[Title 42 CFR L]
[Code of Federal Regulations (annual edition) - October 1, 2008 Edition]
[Title 42 - PUBLIC HEALTH]
[Chapter I - PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN]
[Subchapter L - COMPASSIONATE PAYMENTS]
[From the U.S. Government Printing Office]
42PUBLIC HEALTH12008-10-012008-10-01falseCOMPASSIONATE PAYMENTSLSUBCHAPTER LPUBLIC HEALTHPUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN
SUBCHAPTER L_COMPASSIONATE PAYMENTS
PART 130_RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM--Table of Contents
Subpart A_General Provisions
Sec.
130.1 Purpose.
130.2 Definitions.
130.3 Amount of payments.
Subpart B_Criteria for Eligibility
130.10 Who is eligible for payment under the Act--living persons with
HIV.
130.11 Who is eligible for payment under the Act--survivors of persons
with HIV.
Subpart C_Documentation Required for Complete Petitions
130.20 Form of medical documentation.
130.21 What documentation is required for petitions filed by living
persons with HIV?
130.22 What documentation is required for petitions filed by survivors
of persons with HIV, which are filed in cases where the person
with HIV dies before filing a petition?
130.23 What documentation is required for amendments to petitions, which
are filed by survivors of persons with HIV?
130.24 What additional documentation may the Secretary require to
resolve eligibility or payment issues?
Subpart D_Procedures for Filing and Paying Complete Petitions
130.30 Who may file a petition for payment or an amendment to a
petition?
130.31 How and when is a petition for payment filed?
130.32 How and when will the Secretary determine the order of receipt of
petitions?
130.33 How will the Secretary determine whether a petition is complete?
130.34 How will the Secretary determine whether to pay a petition?
130.35 How and when will the Secretary pay a petition?
Subpart E_Reconsideration Procedures
130.40 Reconsideration of denial of petitions.
Subpart F_Attorney Fees
130.50 Limitation on agent and attorney fees.
Appendix A to Part 130--Definition of HIV Infection or HIV
Appendix B to Part 130--Confidential Physician or Nurse Practitioner
Affidavit
Appendix C to Part 130--Petition Form, Petition Instructions, and
Documentation Checklist
Authority: Secs. 101-108 of Pub. L. 105-369, 112 Stat. 3368 (42
U.S.C. 300c-22 note); sec. 215 of the Public Health Service Act (42
U.S.C. 216).
Source: 65 FR 34864, May 31, 2000, unless otherwise noted.
Subpart A_General Provisions
Sec. 130.1 Purpose.
This part establishes criteria and procedures for implementation of
the Ricky Ray Hemophilia Relief Fund Act of 1998 (the Act). This statute
provides for compassionate payments to certain individuals with blood-
clotting disorders, such as hemophilia, who contracted human
immunodeficiency virus (HIV) due to contaminated antihemophilic factor
within a specified time period, as well as to certain persons who
contracted HIV from these individuals. In the event the individual
eligible for payment is deceased, the Act also provides for payments to
certain survivors of this individual.
Sec. 130.2 Definitions.
As used in this part:
(a) Act means the Ricky Ray Hemophilia Relief Fund Act of 1998, 42
U.S.C. 300c-22 note, as amended.
(b) Antihemophilic factor means any blood product (including, but
not limited to, fresh frozen plasma, cryoprecipitate, factor VIII
concentrate, and factor IX concentrate) used to treat a blood-clotting
disorder.
(c) Blood-clotting disorder means a disorder (including, but not
limited to, hemophilia and von Willebrand's disease) in which the blood
does not clot normally, usually resulting in prolonged bleeding.
(d) Child with HIV means the individual described in Sec.
130.10(c).
(e) Former lawful spouse means a person to whom an individual
described in Sec. 130.10(a):
(1) Was married according to the laws of the place where the person
resided at
[[Page 693]]
any time after the date of the individual's treatment with
antihemophilic factor (this date of treatment must have been between
July 1, 1982, and December 31, 1987); and
(2) Is no longer married.
(f) Former lawful spouse with HIV means the individual described in
Sec. 130.10(b)(2).
(g) Fund means the ``Ricky Ray Hemophilia Relief Fund,'' which is a
Trust Fund established in the Treasury of the United States and
administered by the Secretary of the Treasury.
(h) Hemophilia means a bleeding disorder in which a clotting factor
(including, but not limited to, factors VIII or IX) is missing or does
not function normally.
(i) HIV infection or HIV means any of the following:
(1) For individuals diagnosed with the HIV infection at any age,
including infants: the presence of an opportunistic disease
characteristic of AIDS, sufficient to satisfy the definition of HIV
infection as set forth in Appendix A to this part; or
(2) For individuals diagnosed with the HIV infection at over 15
months of age: the presence of laboratory evidence of HIV based on
identification of:
(i) HIV antibodies;
(ii) HIV viral antigens;
(iii) HIV viral cultures; or
(iv) Plasma HIV RNA; or
(3) For infants diagnosed with the HIV infection due to perinatal
transmission at or before 15 months of age: identification of the
presence of HIV by a positive virologic test (i.e., detection of HIV by
culture, HIV antigen, or HIV DNA or RNA polymerase chain reaction
[PCR]).
(j) Individual with a blood-clotting disorder and HIV means the
individual described in Sec. 130.10(a).
(k) Lawful spouse means a person to whom an individual described in
Sec. 130.10(a) is married according to the laws of the place where the
person resides on the date the petition is filed. If the laws of the
place where the person resides consider an individual who is legally
separated or in a common law marriage to be married, then such a person
is a lawful spouse.
(l) Lawful spouse with HIV means the individual described in Sec.
130.10(b)(1).
(m) Perinatal transmission means transmission of HIV infection from
mother to child that occurs during pregnancy, delivery, or
breastfeeding.
(n) Person(s) with HIV means all of the individuals described in
Sec. 130.10(a), (b) or (c).
(o) Place means any State of the United States of America, the
District of Columbia, and United States territories, commonwealths, and
possessions.
(p) Secretary means the Secretary of Health and Human Services and
any other officer or employee of the Department to whom the authority
involved has been delegated.
Sec. 130.3 Amount of payments.
If there are sufficient amounts in the Fund to make payments, the
Secretary will make a single payment of $100,000 to eligible
individuals, as defined in accordance with subpart B of this part.
Subpart B_Criteria for Eligibility
Sec. 130.10 Who is eligible for payment under the Act--living persons with
HIV.
The following individuals are eligible for payment under the Act if
they are living at the time that payment is to be made on a petition and
have an HIV infection:
(a) An individual who has any form of blood-clotting disorder, such
as hemophilia, who was treated with antihemophilic factor at any place
defined in Sec. 130.2(o), or at any diplomatic area or military
installation of the United States, at any time during the time period
from July 1, 1982, to December 31, 1987.
(b) An individual who is:
(1) The lawful spouse of the individual with a blood-clotting
disorder and HIV; or
(2) The former lawful spouse of the individual with a blood-clotting
disorder and HIV, if the former lawful spouse can assert with reasonable
certainty, through medical documentation, transmission of HIV from the
individual with a blood-clotting disorder and HIV.
[[Page 694]]
(c) An individual who acquired the HIV infection through perinatal
transmission from a parent who is the individual with a blood-clotting
disorder and HIV, the lawful spouse with HIV or the former lawful spouse
with HIV.
Sec. 130.11 Who is eligible for payment under the Act--survivors of persons
with HIV.
(a) Survivors of persons with HIV, as described in Sec. 130.10, are
eligible for payment under the Act if:
(1) The person with HIV dies before filing a petition under the Act.
In this case, an eligible survivor may file a petition as a survivor of
the person with HIV, as set forth in Sec. 130.22; or
(2) The person with HIV has filed a petition under the Act, but dies
before payment is made. In this case, an eligible survivor must file an
amendment to the petition in order to retain the assigned order number
and to receive payment under the Act, as set forth in Sec. 130.23.
(b) Payments to survivors shall be made in the following order:
(1) If the person with HIV is survived by a spouse who is living at
the time of payment, the payment shall be made to the surviving spouse
(hereinafter referred to as ``the surviving spouse'').
(2) If the person with HIV is not survived by a living spouse, the
payment shall be made in equal shares to all children of the individual
who are living at the time of payment (hereinafter referred to as ``the
surviving child/children'').
(3) If the person with HIV is not survived by a spouse or children
who are living at the time of payment, the payment shall be made in
equal shares to the parents of the individual who are living at the time
of payment (hereinafter referred to as ``the surviving parent(s))'.
(c) If the person with HIV is not survived at the time payment is to
be made by any of the survivors listed in paragraph (b) of this section,
no payments will be made for the person with HIV and the payment will
revert back to the Fund.
(d) For purposes of this section, the following definitions apply:
(1) The term spouse means a person who was lawfully married to the
person with HIV according to the laws of the place where the person
resided at the time of death.
(2) The term child includes a recognized natural child, a stepchild
who lived with the person with HIV in a regular parent-child
relationship, and an adopted child.
(3) The term parent includes fathers and mothers through adoption.
Subpart C_Documentation Required for Complete Petitions
Sec. 130.20 Form of medical documentation.
In all instances in which medical documentation is referred to,
medical documentation may be submitted in the following forms:
(a) Copies of relevant portions of medical records, records
maintained by a physician, nurse, or other licensed health care
provider, test results, prescription information, or other documentation
deemed credible by the Secretary; or
(b) An affidavit, signed under penalty of perjury, by a physician,
nurse practitioner or physician assistant, verifying that the medical
criteria necessary for a petitioner to be eligible for payment under the
Act are satisfied. Such an affidavit must include the physician's, nurse
practitioner's or physician assistant's State of practice, and license,
certification or registration number, as applicable. A sample affidavit
is set forth at Appendix B to this part.
(Approved by the Office of Management and Budget under control number
0915-0244)
[65 FR 34864, May 31, 2000, as amended at 66 FR 58671, Nov. 23, 2001]
Sec. 130.21 What documentation is required for petitions filed by living
persons with HIV?
The following rules apply to all petitions filed by persons with
HIV:
(a) All petitions filed under the Act must include written medical
documentation showing the following:
(1) That the individual described in Sec. 130.10(a) has (or had) a
blood-clotting disorder, such as hemophilia;
(2) That the individual with a blood-clotting disorder and HIV was
treated
[[Page 695]]
with antihemophilic factor at any time between July 1, 1982, to December
31, 1987; and
(3) That the individual with a blood-clotting disorder and HIV has
(or had) an HIV infection under any of the criteria set out in the
definition of HIV infection at Sec. 130.2(i).
(b) The individual. Petitions filed by the individual with a blood-
clotting disorder and HIV need only include the documentation described
in paragraph (a) of this section.
(c) The lawful spouse. Petitions filed by the lawful spouse with HIV
must include the following written documentation:
(1) The documentation described in paragraph (a) of this section;
(2) Medical documentation showing that the lawful spouse with HIV
has an HIV infection; and
(3) A marriage certificate or other proof of a lawful marriage,
which shows that the lawful spouse with HIV and the individual with a
blood-clotting disorder and HIV are married.
(d) The former lawful spouse. Petitions filed by the former lawful
spouse with HIV must include the following written documentation:
(1) The documentation described in paragraph (a) of this section;
(2) Medical documentation showing that the former lawful spouse with
HIV has an HIV infection;
(3) A marriage certificate or other proof of a lawful marriage,
which shows that the former lawful spouse with HIV and the individual
with a blood-clotting disorder and HIV were married at any time after
the date of the individual's treatment with antihemophilic factor (this
date of treatment must have been between July 1, 1982, to December 31,
1987);
(4) A divorce certificate or other proof of termination of the
marriage between the former lawful spouse with HIV and the individual
with a blood-clotting disorder and HIV; and
(5) Medical documentation which shows with reasonable certainty that
the former lawful spouse with HIV contracted HIV from the person with a
blood-clotting disorder and HIV.
(e) The child. Petitions filed by the child with HIV must include
the following written documentation:
(1) The documentation described in paragraph (a) of this section;
(2) Medical documentation showing that the child with HIV has an HIV
infection;
(3) A birth certificate or other proof, which shows that the child
with HIV is the child of:
(i) The individual with a blood-clotting disorder and HIV;
(ii) The lawful spouse with HIV; or
(iii) The former lawful spouse with HIV;
(4) A marriage certificate or other proof of a lawful marriage,
which shows that the lawful spouse with HIV or the former lawful spouse
with HIV and the individual with a blood-clotting disorder and HIV are/
were married, except where the individual with a blood-clotting disorder
and HIV is the mother of the child with HIV;
(5) Medical documentation showing that the child with HIV acquired
an HIV infection through perinatal transmission from a parent who is:
(i) The individual with a blood-clotting disorder and HIV;
(ii) The lawful spouse with HIV; or
(iii) The former lawful spouse with HIV; and
(6) Where the child with HIV acquired an HIV infection through
perinatal transmission from the former lawful spouse with HIV, medical
documentation which shows with reasonable certainty that the former
lawful spouse with HIV contracted HIV from the person with the blood-
clotting disorder and HIV.
(Approved by the Office of Management and Budget under control number
0915-0244)
Sec. 130.22 What documentation is required for petitions filed by survivors
of persons with HIV, which are filed in cases where the person with HIV dies
before filing a petition?
(a) In those cases in which the person with HIV, as described in
Sec. 130.10, dies before filing a petition under the Act, a survivor of
that person, as described in Sec. 130.11, may file a petition.
(b) Petitions filed by survivors must include two types of
information:
(1) Documentation regarding the person with HIV; and
[[Page 696]]
(2) Documentation regarding the eligibility of the survivor to
receive payments as a survivor of the person with HIV.
(c) Petitions filed by survivors must include the following
information regarding the person with HIV:
(1) The individual. Petitions filed by a survivor of the individual
with a blood-clotting disorder and HIV must include the documentation
described in Sec. 130.21(b).
(2) The lawful spouse. Petitions filed by a survivor of the lawful
spouse with HIV must include the documentation described in Sec.
130.21(c).
(3) The former lawful spouse. Petitions filed by a survivor of the
former lawful spouse with HIV must include the documentation described
in Sec. 130.21(d).
(4) The child. Petitions filed by a survivor of the child with HIV
must include the documentation described in Sec. 130.21(e).
(d) Petitions filed by survivors must include the following
information regarding the relationship between the survivor and the
person with HIV:
(1) The surviving spouse. Petitions filed by the surviving spouse
must include the following written documentation:
(i) A death certificate for the person with HIV, or other evidence
of that individual's death;
(ii) A marriage certificate or other proof of a lawful marriage,
which shows that the survivor was the spouse, as defined in Sec.
130.11(d)(1), of the person with HIV; and
(iii) A sworn statement signed by the surviving spouse which states
that the surviving spouse and the person with HIV were married at the
time of that individual's death.
(2) The surviving child/children. Petitions filed by the surviving
child/children must include the following written documentation:
(i) A death certificate for the person with HIV, or other evidence
of that individual's death;
(ii) A birth certificate, adoption certificate, documentation that
shows that the survivor is the stepchild of the person with HIV (for
example, a certificate of marriage between the survivor's parent and the
person with HIV), or other documentation which shows that the survivor
is the child, as defined in Sec. 130.11(d)(2), of the person with HIV;
and
(iii) A sworn statement signed by the surviving child/children which
either:
(A) States that, to the best of the petitioner's knowledge, there
are no other survivors who are eligible for payment under the Act, as
described in Sec. 130.11 (i.e., no eligible surviving spouses or other
surviving children); or
(B) Provides information regarding other survivors who are eligible
for payment under the Act.
(3) The surviving parent(s). Petitions filed by the surviving
parent(s) must include the following written documentation:
(i) A death certificate for the person with HIV, or other evidence
of that individual's death;
(ii) A birth certificate, adoption certificate or other
documentation which shows that the survivor is the parent, as defined in
Sec. 130.11(d)(3), of the person with HIV; and
(iii) A sworn statement signed by the surviving parent(s) which
either:
(A) States that, to the best of the petitioner's knowledge, there
are no other survivors who are eligible for payment under the Act, as
described in Sec. 130.11 (i.e., no eligible surviving spouse, surviving
children or other surviving parents); or
(B) Provides information regarding other survivors who are eligible
for payment under the Act.
(Approved by the Office of Management and Budget under control number
0915-0244)
Sec. 130.23 What documentation is required for amendments to petitions, which
are filed by survivors of persons with HIV?
(a) The following survivors must file amendments to petitions in
order to retain the assigned order number described in Sec. 130.32 and
to receive payment under the Act:
(1) A survivor of the person with HIV, when the person with HIV has
filed a petition under the Act, but then died before receiving payment;
(2) The next-ranked survivor eligible to receive payment under the
Act, as described in Sec. 130.11(b), when a previously-ranked survivor
has filed a petition or an amendment to a petition
[[Page 697]]
as a survivor of the person with HIV, but then died before receiving
payment; and
(3) In the case of petitions filed by multiple survivors (i.e.,
multiple surviving children or multiple surviving parents), where one of
the survivors dies before receiving payment, the other survivors must
file an amendment in order to notify the Secretary that the payment
should be made to, and divided among, only the remaining survivors.
(b) Survivors described in paragraph (a) of this section shall amend
the original petition by filing the petition form set forth at Appendix
C to this part, including the section pertaining to amendments to
petitions.
(c) Amendments to petitions filed by survivors must include the
following documentation:
(1) Survivors described in paragraph (a)(1) of this section must
include the documentation described in Sec. 130.22(d), which shows that
the survivor is eligible to file a petition as a survivor of the person
with HIV.
(2) Survivors described in paragraph (a)(2) of this section must
include:
(i) The documentation described in Sec. 130.22(d), which shows that
the survivor is eligible to file a petition as a survivor of the person
with HIV; and
(ii) A death certificate for the survivor whose petition is being
amended, or other evidence of that survivor's death.
(3) Survivors described in paragraph (a)(3) of this section must
include a death certificate for the survivor who has died, or other
evidence of that survivor's death.
(d) Amendments to petitions filed by survivors described in
paragraph (a) of this section will retain the same order number assigned
to the original petition.
(e) In those cases in which the Secretary has reviewed the original
petition prior to receiving an amendment to the petition, the Secretary
will determine whether to pay the survivors described in paragraph (a)
as follows:
(1) If the Secretary has determined that the original petition does
not include all of the documentation described in this Subpart C (i.e.,
it is incomplete), the survivor will be given the opportunity to
complete the petition prior to a final determination in accordance with
the procedures set forth at Sec. 130.33.
(2) If the Secretary has determined that the original petition does
not meet the requirements of the Act, the survivor will be so notified
and payment will not be made. The survivor may seek reconsideration
under Sec. 130.40.
(3) If the Secretary has determined that the original petition meets
the requirements of the Act, and the survivor meets the survivor
requirements of the Act, the survivor will receive payment as described
in Sec. 130.3.
(f) In those cases in which the Secretary has not yet made the
determination whether the original petition meets the requirements of
the Act, the Secretary will review the amended petition according to the
order number assigned to the original petition, and then determine
whether the petition is complete and whether to pay the petition as
described in paragraph (e) of this section.
(Approved by the Office of Management and Budget under control number
0915-0244)
Sec. 130.24 What additional documentation may the Secretary require to
resolve eligibility or payment issues?
(a) In addition to the applicable documentation required under this
subpart, the Secretary may require the petitioner to provide other
documentation, as the Secretary deems appropriate, to resolve issues of
eligibility, or of the procedure for payment, raised by a petition.
(b) Where a petition filed on behalf of a minor or other individual
who is legally incompetent to receive payment has been approved for
payment, the personal representative filing the petition on the
individual's behalf must submit the following before payment can be made
for the legally incompetent individual:
(1) Documentation of a guardianship or conservatorship, established
in accordance with State and local law; and
[[Page 698]]
(2) Information identifying a guardianship or conservatorship
account.
(Approved by the Office of Management and Budget under control number
0915-0244)
[66 FR 58672, Nov. 23, 2001]
Subpart D_Procedures for Filing and Paying Complete Petitions
Sec. 130.30 Who may file a petition for payment or an amendment to a
petition?
The following individuals may file a petition for payment under the
Act:
(a) All eligible individuals, as described in subpart B of this
part, including living persons with HIV and survivors of persons with
HIV; and
(b) Personal representatives of eligible individuals:
(1) Where the eligible individual does not have the legal capacity
to receive payment under the Act, as described in Sec. 130.35(e); or
(2) Where the eligible individual does have the legal capacity to
receive payment under the Act and signs the sworn statement included at
the end of the petition.
(Approved by the Office of Management and Budget under control number
0915-0244)
Sec. 130.31 How and when is a petition for payment filed?
(a) In order to receive payment under the Act, all eligible
individuals, as described in subpart B of this part, must file a
complete petition with the Secretary. A complete petition is one that
contains all of the required documentation described in Subpart C of
this part.
(b) A copy of the petition form, which must be filed by all eligible
individuals, including individuals with a blood-clotting disorder and
HIV, the lawful spouse with HIV, the former lawful spouse with HIV, the
child with HIV, and the survivors of persons with HIV, is set forth at
Appendix C to this part. Appendix C includes the petition form, the
instructions for filing the petition form, and a documentation
checklist.
(c) Where there are multiple surviving children or surviving
parents, payments on the petition will be made to each survivor
separately. The survivors shall:
(1) File one petition form jointly, which will contain the required
documentation for all survivors, and which will be signed by at least
one survivor; or
(2) File separate petition forms, which together will contain all of
the required documentation for all survivors, and which will be signed
by each survivor.
(d) Petitions may be obtained from the Ricky Ray Program Office,
Bureau of Health Professions, HRSA, Room 8A-54, 5600 Fishers Lane,
Rockville, Maryland 20857.
(e) All petitions must be submitted to the Ricky Ray Program Office,
Bureau of Health Professions, HRSA, Room 8A-54, 5600 Fishers Lane,
Rockville, Maryland 20857.
(f) The date on which the Secretary will begin accepting petitions
is July 31, 2000.
(1) In order to be eligible for review, petitions may be postmarked
on or after this date. A legibly dated receipt from a commercial carrier
or U.S. Postal Service will be accepted in lieu of a postmark. Petitions
that are postmarked by a private meter will not be accepted.
(2) Petitions that are postmarked, or accompanied by a receipt from
a commercial carrier or U.S. Postal Service, prior to this date will be
returned to the petitioner. Petitions that are delivered by hand at any
time will be returned to the petitioner.
(g) Deadlines. The deadline for filing a petition is November 13,
2001. To meet this deadline, the petition must be postmarked, or
accompanied by a receipt from a commercial carrier or U.S. Postal
Service, by such date. Any new petition filed after such date will be
returned to the petitioner as ineligible for payment, even if the
petitioner filed a timely Notice of Intent as provided in the procedure
described in the Federal Register of March 24, 1999 (64 FR 14251).
(1) If a petitioner submits a petition to the Secretary by November
13, 2001, and the Secretary has determined, in accordance with Sec.
130.34, that the petition does not meet the requirements of the Act, the
petitioner may submit a
[[Page 699]]
new petition for payment, which includes additional documentation that
was not included in the original petition. The deadline for filing this
new petition is November 13, 2001.
(2) If a petitioner submits a petition to the Secretary by November
13, 2001, and the Secretary has not yet made the determination whether
the petition meets the requirements of the Act, the petitioner may
supplement the original petition with additional documentation at any
time until the date of the Secretary's determination.
(3) If a petitioner files an amendment to a petition, as described
in Sec. 130.23, the deadline for filing this amendment is the date of
the Secretary's determination of eligibility or the date of payment,
whichever is later.
(h) Petitioners who filed claims under the Factor Concentrate
Settlement. Petitioners who filed claims under the class settlement in
the case of Susan Walker v. Bayer Corporation,et al., 96-C-5024 (N.D.
Ill.) (i.e., the Factor Concentrate Settlement) must file a complete
petition with the Secretary, together with all required documentation,
as described in subpart C of this part.
(1) If the petitioner submitted a claim in the Factor Concentrate
Settlement which included all of the documents required to establish
eligibility under the Act, he or she may submit original or duplicate
copies of those documents to the Secretary.
(2) If the petitioner submitted a claim in the Factor Concentrate
Settlement which included some, but not all, of the documents required
to establish eligibility under the Act, he or she may submit original or
duplicate documents as described in paragraph (h)(1) of this section,
together with the additional documents required under the Act.
(3) If the petition is filed by someone other than an individual who
filed a claim in the Factor Concentrate Settlement (e.g., survivors of
the person with HIV, personal representatives), he or she may submit
original or duplicate documents as described in paragraph (h)(1) or
(h)(2) of this section in order to satisfy that portion of the petition
relating to the person with HIV.
(Approved by the Office of Management and Budget under control number
0915-0244)
Sec. 130.32 How and when will the Secretary determine the order of receipt of
petitions?
(a) The order that the petition was received by the Secretary will
be determined by the postmark date or the date indicated by a commercial
carrier or the U.S. Postal Service, in accordance with Sec. 130.31(f).
(b) If the Secretary receives more than one petition which is either
postmarked or dated by a commercial carrier or the U.S. Postal Service
on the same date, the Department will conduct a random selection of each
day's submissions to determine the order within each group of petitions.
(c) A number will be assigned to each petition indicating the order
in which it is selected.
Sec. 130.33 How will the Secretary determine whether a petition is complete?
(a) If the Secretary determines that a petition does not include all
of the documentation described in subpart C of this part (i.e., it is
incomplete), the petitioner will be given the opportunity to complete
the petition prior to a final determination.
(b) The petitioner will be notified that the Secretary has
determined that the petition is incomplete and, for purposes of
retaining the assigned order number described in Sec. 130.32, will be
given 60 calendar days from the date of the notice to submit the missing
information. If the petitioner submits the missing information within 60
calendar days, and the Secretary determines that the petition meets the
requirements of the Act, the petitioner will be paid according to the
assigned order number.
(c) If the petitioner is unable to complete the petition, the
petitioner may submit written documentation to the Secretary, within 60
calendar days, which shows good cause why the required medical or legal
documentation is unavailable. If the Secretary determines that the
petitioner has provided an adequate showing of good cause and is
otherwise eligible for payment under the Act, the petitioner will be
paid according to the assigned order number. The Secretary may allow
additional time beyond the 60-day deadline, as the
[[Page 700]]
Secretary deems appropriate, for the petitioner to provide the
documentation required to complete the petition.
(d) The Secretary will process the petition according to Sec.
130.34 if:
(1) The petition does not include the required documentation, as
described in subpart C, even after the opportunity is given to complete
it;
(2) The 60-day deadline, or the extended deadline under Sec.
130.33(c), as applicable, to complete the petition is not met; or
(3) An adequate showing of good cause why the required medical or
legal documentation is unavailable is not provided.
[65 FR 34864, May 31, 2000, as amended at 66 FR 58672, Nov. 23, 2001]
Sec. 130.34 How will the Secretary determine whether to pay a petition?
(a) Subject to available resources, the Secretary will review each
petition filed under the Act and make one of the following
determinations:
(1) If the Secretary concludes that the petition does not meet the
requirements of the Act, the petitioner will be so notified and payment
will not be made. These petitioners may seek reconsideration under Sec.
130.40.
(2) If the Secretary concludes that the petition does meet the
requirements of the Act, the petitioner will receive payment as
described in Sec. 130.3.
(b) Petitions will be reviewed based upon the assigned number
indicating the order of receipt, as described in Sec. 130.32.
Sec. 130.35 How and when will the Secretary pay a petition?
(a) To the extent practicable, determinations on complete petitions
will be made not later than 120 calendar days after the date that the
Secretary determines that the petition is complete.
(b) Payments on petitions will be made as soon as practicable after
a determination that a complete petition meets the requirements of the
Act.
(c) For each eligible individual, as described in subpart B of this
part, the Secretary will make only one payment on a petition.
(d) Where there are multiple surviving children or surviving
parents, survivors who have submitted all required documentation and are
otherwise eligible for payment under the Act, will be paid their
share(s) of the payment, as described in Sec. 130.11(b)(2) and (3). If
any surviving children or surviving parents who are otherwise eligible
for payment have not submitted the required documentation, their
share(s) of the payment will remain in the Fund until such time as they
complete their petitions by submitting such documentation. If they have
not submitted the required documentation by the time that the Fund
terminates, their share(s) will revert back to the Treasury.
(e) Payments on petitions will be made to eligible individuals, as
described in subpart B, unless the eligible individual is legally
incompetent to receive payment. A personal representative may receive
payment for a legally incompetent individual by submitting the following
written documentation to the Secretary:
(1) Proof showing that the eligible individual does not have the
legal capacity to receive payment under the Act, such as a birth
certificate showing that the eligible individual is a minor, or other
evidence showing that the eligible individual is legally incompetent;
and
(2) Proof showing that the personal representative has the authority
to receive payment for the eligible individual, such as proof of legal
guardianship.
Subpart E_Reconsideration Procedures
Sec. 130.40 Reconsideration of denial of petitions.
(a) Right of reconsideration. Every individual who has filed a
petition and has been denied payment may seek reconsideration. To seek
such reconsideration, the petitioner must put a request for
reconsideration in writing and send it to the Deputy Associate
Administrator for Health Professions, Health Resources and Services
Administration, Room 8A-54, 5600 Fishers Lane, Rockville, Maryland
20857. The request for reconsideration must be received by the Deputy
Associate Administrator for Health Professions within
[[Page 701]]
60 calendar days of the date the Department denied the petition for
payment.
(b) Request for reconsideration. The request for reconsideration
must state the reasons why the petitioner is seeking reconsideration.
However, the request for reconsideration may not include any additional
documentation that was not included in the completed petition.
(c) Review process. When the Deputy Associate Administrator for
Health Professions receives a request for reconsideration, he will
convene a panel of three individuals, who are independent of the Ricky
Ray Program Office, to review the initial determination and make a
recommendation regarding payment. The Deputy Associate Administrator for
Health Professions will review the panel's recommendation and then
determine whether the petitioner is eligible for payment under the Act.
The Deputy Associate Administrator for Health Professions' determination
will constitute the Department's final action on the request for
reconsideration. If the determination is that the petitioner is eligible
for payment, the petitioner will receive payment as described in Sec.
130.3. If the determination is that the petitioner is not eligible for
payment, the Deputy Associate Administrator for Health Professions will
inform the petitioner in writing of the reasons for this determination.
Subpart F_Attorney Fees
Sec. 130.50 Limitation on agent and attorney fees.
As provided by section 107 of the Act:
(a) Notwithstanding any contract, the representative of an
individual may not receive, for services rendered in connection with the
petition of an individual under this Act, more than 5 percent of a
payment made under this Act (i.e., $5,000) on the petition.
(b) Any such representative who violates this section is subject to
a fine of not more than $50,000.
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