# Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Waiver of Collection of Payments Due From Certain Persons Unaware of Loss of CHAMPUS Eligibility > Briefs, arguments, decisions, and more. URL: https://www.frixlaw.com/law-library/documents/fr%3A97-31610 ## Record - **Collection:** Federal Register - **Document type:** Proposed Rule - **Published:** December 4, 1997 - **Citation:** 62 FR 64191 ## Text DEPARTMENT OF DEFENSE Office of the Secretary 32 CFR Part 199 [DoD 6010.8-R] RIN 0720-AA43 Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Waiver of Collection of Payments Due From Certain Persons Unaware of Loss of CHAMPUS Eligibility AGENCY: Office of the Secretary, DoD. ACTION: Proposed rule. ----------------------------------------------------------------------- SUMMARY: This proposed rule authorizes the waiver of collection of payments due from individuals who lost their CHAMPUS eligibility when they became eligible for Medicare Part A, due to disability or end stage renal disease. DATES: Written comments will be accepted until February 2, 1998. ADDRESSES: Forward comments to the Office of the Assistant Secretary of Defense (Health Affairs), 1B657 Pentagon, Washington, DC 20301-1200. FOR FURTHER INFORMATION CONTACT: Cynthia P. Speight, Office of Health Services Financing Policy, (703) 697-8975. SUPPLEMENTARY INFORMATION: Formerly, under Title 10 United States Code, Section 1086(d), a beneficiary lost eligibility for CHAMPUS when he or she became eligible for Medicare Part A, including when eligibility was due to disability or end stage renal disease. Payments made after the beneficiary attained eligibility for Medicare Part A were erroneous payments and subject to collection under the Federal Claims Collection Act. In 1991, Congress amended 10 U.S.C. 1086(d) to provide that those persons eligible for Medicare by reason of disability or end stage renal disease who are enrolled in the supplementary medical insurance program under Medicare Part B retain eligibility for CHAMPUS, secondary to Medicare coverage. Section 743 of the National Defense Authorization Act for Fiscal Year 1996, Public Law 104-106, provides authority, effective February 10, 1996, to waive the collection of erroneous civilian health care benefits from a person under age 65 who lost eligibility for civilian care due to eligibility for Medicare as a result of disability or end stage renal disease. The period of this waiver authority begins January 1, 1967, and ends on the later of July 1, 1996, or the termination date of any special enrollment Medicare period established by law for such person. Since most payments made under CHAMPUS are paid directly to participating providers of care, and not to the beneficiary, the proposed rule also provides for the waiver of collection of such payments made to participating providers. These providers are paid based on a contractual agreement of benefits by the beneficiaries. If the claim for these benefits cannot be paid due to ineligibility of the beneficiary, the beneficiary indebtedness to the provider would remain. Thus, the authority to relieve disabled CHAMPUS beneficiaries from the indebtedness arising from these erroneous payments does not depend upon who actually received the payments. Regulatory Procedures Executive Order 12866 requires that a regulatory impact analysis be performed on any significant regulatory action, defined as one which would have an annual effect on the economy of $100 million or more, or have other significant effects. The Regulatory Flexibility Act requires that each federal agency prepare a regulatory flexibility analysis when the agency issues regulations which would have a significant impact on a substantial number of small entities. This proposed rule is not significant regulatory action under E.O. 12886, nor would it have a significant impact on small entities. The changes set forth in the proposed rule are minor revisions to the existing regulation. In addition, this proposed rule does not impose new information collection requirements for purposes of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501- 3511). This is a proposed rule. All public comments are invited. List of Subjects in 32 CFR Part 199 Claims, Health insurance, Individuals with disabilities, Military personnel. Accordingly, 32 CFR part 199 is proposed to be 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. Section 199.11 is amended as follows: a. By revising paragraphs (b)(1) and (g) heading. b. By redesignating paragraphs (g)(3), (g)(4), (g)(5), (g)(6), (g)(7), (g)(8) and (g)(9) as paragraphs (g)(4), (g)(5), (g)(6), (g)(7), (g)(8), (g)(9) and (g)(10), respectively. c. By adding paragraph (g)(3) and revising newly redesignated paragraph (g)(10). The additions and revisions read as follows: Sec. 199.11 Overpayments recovery. * * * * * (b) * * * (1) Federal statutory authority. The Federal Claims Collection Act (31 U.S.C. 3701 et seq.) provides the basic authority under which claims may be asserted pursuant to this section. It is implemented by joint regulations issued by the Department of Justice and the General Accounting Office, 4 CFR parts 101 through 105. Thereunder, the heads of federal agencies or their designees are required to attempt collection of all claims of the United States for money or property arising out of the activities of their respective agencies. These officials may, with respect to claims that do not exceed $20,000, exclusive of interest, and in conformity with the standards promulgated in the joint regulations, compromise, suspend, or terminate collection action on such claims. Section 743 of the National Defense Authorization Act for Fiscal Year 1996 (Pub. L. 104-106, 110 Stat. 186) authorizes the waiver (see paragraph (g)(3) of this section) of collection of overpayments otherwise due from a person after the termination of the person's CHAMPUS eligibility, because the person became eligible for Medicare Part A by reason of disability or end- stage renal disease. * * * * * (g) Compromise, waiver, suspension or termination of collection actions arisings under the Federal Claims Collection Act. * * * * * (3) Waiver of collection of erroneous payments due from certain persons unaware of loss of CHAMPUS eligibility. (i) The Director, OCHAMPUS may waive collection of payments otherwise due from certain persons as a result of health benefits received under this Part after the termination of the person's eligibility for such benefits. Waiver may be granted if collection of such payments would be against equity and good conscience and not in the best interest of the United States. These criteria are met by a finding that there is no indication of fraud, misrepresentation, fault, or lack of good faith on the part of the person who received the erroneous payment or any other person having an interest in obtaining such waiver. (ii) Persons eligible for waiver. The following persons are eligible for waiver: [[Page 64192]] (A) A person who: (1) Is entitled to Medicare Part A by reason of disability or end stage renal disease; (2) In the absence of such entitlement, would have been eligible for CHAMPUS under section 1086 of title 10, United States Code; and (3) At the time of the receipt of such benefits, was under age 65. (B) Any participating provider of care who received direct payment for care provided to a person described in paragraph (g)(3)(ii)(A) of this section pursuant to an assignment of benefits from such person. (iii) The authority to waive collection of payments under this section shall apply with regard to health benefits provided during the period beginning January 1, 1967, and ending on the later of: the termination date of any special enrollment period for Medicare Part B provided specifically for such persons; or July 1, 1996. * * * * * (10) Effect of compromise, waiver, suspension or termination of collection action. Pursuant to the Internal Revenue Code, 26 U.S.C. 6041, compromises and terminations of undisputed debts not discharged in a Title 11 bankruptcy case and totaling $600 or more for the year will be reported to the Internal Revenue Service in the manner prescribed for inclusion in the debtor's gross income for that year. Any action taken under this paragraph (g) regarding the compromise of a federal claim, or waiver or suspension or termination of collection action on a federal claim is not an initial determination for purposes of the appeal procedures of Sec. 199.10. * * * * * * * Dated: November 26, 1997. L.M. Bynum, Alternate OSD Federal Register Liaison Officer, Department of Defense. [FR Doc. 97-31610 Filed 12-3-97; 8:45 am] BILLING CODE 5000-04-M --- Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/fr%3A97-31610. Public record. Not legal advice.