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

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.

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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. 98-28414 Filed 11-2-98; 8:45 am]

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