80 FR 77083 - Agency Information Collection (Foreign Medical Program Application and Claim Cover Sheet)

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 80, Issue 238 (December 11, 2015)

Page Range		77083-77084
FR Document		2015-31235

The Department of Veterans Affairs (VA) published a collection of information notice in a Federal Register on August 14, 2015. The 30- day Federal Register Notice published 11 days after the 60-day Federal Register Notice published. This document corrects the errors by resubmitting a new 30-day Federal Register Notice.

Federal Register, Volume 80 Issue 238 (Friday, December 11, 2015)

[Federal Register Volume 80, Number 238 (Friday, December 11, 2015)]
[Notices]
[Pages 77083-77084]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-31235]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0648]


Agency Information Collection (Foreign Medical Program 
Application and Claim Cover Sheet)

AGENCY: Department of Veterans Affairs.

ACTION: Notice; correction.

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

SUMMARY: The Department of Veterans Affairs (VA) published a collection 
of information notice in a Federal Register on August 14, 2015. The 30-
day Federal Register Notice published 11 days after the 60-day Federal 
Register Notice published. This document corrects the errors by 
resubmitting a new 30-day Federal Register Notice.

FOR FURTHER INFORMATION CONTACT: Brian McCarthy at (202) 461-6345.

Correction

DEPARTMENT OF VETERANS AFFAIRS

Billing Code 8320-01

[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 January 11, 2016.

ADDRESSES: Submit written comments on the collection of information 
through www.Regulations.gov, or to Office of

[[Page 77084]]

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 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: Revision 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.
    An agency may not conduct or sponsor, and a person is not required 
to respond to a collection of information unless it displays a 
currently valid OMB control number. The Federal Register Notice with a 
60-day comment period soliciting comments on this collection of 
information was published at 80 FR 46104 on August 3, 2015.
    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. 2015-31235 Filed 12-10-15; 8:45 am]
 BILLING CODE 8320-01-P

Federal Register / Vol. 80, No. 238 / Friday, December 11, 2015 / Notices 77083

By direction of the Secretary. With respect to the following By direction of the Secretary.
Kathleen M. Manwell, collection of information, VHA invites Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office comments on: (1) Whether the proposed Program Analyst, VA Privacy Service, Office
of Privacy and Records Management, collection of information is necessary of Privacy and Records Management,
Department of Veterans Affairs. for the proper performance of VHA’s Department of Veterans Affairs.
[FR Doc. 2015–31229 Filed 12–10–15; 8:45 am] functions, including whether the [FR Doc. 2015–31160 Filed 12–10–15; 8:45 am]
BILLING CODE 8320–01–P information will have practical utility; BILLING CODE 8320–01–P
(2) the accuracy of VHA’s estimate of
the burden of the proposed collection of
DEPARTMENT OF VETERANS information; (3) ways to enhance the DEPARTMENT OF VETERANS
AFFAIRS quality, utility, and clarity of the AFFAIRS
information to be collected; and (4) [OMB Control No. 2900–0648]
[OMB Control No. 2900–0691] ways to minimize the burden of the
collection of information on Agency Information Collection
Proposed Information Collection respondents, including through the use (Foreign Medical Program Application
(Learner’s Perceptions Survey (LPS)); of automated collection techniques or and Claim Cover Sheet)
Activity: Comment Request the use of other forms of information
technology. AGENCY: Department of Veterans Affairs.
AGENCY: Veterans Health
Administration, Department of Veterans ACTION: Notice; correction.
Titles
Affairs. SUMMARY: The Department of Veterans
1. Learners’ Perceptions Survey PR,
ACTION: Notice. Affairs (VA) published a collection of
VA Form 10–0439.
2. Learners’ Perceptions Survey AH, information notice in a Federal Register
SUMMARY: The Veterans Health on August 14, 2015. The 30-day Federal
Administration (VHA) is announcing an VA Form 10–0439.
OMB Control Number: 2900–0691. Register Notice published 11 days after
opportunity for public comment on the the 60-day Federal Register Notice
proposed collection of certain Type of Review: Revision.
published. This document corrects the
information by the agency. Under the Abstracts errors by resubmitting a new 30-day
Paperwork Reduction Act (PRA) of Federal Register Notice.
1995, Federal agencies are required to Under the authority of Federal Law 38
U.S.C. Part V, Chapter 73, Section 7302, FOR FURTHER INFORMATION CONTACT:
publish notice in the Federal Register
concerning each proposed collection of the Department of Veterans Affairs (VA) Brian McCarthy at (202) 461–6345.
information, including each proposed provides education and training to over Correction
revision of a currently approved 120,000 national cohort of health care
trainees per year to assist in providing DEPARTMENT OF VETERANS
collection, and allow 60 days for public
an adequate supply of health personnel AFFAIRS
comment in response to the notice. This
notice solicits comments on information for VA and the Nation. VA is further Billing Code 8320–01
needed to identify areas for required to evaluate this program on a [OMB Control No. 2900–0648]
improvement in clinical training continuing basis and determine its
programs. effectiveness in achieving its goals Agency Information Collection
(Federal Law, 38 U.S.C. Part I, Chapter (Foreign Medical Program Application
DATES: Written comments and and Claim Cover Sheet) Activities
5, Section 527). In addition, the
recommendations on the proposed Under OMB Review
Government Performance and Results
collection of information should be
Act (GPRA) of 1993, requires Federal AGENCY: Veterans Health
received on or before February 9, 2016.
agencies to set goals, measure Administration, Department of Veterans
ADDRESSES: Submit written comments performance, and report on the
on the collection of information through Affairs.
accomplishments.
the Federal Docket Management System ACTION: Notice.
Affected Public: Individuals or
(FDMS) at www.Regulations.gov; or to households. SUMMARY: In compliance with the
Brian McCarthy, Office of Regulatory Paperwork Reduction Act (PRA) of 1995
and Administrative Affairs, Veterans Estimated Annual Burden (44 U.S.C. 3501–3521), this notice
Health Administration (10B4), a. Learners’ Perceptions Survey PR, announces that the Veterans Health
Department of Veterans Affairs, 810 VA Form 10–0439—3,750 hours. Administration (VHA), Department of
Vermont Avenue NW., Washington, DC b. Learners’ Perceptions Survey AH, Veterans Affairs, will submit the
20420 or email: Brian.McCarthy4@ VA Form 10–0439—3,750 hours. collection of information abstracted
va.gov. Please refer to ‘‘OMB Control below to the Office of Management and
No. 2900–0691’’ in any correspondence. Estimated Average Burden per Budget (OMB) for review and comment.
During the comment period, comments Respondent The PRA submission describes the
may be viewed online through FDMS. a. Learners’ Perceptions Survey PR, nature of the information collection and
FOR FURTHER INFORMATION CONTACT: VA Form 10–0439—15 minutes. its expected cost and burden and
Brian McCarthy at (202) 461–6345. b. Learners’ Perceptions Survey AH, includes the actual data collection
SUPPLEMENTARY INFORMATION: Under the VA Form 10–0439—15 minutes. instrument.
jstallworth on DSK7TPTVN1PROD with NOTICES

PRA of 1995 (Pub. L. 104–13; 44 U.S.C. Frequency of Response: Annually. DATES: Written comments and
3501–3521), Federal agencies must recommendations on the proposed
Estimated Annual Responses collection of information should be
obtain approval from OMB for each
collection of information they conduct a. Learners’ Perceptions Survey PR, received on or before January 11, 2016.
or sponsor. This request for comment is VA Form 10–0439—15,000. ADDRESSES: Submit written comments
being made pursuant to Section b. Learners’ Perceptions Survey AH, on the collection of information through
3506(c)(2)(A) of the PRA. VA Form 10–0439—15,000. www.Regulations.gov, or to Office of

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77084 Federal Register / Vol. 80, No. 238 / Friday, December 11, 2015 / Notices

Information and Regulatory Affairs, that the VA will provide coverage for By direction of the Secretary.
Office of Management and Budget, Attn: the Veteran’s service-connected Kathleen M. Manwell,
VA Desk Officer; 725 17th St. NW., disability when the Veteran is residing Program Analyst, VA Privacy Service, Office
Washington, DC 20503 or sent through or traveling overseas. of Privacy and Records Management,
electronic mail to oira_submission@ VA Form 10–7959f–1, Foreign Department of Veterans Affairs.
omb.eop.gov. Please refer to ‘‘OMB Medical Program (FMP) Registration [FR Doc. 2015–31235 Filed 12–10–15; 8:45 am]
Control No. 2900–0648’’ in any Form, is used to register into the Foreign BILLING CODE 8320–01–P
correspondence. During the comment Medical Program those Veterans with
period, comments may be viewed online service-connected disabilities that are
through the FDMS. living or traveling overseas. Title 38 DEPARTMENT OF VETERANS
FOR FURTHER INFORMATION CONTACT: CFR 17.125(d) states that requests for AFFAIRS
Crystal Rennie, Enterprise Records consideration of claim reimbursement [OMB Control No. 2900–0465]
Service (005R1B), Department of from approved health care providers
Veterans Affairs, 810 Vermont Avenue and Veterans are to be mailed to VHA Agency Information Collection Activity
NW., Washington, DC 20420, (202) 632– Health Administration Center (HAC). Under OMB Review—Student
7492 or email crystal.rennie@va.gov. The VA Form 10–7959f–2, Claim Cover Verification of Enrollment
Please refer to ‘‘OMB Control No. 2900– Sheet—Foreign Medical Program
0648 (Foreign Medical Program AGENCY: Veterans Benefits
streamlines the claims submission
Application and Claim Cover Sheet)’’ in Administration, Department of Veterans
process for claimants or physicians
any correspondence. Affairs
while also reducing the time spent by
SUPPLEMENTARY INFORMATION: Under the VA on processing FMP claims. The ACTION: Notice.
PRA of 1995 (Pub. L. 104–13; 44 U.S.C. cover sheet will allow foreign providers/ SUMMARY: The Veterans Benefits
3501–3521), Federal agencies must Veterans with a better understanding of Administration (VBA) Department of
obtain approval from the Office of basic information required for the Veterans Affairs (VA), is announcing an
Management and Budget (OMB) for each processing and payment of claims. opportunity for public comment on the
collection of information they conduct An agency may not conduct or proposed collection of certain
or sponsor. This request for comment is sponsor, and a person is not required to information by the agency. Under the
being made pursuant to Section respond to a collection of information Paperwork Reduction Act (PRA) of
3506(c)(2)(A) of the PRA. unless it displays a currently valid OMB 1995, Federal agencies are required to
With respect to the following control number. The Federal Register publish notice in the Federal Register
collection of information, VHA invites Notice with a 60-day comment period concerning each proposed collection of
comments on: (1) Whether the proposed soliciting comments on this collection information, including each proposed
collection of information is necessary of information was published at 80 FR revision of a currently approved
for the proper performance of VHA’s 46104 on August 3, 2015. collection, and allow 60 days for public
functions, including whether the comment in response to the notice.
Affected Public: Individuals or
information will have practical utility;
households. DATES: Written comments and
(2) the accuracy of VHA’s estimate of
the burden of the proposed collection of Estimated Annual Burden: recommendations on the proposed
information; (3) ways to enhance the a. Foreign Medical Program (FMP) collection of information should be
quality, utility, and clarity of the Registration Form—fill, VA Form 10– received on or before February 9, 2016.
information to be collected; and (4) 7959f–1—111 hours. ADDRESSES: Submit written comments
ways to minimize the burden of the b. Claim Cover Sheet—Foreign on the collection of information through
collection of information on Medical Program (FMP)—fill, VA Form Federal Docket Management System
respondents, including through the use 10–7959f–2—3,652 hours. (FDMS) at www.Regulations.gov, or to
of automated collection techniques or Nancy J. Kessinger, Veterans Benefits
Estimated Average Burden per Administration (20M33), Department of
the use of other forms of information Respondent:
technology. Veterans Affairs, 810 Vermont Avenue
a. Foreign Medical Program (FMP) NW., Washington, DC 20420 or email to
SUPPLEMENTARY INFORMATION:
Registration Form—fill, VA Form 10– nancy.kessinger@va.gov. Please refer to
Titles:
7959f–1—4 minutes. ‘‘OMB Control No. 2900–0465’’ in any
1. Foreign Medical Program (FMP)
Registration Form. b. Claim Cover Sheet—Foreign correspondence. During the comment
2. Claim Cover Sheet—Foreign Medical Program (FMP)—fill, VA Form period, comments may be viewed online
Medical Program (FMP). 10–7959f–2—11 minutes. through FDMS.
OMB Control Number: 2900–0648. Frequency of Response: FOR FURTHER INFORMATION CONTACT:
Type of Review: Revision of a a. Foreign Medical Program (FMP) Nancy J. Kessinger at (202) 632–8924 or
currently approved collection. Registration Form—fill, VA Form 10– FAX (202) 632–8925.
Abstracts: This information collection 7959f–1—Annually. SUPPLEMENTARY INFORMATION: Under the
is needed to carry out the health care b. Claim Cover Sheet—Foreign PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
benefits allowed by the Foreign Medical Medical Program (FMP)—fill, VA Form 3501–21), Federal agencies must obtain
Program (FMP). It is a federal health 10–7959f–2—12 times a year. approval from the Office of Management
benefits program for Veterans and Budget (OMB) for each collection of
jstallworth on DSK7TPTVN1PROD with NOTICES

administered by the Department of Estimated Annual Responses:
information they conduct or sponsor.
Veterans Affairs (VA) Veterans Health a. Foreign Medical Program (FMP) This request for comment is being made
Administration (VHA). FMP is a Fee for Registration Form—fill, VA Form 10– pursuant to Section 3506(c) (2)(A) of the
Service (indemnity plan) program. FMP 7959f–1—1,660. PRA.
provides reimbursement for VA b. Claim Cover Sheet—Foreign With respect to the following
adjudicated service-connected Medical Program (FMP)—fill, VA Form collection of information, VBA invites
conditions. Title 38 CFR 17.35 states 10–7959f–2—19,920. comments on: (1) Whether the proposed

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Document Created: 2018-03-02 09:13:54
Document Modified: 2018-03-02 09:13:54

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; correction.
Dates		Written comments and recommendations on the proposed collection of information should be received on or before January 11, 2016.
Contact		Brian McCarthy at (202) 461-6345.
FR Citation		80 FR 77083