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IMMEDIATE ACTION NEEDED

The BOP will begin charging inmates $2.00 per health care visitif this proposed rule is implemented. The BOP will take comments on the proposed rule change until December 9, 2002. Federal CURE needs you to send letters to your Senators, Representatives, and to the Bureau of Prisons opposing this rule. Federal CURE’s letter to the BOP is included at the end of this message. Please feel free to use it as a sample letter and adapt it for your use.

Letters to the BOP should be addressed to:

Sarah Qureshi
Office of General Counsel
Bureau of Prisons
320 First Street, NW
Washington, DC 20534
Phone: (202) 307-2105
E-Mail: squreshi@bop.gov

THE FOLLOWING WAS TAKEN DIRECTLY FROM THE FEDERAL REGISTER

Under the Federal Prisoner Health Care Copayment Act of 2000 (Pub. L. 106-294, October 12, 2000, 114 Stat. 1038), the Bureau of Prisons may assess and collect a fee for health care services provided in connection with certain kinds of inmate health care visits. In this document, we propose rules describing procedures we will follow for charging inmates health service fees for certain kinds of health care services.

Who Do These Rules Apply To?

These rules apply to anyone incarcerated in an institution under
our jurisdiction and to anyone, as designated by the Director, who has been charged with or convicted of an offense against the United States.

What Will This Rule Do?

Through this rule, the Bureau will add a subpart F to its
regulations in 28 CFR part 549, on Medical Services. Under these rules, an inmate must pay a $2.00 fee for health care services if (1) he/she receives services in connection with a visit that he/she requested, except for certain services, or (2) he/she injured an inmate who, as a result of the injury, needs a health care visit.
Under these rules, and under the Federal Prisoner Health Care
Copayment Act of 2000, we will not charge fees for health care services based on staff referrals, staff-approved follow-up treatment for a chronic condition, preventative health care services, emergency
services, prenatal care, diagnosis or treatment of chronic infectious
diseases, mental health care, or substance abuse treatment.
If inmates disagree with a health care service fee that we charge
them, they may appeal it through the Bureau's Administrative Remedy
Program. Also, if an inmate is indigent and unable to pay the health care service fee, we will not charge that inmate.

Where To Send Comments

You can send written comments on this rule to the:

Rules Unit,
Office of General Counsel, Bureau of Prisons, 320 First Street, NW.,
Washington, DC 20534

We will consider comments received during the comment period before taking final action. We will try to consider comments received after the end of the comment period. In light of comments received, we may change the rule.
We do not plan to have oral hearings on this rule. All the comments received remain on file for public inspection at the above address.

Kathleen Hawk Sawyer,
Director, Bureau of Prisons

ACTUAL PROPOSED LANGUAGE IMPLEMENTING CHARGES

Under rulemaking authority vested in the Attorney General in 5
U.S.C. 552(a) and delegated to the Director, Bureau of Prisons, we propose to amend 28 CFR part 549 as follows.

SUBCHAPTER C--INSTITUTIONAL MANAGEMENT

PART 549--MEDICAL SERVICES

1. Revise the authority citation for 28 CFR 549 to read as follows:

Authority: 5 U.S.C. 301; 18 U.S.C. 3621, 3622, 3624, 4001, 4005,
4014, 4042, 4045, 4081, 4082, (Repealed in part as to offenses
committed on or after November 1, 1987), 4241-4247, 5006-5024
(Repealed October 12, 1984, as to offenses committed after that
date), 5039; 28 U.S.C. 509, 510.

2. Add a new Subpart F to read as follows:

Subpart F--Fees for Health Care Services

Sec.
549.70 Purpose and scope.
549.71 Inmates affected.
549.72 Services provided without fees.
549.73 Appealing the fee.
549.74 Inmates without funds.

Sec. 549.70 Purpose and scope.

(a) The Bureau of Prisons (Bureau) may, under certain
circumstances, charge you, an inmate under our care and custody, a fee for providing you with health care services.
(b) Generally, if you are an inmate as described in Sec. 549.71,
you must pay a fee for health care services of $2.00 per health care
visit if you:
(1) Receive health care services in connection with a health care
visit that you requested, (except for services described in Sec.
549.72); or
(2) Are found responsible through the Disciplinary Hearing Process to have injured an inmate who, as a result of the injury, requires a health care visit.

Sec. 549.71 Inmates affected.

This subpart applies to:
(a) Any individual incarcerated in an institution under the
Bureau's jurisdiction; or
(b) Any other individual, as designated by the Director, who has
been charged with or convicted of an offense against the United States.

Sec. 549.72 Services provided without fees.

We will not charge a fee for:
(a) Health care services based on staff referrals;
(b) Staff-approved follow-up treatment for a chronic condition;
(c) Preventive health care services;
(d) Emergency services;
(e) Prenatal care;
(f) Diagnosis or treatment of chronic infectious diseases;
(g) Mental health care; or
(g) Mental health care; or
(h) Substance abuse treatment.

Sec. 549.73 Appealing the fee.

You may seek review through the Bureau's Administrative Remedy
Program (see 28 CFR part 542) if you disagree with either the fee
charge or the amount.

Sec. 549.74 Inmates without funds.

You will not be charged a health care service fee if you are
considered indigent and unable to pay the health care service fee. The Warden may establish rules and processes to prevent abuses of this provision.

November 15, 2002

Sarah Qureshi
Office of General Counsel
Bureau of Prisons
320 First Street, NW
Washington, DC 20534

RE: 28 CFR 549, Subpart F – Fees for Healthcare Services

Dear Ms. Qureshi:

As Executive Director of Federal CURE, Inc., I am writing to express our opposition to the adoption of the proposed inmate fee for healthcare services. On behalf of the 164,000 federal inmates and their families, please note that without exception all federal inmates are opposed to the adoption of this rule. The extreme financial hardship that this will inflict on most federal inmates combined with the BOP’s concurrent increase in telephone rates is unconscionable.

Alternatively, Federal CURE would suggest the following:

(1) The BOP should facilitate the billing of medical care and prescription drug charges to the hospitalization plans of those inmates whose coverage continues while they are incarcerated.
(2) The BOP should pay reasonable wages for inmate labor instead of the minimal amounts currently paid so that inmates can pay these increased amounts instead of forcing families to bear these additional costs.

Further, it is our belief that once enforced, it creates a liability for the BOP in the form of medical malpractice. Given the tremendous cost of medical malpractice awards in today’s litigious society, it is a given that inmates will file more and more such suits against the BOP. Payment of medical malpractice awards would cost the BOP way more than will be gained by the $2 charge per visit.

On behalf of Federal CURE and the 164,000+ federal inmates whose interests we represent, I respectfully request that you not enact this charge.

With Sincere Regards,

FedCURE