DEPARTMENT OF HEALTH AND HUMAN SERVICES

Social Security Administration

20 CFR Part 404

[Regulations No. 4]

RIN 0960 None Assigned

Federal Old-Age, Survivors and Disability Insurance; Determining Disability
and Blindness; Extension of Expiration Date for Cardiovascular System Listing

AGENCY: Social Security Administration, HHS.

ACTION: Final rule.

SUMMARY: We are extending the date on which parts A and B of the
cardiovascular system listings, found in appendix 1 of part 404, subpart P,
will no longer be effective from January 6, 1994, to February 15, 1994. We
have made no revisions in the medical criteria in the cardiovascular system
listings; they remain the same as they now appear in the Code of Federal
Regulations. We are presently considering comments we received on a Notice of
Proposed Rulemaking (NPRM) to update the medical criteria contained in part A
and part B of the cardiovascular system listings. When we have completed our
review, any revised criteria will be published as final regulations.

EFFECTIVE DATE: This final rule will be effective January 6, 1994.

FOR FURTHER INFORMATION CONTACT:

Irving Darrow, Esq., Legal Assistant, Office of Regulations, Social Security
Administration, 6401 Security Boulevard, Baltimore, MD 21235, (410) 9660512.

SUPPLEMENTARY INFORMATION: On December 6, 1985, a revised Listing of
Impairments in appendix 1 to subpart P of part 404 was published in the
Federal Register (50 FR 50068). The Listing of Impairments describes, for each
of 13 major body systems, impairments that are considered severe enough to
preclude a person from engaging in any gainful activity (part A), or in the
case of a child under the age of 18, impairments that are considered severe
enough to prevent the child from functioning independently, appropriately, and
effectively in an age-appropriate manner (part B). The Listing of Impairments
is used for evaluating disability and blindness at the third step of the
sequential evaluation process for adults and children under the Social
Security disability program and the supplemental security income program.

When the revised Listing of Impairments was published in 1985, we indicated
that medical advances in disability evaluation and treatment and program
experience would require that the listings be periodically reviewed and
updated. Accordingly, we established termination dates ranging from 4 to 8
years for each of the listings for specific body systems. A date of December
6, 1989, was established for the cardiovascular system listings in part A to
no longer be effective. A date of December 6, 1993, was established for part B
of the cardiovascular system listings to no longer be effective.

The potential program impact of the changes to update the cardiovascular
system listings required careful analysis and consideration within the Agency.
As our analysis continued, it became evident that we would be unable to
publish a proposed and then a final regulation containing revised criteria for
part A of the cardiovascular system listings by December 6, 1989. We published
in the Federal Register of December 5, 1989 (54 FR 50233), a final regulation
extending the current part A cardiovascular system listings for a period of 18
months through June 5, 1991. The part A cardiovascular system listings were
again extended an additional 12 months through June 5, 1992, by final
regulation published in the Federal Register on June 6, 1991 (56 FR 26030),
and were extended to January 5, 1993, by final regulation published in the
Federal Register on June 5, 1992 (57 FR 23945), and to July 6, 1993, by final
regulation published in the Federal Register on December 29, 1992 (57 FR
61795). The part A and part B cardiovascular system listings were extended to
January 6, 1994, by final regulation published in the Federal Register on July
6, 1993 (58 FR 36133).

     On July 9, 1991, we published an NPRM proposing revisions to the medical
criteria contained in parts A and B of the cardiovascular system listings (56
FR 31266), with provisions for a 60-day comment period. The complex issues
raised by the numerous comments we received have required extensive analysis
and careful consideration. In order to ensure sufficient time for this review,
we are extending the date on which the current cardiovascular system listings
in parts A and B will no longer be effective from January 6, 1994, to February
15, 1994.

Regulatory Procedures

The Department, even when not required by statute, as a matter of policy,
generally follows the Administrative Procedure Act notice of proposed
rulemaking and public comment procedures specified in 5 U.S.C. 553 in the
development of its regulations. The Administrative Procedure Act provides
exceptions to its notice and public comment procedures when an agency finds
there is good cause for dispensing with such procedures on the basis that they
are impracticable, unnecessary, or contrary to the public interest. We have
determined that, under 5 U.S.C. 553(b)(B), good cause exists for waiver of
notice of proposed rulemaking and public comment procedures on this rule
because it only extends the dates on which parts A and B of the cardiovascular
system listings will no longer be effective and makes no substantive changes
to these listings. The current regulations expressly provide that the listings
may be extended by the Secretary, as well as revised and promulgated again.
Because we are not making any revisions to the current listings, we have
determined that use of public comment procedures is unnecessary under the
Administrative Procedure Act.

Regulatory Flexibility Act

We certify that this regulation will not have a significant economic impact on
a substantial number of small entities. Therefore, a regulatory flexibility
analysis as provided in Public Law 96354, the Regulatory Flexibility Act, is
not required.

Paperwork Reduction Act

This regulation imposes no reporting or recordkeeping requirements
necessitating clearance by the Office of Management and Budget.

(Catalog of Federal Domestic Assistance Program No. 93.802, Social
Security-Disability Insurance; No. 93.807, Supplemental Security Income)

List of Subjects in 20 CFR Part 404

Administrative practice and procedure, Blind, Disability benefits, Old-age,
Survivors and disability insurance, Reporting and recordkeeping requirements.

Dated: December 21, 1993.

Shirley Chater,

Commissioner of Social Security.

Approved: December 29, 1993.

Donna E. Shalala,

Secretary of Health and Human Services.

For the reasons set forth in the preamble, part 404, title 20 of the Code of
Federal Regulations is amended as set forth below.

PART 404 FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950 )

1. The authority citation for subpart P of part 404 is revised to read as
follows:

Authority: Secs. 202, 205 (a), (b), and (d) through (h), 216(i), 221 (a) and
(i), 222(c), 223, 225, and 1102 of the Social Security Act; 42 U.S.C. 402, 405
(a), (b), and (d) through (h), 416(i), 421 (a) and (i), 422(c), 423, 425, and
1302.

2. Appendix 1 to subpart P is amended by revising item 5 of the introductory
text before part A to read as follows:

Appendix 1 to Subpart P Listing of Impairments

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5. Cardiovascular System (4.00 and 104.00): February 15, 1994.

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[FR Doc. 94222 Filed 1594; 8:45 am]

BILLING CODE 419029M


