80 FR 48958 - Agency Information Collection (Foreign Medical Program Application and Claim Cover Sheet) Activities Under OMB Review
DEPARTMENT OF VETERANS AFFAIRS Federal Register Volume 80, Issue 157 (August 14, 2015)
Federal Register Volume 80, Issue 157 (August 14, 2015)
| Page Range | 48958-48959 | |
| FR Document | 2015-19965 |
[Federal Register Volume 80, Number 157 (Friday, August 14, 2015)] [Notices] [Pages 48958-48959] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-19965] ----------------------------------------------------------------------- DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0648] Agency Information Collection (Foreign Medical Program Application and Claim Cover Sheet) Activities Under OMB Review AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Health Administration (VHA), Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden and includes the actual data collection instrument. DATES: Written comments and recommendations on the proposed collection of information should be received on or before September 14, 2015. ADDRESSES: Submit written comments on the collection of information through www.Regulations.gov, or to Office of Information and Regulatory Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 17th St. NW., Washington, DC 20503 or sent through electronic mail to [email protected]. Please refer to ``OMB Control No. 2900- 0648'' in any correspondence. During the comment period, comments may be viewed online through the FDMS. FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7492 or email [email protected]. Please refer to ``OMB Control No. 2900-0648'' (Foreign Medical Program Application and Claim Cover Sheet) in any correspondence. SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 U.S.C. 3501-3521), Federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. This request for comment is being made pursuant to Section 3506(c)(2)(A) of the PRA. With respect to the following collection of information, VHA invites [[Page 48959]] comments on: (1) Whether the proposed collection of information is necessary for the proper performance of VHA's functions, including whether the information will have practical utility; (2) the accuracy of VHA's estimate of the burden of the proposed collection of information; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or the use of other forms of information technology. SUPPLEMENTARY INFORMATION: Titles 1. Foreign Medical Program (FMP) Registration Form. 2. CLAIM COVER SHEET--FOREIGN MEDICAL PROGRAM (FMP). OMB Control Number: 2900-0648. Type of Review: Extension of a currently approved collection. Abstracts This information collection is needed to carry out the health care benefits allowed by the Foreign Medical Program (FMP). It is a federal health benefits program for Veterans administered by the Department of Veterans Affairs (VA) Veterans Health Administration (VHA). FMP is a Fee for Service (indemnity plan) program. FMP provides reimbursement for VA adjudicated service-connected conditions. Title 38 CFR 17.35 states that the VA will provide coverage for the Veteran's service- connected disability when the Veteran is residing or traveling overseas. VA Form 10-7959f-1, Foreign Medical Program (FMP) Registration Form, is used to register into the Foreign Medical Program those Veterans with service-connected disabilities that are living or traveling overseas. Title 38 CFR 17.125(d) states that requests for consideration of claim reimbursement from approved health care providers and Veterans are to be mailed to VHA Health Administration Center (HAC). The VA Form 10-7959f-2, Claim Cover Sheet--Foreign Medical Program streamlines the claims submission process for claimants or physicians while also reducing the time spent by VA on processing FMP claims. The cover sheet will allow foreign providers/Veterans with a better understanding of basic information required for the processing and payment of claims. Affected Public: Individuals or households. Estimated Annual Burden a. Foreign Medical Program (FMP) Registration Form--fill, VA Form 10-7959f-1--111 hours. b. CLAIM COVER SHEET--FOREIGN MEDICAL PROGRAM (FMP)--fill, VA Form 10-7959f-2--3,652 hours. Estimated Average Burden per Respondent a. Foreign Medical Program (FMP) Registration Form--fill, VA Form 10-7959f-1--4 minutes. b. CLAIM COVER SHEET--FOREIGN MEDICAL PROGRAM (FMP)--fill, VA Form 10-7959f-2--11 minutes. Frequency of Response a. Foreign Medical Program (FMP) Registration Form--fill, VA Form 10-7959f-1--Annually b. CLAIM COVER SHEET--FOREIGN MEDICAL PROGRAM (FMP)--fill, VA Form 10-7959f-2--12 times a year. Estimated Annual Responses a. Foreign Medical Program (FMP) Registration Form--fill, VA Form 10-7959f-1--1,660. b. CLAIM COVER SHEET--FOREIGN MEDICAL PROGRAM (FMP)--fill, VA Form 10-7959f-2--19,920. By direction of the Secretary. Kathleen M. Manwell, Program Analyst, VA Privacy Service, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2015-19965 Filed 8-13-15; 8:45 am] BILLING CODE 8320-01-P
![48958 Federal Register / Vol. 80, No. 157 / Friday, August 14, 2015 / Notices
consideration of amending the relevant Budget (OMB) for review and comment. DEPARTMENT OF VETERANS
provisions in Chapters Five and Seven The PRA submission describes the AFFAIRS
of the Guidelines Manual. nature of the information collection and
(7) Continuation of its work with its expected cost and burden; it includes [OMB Control No. 2900–0648]
Congress and other interested parties on the actual data collection instrument.
child pornography offenses to Agency Information Collection
DATES: Comments must be submitted on (Foreign Medical Program Application
implement the recommendations set or before September 14, 2015.
forth in the Commission’s December and Claim Cover Sheet) Activities
ADDRESSES: Submit written comments Under OMB Review
2012 report to Congress, titled Federal on the collection of information through
Child Pornography Offenses. www.Regulations.gov, or to Office of AGENCY: Veterans Health
(8) Implementation of the USA Information and Regulatory Affairs, Administration, Department of Veterans
FREEDOM Act of 2015, Public Law Office of Management and Budget, Attn: Affairs.
114–23, and any other crime legislation VA Desk Officer; 725 17th St. NW., ACTION: Notice.
enacted during the 114th Congress Washington, DC 20503 or sent through
warranting a Commission response. electronic mail to oira_submission@ SUMMARY: In compliance with the
(9) Study of animal fighting offenses Paperwork Reduction Act (PRA) of 1995
omb.eop.gov. Please refer to ‘‘OMB
and consideration of any amendments (44 U.S.C. 3501–3521), this notice
Control No. 2900—NEW (Post
to the Guidelines Manual that may be announces that the Veterans Health
Engagement)’’ in any correspondence.
appropriate. Administration (VHA), Department of
(10) Possible consideration of FOR FURTHER INFORMATION CONTACT:
Crystal Rennie, Enterprise Records Veterans Affairs, will submit the
amending the policy statement collection of information abstracted
pertaining to ‘‘compassionate release,’’ Service (005R1B), Department of
Veterans Affairs, 810 Vermont Avenue below to the Office of Management and
§ 1B1.13 (Reduction in Term of Budget (OMB) for review and comment.
Imprisonment as a Result of Motion by NW., Washington, DC 20420, (202) 632–
7492 or email crystal.rennie@va.gov. The PRA submission describes the
Director of Bureau of Prisons). nature of the information collection and
(11) Resolution of circuit conflicts, Please refer to ‘‘OMB Control No.
2900—NEW (Post Engagement)’’ its expected cost and burden and
pursuant to the Commission’s includes the actual data collection
continuing authority and responsibility, SUPPLEMENTARY INFORMATION:
Title: Post Engagement. instrument.
under 28 U.S.C. 991(b)(1)(B) and
Braxton v. United States, 500 U.S. 344 OMB Control Number: 2900—NEW. DATES: Written comments and
(1991), to resolve conflicting Type of Review: New collection. recommendations on the proposed
Abstract: The Office of Small and collection of information should be
interpretations of the guidelines by the
Disadvantaged Business Utilization received on or before September 14,
federal courts.
(12) Consideration of any (OSDBU) needs to measure the return 2015.
miscellaneous guideline application on investment (ROI) the National
Veteran Small Business Engagement ADDRESSES: Submit written comments
issues coming to the Commission’s on the collection of information through
attention from case law and other provides to VA and its attendees. VA
intends to gather data that will allow www.Regulations.gov, or to Office of
sources. Information and Regulatory Affairs,
OSDBU to measure the efficiency of this
Authority: 28 U.S.C. 994(a), (o); USSC event, to learn how to better serve its Office of Management and Budget, Attn:
Rules of Practice and Procedure 5.2.
stakeholders needs, and to share this VA Desk Officer; 725 17th St. NW.,
information with potential attendees. Washington, DC 20503 or sent through
Patti B. Saris,
An agency may not conduct or electronic mail to oira_submission@
Chair, United States Sentencing Commission.
sponsor, and a person is not required to omb.eop.gov. Please refer to ‘‘OMB
[FR Doc. 2015–20109 Filed 8–13–15; 8:45 am] Control No. 2900–0648’’ in any
respond to a collection of information
BILLING CODE 2210–40–P correspondence. During the comment
unless it displays a currently valid OMB
control number. The Federal Register period, comments may be viewed online
Notice with a 60-day comment period through the FDMS.
DEPARTMENT OF VETERANS soliciting comments on this collection FOR FURTHER INFORMATION CONTACT:
AFFAIRS of information was published at 80 FRN Crystal Rennie, Enterprise Records
[OMB Control No. 2900–NEW] 26640 on May 8, 2015. Service (005R1B), Department of
Affected Public: NVSBE attendees, to Veterans Affairs, 810 Vermont Avenue
Agency Information Collection—The include federal employees, small NW., Washington, DC 20420, (202) 632–
Department of Veterans Affairs Office business owners, commercial 7492 or email crystal.rennie@va.gov.
of Small and Disadvantaged Business corporations, and prime contractors. Please refer to ‘‘OMB Control No. 2900–
Utilization Under OMB Review Estimated Annual Burden: 117 hours. 0648’’ (Foreign Medical Program
Estimated Average Burden per Application and Claim Cover Sheet) in
AGENCY: Office of Small and Respondent: 7 minutes.
Disadvantaged Business Utilization any correspondence.
Frequency of Response: Every year SUPPLEMENTARY INFORMATION: Under the
(OSDBU), The Department of Veterans after the NVSBE.
Affairs (VA). PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
Estimated Number of Respondents:
3501–3521), Federal agencies must
asabaliauskas on DSK5VPTVN1PROD with NOTICES
ACTION: Notice. 1,000 per year.
obtain approval from the Office of
SUMMARY: In compliance with the By direction of the Secretary. Management and Budget (OMB) for each
Paperwork Reduction Act (PRA) of 1995 Kathleen M. Manwell, collection of information they conduct
(44 U.S.C. 3501–3521), this notice Program Analyst, VA Privacy Service, Office or sponsor. This request for comment is
announces that OSDBU, Department of of Privacy and Records Management, being made pursuant to Section
Veterans Affairs, has submitted the Department of Veterans Affairs. 3506(c)(2)(A) of the PRA.
collection of information abstracted [FR Doc. 2015–19963 Filed 8–13–15; 8:45 am] With respect to the following
below to the Office of Management and BILLING CODE 8320–01–P collection of information, VHA invites
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![Federal Register / Vol. 80, No. 157 / Friday, August 14, 2015 / Notices 48959
comments on: (1) Whether the proposed Estimated Annual Burden DATES: Written comments and
collection of information is necessary a. Foreign Medical Program (FMP) recommendations on the proposed
for the proper performance of VHA’s Registration Form—fill, VA Form 10– collection of information should be
functions, including whether the 7959f–1—111 hours. received on or before September 14,
information will have practical utility; b. CLAIM COVER SHEET—FOREIGN 2015.
(2) the accuracy of VHA’s estimate of MEDICAL PROGRAM (FMP)—fill, VA ADDRESSES: Submit written comments
the burden of the proposed collection of Form 10–7959f–2—3,652 hours. on the collection of information through
information; (3) ways to enhance the www.Regulations.gov, or to Office of
quality, utility, and clarity of the Estimated Average Burden per
Information and Regulatory Affairs,
information to be collected; and (4) Respondent
Office of Management and Budget, Attn:
ways to minimize the burden of the a. Foreign Medical Program (FMP) VA Desk Officer; 725 17th St. NW.,
collection of information on Registration Form—fill, VA Form 10– Washington, DC 20503 or sent through
respondents, including through the use 7959f–1—4 minutes. electronic mail to oira_submission@
of automated collection techniques or b. CLAIM COVER SHEET—FOREIGN omb.eop.gov. Please refer to ‘‘OMB
the use of other forms of information MEDICAL PROGRAM (FMP)—fill, VA Control No. 2900–0090 (Application for
technology. Form 10–7959f–2—11 minutes. Voluntary Service VA Form 10–7055
SUPPLEMENTARY INFORMATION: Frequency of Response and Associated Internet Application)’’
in any correspondence. During the
Titles a. Foreign Medical Program (FMP)
comment period, comments may be
Registration Form—fill, VA Form 10–
viewed online through the FDMS.
1. Foreign Medical Program (FMP) 7959f–1—Annually
b. CLAIM COVER SHEET—FOREIGN FOR FURTHER INFORMATION CONTACT:
Registration Form.
MEDICAL PROGRAM (FMP)—fill, VA Crystal Rennie, Enterprise Records
2. CLAIM COVER SHEET—FOREIGN Service (005R1B), Department of
MEDICAL PROGRAM (FMP). Form 10–7959f–2—12 times a year.
Veterans Affairs, 810 Vermont Avenue
OMB Control Number: 2900–0648. Estimated Annual Responses NW., Washington, DC 20420, (202) 632–
Type of Review: Extension of a a. Foreign Medical Program (FMP) 7492 or email crystal.rennie@va.gov.
currently approved collection. Registration Form—fill, VA Form 10– Please refer to ‘‘OMB Control No. 2900–
7959f–1—1,660. 0090’’ in any correspondence.
Abstracts b. CLAIM COVER SHEET—FOREIGN SUPPLEMENTARY INFORMATION: Under the
This information collection is needed MEDICAL PROGRAM (FMP)—fill, VA PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
to carry out the health care benefits Form 10–7959f–2—19,920. 3501–3521), Federal agencies must
allowed by the Foreign Medical Program By direction of the Secretary. obtain approval from the Office of
(FMP). It is a federal health benefits Kathleen M. Manwell, Management and Budget (OMB) for each
program for Veterans administered by Program Analyst, VA Privacy Service, Office collection of information they conduct
the Department of Veterans Affairs (VA) of Privacy and Records Management, or sponsor. This request for comment is
Veterans Health Administration (VHA). Department of Veterans Affairs. being made pursuant to Section
FMP is a Fee for Service (indemnity [FR Doc. 2015–19965 Filed 8–13–15; 8:45 am] 3506(c)(2)(A) of the PRA.
plan) program. FMP provides With respect to the following
BILLING CODE 8320–01–P
reimbursement for VA adjudicated collection of information, VHA invites
service-connected conditions. Title 38 comments on: (1) Whether the proposed
CFR 17.35 states that the VA will DEPARTMENT OF VETERANS collection of information is necessary
provide coverage for the Veteran’s AFFAIRS for the proper performance of VHA’s
service-connected disability when the functions, including whether the
[OMB Control No. 2900–0090] information will have practical utility;
Veteran is residing or traveling overseas.
(2) the accuracy of VHA’s estimate of
VA Form 10–7959f–1, Foreign Agency Information Collection
the burden of the proposed collection of
Medical Program (FMP) Registration (Application for Voluntary Service VA
information; (3) ways to enhance the
Form, is used to register into the Foreign Form 10–7055 and Associated Internet
quality, utility, and clarity of the
Medical Program those Veterans with Application)
information to be collected; and (4)
service-connected disabilities that are ways to minimize the burden of the
AGENCY: Veterans Health
living or traveling overseas. Title 38 collection of information on
Administration, Department of Veterans
CFR 17.125(d) states that requests for respondents, including through the use
Affairs.
consideration of claim reimbursement of automated collection techniques or
ACTION: Notice.
from approved health care providers the use of other forms of information
and Veterans are to be mailed to VHA SUMMARY: In compliance with the technology.
Health Administration Center (HAC). Paperwork Reduction Act (PRA) of 1995 SUPPLEMENTARY INFORMATION:
The VA Form 10–7959f–2, Claim Cover (44 U.S.C. 3501–3521), this notice Titles: Application for Voluntary
Sheet—Foreign Medical Program announces that the Veterans Health Service VA Form 10–7055 and
streamlines the claims submission Administration (VHA), Department of Associated Internet Application.
process for claimants or physicians Veterans Affairs, will submit the
asabaliauskas on DSK5VPTVN1PROD with NOTICES
OMB Control Number: 2900–0900,
while also reducing the time spent by collection of information abstracted (Application for Voluntary Service VA
VA on processing FMP claims. The below to the Office of Management and Form 10–7055 and Associated Internet
cover sheet will allow foreign providers/ Budget (OMB) for review and comment. Application).
Veterans with a better understanding of The PRA submission describes the Type of Review: Revision.
basic information required for the nature of the information collection and Abstract: This application (VA Form
processing and payment of claims. its expected cost and burden and 10–7055 and the associated web form)
Affected Public: Individuals or includes the actual data collection will be here-in-after referred to as the
households. instrument. form. The form is used to assist
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Document Created: 2018-02-23 10:59:16
Document Modified: 2018-02-23 10:59:16
| 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 and recommendations on the proposed collection of information should be received on or before September 14, 2015. | |
| Contact | Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7492 or email [email protected] Please refer to ``OMB Control No. 2900-0648'' (Foreign Medical Program Application and Claim Cover Sheet) in any correspondence. | |
| FR Citation | 80 FR 48958 |
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