[Federal Register Volume 77, Number 93 (Monday, May 14, 2012)]
[Rules and Regulations]
[Pages 28258-28259]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-11486]



38 CFR Part 17

RIN 2900-AO28

Copayments for Medications in 2012

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.


SUMMARY: This document affirms as final, without change, an interim 
final rule amending the Department of Veterans Affairs (VA) medical 
regulations concerning the copayment required for certain medications. 
The interim final rule froze until December 31, 2012, the copayment 
amount for veterans in the VA health care system in enrollment priority 
categories 2 through 6 at the 2011 level, which was $8. The interim 
final rule also froze until December 31, 2012, the maximum annual 
copayment amount for enrollment priority categories 2 through 6, which 
was $960. On January 1, 2013, the copayment amounts may increase based 
on the prescription drug component of the Medical Consumer Price Index 
(CPI-P). If the copayment increases, the maximum annual copayment 
amount will automatically increase in turn.

DATES: Effective Date: This rule is effective May 14, 2012.

FOR FURTHER INFORMATION CONTACT: Kristin Cunningham, Director, Business 
Policy, Chief Business Office, 810 Vermont Avenue NW., Washington, DC 
20420, (202) 461-1599. (This is not a toll-free number.)

SUPPLEMENTARY INFORMATION: An interim final rule amending VA's medical 
regulations concerning the copayment required for certain medications 
was published in the Federal Register on December 20, 2011 (76 FR 
78824). Interested persons were invited to submit comments to the 
interim final rule on or before February 21, 2012, and we received no 
comments. Therefore, based on the rationale set forth in the interim 
final rule, VA is adopting the interim final rule as a final rule with 
no changes.

Administrative Procedure Act

    This document affirms as final, without change, the interim final 
rule that is already in effect. In accordance with 5 U.S.C. 
553(b)(3)(B) and (d)(3), the Secretary of Veterans Affairs concluded 
that there was good cause to dispense with the opportunity for advance 
notice and opportunity for public comment and good cause to publish 
this rule with an immediate effective date. The Secretary found that it 
was impracticable, unnecessary, and contrary to the public interest to 
delay this regulation for the purpose of soliciting advance public 
comment or to have a delayed effective date. Increasing the copayment 
amount on January 1, 2012, might have caused a significant financial 
hardship for some veterans. Nevertheless, the Secretary invited public 
comment on the interim final rule but did not receive any comments.

Effect of Rulemaking

    Title 38 of the Code of Federal Regulations, as revised by this 
rulemaking, represents VA's implementation of its legal authority on 
this subject. Other than future amendments to this regulation or 
governing statutes, no contrary guidance or procedures are authorized. 
All existing or subsequent VA guidance must be read to conform with 
this rulemaking if possible or, if not possible, such guidance is 
superseded by this rulemaking.

Paperwork Reduction Act

    This final rule contains no collections of information under the 
Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3521).

Regulatory Flexibility Act

    The Secretary hereby certifies that this final rule will not have a 
significant economic impact on a substantial number of small entities 
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. This final rule will temporarily freeze the copayments that 
certain veterans are required to pay for prescription drugs furnished 
by VA. This final rule affects individuals and has no impact on small 
entities. Therefore, under 5 U.S.C. 605(b), this final rule is exempt 
from the initial and final regulatory flexibility analysis requirements 
of sections 603 and 604.

Executive Orders 12866 and 13563

    Executive Orders 12866 and 13563 direct agencies to assess the 
costs and benefits of available regulatory alternatives and, when 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety effects, and other advantages; distributive impacts; 
and equity). Executive Order 13563 (Improving Regulation and Regulatory 
Review) emphasizes the importance of quantifying both costs and 
benefits, reducing costs, harmonizing rules, and promoting flexibility. 
Executive Order 12866 (Regulatory Planning and Review) defines a 
``significant regulatory action,'' which requires review by the Office 
of Management and Budget (OMB), as ``any regulatory action that is 
likely to result in a rule that may: (1) Have an annual effect on the 
economy of $100 million or more or adversely affect in a material way 
the economy, a sector of the economy, productivity, competition, jobs, 
the environment, public health or safety, or State, local, or tribal 
governments or communities; (2) Create a serious inconsistency or 
otherwise interfere with an action taken or planned by another agency; 
(3) Materially alter the budgetary impact of entitlements, grants, user 
fees, or loan programs or the rights and obligations of recipients 
thereof; or (4) Raise novel legal or policy issues arising out of legal 
mandates, the President's priorities, or the principles set forth in 
this Executive Order.''
    The economic, interagency, budgetary, legal, and policy 
implications of this regulatory action have been examined and it has 
been determined not to be a significant regulatory action under 
Executive Order 12866.

[[Page 28259]]

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any given year. This rule will have no such effect on 
State, local, and tribal governments, or on the private sector.

Catalog of Federal Domestic Assistance Numbers

    The Catalog of Federal Domestic Assistance program number and title 
for this rule are as follows: 64.005, Grants to States for Construction 
of State Home Facilities; 64.007, Blind Rehabilitation Centers; 64.008, 
Veterans Domiciliary Care; 64.009, Veterans Medical Care Benefits; 
64.010, Veterans Nursing Home Care; 64.011, Veterans Dental Care; 
64.012, Veterans Prescription Service; 64.013, Veterans Prosthetic 
Appliances; 64.014, Veterans State Domiciliary Care; 64.015, Veterans 
State Nursing Home Care; 64.016, Veterans State Hospital Care; 64.018, 
Sharing Specialized Medical Resources; 64.019, Veterans Rehabilitation 
Alcohol and Drug Dependence; 64.022, Veterans Home Based Primary Care; 
and 64.024, VA Homeless Providers Grant and Per Diem Program.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. John R. 
Gingrich, Chief of Staff, Department of Veterans Affairs, approved this 
document on May 7, 2012 for publication.

List of Subjects in 38 CFR Part 17

    Administrative practice and procedure; Alcohol abuse; Alcoholism; 
Claims; Day care; Dental health; Drug abuse; Foreign relations; 
Government contracts; Grant programs--health; Grant programs--veterans; 
Health care; Health facilities; Health professions; Health records; 
Homeless; Medical and dental schools; Medical devices; Medical 
research; Mental health programs; Nursing homes; Philippines; Reporting 
and recordkeeping requirements; Scholarships and fellowships; Travel 
and transportation expenses; Veterans.

    Dated: May 8, 2012.
Robert C. McFetridge,
Director of Regulation Policy and Management, Office of General 
Counsel, Department of Veterans Affairs.


Accordingly, the interim final rule amending 38 CFR part 17 that was 
published in the Federal Register at 76 FR 78824 on December 20, 2011, 
is adopted as a final rule without change.

[FR Doc. 2012-11486 Filed 5-11-12; 8:45 am]