Notice2023-12479
Expiration of Temporary Changes to TRICARE Regulations During the Coronavirus Disease 2019 (COVID-19) Pandemic
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
June 12, 2023
Issuing agencies
Defense Department
Abstract
The ASD(HA) is publishing this notice to announce that temporary changes to the TRICARE regulations related to the coronavirus disease 2019 (COVID-19) pandemic were terminated on April 10, 2023, for those temporary changes that terminate at the end of the President's national emergency; on May 11, 2023, for changes that terminate at the end of the Health and Human Services (HHS) Public Health Emergency (PHE); and will be terminated on September 30, 2023, for the temporary regulation change creating a diagnosis related group (DRG) add-on for New COVID-19 Treatments Add-on Payments (NCTAPs).
Full Text
<html>
<head>
<title>Federal Register, Volume 88 Issue 112 (Monday, June 12, 2023)</title>
</head>
<body><pre>
[Federal Register Volume 88, Number 112 (Monday, June 12, 2023)]
[Notices]
[Pages 38038-38039]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-12479]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
Expiration of Temporary Changes to TRICARE Regulations During the
Coronavirus Disease 2019 (COVID-19) Pandemic
AGENCY: Office of the Assistant Secretary of Defense for Health Affairs
(ASD(HA)), Department of Defense (DoD).
ACTION: Notice of expiration of temporary changes.
-----------------------------------------------------------------------
SUMMARY: The ASD(HA) is publishing this notice to announce that
temporary changes to the TRICARE regulations related to the coronavirus
disease 2019 (COVID-19) pandemic were terminated on April 10, 2023, for
those temporary changes that terminate at the end of the President's
national emergency; on May 11, 2023, for changes that terminate at the
end of the Health and Human Services (HHS) Public Health Emergency
(PHE); and will be terminated on September 30, 2023, for the temporary
regulation change creating a diagnosis related group (DRG) add-on for
New COVID-19 Treatments Add-on Payments (NCTAPs).
FOR FURTHER INFORMATION CONTACT: Erica Ferron, 303-676-3626,
<a href="/cdn-cgi/l/email-protection#0b6e7962686a2568256d6e797964652568627d4b636e6a677f6325666267"><span class="__cf_email__" data-cfemail="5a3f2833393b7439743c3f282835347439332c1a323f3b362e3274373336">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: The ASD(HA) approved temporary modifications
to TRICARE regulations in response to the COVID-19 pandemic and the
President's national emergency for the COVID-19 outbreak (Proclamation
9994, 85 Federal Register (FR) 15337). Interim final rules (IFRs)
implementing temporary changes to the TRICARE regulation were published
on May 12, 2020 (85 FR 27921); September 3, 2020 (85 FR 54914); October
30, 2020 (85 FR 68753); and January 12, 2023 (88 FR 1992). All
provisions of the IFR published on May 12, 2020, and all but one
provision of the IFR published on September 3, 2020, were finalized,
with changes, in a final rule published June 1, 2022 (87 FR 33001).
The temporary provisions in the four IFRs, as modified by the final
rule where applicable, were set to expire automatically, depending on
the particular temporary provision, at: (1) the termination of the
President's national emergency; (2) the termination of the associated
Secretary of HHS's PHE; (3) the termination of the Centers for Medicare
and Medicaid Services' (CMS's) Hospitals Without Walls initiative; or
(4) at the end of the fiscal year in which the HHS PHE terminates. On
January 30, 2023, the Biden Administration announced plans to terminate
both the President's national emergency and the HHS PHE on May 11,
2023.\1\ CMS has previously stated that the Hospital Without Walls
initiative would terminate when the HHS PHE ended.\2\ Public Law 118-3
was subsequently enacted on April 10, 2023, immediately terminating the
President's national emergency.\3\ Several provisions in the IFRs are
permanent changes; these provisions will not expire.
---------------------------------------------------------------------------
\1\ <a href="https://www.whitehouse.gov/wp-content/uploads/2023/01/SAP-H.R.-382-H.J.-Res.-7.pdf">https://www.whitehouse.gov/wp-content/uploads/2023/01/SAP-H.R.-382-H.J.-Res.-7.pdf</a>.
\2\ <a href="https://www.cms.gov/files/document/hospitals-and-cahs-ascs-and-cmhcs-cms-flexibilities-fight-covid-19.pdf">https://www.cms.gov/files/document/hospitals-and-cahs-ascs-and-cmhcs-cms-flexibilities-fight-covid-19.pdf</a>.
\3\ <a href="https://www.congress.gov/bill/118th-congress/house-joint-resolution/7/text">https://www.congress.gov/bill/118th-congress/house-joint-resolution/7/text</a>.
---------------------------------------------------------------------------
The Department stated in its IFRs that the ASD(HA) would publish a
document in the FR announcing the termination dates for the temporary
provisions; this FR notice satisfies that requirement. This document
also provides notice that the ASD(HA) is not extending any of the
provisions overseas beyond their termination in the United States.
A. The following temporary regulatory changes ended at the end of
the day on April 10, 2023, in the United States and overseas as stated
in this notice. DoD will publish final rules removing these temporary
regulatory changes from the Code of Federal Regulations (CFR) after
their termination date:
1. Paragraph 199.4(b)(3)(xiv) of Title 32 of the CFR: Temporary
waiver of the requirement for a three-day prior hospital stay before
admission to a skilled nursing facility ended for all new skilled
nursing facility admissions after April 10, 2023.
2. Title 32 CFR 199.4(e)(26)(iii)(B): Temporary coverage of
National Institute of Allergy and Infectious Disease (NIAID)-sponsored
COVID-19 clinical trials ended on April 10, 2023. Eligible
beneficiaries who enrolled in a covered trial on or before April 10,
2023, will continue to have their care covered through the end of the
trial.
3. Title 32 CFR 199.4(g)(15)(i)(A): Temporary coverage of the
treatment use of investigational drugs under U.S. Food and Drug
Administration (FDA)-approved expanded access programs ended for all
new episodes of treatment after April 10, 2023.
4. Title 32 CFR 199.6(c)(2)(i): Temporary waiver of certain
interstate and international licensing requirements ended for all care
received after April 10, 2023.
B. The following temporary regulatory changes ended at the end of
the day on May 11, 2023, in the United States and overseas as stated in
this notice. DoD will publish final rules removing these temporary
regulatory changes from the CFR after their termination date:
1. Title 32 CFR 199.6(b)(4)(i)(I): Temporary waiver of certain
acute care facility requirements for facilities registering with
Medicare as a hospital under CMS's Hospitals Without Walls initiative
ended on May 11, 2023. Care provided after May 11, 2023, will be
reimbursed under the methodology appropriate for the facility's current
status (ambulatory surgery center, etc.), consistent with Medicare's
guidance to facilities qualified as acute care facilities
[[Page 38039]]
under the Hospital Without Walls initiative.\4\
---------------------------------------------------------------------------
\4\ <a href="https://www.cms.gov/files/document/hospitals-and-cahs-ascs-and-cmhcs-cms-flexibilities-fight-covid-19.pdf">https://www.cms.gov/files/document/hospitals-and-cahs-ascs-and-cmhcs-cms-flexibilities-fight-covid-19.pdf</a>.
---------------------------------------------------------------------------
2. Title 32 CFR 199.14(a)(1)(iii)(E)(2): Temporary adjustments to
the DRG-based reimbursement amounts for patients diagnosed with COVID-
19 ended for all new admissions after May 11, 2023.
3. Title 32 CFR 199.14(a)(9)(i): Temporary reimbursement of all
long-term care hospitals (LTCHs) at the LTCH prospective payment system
standard Federal rate ended for all new admissions after May 11, 2023.
C. The temporary regulation change creating a DRG add-on for NCTAPs
(32 CFR 199.14(a)(1)(iv)(C)) will end for all new admissions after
September 30, 2023. The NCTAP is designed to mitigate potential
financial disincentives for hospitals to provide new COVID-19
treatments for eligible inpatient cases that use certain new products
with current FDA approval or emergency use authorization to treat
COVID-19. DoD will publish a final rule removing this temporary
regulatory change from the CFR after its termination date.
D. The following provisions permanently adopted in the IFRs, as
modified by the final rule, where applicable, remain in effect:
1. Title 32 CFR 199.6(b)(4)(xxi) and paragraph 199.14(c): Addition
of freestanding End Stage Renal Disease (ESRD) facilities as authorized
institutional providers and adoption of a reimbursement system for
freestanding ESRD facilities.
2. Title 32 CFR 199.14(a)(1)(iv)(A): Adoption of Medicare's New
Technology Add On Payments; permanent, special payments that are
offered because new medical services and new technologies are not yet
included in the calculation of standardized DRG rates.
3. Title 32 CFR 199.14(a)(1)(iv)(B): Adoption of Medicare's
Hospital Value Based Purchasing Program.
E. The Department is evaluating certain temporary provisions
adopted in the IFRs not yet finalized in a final rule (specifically,
temporary coverage of the treatment use of investigational drugs
approved under FDA expanded access program, NIAID-sponsored clinical
trials, and NCTAPs). If the ASD(HA) determines permanent changes to the
regulation are required, such changes would be announced in future
final rules. The effective date of such coverage would be announced in
the final rule. Until such rules publish, these provisions expire as
stated in the original IFRs and announced in this notice.
Dated: June 7, 2023.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2023-12479 Filed 6-9-23; 8:45 am]
BILLING CODE 5001-06-P
</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>Indexed from Federal Register on June 12, 2023.
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.