Rule2021-25720
TRICARE Program: TRICARE Reserve Select Coverage for Members of the Selected Reserve
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
November 30, 2021
Effective
December 30, 2021
Issuing agencies
Defense Department
Abstract
This final rule implements the National Defense Authorization Act for Fiscal Year 2020 (NDAA-2020), which removes the permanent eligible exclusion for TRICARE Reserve Select (TRS) coverage for a member of the Selected Reserve of the Ready Reserve who is enrolled or eligible to enroll in a Federal Employees Health Benefits (FEHB) Program health insurance plan. The law now excludes TRS coverage for such members only during the period preceding January 1, 2030. The law was effective upon enactment of NDAA-2020 on December 20, 2019. In implementing the statutory changes, this final rule will improve TRICARE by increasing options for access to care for Federal employees.
Full Text
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<title>Federal Register, Volume 86 Issue 227 (Tuesday, November 30, 2021)</title>
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[Federal Register Volume 86, Number 227 (Tuesday, November 30, 2021)]
[Rules and Regulations]
[Pages 67860-67862]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-25720]
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DEPARTMENT OF DEFENSE
Office of the Secretary
32 CFR Part 199
[Docket ID: DOD-2020-HA-0073]
RIN 0720-AB79
TRICARE Program: TRICARE Reserve Select Coverage for Members of
the Selected Reserve
AGENCY: Department of Defense.
ACTION: Final rule.
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SUMMARY: This final rule implements the National Defense Authorization
Act for Fiscal Year 2020 (NDAA-2020), which removes the permanent
eligible exclusion for TRICARE Reserve Select (TRS) coverage for a
member of the Selected Reserve of the Ready Reserve who is enrolled or
eligible to enroll in a Federal Employees Health Benefits (FEHB)
Program health insurance plan. The law now excludes TRS coverage for
such members only during the period preceding January 1, 2030. The law
was effective upon enactment of NDAA-2020 on December 20, 2019. In
implementing the statutory changes, this final rule will improve
TRICARE by increasing options for access to care for Federal employees.
DATES: This final rule is effective December 30, 2021.
FOR FURTHER INFORMATION CONTACT: Mr. Jeremy Schneider, Defense Health
Agency, TRICARE Health Plan, TRICARE Policy and Programs Section,
<a href="/cdn-cgi/l/email-protection#8ae0eff8efe7f3a4e7a4f9e9e2e4efe3eeeff8a4e9e3fccae7ebe3e6a4e7e3e6"><span class="__cf_email__" data-cfemail="3e545b4c5b53471053104d5d56505b575a5b4c105d57487e535f575210535752">[email protected]</span></a>, (703) 275-6208.
SUPPLEMENTARY INFORMATION:
I. Executive Summary
A. Purpose of the Rule
This rule is required to implement section 701 of NDAA-2020. As a
``housekeeping'' matter, this rule includes necessary changes to the
TRICARE regulation to conform it to the new statutory requirements
enacted in the NDAA-2020, over which the Department has no
administrative discretion. In implementing section 701 of NDAA-2020,
this rule advances the better care component of the Military Health
System's aims by expanding the options available to Federal employees.
B. Exception to Notice and Comment
Agency informal rule-making is governed by section 553 of the
Administrative Procedure Act (APA), 5 U.S.C. 551 et seq. Section 553(b)
requires that, unless the rule falls within one of the enumerated
exemptions, an agency must publish a notice of proposed rulemaking in
the Federal Register that provides interested persons an opportunity to
submit written data, views, or arguments, prior to finalization of
regulatory requirements. Section 553(b)(B) of the APA authorizes an
agency to dispense with the prior notice and opportunity for public
comment requirement when the agency, for ``good cause,'' finds that
notice and public comment thereon are impracticable, unnecessary, or
contrary to the public interest. Section 553 also requires an agency to
include an explanation of such good cause with the publication of the
rule. As noted in the preamble, the change in law was effective upon
enactment on December 20, 2019. The change in law is self-executing and
Department of Defense (DoD) has no discretion for implementing the law,
including amending the TRICARE regulation to conform it to the
statutory requirements. Because DoD cannot change the law, it is
impracticable and unnecessary to delay amending the TRICARE regulation
to conform it to the law until a full public notice-and-comment process
is completed. In addition, it would be contrary to public interest to
retain in existence a TRICARE regulation relied upon by the public
which contains an eligibility requirement which is legally inconsistent
with the controlling legislation for TRS coverage pending completion of
a full public notice-and-comment process. Pursuant to 5 U.S.C.
553(b)(B), and for reasons stated in this preamble, the Assistant
Secretary of Defense for Health Affairs (ASD(HA)), therefore, concludes
that there is good cause to dispense with prior public notice and the
opportunity to comment on this rule before finalizing this rule.
C. Summary of Major Provisions
The rule amends the TRICARE regulation to conform it to the current
law that defines eligibility for TRICARE Reserve Select, specifying
that Selected Reserve members eligible for or enrolled in a Federal
Employee Health Benefits (FEHB) plan (5 U.S.C. Chapter 89, ``Health
Insurance'') are eligible to enroll in TRS beginning January 1, 2030.
D. Legal Authority for This Program
The statutory authority for this final rule is 10 U.S.C. 1076d, as
amended by Public Law 116-92, NDAA-2020, Section 701, ``Modification of
Eligibility for TRICARE Reserve Select for Certain Members of the
Selected Reserve.'' This final rule amends title 32, Code of Federal
Regulations (CFR), Sec. 199.24, ``TRICARE Reserve Select,'' which
offers the TRICARE Select self-managed, preferred-provider network
option and can be found at <a href="https://www.ecfr.gov/cgi-bin/textidx?SID=2e53e1af44c38aa7d9076c076a2acd02&mc=true&node=se32.2.199_124&rgn=div8">https://www.ecfr.gov/cgi-bin/textidx?SID=2e53e1af44c38aa7d9076c076a2acd02&mc=true&node=se32.2.199_124&rgn=div8</a>. The TRICARE Reserve Select program is established under 10
U.S.C. 1076d, ``TRICARE program: TRICARE Reserve Select coverage for
members of the Selected Reserve.''
II. Regulatory History
This final rule is the only regulatory action relating to
implementation of section 701 of NDAA-2020.
III. Regulatory Analysis
A. Regulatory Planning and Review
a. Executive Orders
Executive Order 12866, ``Regulatory Planning and Review'' and Executive
Order 13563, ``Improving Regulation and Regulatory Review''
Executive Orders (E.O.s) 12866 and 13563 direct agencies to assess
all costs and benefits of available regulatory
[[Page 67861]]
alternatives and, if regulation is necessary, to select regulatory
approaches that maximize net benefits (including potential economic,
environmental, public health and safety effects, distribute impacts,
and equity). E.O. 13563 emphasizes the importance of quantifying both
costs and benefits, of reducing costs, of harmonizing rules, and of
promoting flexibility. This rule has been designated a ``non-
significant regulatory action,'' although, not determined to be
economically significant, under section 3(f) of E.O. 12866.
Accordingly, the rule has not been reviewed by the Office of Management
and Budget. This rule is not economically significant as its effect on
the economy is less than $100 million, will not materially adversely
affect the economy, a sector of the economy; productivity, competition,
jobs, the environment, public health or safety, or State, local, or
tribal governments or communities. Net benefit is supported by the
Defense Health Agency's mission of complying with all NDAA constraints
and providing the best health care options to beneficiaries.
b. Summary
This rule amends the current TRICARE regulation which, consistent
with 10 U.S.C. 1076d prior to NDAA-2020 amendment, excluded from TRS
eligibility any Selected Reserve member who was also enrolled in, or
eligible for a health benefit plan under the Federal Employee Health
Benefits program under 5 U.S.C. chapter 89, section 8903. According to
NDAA-2020, this exclusion will be repealed and these government
employees will be eligible for coverage under TRS beginning January 1,
2030, provided they meet all other TRS eligibility requirements.
c. Affected Population
This rulemaking action will apply to an employee of the Federal
Government who, under 5 U.S.C. chapter 89, is eligible for the Federal
Employee Health Benefit Program and eligible for TRS as described by 32
CFR 199.24(b), ``Qualifications for TRICARE Reserve Select coverage''.
These specific beneficiaries will have the option to enroll in TRS
beginning January 1, 2030. This enrollment will be voluntary, and will
proceed through established enrollment procedures. The affected
population will receive notification of this rule change via
publication of this final rule and by TRS program literature published
by the Defense Health Agency and distributed by TRICARE regional
managed care support contractors.
d. Costs
The Future Years Defense Program (FYDP) only projects five years
into the future, thus, an accurate estimate of monetary cost to the
government cannot be done. Projections templated over FY2020 through
FY2025 project cost savings to the DoD in excess of $10 million per
fiscal year (FY). This net takes into consideration the revenue lost
through fewer Federal Employees Health FEHB Program plan premium
contributions and assumes that approximately 33% of employees eligible
to switch from their current FEHB Program plan to TRS will do so.
Again, these projections are for FY2020-FY2025, and this rule is not to
be implemented until calendar year 2030.
The administrative costs of this rule are assessed as only
including increased customer service queries and beneficiary education
required to ensure beneficiaries have all the necessary information to
make an informed decision. Administrative processes to manage plan
changes triggered by this rule are already in place.
There is no projected cost to the public. Should they decide to
change health plans, employees affected by this rule may experience
cost savings due to lower premiums, catastrophic cap, deductible, and
other cost shares. However, these savings are subject to plan specifics
at the time of rule implementation.
e. Benefits
Extending TRS eligibility to Federal employees increases health
care options for beneficiaries, especially through the preferred-
provider network (PPN). Depending on their health care needs, the PPN
provided by TRS may increase access to care for eligible Federal
employees who choose to enroll. The projected monetary cost saving to
the government, still to be itemized, is the final important benefit;
this rulemaking action frees up Government funds for appropriate
reallocation.
f. Alternatives
Alternative 1: No action. Not implementing this rule would be in
direct violation of the law set forth in NDAA-2020 requiring TRS to be
an option for eligible Federal employees who desire to enroll in TRS
coverage beginning January 1, 2030. The result of taking no action
would be continued cost to the government in the form of FEHB plans
that could have been transferred to TRS beginning in CY2030. Cost to
beneficiaries would be the loss of additional coverage options and
likely increased health care out-of-pocket costs. There is no benefit
to taking no action and the Department has no discretion to forgo
compliance with the law requiring this rulemaking action.
Alternative 2: Postponed action. Postponement of rulemaking would
result in inconsistency between the TRICARE regulation and the
controlling statute. The statute is self-executing and was effective
upon enactment of NDAA-2020 on December 20, 2019. Delaying rulemaking
to conform the regulation with the law will result in inaccurate
information available to the public regarding statutory eligibility for
TRS coverage.
Public Law 96-354, ``Regulatory Flexibility Act'' (5 U.S.C. 601)
The Department of Defense certifies that this final rule is not
subject to the Regulatory Flexibility Act (5 U.S.C. 601) because it
would not, if promulgated, have a significant economic impact on a
substantial number of small entities. Therefore, the Regulatory
Flexibility Act, as amended, does not require us to prepare a
regulatory flexibility analysis.
C. Congressional Review Act
The Congressional Review Act, 5 U.S.C. 801 et seq., as amended by
the Small Business Regulatory Enforcement Fairness Act of 1996,
generally provides that before a rule may take effect, the agency
promulgating the rule must submit a rule report, which includes a copy
of the rule, to each House of the Congress and to the Comptroller
General of the United States. DoD will submit a report containing this
rule and other required information to the U.S. Senate, the U.S. House
of Representatives, and the Comptroller General of the United States. A
major rule cannot take effect until 60 days after it is published in
the Federal Register. This final rule is not a ``major rule'' as
defined by 5 U.S.C. 804(2).
D. Sec. 202, Public Law 104-4, ``Unfunded Mandates Reform Act''
Section 202 of the Unfunded Mandates Reform Act of 1995 (UMRA) (2
U.S.C. 1532) requires agencies to assess anticipated costs and benefits
before issuing any rule whose mandates require spending in any 1 year
of $100 million in 1995 dollars, updated annually for inflation. This
final rule will not mandate any requirements for State, local, or
tribal governments, nor will affect private sector costs.
E. Public Law 96-511, ``Paperwork Reduction Act'' (44 U.S.C. Chapter
35)
It has been determined that 32 CFR 199.24 does not impose reporting
or
[[Page 67862]]
recordkeeping requirements under the Paperwork Reduction Act of 1995.
Existing information collection requirements of the TRICARE program
will be utilized, using a DD Form 2896-1, Reserve Component Health
Coverage Request Form. This enrollment form, accessible through the
Beneficiary Web Enrollment (BWE) website, does not meet information
collection requirements and thus does not trigger requirements of the
Paperwork Reduction Act.
F. Executive Order 13132, ``Federalism''
E.O. 13132 establishes certain requirements that an agency must
meet when it promulgates a rule that imposes substantial direct
requirement costs on State and local governments, preempts State law,
or otherwise has federalism implications. This final rule will not have
a substantial effect on State and local governments.
List of Subjects in 32 CFR Part 199
Administrative practice and procedure, Claims, Fraud, Health care,
Health insurance, Individuals with disabilities, Mental health
programs, Military personnel.
Accordingly, 32 CFR part 199 is amended as follows:
PART 199--CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED
SERVICES (CHAMPUS)
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. Amend Sec. 199.24 by revising paragraph (b)(1) introductory text to
read as follows:
Sec. 199.24 TRICARE Reserve Select.
* * * * *
(b) * * *
(1) Ready Reserve member. A Ready Reserve member qualifies to
purchase TRICARE Reserve Select coverage prior to January 1, 2030, if
the Service member meets the criteria listed in both paragraphs
(b)(1)(i) and (ii) of this section. Beginning January 1, 2030, only the
criteria in paragraph (b)(1)(i) of this section is necessary for
qualification.
* * * * *
Dated: November 19, 2021.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2021-25720 Filed 11-29-21; 8:45 am]
BILLING CODE 5001-06-P
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This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.