their families, and other beneficiaries required to pay an annual enrollment fee would be
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offered additional flexibility in fee payment by allowing for monthly or quarterly installment payments of enrollment fees. Subsequent to our notice of proposed rulemaking, section 712 of the FY 1999 National Defense Authorization Act modified 10 U.S.C. 1097a to expand payment options to include monthly payment of enrollment fees via an allotment from retired or retainer pay, or monthly payment via electronic funds transfer from a financial institution. Provisions of the Final Rule
The final rule has been modified to implement the statutory direction given in the FY 1999 National Defense Authorization Act.
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Regulatory Procedures
Executive Order 12866 requires certain regulatory assessments for any significant regulatory action, defined as one which would result in an annual effect on the economy of $100 million or more, or have other substantial impacts.
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 a significant regulatory action under the provisions of Executive Order 12866, and it would not have a significant impact on a substantial number of small entities.
The final rule will not impose additional information collection requirements on the public under the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 55).
List of Subjects in 32 CFR Part 199
Claims, Health insurance, Individuals and disabilities, Military personnel, Reporting and recordkeeping requirements.
Accordingly, 32 CFR Part 199 is amended as follows:
PART 199--[AMENDED]
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The authority citation for part 199 continues to read as follows:
Authority: 5 U.S.C. 301, 10 U.S.C. Chapter 55.
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Section 199.17 is amended by revising paragraphs (o)(2) and (o)(3), redesignating paragraphs (o)(4) and (o)(5) and (o)(5) and (o)(6), and adding new paragraph (o)(4), to read as follows:
Sec. 199.17 TRICARE Program.
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(o) * * *
(2) Enrollment period. Beneficiaries who select the TRICARE Prime option remain enrolled for 12 month increments until: they take action to disenroll; they are no longer eligible for enrollment in TRICARE Prime; or they are disenrolled for failure to pay required enrollment fees. For those who remain eligible for TRICAREPrime enrollment, no later than 15 days before the expiration date of an enrollment, the sponsor will be sent a written notification of the pending expiration and renewal of the TRICARE Prime enrollment. TRICARE Prime enrollments shall be automatically renewed upon the expiration of the enrollment unless the renewal is declined by the sponsor. Termination of enrollment for failure to pay enrollment fees is addressed in paragraph (o)(3) of this section.
(3) Installment payments of enrollment fee. The enrollment fee required by Sec. 199.18(c) may be paid in monthly or quarterly installments. Monthly fees may be payable by an allotment from retired or retainer pay, or paid from a financial institution through an electronic transfer of funds. For beneficiaries paying enrollment fees on an installment basis, failure to make a required installment payment on a timely basis [including a grace period, as determined by the Assistant Secretary of Defense (Health Affairs)] will result in termination of the beneficiary's enrollment in Prime and disqualification from future enrollment in Prime for a period of one year.
(4) Voluntary disenrollment. Any beneficiary for whom enrollment in Prime is voluntary may disenroll at any time. Disenrollment will take effect in accordance with administrative procedures established by the Assistant Secretary of Defense (Health Affairs). Beneficiaries who disenroll prior to their annual enrollment renewal date will not be eligible to reenroll in Prime for a one-year period from the effective date of the disenrollment. This one year exclusion may be waived by the Assistant Secretary of Defense (Health Affairs) based on extraordinary circumstances. * * * * *
Dated: March 17, 1999. L.M. Bynum, Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 99-7034Filed3-22-99; 8:45 am]
BILLING CODE 5000-04-M
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