81_FR_42818 81 FR 42692 - Submission for OMB Review; Comment Request

81 FR 42692 - Submission for OMB Review; Comment Request

DEPARTMENT OF DEFENSE
Office of the Secretary

Federal Register Volume 81, Issue 126 (June 30, 2016)

Page Range42692-42692
FR Document2016-15465

The Department of Defense has submitted to OMB for clearance, the following proposal for collection of information under the provisions of the Paperwork Reduction Act.

Federal Register, Volume 81 Issue 126 (Thursday, June 30, 2016) 
[Federal Register Volume 81, Number 126 (Thursday, June 30, 2016)]
[Notices]
[Page 42692]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-15465]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID: DOD-2012-HA-0160]


Submission for OMB Review; Comment Request

ACTION: Notice.

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SUMMARY: The Department of Defense has submitted to OMB for clearance, 
the following proposal for collection of information under the 
provisions of the Paperwork Reduction Act.

DATES: Consideration will be given to all comments received by August 
1, 2016.

FOR FURTHER INFORMATION CONTACT: Fred Licari, 571-372-0493.

SUPPLEMENTARY INFORMATION: 
    Title, Associated Form and OMB Number: Third Party Collection 
Program/Medical Services Account/Other Health Insurance; DD Form 2569; 
OMB Control Number 0720-0055.
    Type of Request: Revision.
    Number of Respondents: 3,900,000.
    Responses per Respondent: 1.5.
    Annual Responses: 5,850,000.
    Average Burden per Response: 4 minutes.
    Annual Burden Hours: 390,000.
    Needs and Uses: The information collection requirement is necessary 
to obtain health insurance policy information used for coordination of 
health care benefits and billing third party payers and other federal 
agencies for health care provided to their beneficiaries and also to 
civilian non-Uniformed Service beneficiaries for health care provided 
to them. DoD implemented the Third Party Collection Program (TPCP) in 
FY87 based on the authority granted in 10 U.S.C. 1095 and implemented 
by 32 CFR 220 in accordance with the Consolidated Omnibus Budget 
Reconciliation Act of 1986 (COBRA) (Pub. L. 99-272, section 2001, April 
7, 1986). Under the TPCP, DoD is authorized to collect from third-party 
payers the cost of inpatient and outpatient services rendered to DoD 
beneficiaries who have other health insurance. Military treatment 
facilities (MTFs) are required to make this form available to third-
party payers upon request. A third-party payer may not request any 
other assignment of benefits form from the subscriber. Also, for 
civilian non-Uniformed Services beneficiary and interagency patients, 
DD Form 2569 is necessary and serves as an assignment of benefits, 
approval to submit claims to payers on behalf of the patient and 
authorization to release medical information.
    Affected Public: Individuals and households.
    Frequency: Annually.
    Respondent's Obligation: Required to Obtain Benefits.
    OMB Desk Officer: Ms. Stephanie Tatham.
    Comments and recommendations on the proposed information collection 
should be emailed to Ms. Stephanie Tatham, DoD Desk Officer, at 
[email protected]. Please identify the proposed information 
collection by DoD Desk Officer and the Docket ID number and title of 
the information collection.
    You may also submit comments and recommendations, identified by 
Docket ID number and title, by the following method:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
    Instructions: All submissions received must include the agency 
name, Docket ID 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.
    DOD Clearance Officer: Mr. Frederick Licari.
    Written requests for copies of the information collection proposal 
should be sent to Mr. Licari at WHS/ESD Directives Division, 4800 Mark 
Center Drive, East Tower, Suite 02G09, Alexandria, VA 22350-3100.

    Dated: June 24, 2016.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2016-15465 Filed 6-29-16; 8:45 am]
BILLING CODE 5001-06-P

42692 Federal Register / Vol. 81, No. 126 / Thursday, June 30, 2016 / Notices services, and Contract Engineering additional U.S. Government or (MTFs) are required to make this form Services. There is no MDE contractor representatives to Iraq. available to third-party payers upon associated with this possible sale. There will be no adverse impact on request. A third-party payer may not The total overall estimated cost is U.S. defense readiness as a result of this request any other assignment of benefits $181 million. proposed sale. form from the subscriber. Also, for (iv) Military Department: Air Force All defense articles and services listed civilian non-Uniformed Services (v) Prior Related Cases, if any: IQ–D– in this transmittal have been authorized beneficiary and interagency patients, DD QAH–$20M–13 FEB 09, IQ–D–QAF– for release and export to the Form 2569 is necessary and serves as an $5M–26 OCT 08 Government of Iraq. (vi) Sales Commission, Fee, etc., Paid, assignment of benefits, approval to [FR Doc. 2016–15476 Filed 6–29–16; 8:45 am] submit claims to payers on behalf of the Offered, or Agreed to be Paid: None (vii) Sensitivity of Technology BILLING CODE 5001–06–P patient and authorization to release Contained in the Defense Article or medical information. Defense Services Proposed to be Sold: DEPARTMENT OF DEFENSE Affected Public: Individuals and None households. (viii) Date Report Delivered to Office of the Secretary Congress: 14 June 2016 Frequency: Annually. * as defined in Section 47(6) of the [Docket ID: DOD–2012–HA–0160] Respondent’s Obligation: Required to Arms Export Control Act. Obtain Benefits. Submission for OMB Review; POLICY JUSTIFICATION Comment Request OMB Desk Officer: Ms. Stephanie The Government of Iraq–AC–208 Tatham. Sustainment, Logistics, and Spares ACTION: Notice. Comments and recommendations on Support SUMMARY: The Department of Defense the proposed information collection The Government of Iraq has requested has submitted to OMB for clearance, the should be emailed to Ms. Stephanie a possible sale of a five-year following proposal for collection of Tatham, DoD Desk Officer, at Oira_ sustainment package for its AC/RC–208 information under the provisions of the submission@omb.eop.gov. Please fleet that includes: Operational, Paperwork Reduction Act. identify the proposed information intermediate, and depot-level DATES: Consideration will be given to all collection by DoD Desk Officer and the maintenance; spare parts; component comments received by August 1, 2016. Docket ID number and title of the repair; publication updates; information collection. FOR FURTHER INFORMATION CONTACT: Fred maintenance training; and logistics. Licari, 571–372–0493. You may also submit comments and Also included in this sale are Contract recommendations, identified by Docket SUPPLEMENTARY INFORMATION: Logistics Services (CLS), training ID number and title, by the following services, and Contract Engineering Title, Associated Form and OMB Number: Third Party Collection method: Services. There is no MDE associated with this possible sale. The total overall Program/Medical Services Account/ • Federal eRulemaking Portal: http:// estimated value is $181 million. Other Health Insurance; DD Form 2569; www.regulations.gov. Follow the The purchase of this sustainment OMB Control Number 0720–0055. instructions for submitting comments. package will allow the Iraqi Air Force Type of Request: Revision. Instructions: All submissions received (IqAF) to continue to operate its fleet of Number of Respondents: 3,900,000. must include the agency name, Docket eight C–208 light attack and Responses per Respondent: 1.5. ID number and title for this Federal Intelligence, Surveillance, and Annual Responses: 5,850,000. Average Burden per Response: 4 Register document. The general policy Reconnaissance (ISR) aircraft beyond for comments and other submissions the June 2016 end of its existing CLS minutes. Annual Burden Hours: 390,000. from members of the public is to make contract. Limited IqAF maintenance these submissions available for public capability necessitates continued CLS. Needs and Uses: The information collection requirement is necessary to viewing on the Internet at http:// Ultimately, the goal is for the IqAF to obtain health insurance policy www.regulations.gov as they are become self-sufficient in the areas of information used for coordination of received without change, including any aircraft maintenance and logistics health care benefits and billing third personal identifiers or contact training. Iraq will have no difficulty absorbing this support. party payers and other federal agencies information. The proposed sale will contribute to for health care provided to their DOD Clearance Officer: Mr. Frederick the foreign policy and national security beneficiaries and also to civilian non- Licari. goals of the United States by helping to Uniformed Service beneficiaries for health care provided to them. DoD Written requests for copies of the improve a critical capability of the Iraq information collection proposal should Security Forces in defeating the Islamic implemented the Third Party Collection Program (TPCP) in FY87 based on the be sent to Mr. Licari at WHS/ESD State of Iraq and the Levant. authority granted in 10 U.S.C. 1095 and Directives Division, 4800 Mark Center The proposed sale of this equipment and support will not alter the basic implemented by 32 CFR 220 in Drive, East Tower, Suite 02G09, military balance in the region. accordance with the Consolidated Alexandria, VA 22350–3100. The principal contractors will be Omnibus Budget Reconciliation Act of mstockstill on DSK3G9T082PROD with NOTICES Dated: June 24, 2016. Orbital ATK in Falls Church, Virginia, 1986 (COBRA) (Pub. L. 99–272, section Aaron Siegel, and Flight Safety International in 2001, April 7, 1986). Under the TPCP, Alternate OSD Federal Register Liaison Flushing, New York. There are no DoD is authorized to collect from third- Officer, Department of Defense. known offset agreements proposed in party payers the cost of inpatient and [FR Doc. 2016–15465 Filed 6–29–16; 8:45 am] connection with this potential sale. outpatient services rendered to DoD Implementation of this proposed sale beneficiaries who have other health BILLING CODE 5001–06–P will not require the assignment of any insurance. Military treatment facilities VerDate Sep<11>2014 20:01 Jun 29, 2016 Jkt 238001 PO 00000 Frm 00064 Fmt 4703 Sfmt 9990 E:\FR\FM\30JNN1.SGM 30JNN1


Document Created: 2018-02-08 07:44:47
Document Modified: 2018-02-08 07:44:47
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesConsideration will be given to all comments received by August 1, 2016.
ContactFred Licari, 571-372-0493.
FR Citation81 FR 42692 
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