[Federal Register Volume 79, Number 242 (Wednesday, December 17, 2014)]
[Rules and Regulations]
[Pages 75043-75044]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-29554]
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Rules and Regulations
Federal Register
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Federal Register / Vol. 79, No. 242 / Wednesday, December 17, 2014 /
Rules and Regulations
[[Page 75043]]
OFFICE OF PERSONNEL MANAGEMENT
5 CFR Part 890
RIN 3206-AN03
Federal Employees Health Benefits Program Miscellaneous Changes:
Medically Underserved Areas
AGENCY: U.S. Office of Personnel Management.
ACTION: Direct final rule.
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SUMMARY: The U.S. Office of Personnel Management (OPM) is issuing a
direct final rule to discontinue the annual determination of the
Medically Underserved Areas (MUAs) for the Federal Employees Health
Benefits (FEHB) Program.
DATES: Effective January 1, 2015. Comments due February 17, 2015.
ADDRESSES: Send written comments to Lynelle T. Frye, Policy Analyst,
Planning and Policy Analysis, U.S. Office of Personnel Management, Room
4312, 1900 E Street NW., Washington, DC; or FAX to (202) 606-4640 Attn:
Lynelle T. Frye. You may also submit comments using the Federal
eRulemaking Portal: http://www.regulations.gov. Follow the instructions
for submitting comments.
FOR FURTHER INFORMATION CONTACT: Lynelle T. Frye, Policy Analyst, at
(202) 606-0004 or email: [email protected].
SUPPLEMENTARY INFORMATION: Due to the enactment of Section 2706(a) of
the Public Health Service Act (PHSA), OPM has concluded that the annual
determination of Medically Underserved Areas (MUAs) for the FEHB
Program is no longer required. Section 2706(a) of the PHSA requires
that a health insurance issuer or group health plan offering coverage
shall not discriminate with respect to coverage against any health care
provider who performs covered services when acting within the scope of
their license or certification under applicable state law in any area
of a state.
Background
The Federal Employees Health Benefits (FEHB) law (5 U.S.C.
8902(m)(2)) requires that a State be designated as a Medically
Underserved Area if 25% or more of the population lives in an area
identified by the Department of Health and Human Services (HHS) as a
primary medical care manpower shortage area.
It is intended to provide special consideration for enrollees who
obtain health services in states with critical shortages of primary
care physicians. As such, FEHB fee-for-service plans are required to
provide benefits for covered services (subject to their contract terms)
provided by any licensed provider practicing within the scope of his/
her license, such as physician assistants or nurse midwives, which
otherwise may not be considered as covered providers by the fee-for-
service plan.
After the enactment of Section 2706(a) of the Public Health Service
Act (PHSA) the Department of Labor offered guidance to health plans and
health insurance issuers that, to the extent an item or service is a
covered benefit under the plan or coverage, and consistent with
reasonable medical management techniques specified under the plan with
respect to the frequency, method, treatment or setting for an item or
service, a plan or issuer shall not discriminate based on a provider's
license or certification, to the extent the provider is acting within
the scope of the provider's license or certification under applicable
state law. This provision does not require plans or issuers to accept
all types of providers into a network. This provision also does not
govern provider reimbursement rates, which may be subject to quality,
performance, or market standards and considerations.
The effect of Section 2706(a) of the PHSA is to expand the
geographic area of coverage for all licensed providers offering covered
services within the scope of their license to all areas of all States
rather than the only those areas designated as Medically Underserved
under 5 U.S.C. 8902(m)(2).
OPM has concluded that Section 2706(a) of the PHSA renders the
annual determination of the MUAs for FEHB no longer required. It serves
a similar purpose, since this Section is to expand the geographic area
of coverage for all licensed providers offering covered services within
the scope of their license to all areas of all States rather than the
only those areas designated as Medically Underserved under 5 U.S.C.
8902(m)(2).
With this change, we are not seeking a comment period since we feel
it serves the same purpose as MUA.
Regulatory Impact Analysis
OPM has examined the impact of this proposed rule as required by
Executive Order 12866 and Executive Order 13563, which directs agencies
to assess all costs and benefits of available regulatory alternatives
and, if regulation is necessary, to select regulatory approaches that
maximize net benefits (including potential economic, environmental,
public, health, and safety effects, distributive impacts, and equity).
A regulatory impact analysis must be prepared for major rules with
economically significant effects of $100 million or more in any one
year. This rule is not considered a major rule because there will be a
minimal impact on costs to Federal agencies.
Regulatory Flexibility Act
I certify that this regulation will not have a significant economic
impact on a substantial number of small entities because the regulation
only affects health insurance benefits of Federal employees and
annuitants.
Regulatory Review
This rule has been reviewed by the Office of Management and Budget
in accordance with Executive Order 12866.
Federalism
We have examined this rule in accordance with Executive Order
13132, Federalism, and have determined that this rule will not have any
negative impact on the rights, roles, and responsibilities of State,
local, or Tribal governments.
Paperwork Reduction Act
The Paperwork Reduction Act of 1995 (44 U.S.C. chapter 35; see 5
CFR part 1320) requires that the U.S. Office of Management and Budget
(OMB) approve all collections of information by a Federal agency from
the public before they can be implemented.
[[Page 75044]]
Respondents are not required to respond to any collection of
information unless it displays a current valid OMB control number. OPM
is not proposing any additional collections in this rule.
List of Subjects in 5 CFR Part 890
Administrative practice and procedure; Government employees; Health
facilities; Health insurance; Health professions; Hostages; Iraq;
Kuwait; Lebanon; Military personnel; Reporting and recordkeeping
requirements; Retirement.
U.S. Office of Personnel Management.
Kathleen Archuleta,
Director.
Accordingly, OPM is amending 5 CFR part 890 as follows:
PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM
0
1. The authority citation for part 890 continues to read as follows:
Authority: 5 U.S.C. 8913; Sec. 890.301 also issued under sec.
311 of Pub. L. 111-03, 123 Stat. 64; Sec. 890.111 also issued under
section 1622(b) of Pub. L. 104-106, 110 Stat. 521; Sec. 890.112 also
issued under section 1 of Pub. L. 110-279, 122 Stat. 2604; 5 U.S.C.
8913; Sec. 890.803 also issued under 50 U.S.C. 403p, 22 U.S.C. 4069c
and 4069c-1; subpart L also issued under sec. 599C of Pub. L. 101-
513, 104 Stat. 2064, as amended; Sec. 890.102 also issued under
sections 11202(f), 11232(e), 11246 (b) and (c) of Pub. L. 105-33,
111 Stat. 251; and section 721 of Pub. L. 105-261, 112 Stat. 2061;
Pub. L. 111-148, as amended by Pub. L. 111-152.
Subpart G--[Removed and Reserved]
0
1. Remove and Reserve subpart G, consisting of Sec. Sec. 890.701 and
890.702.
[FR Doc. 2014-29554 Filed 12-16-14; 8:45 am]
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