[Federal Register Volume 79, Number 101 (Tuesday, May 27, 2014)]
[Rules and Regulations]
[Pages 30043-30044]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-12092]



38 CFR Part 17

RIN 2900-AO91

Copayments for Medications in 2014

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.


SUMMARY: This document adopts as a final rule, without change, an 
interim final rule amending the Department of Veterans Affairs (VA) 
medical regulations to freeze the copayments required for certain 
medications provided by VA until December 31, 2014. Under that rule, 
the copayment amounts for all veterans were maintained at the same 
rates as they were in 2013, which were $8 for veterans in priority 
groups 2-6 and $9 for veterans in priority groups 7 and 8. On January 
1, 2015, the copayment amounts may increase based on the prescription 
drug component of the Medical Consumer Price Index (CPI-P).

DATES: Effective Date: This rule is effective on May 27, 2014.

FOR FURTHER INFORMATION CONTACT: Kristin Cunningham, Director, Business 
Policy, Chief Business Office, 810 Vermont Avenue NW., Washington, DC 
20420, (202) 382-2508. (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 30, 2013. 78 FR 
79315-79317. Interested persons were invited to submit comments to the 
interim final rule on or before February 28, 2014, 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

    In accordance with 5 U.S.C. 553(b)(B) and (d)(3), the Secretary of 
Veterans Affairs concluded that there was good cause to publish this 
rule without prior opportunity for public comment and to publish this 
rule with an immediate effective date. The Secretary found that it was 
impracticable and contrary to the public interest to delay this rule 
for the purpose of soliciting advance public comment or to have a 
delayed effective date. Increasing the copayment amount on January 1, 
2014, might have caused a significant financial hardship for some 
veterans and may have decreased patient adherence to medical plans, 
resulting in other unpredictable negative health effects. 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 
final 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 provisions constituting a collection of 
information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-

Regulatory Flexibility Act

    The Secretary hereby certifies that this final rule will not have a 
significant economic impact on a substantial

[[Page 30044]]

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 directly affects 
only individuals and will not directly affect small entities. 
Therefore, pursuant to 5 U.S.C. 605(b), this final rule is exempt from 
the initial and final regulatory flexibility analysis requirements of 5 
U.S.C. 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,'' requiring review by the Office of 
Management and Budget (OMB), unless OMB waives such review, 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 that it may be a significant regulatory action under 
Executive Order 12866. VA's impact analysis can be found as a 
supporting document at http://www.regulations.gov, usually within 48 
hours after the rulemaking document is published. Additionally, a copy 
of the rulemaking and its impact analysis are available on VA's Web 
site at http://www1.va.gov/orpm/, by following the link for ``VA 
Regulations Published.''

Congressional Review Act

    This regulatory action may have been considered a major rule under 
the Congressional Review Act, 5 U.S.C. 801-08, because it may have 
resulted in an annual effect on the economy of $100 million or more. 
Although this regulatory action may have constituted a major rule 
within the meaning of the Congressional Review Act, 5 U.S.C. 804(2), it 
was not subject to the 60-day delay in effective date applicable to 
major rules under 5 U.S.C. 801(a)(3) because the Secretary found that 
good cause existed under 5 U.S.C. 808(2) to make this regulatory action 
effective on January 1, 2014, consistent with the reasons given for the 
publication in the interim final rule. Increasing the copayment amount 
on January 1, 2014, might have caused a significant financial hardship 
for some veterans and may have decreased patient adherence to medical 
plans, and could have had other unpredictable negative health effects. 
Accordingly, the Secretary found that additional advance notice and 
public procedure thereon were impractical, unnecessary, and contrary to 
the public interest. In accordance with 5 U.S.C. 801(a)(1), VA 
submitted to the Comptroller General and to Congress a copy of this 
regulatory action and VA's Regulatory Impact Analysis (RIA).

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 the 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 one year. This final rule will have no such effect on 
State, local, and tribal governments, or on the private sector.

Catalog of Federal Domestic Assistance

    The Catalog of Federal Domestic Assistance numbers and titles for 
the programs affected by this document 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. Jose D. 
Riojas, Chief of Staff, Department of Veterans Affairs, approved this 
document on May 19, 2014, 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 21, 2014.
Janet Coleman,
Acting Chief, Regulations Development, Tracking, and Control.


    Based on the rationale set forth in the interim final rule 
published in the Federal Register at 78 FR 79315 on December 30, 2013, 
and in this document, VA is adopting the provisions of the interim 
final rule as a final rule with no changes.

[FR Doc. 2014-12092 Filed 5-23-14; 8:45 am]