[Federal Register: September 21, 2005 (Volume 70, Number 182)]
[Rules and Regulations]
[Page 55251-55252]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr21se05-13]
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DEPARTMENT OF DEFENSE
Office of the Secretary
32 CFR Part 199
RIN 0720-AA93
TRICARE; Changes Included in the National Defense Authorization
Act for Fiscal Year 2005; TRICARE Dental Program
AGENCY: Office of the Secretary. DoD.
ACTION: Interim final rule.
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SUMMARY: The Department is publishing this interim final rule to
implement sections 711 and 715 of the Ronald W. Reagan National Defense
Authorization Act for Fiscal Year 2005 (NDAA-05), Public Law 108-375.
Specifically, that legislation makes young dependents of deceased
Service members eligible for enrollment in the TRICARE Dental Program
when the child was not previously enrolled because of age, and
authorizes post-graduate dental residents in a dental treatment
facility of the uniformed services under a graduate dental education
program accredited by the American Dental Association to provide dental
treatment to dependents who are 12 years of age or younger and who are
covered by a dental plan established under 10 U.S.C. 1076a. This rule
also corrects certain references in 32 CFR 199.13. The rule is being
published as an interim final rule with comment period in order to
comply with statutory effective dates. Public comments are invited and
will be considered for possible revisions to the final rule.
DATES: This rule is effective November 21, 2005.
Comments: Written comments received at the address indicated below
by November 21, 2005 will be accepted. Because of staff and resource
limitations, we can only accept comments by mail or electronic mail (e-
mail). We are unable to accept comments by facsimile (FAX)
transmission. Send e-mail comments to TDP.rule@tma.osd.mil Mail written
comments to the following address only: TRICARE Management Activity,
TRICARE Operation/Dental Division, Skyline 5, Suite 810, 5111 Leesburg
Pike, Falls Church, VA 22041-3206; Attention: Col. Gary C. Martin,
Director. Please allow sufficient time for mailed comments to be timely
received in the event of delivery delays.
FOR FURTHER INFORMATION CONTACT: Col. Gary C. Martin, Office of the
Assistant Secretary of Defense (Health Affairs), TRICARE Management
Activity, telephone (703) 681-0039. Questions regarding payment of
specific claims should be addressed to the appropriate TRICARE
contractor.
SUPPLEMENTARY INFORMATION:
I. Background
Opportunity for Young Child Dependent of Decease Member To Become
Eligible for Enrollment in a TRICARE Dental Plan
Currently, military members may enroll dependent children of any
age in the TRICARE Dental Progam (TDP), but many members choose not to
enroll young children until they are automatically enrolled at four
years of age. Unfortunately, when a member on active duty for a period
of more than thirty days or a member of the Ready Reserve (i.e.,
Selected Reserve and Individual Ready Reserve) dies, dependent children
less than four years of age who are not enrolled in the TDP at the time
of the member's death are ineligible for enrollment for the three-year
TDP survivor's benefit. The NDAA for FY05 corrects this inequity by
giving young dependent children of deceased Service members the
opportunity to become eligible for enrollment in the TDP although they
were not previously enrolled due to their age.
Professional Accreditation of Military Dentists
Currently, section 199.13(a)(2)(iii) of this Part excludes
dependents of active duty, Selected Reserve and individual Ready
Reserve members enrolled in the TRICARE Dental Program (TDP) from
obtaining benefit services provided by the TDP in military dental care
facilities except for emergency treatment, dental care provided outside
the United States, and services incidental to non-covered services. Due
to insufficient numbers of pediatric patients available for treatment
in DoD's training facilities, the uniformed services faced significant
problems with program accreditation and pediatric dental training. The
Services had difficulty maintaining accreditation of post-graduate
training programs because of a lack of pediatric dental patients with
the proper dental case mix required for training. in addition, without
adequate case numbers and case complexity, residents who at completion
of their training were assigned overseas were not always fully trained
to manage and treat pediatric dental patients.
Therefore, section 715 of the NDAA FY 05 provides the uniformed
services with authority to maintain American Dental Association
accreditation standards for certain military dental specialty training
programs that require treatment of pediatric patients and to provide
pediatric training to meet requirements for the delivery of authorized
dental care to children accompanying sponsors at OCONUS locations. The
statute authorizes the Services to treat in their facilities a limited
number of pediatric dental patients enrolled in the TDP. The Services
have estimated their pediatric patient load requirements to sustain
training facilities at 500-600 patients annually per Service. only
those patients age 12 years or younger meeting training needs and
accepted for care in DoD's training programs will be treated in those
programs to the maximum of 2,000 patients annually across DoD. To
ensure strict compliance with the amended statute, Health Affairs will
allocate specific numbers of patient training cases to each Service
POC. Service POCs will implement registries to track the number of
patients served on a daily basis to ensure that the respective patient
case caps are not exceeded. Each Service will forward a semi-annual
report to the Dental Care Division, TRICARE Management Activity. An
annual report will be submitted at the end of each fiscal year to the
Assistant Secretary of Defense for Health Affairs.
II. Regulatory Procedures
Executive Order (EO) 12866
Executive Order 12866 requires that a comprehensive regulatory
impact analysis be performed on any economically significant regulatory
action, defined as one that would result in an annual effect of $100
million or more on the national economy or which would 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 rule is not an economically significant regulatory
action and will not have a significant impact on a substantial number
of small entities for purposes of the RFA, thus this interim final rule
is not subject to any of these requirements. This rule, although not
economically significant under Executive Order 12866, is a significant
rule under Executive Order 12866 and has been reviewed by the Office of
Management and Budget. This rule is being issued as an interim final
rule, with comment period, as an exception to our standard practice of
soliciting public comments
[[Page 55252]]
prior to issuance. This is because the effective date of the changes to
these statutes was October 28, 2004. The rule changes the regulation to
conform to the new statutory entitlement. Based on these statutory
requirements, the Assistant Secretary of Defense (Health Affairs) has
determined that following the standard practice in this case would be
unnecessary, impractical and contrary to the public interest. Public
comments are invited. All comments will be carefully considered. A
discussion of the major issues received by public comments will be
included with the issuance of the final rule.
Paperwork Reduction Act
This rule will not impose additional information collection
requirements on the public under the Paperwork Reduction Act of 1995
(44 U.S.C. 3501-3511).
List of Subjects in 32 CFR Part 199
Claims, Dental Program, Dental Health, Health care, Health
insurance, Military personnel.
0
For the reasons set out in the preamble, the Department of Defense
amends 32 CFR part 199 as follows:
PART 199--[AMENDED]
0
1. The authority citation for Part 199 continues to read as follows:
Authority: 5 U.S.C. 301; 10 U.S.C. chapter 55.
0
2. Section 199.13 is amended by revising paragraphs (a)(2)(iii),
(c)(2)(i)(a)(2) and (c)(3)(ii)(E)(2), and adding paragraphs (a)(2)(iv)
and (i) to read as follows:
Sec. 199.13 TRICARE Dental Program.
(a) * * *
(2) * * *
(iii) Exclusion of benefit services performed in military dental
care facilities. Except for emergency treatment, dental care provided
outside the United States, services incidental to noncovered services,
and services provided under paragraph (a)(2)(iv), dependents of active
duty, Selected Reserve and Individual Ready Reserve members enrolled in
the TDP may not obtain those services that are benefits of the TDP in
military dental care facilities, as long as those covered benefits are
available for cost-sharing under the TDP. Enrolled dependents of active
duty, Selected Reserve and Individual Ready Reserve members may
continue to obtain noncovered services from military dental care
facilities subject to the provisions for space available care.
(iv) Exception to the exclusion of services performed in military
dental care facilities.
(A) Dependents who are 12 years of age or younger and are covered
by a dental plan established under this section may be treated by
postgraduate dental residents in a dental treatment facility of the
uniformed services under a graduate dental education program accredited
by the American Dental Association if
(1) Treatment of pediatric dental patients is necessary in order to
satisfy an accreditation standard of the American Dental Association
that is applicable to such program, or training in pediatric dental
care is necessary for the residents to be professionally qualified to
provide dental care for dependent children accompanying members of the
uniformed services outside the United States; and
(2) The number of pediatric patients at such facility is
insufficient to support satisfaction of the accreditation or
professional requirements in pediatric dental care that apply to such
programs or students.
(B) The total number of dependents treated in all facilities of the
uniformed services under paragraph (a)(2)(iv) in a fiscal year may not
exceed 2,000.
* * * * *
(c) * * *
(2) * * *
(i) * * *
(A) * * *
(2) Child. To be eligible, the child must be unmarried and meet one
of the requirements set forth in section 199.3(b)(2)(ii)(A)-(F) or
199.3(b)(2)(ii)(H).
* * * * *
(c) * * *
(3) * * *
(ii) * * *
(E) * * *
(2) Continuation of eligibility. Eligible dependents of active duty
members while on active duty for a period of more than 30 days and
eligible dependents of members of the Ready Reserve (i.e., Selected
Reserve or Individual Ready Reserve, as specified in 10 U.S.C. 10143
and 10144(b) respectively), shall be eligible for continued enrollment
in the TDP for up to three (3) years from the date of the member's
death, if, on the date of the death of the member, the dependent is
enrolled in the TDP, or is not enrolled by reason of discontinuance of
a former enrollment under paragraphs (e)(3)(ii)(E)(4)(ii) and
(c)(3)(ii)(E)(4)(iii) of this section, or is not enrolled because the
dependent was under the minimum age for enrollment at the time of the
member's death. This continued enrollment is not contingent on the
Selected Reserve or Individual Ready Reserve member's own enrollment in
the TDP. During the three-year period of continuous enrollment, the
government will pay both the Government and the beneficiary's portion
of the premium share.
* * * * *
(i) Implementing Instructions. The Director, TRICARE Management
Activity or designee may issue TRICARE Dental Program policies,
standards, and criteria as may be necessary to implement the intent of
this section.
* * * * *
Dated: September 14, 2005.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 05-18753 Filed 9-20-05; 8:45 am]
BILLING CODE 5001-06-M