# PUBLIC COMMENT ON PROPOSED REGULATIONS: Providing a Minimum Evaluation for Bradycardia

**Submitted by the Center for Federal Accountability (CFA)**  
**Document Number:** 2026-01875

## Executive Summary

The Center for Federal Accountability submits this draft comment to support timely public record participation while full model-backed legal analysis is queued. This draft identifies baseline accountability concerns and preserves key issues for agency consideration before the close of comments.

## Table of Authorities (to be finalized)

- Administrative Procedure Act (5 U.S.C. 551 et seq.)
- Agency enabling statute and implementing regulations (rule-specific citations to be finalized)

## Key Concerns

- The agency should clearly identify statutory authority for each material requirement in the proposal.
- The agency should provide transparent cost, burden, and implementation assumptions with reproducible methodology.
- The agency should address foreseeable operational risks and unintended consequences for regulated parties and the public.

## Preliminary Analysis

This preliminary draft is generated from the available Federal Register text excerpt below and is intended to preserve issues for the rulemaking record. A full model-backed CFA legal analysis can be substituted in a subsequent revision.

> Federal Register, Volume 91 Issue 20 (Friday, January 30, 2026) [Federal Register Volume 91, Number 20 (Friday, January 30, 2026)] [Proposed Rules] [Pages 4024-4026] From the Federal Register Online via the Government Publishing Office [ www.gpo.gov ] [FR Doc No: 2026-01875] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 4 RIN 2900-AS40 Providing a Minimum Evaluation for Bradycardia AGENCY: Department of Veterans Affairs. ACTION: Proposed rule. ----------------------------------------------------------------------- SUMMARY: The Department of Veterans Affairs (VA) proposes to revise diagnostic code (DC) 7009, Bradycardia (Bradyarrhythmia), to provide a minimum 10% evaluation after pacemaker implantation. This revision will allow VA to align DC 7009 with DC 7018, Implantable cardiac pacemakers. VA also proposes to remove Note (1) found under DC 7009. DATES: Comments must be received by March 31, 2026. ADDRESSES: You may submit comments through www.regulations.gov under RIN 2900-AS40. That website includes a plain-language summary of this rulemaking. Instructions for accessing agency documents, submitting comments, and viewing the rulemaking docket are available on www.regulations.gov under ``FAQ.'' FOR FURTHER INFORMATION CONTACT: Argentina Hauser and Cintia Darlington, Veterans Benefit Administration, (202) 461-9700. SUPPLEMENTARY INFORMATION: I. Background VA published a final rule in the Federal Register at 86 FR 54089 on September 30, 2021, that amended the portion of the rating schedule that addresses the cardiovascular system and added DC 7009 to evaluate symptomatic bradyarrhythmia that requires pacemaker implantation. Bradycardia is characterized by a resting heart rate slower than 60 beats per minute, and bradyarrhythmia is a slow heart rate resulting from an irregular heartbeat or arrhythmia. See ``Bradyarrhythmia,'' Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/23349-bradyarrhythmia (last visited January 12, 2026). Like other types of arrhythmias or heart conditions, providers may recommend…

## CFA Recommendations

1. Publish a clear crosswalk from each proposed requirement to its statutory basis.
2. Expand and disclose the quantitative assumptions used in cost-benefit analysis.
3. Provide implementation alternatives and phase-in options to reduce compliance risk.
4. Extend or reopen comment if substantial updates are made after publication.

## CFA Contact

Center for Federal Accountability (CFA)  
8401 Mayland Dr # 7387  
Richmond, VA 23294  
policy@federalaccountability.com | https://www.federalaccountability.com/

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_Generated via cursor provider fallback at 2026-03-23T20:58:36.738862+00:00._