80 FR 43800 - Proposed Extension of Existing Collection; Comment Request

DEPARTMENT OF LABOR
Office of Workers' Compensation Programs

Federal Register Volume 80, Issue 141 (July 23, 2015)

Page Range		43800-43801
FR Document		2015-18001

The Department of Labor, as part of its continuing effort to reduce paperwork and respondent burden, conducts a preclearance consultation program to provide the general public and Federal agencies with an opportunity to comment on proposed and/or continuing collections of information in accordance with the Paperwork Reduction Act of 1995 (PRA95) [44 U.S.C. 3506(c)(2)(A)]. This program helps to ensure that requested data can be provided in the desired format, reporting burden (time and financial resources) is minimized, collection instruments are clearly understood, and the impact of collection requirements on respondents can be properly assessed. Currently, the Office of Workers' Compensation Programs is soliciting comments concerning the proposed extension of the existing collection: Uniform Billing Form (OWCP-04). A copy of the proposed information collection request can be obtained by contacting the office listed below in the addresses section of this Notice.

Federal Register, Volume 80 Issue 141 (Thursday, July 23, 2015)

[Federal Register Volume 80, Number 141 (Thursday, July 23, 2015)]
[Notices]
[Pages 43800-43801]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-18001]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Proposed Extension of Existing Collection; Comment Request

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Department of Labor, as part of its continuing effort to 
reduce paperwork and respondent burden, conducts a preclearance 
consultation program to provide the general public and Federal agencies 
with an opportunity to comment on proposed and/or continuing 
collections of information in accordance with the Paperwork Reduction 
Act of 1995 (PRA95) [44 U.S.C. 3506(c)(2)(A)]. This program helps to 
ensure that requested data can be provided in the desired format, 
reporting burden (time and financial resources) is minimized, 
collection instruments are clearly understood, and the impact of 
collection requirements on respondents can be properly assessed. 
Currently, the Office of Workers' Compensation Programs is soliciting 
comments concerning the proposed extension of the existing collection: 
Uniform Billing Form (OWCP-04). A copy of the proposed information 
collection request can be obtained by contacting the office listed 
below in the addresses section of this Notice.

[[Page 43801]]


DATES: Written comments must be submitted to the office listed in the 
addresses section below on or before September 21, 2015.

ADDRESSES: Ms. Yoon Ferguson, U.S. Department of Labor, 200 
Constitution Ave. NW., Room S-3323, Washington, DC 20210, telephone/fax 
(202) 354-9647, Email ferguson.yoon@dol.gov. Please use only one method 
of transmission for comments (mail, fax, or Email).

SUPPLEMENTARY INFORMATION:
    I. Background: The Office of Workers' Compensation Programs (OWCP) 
is the agency responsible for administration of the Federal Employees' 
Compensation Act (FECA), 5 U.S.C. 8101 et seq., the Black Lung Benefits 
Act (BLBA), 30 U.S.C. 901 et seq., and the Energy Employees 
Occupational Illness Compensation Program Act of 2000 (EEOICPA), 42 
U.S.C. 7384 et seq. All three of these statutes require that OWCP pay 
for medical treatment of beneficiaries; this medical treatment can 
include inpatient/outpatient hospital services, as well as services 
provided by nursing homes, skilled nursing facilities and home health 
aides in the home. In order to determine whether billed amounts are 
appropriate, OWCP needs to identify the patient, the specific services 
that were rendered and their relationship to the work-related injury or 
illness. The regulations implementing these statutes require the use of 
Form OWCP-04 or UB-04 for the submission of medical bills from 
institutional providers (20 CFR 10.801, 30.701, 725.405, 725.406, 
725.701 and 725.704). The Uniform Billing form, known as the paper UB-
04, has been approved by the American Hospital Association, the Centers 
for Medicare and Medicaid Services and the Civilian Health and Medical 
Program of Uniformed Services (CHAMPUS), by various other government 
health care providers, and the private sector, to request payment to 
institutional providers of medical services. The paper UB-04 has been 
designed by the National Uniform Billing Committee and is neither a 
government-printed form nor distributed by OWCP. However, this 
collection includes the paper UB-04 as a collection instrument, with 
detailed instructions prepared by OWCP to ensure that it obtains only 
the information needed to consider requests for payment from 
institutional providers using this billing form. This information 
collection is currently approved for use through January 31, 2016.
    II. Review Focus: The Department of Labor is particularly 
interested in comments which:
    * Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    * evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    * enhance the quality, utility and clarity of the information to be 
collected; and
    * minimize the burden of the collection of information on those who 
are to respond, including through the use of appropriate automated, 
electronic, mechanical, or other technological collection techniques or 
other forms of information technology, e.g., permitting electronic 
submissions of responses.
    III. Current Actions: The Department of Labor seeks the approval of 
the extension of this currently approved information collection in 
order to carry out its responsibility to provide payment for covered 
medical services to beneficiaries who are covered under FECA, BLBA and 
EEOICPA.
    Type of Review: Extension.
    Agency: Office of Workers' Compensation Programs.
    Title: Uniform Billing Form.
    OMB Number: 1240-0019.
    Agency Number: OWCP-04.
    Affected Public: Individuals or households; Businesses or other 
for-profit; Not-for-profit institutions.
    Total Respondents: 6,277.
    Total Responses: 221,992.
    Time per Response: 1-7 minutes
    Estimated Total Burden Hours: 25,503.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $0.
    Comments submitted in response to this notice will be summarized 
and/or included in the request for Office of Management and Budget 
approval of the information collection request; they will also become a 
matter of public record.

    Dated: July 17, 2015.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs, US 
Department of Labor.
[FR Doc. 2015-18001 Filed 7-22-15; 8:45 am]
 BILLING CODE 4510-CR-P

43800 Federal Register / Vol. 80, No. 141 / Thursday, July 23, 2015 / Notices

OMB Control Number: 1210–0144. I. Background: The Office of Workers’ Agency: Office of Workers’
Affected Public: Private Sector- Compensation Programs (OWCP) is the Compensation Programs.
businesses or other for-profits and not- agency responsible for administration of Title: Overpayment Recovery
for-profit institutions. the Federal Employees’ Compensation Questionnaire.
Total Estimated Number of Act (FECA), 5 U.S.C. 8101 et seq., the OMB Number: 1240–0051.
Respondents: 276,000. Black Lung Benefits Act (BLBA), 30 Agency Number: OWCP–20.
Total Estimated Number of U.S.C. 901 et seq., and the Energy Affected Public: Individuals and
Responses: 276,000. Employees Occupational Illness households.
Total Estimated Annual Time Burden: Compensation Program Act of 2000 Total Respondents: 3,393.
2,000 hours. (EEOICPA), 42 U.S.C. 7384 et seq. This Total Responses: 3,393.
Total Estimated Annual Other Costs information collection is used by OWCP Time per Response: 1 hour.
Burden: $1,100,000. examiners to ascertain the financial Estimated Total Burden Hours: 3,393.
Dated: July 16, 2015. condition of the beneficiary to Total Burden Cost (capital/startup):
Michel Smyth, determine if the overpayment or any $0.
Departmental Clearance Officer. part can be recovered; to identify the Total Burden Cost (operating/
[FR Doc. 2015–18002 Filed 7–22–15; 8:45 am] possible concealment or improper maintenance): $1,954.
BILLING CODE 4510–29–P
transfer of assets; and to identify and Comments submitted in response to
consider present and potential income this notice will be summarized and/or
and current assets for enforced included in the request for Office of
DEPARTMENT OF LABOR collection proceedings. The Management and Budget approval of the
questionnaire provides a means for the information collection request; they will
Office of Workers’ Compensation beneficiary to explain why he/she is also become a matter of public record.
Programs without fault in an overpayment matter. Dated: July 17, 2015.
If this information were not collected Yoon Ferguson,
Proposed Extension of Existing BLBA, EEOICPA and FECA would have
Collection; Comment Request Agency Clearance Officer, Office of Workers’
little basis to determine appropriate Compensation Programs, US Department of
collection proceedings. This Labor.
ACTION: Notice.
information collection is currently [FR Doc. 2015–18000 Filed 7–22–15; 8:45 am]
SUMMARY: The Department of Labor, as approved for use through December 31,
BILLING CODE 4510–CR–P
part of its continuing effort to reduce 2015.
paperwork and respondent burden, II. Review Focus: The Department of
conducts a preclearance consultation Labor is particularly interested in DEPARTMENT OF LABOR
program to provide the general public comments which:
and Federal agencies with an * evaluate whether the proposed Office of Workers’ Compensation
opportunity to comment on proposed collection of information is necessary Programs
and/or continuing collections of for the proper performance of the
information in accordance with the functions of the agency, including Proposed Extension of Existing
Paperwork Reduction Act of 1995 whether the information will have Collection; Comment Request
(PRA95) [44 U.S.C. 3506(c)(2)(A)]. This practical utility;
program helps to ensure that requested * evaluate the accuracy of the ACTION: Notice.
data can be provided in the desired agency’s estimate of the burden of the
proposed collection of information, SUMMARY: The Department of Labor, as
format, reporting burden (time and
including the validity of the part of its continuing effort to reduce
financial resources) is minimized,
methodology and assumptions used; paperwork and respondent burden,
collection instruments are clearly
* enhance the quality, utility and conducts a preclearance consultation
understood, and the impact of collection
clarity of the information to be program to provide the general public
requirements on respondents can be
collected; and and Federal agencies with an
properly assessed. Currently, the Office
* minimize the burden of the opportunity to comment on proposed
of Workers’ Compensation Programs is
collection of information on those who and/or continuing collections of
soliciting comments concerning the
are to respond, including through the information in accordance with the
proposed collection: Overpayment
Recovery Questionnaire (OWCP–20). A use of appropriate automated, Paperwork Reduction Act of 1995
copy of the proposed information electronic, mechanical, or other (PRA95) [44 U.S.C. 3506(c)(2)(A)]. This
collection request can be obtained by technological collection techniques or program helps to ensure that requested
contacting the office listed below in the other forms of information technology, data can be provided in the desired
addresses section of this Notice. e.g., permitting electronic submissions format, reporting burden (time and
of responses. financial resources) is minimized,
DATES: Written comments must be
III. Current Actions: The Department collection instruments are clearly
submitted to the office listed in the understood, and the impact of collection
of Labor seeks the approval of the
addresses section below on or before requirements on respondents can be
extension of this currently approved
September 21, 2015. properly assessed. Currently, the Office
information collection in order to
ADDRESSES: Ms. Yoon Ferguson, U.S. of Workers’ Compensation Programs is
determine whether or not the recovery
Department of Labor, 200 Constitution
mstockstill on DSK4VPTVN1PROD with NOTICES

of any Black Lung Benefits Act (BLBA), soliciting comments concerning the
Ave., NW., Room S–3323, Washington, Energy Employees Occupational Illness proposed extension of the existing
DC 20210, telephone/fax (202) 354– Compensation Program Act (EEOICPA) collection: Uniform Billing Form
9647, Email ferguson.yoon@dol.gov. or Federal Employees’ Compensation (OWCP–04). A copy of the proposed
Please use only one method of Act (FECA) overpayment may be information collection request can be
transmission for comments (mail or waived, compromised, terminated, or obtained by contacting the office listed
Email). collected in full. below in the ADDRESSES section of this
SUPPLEMENTARY INFORMATION: Type of Review: Extension. Notice.

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Federal Register / Vol. 80, No. 141 / Thursday, July 23, 2015 / Notices 43801

DATES: Written comments must be * Evaluate whether the proposed NATIONAL SCIENCE FOUNDATION
submitted to the office listed in the collection of information is necessary
ADDRESSES section below on or before for the proper performance of the Agency Information Collection
September 21, 2015. functions of the agency, including Activities: Proposed Collection;
ADDRESSES: Ms. Yoon Ferguson, U.S. whether the information will have Comment Request
Department of Labor, 200 Constitution practical utility;
AGENCY: National Science Foundation.
Ave. NW., Room S–3323, Washington, * evaluate the accuracy of the ACTION: Notice.
DC 20210, telephone/fax (202) 354– agency’s estimate of the burden of the
9647, Email ferguson.yoon@dol.gov. proposed collection of information, SUMMARY: The National Science
Please use only one method of including the validity of the Foundation (NSF) is announcing plans
transmission for comments (mail, fax, or methodology and assumptions used; to request renewal of this collection. In
Email). accordance with the requirement of
* enhance the quality, utility and
SUPPLEMENTARY INFORMATION: clarity of the information to be section 3506(c)(2)(A) of the Paperwork
I. Background: The Office of Workers’ collected; and Reduction Act of 1995, we are providing
Compensation Programs (OWCP) is the opportunity for public comment on this
agency responsible for administration of * minimize the burden of the action. After obtaining and considering
the Federal Employees’ Compensation collection of information on those who public comment, NSF will prepare the
Act (FECA), 5 U.S.C. 8101 et seq., the are to respond, including through the submission requesting OMB clearance
Black Lung Benefits Act (BLBA), 30 use of appropriate automated, of this collection for no longer than 3
U.S.C. 901 et seq., and the Energy electronic, mechanical, or other years.
Employees Occupational Illness technological collection techniques or Comments are invited on: (a) Whether
Compensation Program Act of 2000 other forms of information technology, the proposed collection of information
(EEOICPA), 42 U.S.C. 7384 et seq. All e.g., permitting electronic submissions is necessary for the proper performance
three of these statutes require that of responses. of the functions of the Agency,
OWCP pay for medical treatment of III. Current Actions: The Department including whether the information shall
beneficiaries; this medical treatment can of Labor seeks the approval of the have practical utility; (b) the accuracy of
include inpatient/outpatient hospital extension of this currently approved the Agency’s estimate of the burden of
services, as well as services provided by information collection in order to carry the proposed collection of information;
nursing homes, skilled nursing facilities out its responsibility to provide (c) ways to enhance the quality, utility,
and home health aides in the home. In payment for covered medical services to and clarity of the information on
order to determine whether billed beneficiaries who are covered under respondents, including through the use
amounts are appropriate, OWCP needs FECA, BLBA and EEOICPA. of automated collection techniques or
to identify the patient, the specific Type of Review: Extension. other forms of information technology,
services that were rendered and their and (d) ways to minimize the burden of
relationship to the work-related injury Agency: Office of Workers’
the collection of information on
or illness. The regulations implementing Compensation Programs.
respondents, including through the use
these statutes require the use of Form Title: Uniform Billing Form. of automated collection techniques or
OWCP–04 or UB–04 for the submission OMB Number: 1240–0019. other forms of information technology.
of medical bills from institutional DATES: Written comments should be
providers (20 CFR 10.801, 30.701, Agency Number: OWCP–04.
received by September 21, 2015, to be
725.405, 725.406, 725.701 and 725.704). Affected Public: Individuals or assured of consideration. Comments
The Uniform Billing form, known as the households; Businesses or other for- received after that date would be
paper UB–04, has been approved by the profit; Not-for-profit institutions. considered to the extent practicable.
American Hospital Association, the Total Respondents: 6,277. ADDRESSES: Written comments
Centers for Medicare and Medicaid
Services and the Civilian Health and Total Responses: 221,992. regarding the information collection and
Medical Program of Uniformed Services Time per Response: 1–7 minutes requests for copies of the proposed
(CHAMPUS), by various other information collection request should be
Estimated Total Burden Hours: addressed to Suzanne Plimpton, Reports
government health care providers, and 25,503.
the private sector, to request payment to Clearance Officer, National Science
Total Burden Cost (capital/startup): Foundation, 4201 Wilson Blvd., Rm.
institutional providers of medical
$0. 1265, Arlington, VA 22230, or by email
services. The paper UB–04 has been
designed by the National Uniform Total Burden Cost (operating/ to splimpto@nsf.gov.
Billing Committee and is neither a maintenance): $0. FOR FURTHER INFORMATION CONTACT:
government-printed form nor Comments submitted in response to Suzanne Plimpton on (703) 292–7556 or
distributed by OWCP. However, this this notice will be summarized and/or send email to splimpto@nsf.gov.
collection includes the paper UB–04 as included in the request for Office of Individuals who use a
a collection instrument, with detailed Management and Budget approval of the telecommunications device for the deaf
instructions prepared by OWCP to information collection request; they will (TDD) may call the Federal Information
ensure that it obtains only the also become a matter of public record. Relay Service (FIRS) at 1–800–877–
8339, which is accessible 24 hours a
mstockstill on DSK4VPTVN1PROD with NOTICES

information needed to consider requests
Dated: July 17, 2015. day, 7 days a week, 365 days a year
for payment from institutional providers
using this billing form. This information Yoon Ferguson, (including federal holidays).
collection is currently approved for use Agency Clearance Officer, Office of Workers’ SUPPLEMENTARY INFORMATION:
through January 31, 2016. Compensation Programs, US Department of Title of Collection: Monitoring for the
II. Review Focus: The Department of Labor. National Science Foundation’s Math
Labor is particularly interested in [FR Doc. 2015–18001 Filed 7–22–15; 8:45 am] and Science Partnership (MSP) Program.
comments which: BILLING CODE 4510–CR–P OMB Control No.: 3145–0199.

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Document Created: 2015-12-15 12:52:59
Document Modified: 2015-12-15 12:52:59

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		Written comments must be submitted to the office listed in the
FR Citation		80 FR 43800

80 FR 43800 - Proposed Extension of Existing Collection; Comment Request

DEPARTMENT OF LABOROffice of Workers' Compensation Programs

Federal Register Volume 80, Issue 141 (July 23, 2015)

DEPARTMENT OF LABOR
Office of Workers' Compensation Programs