80 FR 26009 - Proposed Collection; Comment Request

DEPARTMENT OF DEFENSE
Office of the Secretary

Federal Register Volume 80, Issue 87 (May 6, 2015)

Page Range		26009-26010
FR Document		2015-10509

In compliance with the Paperwork Reduction Act of 1995, the Office of the Assistant Secretary of Defense for Health Affairs announces a proposed public information collection and seeks public comment on the provisions thereof. Comments are invited on: (a) Whether the proposed collection of information is necessary for the proper performance of the functions of the agency, including whether the information shall have practical utility; (b) the accuracy of the agency's estimate of the burden of the proposed information collection; (c) ways to enhance the quality, utility, and clarity of the information to be collected; and (d) ways to minimize the burden of the information collection on respondents, including through the use of automated collection techniques or other forms of information technology.

Federal Register, Volume 80 Issue 87 (Wednesday, May 6, 2015)

[Federal Register Volume 80, Number 87 (Wednesday, May 6, 2015)]
[Notices]
[Pages 26009-26010]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-10509]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID: DoD-2015-HA-0038]


Proposed Collection; Comment Request

AGENCY: Office of the Assistant Secretary of Defense for Health 
Affairs, DoD.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the 
Office of the Assistant Secretary of Defense for Health Affairs 
announces a proposed public information collection and seeks public 
comment on the provisions thereof. Comments are invited on: (a) Whether 
the proposed collection of information is necessary for the proper 
performance of the functions of the agency, including whether the 
information shall have practical utility; (b) the accuracy of the 
agency's estimate of the burden of the proposed information collection; 
(c) ways to enhance the quality, utility, and clarity of the 
information to be collected; and (d) ways to minimize the burden of the 
information collection on respondents, including through the use of 
automated collection techniques or other forms of information 
technology.

DATES: Consideration will be given to all comments received by July 6, 
2015.

ADDRESSES: You may submit comments, identified by docket number and 
title, by any of the following methods:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
     Mail: Department of Defense, Office of the Deputy Chief 
Management Officer, Directorate of Oversight and Compliance, Regulatory 
and Audit Matters Office, 9010 Defense Pentagon, Washington, DC 20301-
9010.
    Instructions: All submissions received must include the agency 
name, docket number and title for this Federal Register document. The 
general policy for comments and other submissions from members of the 
public is to make these submissions available for public viewing on the 
Internet at http://www.regulations.gov as they are received without 
change, including any personal identifiers or contact information.
    Any associated form(s) for this collection may be located within 
this same electronic docket and downloaded for review/testing. Follow 
the instructions at http://www.regulations.gov for submitting comments. 
Please submit comments on

[[Page 26010]]

any given form identified by docket number, form number, and title.

FOR FURTHER INFORMATION CONTACT: To request more information on this 
proposed information collection or to obtain a copy of the proposal and 
associated collection instruments, please write to the Defense Health 
Agency, TRICARE, Medical Benefits & Reimbursement Office, 16401 E. 
Centretech Parkway, Aurora, CO 80011, ATTN: Amber Butterfield, or call 
TRICARE, Medical Benefits and Reimbursement Office at (303) 676-3565.

SUPPLEMENTARY INFORMATION: 
    Title; Associated Form; and OMB Number: Health Insurance Claim 
Form, CMS-1500 OMB Control Number 0720-0001.
    Needs and Uses: The information collection requirement is used by 
TRICARE to determine reimbursement for health care services or supplies 
rendered by individual professional providers to TRICARE beneficiaries. 
The requested information is used to determine beneficiary eligibility, 
appropriateness and cost of care, other health insurance liability and 
whether services received are covered benefits.
    Affected Public: Business or other for profit; Not-for-profit 
institutions, Federal government, state, local or tribal government.
    Annual Burden Hours: 22,108,225.
    Number of Respondents: 88,432,900.
    Responses per Respondent: 1.
    Average Burden per Response: 15 minutes.
    Frequency: On occasion.
    Respondents are individual professional providers or healthcare 
related providers, who file for reimbursement of civilian health care 
services or supplies provided to TRICARE beneficiaries under the 
Civilian Health and Medical Program of the Uniformed Services. TRICARE 
is a health benefits entitlement program for active duty, the 
dependents of active duty Uniformed Services member and deceased 
sponsors, retirees and their dependents, dependents of Department of 
Homeland Security (Coast Guard) sponsors, and certain North Atlantic 
Treaty Organizations, National Oceanic and Atmospheric Administration, 
and Public Health Service eligible beneficiaries. Use of this form 
continues TRICARE's commitment to use the national standard claim form 
for reimbursement of services/supplies provided by individual 
professional providers or healthcare related providers, and is accepted 
by all major commercial and government payers.

    Dated: April 30, 2015.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2015-10509 Filed 5-5-15; 8:45 am]
BILLING CODE 5001-06-P

Federal Register / Vol. 80, No. 87 / Wednesday, May 6, 2015 / Notices 26009

SUMMARY: In compliance the Paperwork SUPPLEMENTARY INFORMATION: DEPARTMENT OF DEFENSE
Reduction Act of 1995, the Office of the Title; Associated Form; and OMB
Assistant Secretary of Defense for Office of the Secretary
Number: Active Duty Dental Program
Health Affairs announces a proposed (ADDP) Claim Form; OMB Control [Docket ID: DoD–2015–HA–0038]
public information collection and seeks Number 0720–0053.
public comment on the provisions Proposed Collection; Comment
thereof. Comments are invited on: (a) Needs and Uses: The information
Request
Whether the proposed collection of collection is necessary to obtain and
information is necessary for the proper record the dental readiness of Service AGENCY: Office of the Assistant
performance of the functions of the Members using the Active Duty Dental Secretary of Defense for Health Affairs,
agency, including whether the Program (ADDP) and at the same time DoD.
information shall have practical utility; submit the claim for the dental ACTION: Notice.
(b) the accuracy of the agency’s estimate procedures provided so that claims can
of the burden of the proposed be processed and reimbursement made SUMMARY: In compliance with the
information collection; (c) ways to to the provider. Many Service Members Paperwork Reduction Act of 1995, the
enhance the quality, utility, and clarity are not located near a military dental Office of the Assistant Secretary of
of the information to be collected; and treatment facility and receive their Defense for Health Affairs announces a
(d) ways to minimize the burden of the dental care in the private sector. proposed public information collection
information collection on respondents, and seeks public comment on the
Affected Public: Business or other for provisions thereof. Comments are
including through the use of automated
collection techniques or other forms of profit institutions; Not-for-profit invited on: (a) Whether the proposed
information technology. institutions. collection of information is necessary
DATES: Consideration will be given to all Annual Burden Hours: 25,000. for the proper performance of the
comments received by July 6, 2015. Number of Respondents: 75,000. functions of the agency, including
whether the information shall have
ADDRESSES: You may submit comments, Responses per Respondent: 4. practical utility; (b) the accuracy of the
identified by docket number and title,
Average Burden per Response: 5 agency’s estimate of the burden of the
by any of the following methods:
• Federal eRulemaking Portal: http:// minutes. proposed information collection; (c)
www.regulations.gov. Follow the Frequency: On occasion. ways to enhance the quality, utility, and
instructions for submitting comments. clarity of the information to be
Respondents are dental providers who collected; and (d) ways to minimize the
• Mail: Department of Defense, Office submit claims in order to be reimbursed
of the Deputy Chief Management burden of the information collection on
for delivered dental care. The ADDP respondents, including through the use
Officer, Directorate of Oversight and
Claim form allows civilian dental of automated collection techniques or
Compliance, Regulatory and Audit
Matters Office, 9010 Defense Pentagon, providers to submit the claim for dental other forms of information technology.
Washington, DC 20301–9010. procedures provided to active duty DATES: Consideration will be given to all
Instructions: All submissions received service members and to update their comments received by July 6, 2015.
must include the agency name, docket dental readiness classification at the ADDRESSES: You may submit comments,
number and title for this Federal same time. The completed form is identified by docket number and title,
Register document. The general policy forwarded to the ADDP contractor, by any of the following methods:
for comments and other submissions United Concordia Companies, Inc. for • Federal eRulemaking Portal: http://
from members of the public is to make reimbursement and the electronic www.regulations.gov. Follow the
these submissions available for public update of the dental readiness. If the instructions for submitting comments.
viewing on the Internet at http:// form is not available, civilian providers • Mail: Department of Defense, Office
www.regulations.gov as they are will not have a mechanism to submit of the Deputy Chief Management
received without change, including any dental claims with the information Officer, Directorate of Oversight and
personal identifiers or contact required for reimbursement to provide Compliance, Regulatory and Audit
information. an updated dental readiness Matters Office, 9010 Defense Pentagon,
Any associated form(s) for this classification for the member. Dental Washington, DC 20301–9010.
collection may be located within this readiness classification allows the Instructions: All submissions received
same electronic docket and downloaded Services to ensure that all Service must include the agency name, docket
for review/testing. Follow the Members are ready for worldwide number and title for this Federal
instructions at http:// deployment. Dental readiness is an Register document. The general policy
www.regulations.gov for submitting integral part of medical readiness, and for comments and other submissions
comments. Please submit comments on from members of the public is to make
medical readiness is fundamental to the
any given form identified by docket these submissions available for public
readiness of our forces.
number, form number, and title. viewing on the Internet at http://
FOR FURTHER INFORMATION CONTACT: To Dated: April 30, 2015. www.regulations.gov as they are
request more information on this Aaron Siegel, received without change, including any
proposed information collection or to Alternate OSD Federal Register Liaison personal identifiers or contact
obtain a copy of the proposal and Officer, Department of Defense. information.
tkelley on DSK3SPTVN1PROD with NOTICES

associated collection instruments, [FR Doc. 2015–10513 Filed 5–5–15; 8:45 am] Any associated form(s) for this
please write to the TRICARE Dental BILLING CODE 5001–06–P
collection may be located within this
Care Office, Health Plan Execution and same electronic docket and downloaded
Operation, Defense Health Agency for review/testing. Follow the
(DHA), Rm. 3M451, ATTN: COL Colleen instructions at http://
C. Shull, Falls Church, VA 22042 or call www.regulations.gov for submitting
(703) 681–9517, DSN 761. comments. Please submit comments on

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26010 Federal Register / Vol. 80, No. 87 / Wednesday, May 6, 2015 / Notices

any given form identified by docket Dated: April 30, 2015. DEPARTMENT OF DEFENSE
number, form number, and title. Aaron Siegel,
FOR FURTHER INFORMATION CONTACT: To Alternate OSD Federal Register Liaison Department of the Navy
request more information on this Officer, Department of Defense.
[FR Doc. 2015–10509 Filed 5–5–15; 8:45 am]
Meeting of the U.S. Naval Academy
proposed information collection or to Board of Visitors
obtain a copy of the proposal and BILLING CODE 5001–06–P
associated collection instruments, AGENCY: Department of the Navy, DoD.
please write to the Defense Health ACTION:Notice of partially closed
Agency, TRICARE, Medical Benefits & DEPARTMENT OF DEFENSE meeting.
Reimbursement Office, 16401 E.
Centretech Parkway, Aurora, CO 80011, Department of the Army, Corps of SUMMARY: The U.S. Naval Academy
ATTN: Amber Butterfield, or call Engineers Board of Visitors will meet to make such
TRICARE, Medical Benefits and Termination of Environmental Impact inquiry, as the Board shall deem
Reimbursement Office at (303) 676– Statement for the Gray’s Beach necessary, into the state of morale and
3565. Restoration Project, Waikiki, Island of discipline, the curriculum, instruction,
Oahu, Hawaii physical equipment, fiscal affairs, and
SUPPLEMENTARY INFORMATION:
academic methods of the Naval
Title; Associated Form; and OMB Academy. The executive session of this
Number: Health Insurance Claim Form, AGENCY: U.S. Army Corps of Engineers,
DoD. meeting from 11:00 a.m. to 12:00 p.m.
CMS–1500 OMB Control Number 0720– on June 15, 2015, will include
0001. ACTION: Notice of intent; withdrawal.
discussions of new and pending
Needs and Uses: The information administrative/minor disciplinary
collection requirement is used by SUMMARY: The U.S. Army Corps of
Engineers (Corps), Honolulu District, is infractions and non-judicial punishment
TRICARE to determine reimbursement proceedings involving Midshipmen
for health care services or supplies issuing this notice to advise Federal,
state, and local governmental agencies attending the Naval Academy to include
rendered by individual professional but not limited to individual honor/
providers to TRICARE beneficiaries. The and the public that the Corps is
withdrawing its Notice of Intent (NOI) conduct violations within the Brigade;
requested information is used to the disclosure of which would
determine beneficiary eligibility, to prepare a Draft Environmental Impact
Statement (EIS) for the Gray’s Beach constitute a clearly unwarranted
appropriateness and cost of care, other invasion of personal privacy. For this
health insurance liability and whether Restoration Project located in Waikiki
on the Island of Oahu, Hawaii (Corps reason, the executive session of this
services received are covered benefits. meeting will be closed to the public.
Affected Public: Business or other for File No. POH–2007–00192).
DATES: The open session of the meeting
profit; Not-for-profit institutions, FOR FURTHER INFORMATION CONTACT:
will be held on June 15, 2015, from 9:00
Federal government, state, local or tribal Susan Meyer, Senior Project Manager, a.m. to 11:00 a.m. The executive session
government. Regulatory Office. Mailing address: U.S. held from 11:00 a.m. to 12:00 p.m. will
Annual Burden Hours: 22,108,225. Army Corps of Engineers, Honolulu be the closed portion of the meeting.
Number of Respondents: 88,432,900. District, CEPOH–RO (Attn: Ms. Susan
Meyer), Building 230, Ft. Shafter, ADDRESSES: The meeting will be held at
Responses per Respondent: 1.
Hawaii 96858–5440. Email address: the U.S. Naval Academy, Annapolis,
Average Burden per Response: 15
susan.a.meyer@usace.army.mil. MD. The meeting will be handicap
minutes.
accessible.
Frequency: On occasion. SUPPLEMENTARY INFORMATION: The Corps
Respondents are individual FOR FURTHER INFORMATION CONTACT:
published an NOI in the Federal
professional providers or healthcare Lieutenant Commander Eric Madonia,
Register on November 17, 2008 (73 FR
related providers, who file for USN, Executive Secretary to the Board
67847) to prepare a Draft EIS pursuant
reimbursement of civilian health care of Visitors, Office of the Superintendent,
to the National Environmental Policy
services or supplies provided to U.S. Naval Academy, Annapolis, MD
Act for the proposed Gray’s Beach
TRICARE beneficiaries under the 21402–5000, (410) 293–1503.
Restoration Project. A public scoping
Civilian Health and Medical Program of meeting was held on December 17, 2008 SUPPLEMENTARY INFORMATION: This
the Uniformed Services. TRICARE is a to solicit public input on the scope of notice of meeting is provided per the
health benefits entitlement program for analysis; significant issues to be Federal Advisory Committee Act, as
active duty, the dependents of active evaluated in the Draft EIS; cooperating amended (5 U.S.C. App.). The executive
duty Uniformed Services member and agencies; direct, indirect and session of the meeting from 11:00 a.m.
deceased sponsors, retirees and their cumulative impacts resulting from the to 12:00 p.m. on June 15, 2015, will
dependents, dependents of Department proposed action; and proposed consist of discussions of new and
of Homeland Security (Coast Guard) alternatives. Since that time, the project pending administrative/minor
sponsors, and certain North Atlantic proponent has withdrawn its disciplinary infractions and non-judicial
Treaty Organizations, National Oceanic Department of the Army permit punishment proceedings involving
and Atmospheric Administration, and application and is no longer actively Midshipmen attending the Naval
Public Health Service eligible pursuing the proposed project. Academy to include but not limited to
beneficiaries. Use of this form continues Therefore, the Corps is withdrawing the individual honor/conduct violations
tkelley on DSK3SPTVN1PROD with NOTICES

TRICARE’s commitment to use the NOI to prepare a Draft EIS. within the Brigade. The discussion of
national standard claim form for such information cannot be adequately
reimbursement of services/supplies Christopher W. Crary, segregated from other topics, which
provided by individual professional Lieutenant Colonel, U.S. Army, District precludes opening the executive session
providers or healthcare related Engineer. of this meeting to the public.
providers, and is accepted by all major [FR Doc. 2015–10618 Filed 5–5–15; 8:45 am] Accordingly, the Department of the
commercial and government payers. BILLING CODE 3720–58–P Navy/Assistant for Administration has

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Document Created: 2015-12-16 07:40:47
Document Modified: 2015-12-16 07:40:47

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice.
Dates		Consideration will be given to all comments received by July 6, 2015.
Contact		To request more information on this proposed information collection or to obtain a copy of the proposal and associated collection instruments, please write to the Defense Health Agency, TRICARE, Medical Benefits & Reimbursement Office, 16401 E. Centretech Parkway, Aurora, CO 80011, ATTN: Amber Butterfield, or call TRICARE, Medical Benefits and Reimbursement Office at (303) 676-3565.
FR Citation		80 FR 26009

80 FR 26009 - Proposed Collection; Comment Request

DEPARTMENT OF DEFENSEOffice of the Secretary

Federal Register Volume 80, Issue 87 (May 6, 2015)

DEPARTMENT OF DEFENSE
Office of the Secretary