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CFR Citation: 32 CFR Part 199

DOCUMENT ID: [DoD-2007-HA-0015; RIN 0720-AB13]

NOTICE: RULES

ACTION: Civilian health and medical program of the uniformed services (CHAMPUS):

DOCUMENT ACTION: Final rule.

SUBJECT CATEGORY: TRICARE; Expansion of Geographic Scope of the TRICARE Retiree Dental Program

DATES: Effective Date: This rule is effective November 16, 2007.

DOCUMENT SUMMARY: This final rule expands the geographic scope of the TRICARE Retiree Dental Program (TRDP) to overseas locations not currently covered by the program. At this time, TRDP is applicable only in the 50 United States (U.S.) and the District of Columbia, Canada, Puerto Rico, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands. Expanding the geographic scope of the program will ensure that all TRICAREeligible retirees are eligible for the same dental benefits, regardless of their location. There are no additional Government costs associated with this final expansion of TRDP overseas as TRDP costs are borne entirely by enrollees through premium payments.

SUMMARY: TRICARE program—; Retiree Dental Program; overseas locations expansion,

SUPPLEMENTAL INFORMATION

This final rule expands the geographic scope of TRDP to overseas locations not currently covered by the program. Although 10 U.S.C. 1076c does not restrict the geographic availability of the TRDP, per 32 CFR 199.22(b)(3), TRDP is currently limited to the 50 United States and the District of Columbia, Canada, Puerto Rico, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands. Expanding the geographic scope of the program will ensure that all TRICAREeligible retirees are eligible for the same dental benefits, regardless of their location. This expansion of the geographic scope of the TRDP program is based upon feedback from the TRICAREeligible retiree community which indicated that there is a demand for this program in all overseas locations.

Although the TRDP is administered in a manner similar to the TRICARE Dental
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Program (TDP), there are significant differences in program funding. TDP costs are shared for two of the four eligible categories of TDP enrollees between the enrollees and the Department of Defense; however, for the other two categories of TDP enrollees, and all TRDP enrollees, costs are borne entirely by enrollees through premium payments. Enrollees are also responsible for any dental costs in excess of the TRDP coverage limits, and the contractor is solely responsible for any program costs in excess of annual premium payments.

Therefore, there are no additional Government costs associated with this expansion of TRDP coverage overseas. Specific methods of TRDP program administration, payment rates and procedures, provider licensure and certification requirements, and other program elements may differ by location to the extent necessary for the effective and efficient operation of the plan. These differences may include, but are not limited to, specific provisions for preauthorization of care, varying licensure and certification requirements for foreign providers, and other differences based on limitations in the availability and capabilities of the Uniformed Services overseas dental treatment facilities and a particular nation's civilian sector providers in certain areas.

II. Review of Public Comments

We provided a 60day comment period on the proposed rule which was published in the Federal Register on April 16, 2007 (72 FR 18927). No comments were received.

III. Regulatory Procedures

Executive Order 12866 directs agencies to assess all costs and benefits available, regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety, and other advantages; distributive impacts; and equity). The Order classifies a rule as a significant regulatory action requiring review by the Office of Management and Budget (OMB) if it meets any one of a number of specified conditions, including having an annual effect on the national economy of $100 million or more, creating a serious inconsistency or interfering with an action of another agency, materially altering the budgetary impact of entitlements or the rights of entitlement recipients, or raising novel legal or policy issues. DoD has examined the economic, legal, and policy implications of this final rule and has concluded that it is a significant regulatory action because it may raise novel legal or policy issues of enhancing the dental health of military retirees and their dependents who reside overseas. The changes set forth in the final rule to the existing regulation do not change the basic TRDP benefit structure.

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 final rule does not have a significant impact on small entities.

This final rule is not a major rule under the Congressional Review Act because its economic impact will be less than $100 million.

Executive Order 13132 requires that each Federal Agency shall consult with State and local officials and obtain their input if a rule has federalism implications which have substantial direct effects on the States, on the relationship between the National Government and the States, or on the distribution of power and responsibilities among the various levels of government. We have examined the impact of the final rule under Executive Order 13132 and it does not have policies that have federalism implications that would have substantial direct effects on the States, on the relationship between the National Government and the States, or on the distribution of power and responsibilities among the various levels of government; therefore, consultation with State and local officials is not required.

This rule contains a collectionofinformation requirement subject to the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 35013511) and which has been approved by OMB under control number 07200015. This rule will not change this requirement, but will only increase the number of beneficiaries who are eligible to enroll in the TDRP by approximately 100,000 people. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Respondents should be aware that notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the PRA, unless that collection of information displays a currently valid OMB Control Number.

This rule does not contain unfunded mandates. It does not contain a Federal mandate that may result in the expenditure by State, local and tribunal governments, in aggregate, or by the private sector, of $100 million or more in any one year.

List of Subjects in 32 CFR Part 199

Claims, Dental health, Health care, Health insurance, Individuals with disabilities, Military personnel.
Accordingly, 32 CFR part 199 is amended as follows:
PART 199[AMENDED]
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. Sec. 199.22 is amended by revising paragraph (b)(3) to read as follows:
Sec. 199.22 TRICARE Retiree Dental Program (TRDP).
* * * * *
(b) * * *
(3) Geographic scope. (i) The TRDP is applicable to authorized providers in the 50 United States and the District of Columbia, Canada, Puerto Rico, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands.
(ii) The Assistant Secretary of Defense (Health Affairs) (ASD (HA)) may extend the TRDP to geographic areas other than those specified in paragraph (b)(3)(i) of this section. In extending the TRDP overseas, the ASD (HA) is authorized to establish program elements, methods of administration, and payment rates and procedures that are different from those in effect for the areas specified in paragraph (b)(3)(i) of this section to the extent the ASD (HA), or designee, determines necessary for the effective and efficient operation of the TRDP. These differences may include, but are not limited to, specific provisions for preauthorization of care, varying licensure and certification requirements for foreign providers, and other differences based on limitations in the availability and capabilities of the Uniformed Services overseas dental treatment facilities and a particular nation's civilian sector providers in certain areas. The Director, TRICARE Management Activity shall issue guidance, as necessary, to implement the provisions of this paragraph. TRDP enrollees residing in overseas locations will be eligible for the same benefits as enrollees residing in the continental
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United States, although dental services may not be available or accessible in all locations.
* * * * *

Dated: November 9, 2007.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense. [FR Doc. E722445 Filed 111507; 8:45 am]
BILLING CODE 500106P

FOR FURTHER INFORMATION CONTACT Col. Gary Martin, Office of the Assistant Secretary of Defense (Health Affairs), TRICARE Management Activity, telephone (703) 6810039.