81 FR 9513 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Provider Enrollment Form
DEPARTMENT OF LABOR
Office of the Secretary Federal Register Volume 81, Issue 37 (February 25, 2016)
Office of the Secretary
Federal Register Volume 81, Issue 37 (February 25, 2016)
| Page Range | 9513-9513 | |
| FR Document | 2016-03986 |
[Federal Register Volume 81, Number 37 (Thursday, February 25, 2016)] [Notices] [Page 9513] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2016-03986] ----------------------------------------------------------------------- DEPARTMENT OF LABOR Office of the Secretary Agency Information Collection Activities; Submission for OMB Review; Comment Request; Provider Enrollment Form ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: The Department of Labor (DOL) is submitting the Office of Workers' Compensation Programs (OWCP) sponsored information collection request (ICR) revision titled, ``Provider Enrollment Form,'' to the Office of Management and Budget (OMB) for review and approval for use in accordance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501 et seq.). Public comments on the ICR are invited. DATES: The OMB will consider all written comments that agency receives on or before March 28, 2016. ADDRESSES: A copy of this ICR with applicable supporting documentation; including a description of the likely respondents, proposed frequency of response, and estimated total burden may be obtained free of charge from the RegInfo.gov Web site at http://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=201601-1240-007 or by contacting Michel Smyth by telephone at 202-693-4129, TTY 202-693-8064, (these are not toll-free numbers) or sending an email to [email protected]. Submit comments about this request by mail or courier to the Office of Information and Regulatory Affairs, Attn: OMB Desk Officer for DOL- OWCP, Office of Management and Budget, Room 10235, 725 17th Street NW., Washington, DC 20503; by Fax: 202-395-5806 (this is not a toll-free number); or by email: [email protected]. Commenters are encouraged, but not required, to send a courtesy copy of any comments by mail or courier to the U.S. Department of Labor--OASAM, Office of the Chief Information Officer, Attn: Departmental Information Compliance Management Program, Room N1301, 200 Constitution Avenue NW., Washington, DC 20210; or by email: [email protected]. FOR FURTHER INFORMATION CONTACT: Michel Smyth by telephone at 202-693- 4129, TTY 202-693-8064, (these are not toll-free numbers) or sending an email to [email protected]. Authority: 44 U.S.C. 3507(a)(1)(D). SUPPLEMENTARY INFORMATION: This ICR seeks approval under the PRA for revisions to the Provider Enrollment Form, Form OWCP-1168, information collection that requests profile information on a provider enrolling in one or more OWCP benefit programs, so the OWCP can pay for services rendered to beneficiaries using an automated bill processing system. This information collection has been classified as a revision, because while not affecting burden estimates, the agency has updated Form OWCP- 1168 including the provider letter, Privacy Act statement, and several items on the form and instructions. Federal Employees' Compensation Act section 9, Black Lung Benefits Act section 413, and Energy Employees Occupational Illness Compensation Program Act of 2000 section 3629(c) authorize this information collection. See 5 U.S.C. 8103, 30 U.S.C. 936, and 42 U.S.C. 7384t. This information collection is subject to the PRA. A Federal agency generally cannot conduct or sponsor a collection of information, and the public is generally not required to respond to an information collection, unless it is approved by the OMB under the PRA and displays a currently valid OMB Control Number. In addition, notwithstanding any other provisions of law, no person shall generally be subject to penalty for failing to comply with a collection of information that does not display a valid Control Number. See 5 CFR 1320.5(a) and 1320.6. The DOL obtains OMB approval for this information collection under Control Number 1240-0021. The DOL notes that existing information collection requirements submitted to the OMB receive a month-to-month extension while they undergo review. New requirements would only take effect upon OMB approval. For additional substantive information about this ICR, see the related notice published in the Federal Register on July 7, 2015 (80 FR 38749). Interested parties are encouraged to send comments to the OMB, Office of Information and Regulatory Affairs at the address shown in the ADDRESSES section within thirty (30) days of publication of this notice in the Federal Register. In order to help ensure appropriate consideration, comments should mention OMB Control Number 1240-0021. The OMB is particularly interested in comments that: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 submission of responses. Agency: DOL-OWCP. Title of Collection: Provider Enrollment Form. OMB Control Number: 1240-0021. Affected Public: Private Sector--businesses or other for profits. Total Estimated Number of Respondents: 31,979. Total Estimated Number of Responses: 31,979. Total Estimated Annual Time Burden: 4,252 hours. Total Estimated Annual Other Costs Burden: $16,629. Dated: February 17, 2016. Michel Smyth, Departmental Clearance Officer. [FR Doc. 2016-03986 Filed 2-24-16; 8:45 am] BILLING CODE 4510-CR-P
![Federal Register / Vol. 81, No. 37 / Thursday, February 25, 2016 / Notices 9513
Adjustment Assistance toll free at 888– Washington, DC 20210; or by email: appropriate consideration, comments
365–6822. DOL_PRA_PUBLIC@dol.gov. should mention OMB Control Number
Signed at Washington, DC, this 11th day of FOR FURTHER INFORMATION CONTACT: 1240–0021. The OMB is particularly
February 2016. Michel Smyth by telephone at 202–693– interested in comments that:
Jessica R. Webster, 4129, TTY 202–693–8064, (these are not • Evaluate whether the proposed
Certifying Officer, Office of Trade Adjustment toll-free numbers) or sending an email collection of information is necessary
Assistance. to DOL_PRA_PUBLIC@dol.gov. for the proper performance of the
[FR Doc. 2016–04003 Filed 2–24–16; 8:45 am] Authority: 44 U.S.C. 3507(a)(1)(D). functions of the agency, including
whether the information will have
BILLING CODE 4510–FN–P SUPPLEMENTARY INFORMATION: This ICR practical utility;
seeks approval under the PRA for • Evaluate the accuracy of the
revisions to the Provider Enrollment agency’s estimate of the burden of the
DEPARTMENT OF LABOR Form, Form OWCP–1168, information proposed collection of information,
collection that requests profile including the validity of the
Office of the Secretary
information on a provider enrolling in methodology and assumptions used;
Agency Information Collection one or more OWCP benefit programs, so • Enhance the quality, utility, and
Activities; Submission for OMB the OWCP can pay for services rendered clarity of the information to be
Review; Comment Request; Provider to beneficiaries using an automated bill collected; and
Enrollment Form processing system. This information • Minimize the burden of the
collection has been classified as a collection of information on those who
ACTION: Notice. revision, because while not affecting are to respond, including through the
burden estimates, the agency has use of appropriate automated,
SUMMARY: The Department of Labor updated Form OWCP–1168 including electronic, mechanical, or other
(DOL) is submitting the Office of the provider letter, Privacy Act technological collection techniques or
Workers’ Compensation Programs statement, and several items on the form other forms of information technology,
(OWCP) sponsored information and instructions. Federal Employees’ e.g., permitting electronic submission of
collection request (ICR) revision titled, Compensation Act section 9, Black Lung responses.
‘‘Provider Enrollment Form,’’ to the Benefits Act section 413, and Energy Agency: DOL–OWCP.
Office of Management and Budget Employees Occupational Illness Title of Collection: Provider
(OMB) for review and approval for use Compensation Program Act of 2000 Enrollment Form.
in accordance with the Paperwork section 3629(c) authorize this OMB Control Number: 1240–0021.
Reduction Act (PRA) of 1995 (44 U.S.C. information collection. See 5 U.S.C. Affected Public: Private Sector—
3501 et seq.). Public comments on the 8103, 30 U.S.C. 936, and 42 U.S.C. businesses or other for profits.
ICR are invited. 7384t. Total Estimated Number of
This information collection is subject Respondents: 31,979.
DATES: The OMB will consider all
to the PRA. A Federal agency generally Total Estimated Number of
written comments that agency receives
cannot conduct or sponsor a collection Responses: 31,979.
on or before March 28, 2016.
of information, and the public is Total Estimated Annual Time Burden:
ADDRESSES: A copy of this ICR with generally not required to respond to an 4,252 hours.
applicable supporting documentation; information collection, unless it is Total Estimated Annual Other Costs
including a description of the likely approved by the OMB under the PRA Burden: $16,629.
respondents, proposed frequency of and displays a currently valid OMB
response, and estimated total burden Control Number. In addition, Dated: February 17, 2016.
may be obtained free of charge from the notwithstanding any other provisions of Michel Smyth,
RegInfo.gov Web site at http://www. law, no person shall generally be subject Departmental Clearance Officer.
reginfo.gov/public/do/PRAViewICR?ref_ to penalty for failing to comply with a [FR Doc. 2016–03986 Filed 2–24–16; 8:45 am]
nbr=201601-1240-007 or by contacting collection of information that does not BILLING CODE 4510–CR–P
Michel Smyth by telephone at 202–693– display a valid Control Number. See 5
4129, TTY 202–693–8064, (these are not CFR 1320.5(a) and 1320.6. The DOL
toll-free numbers) or sending an email obtains OMB approval for this DEPARTMENT OF LABOR
to DOL_PRA_PUBLIC@dol.gov. information collection under Control
Submit comments about this request Number 1240–0021. The DOL notes that Office of the Secretary
by mail or courier to the Office of existing information collection
Agency Information Collection
Information and Regulatory Affairs, requirements submitted to the OMB
Activities; Submission for OMB
Attn: OMB Desk Officer for DOL– receive a month-to-month extension
Review; Comment Request; Health
OWCP, Office of Management and while they undergo review. New
Insurance Claim Form
Budget, Room 10235, 725 17th Street requirements would only take effect
NW., Washington, DC 20503; by Fax: upon OMB approval. For additional ACTION: Notice.
202–395–5806 (this is not a toll-free substantive information about this ICR,
number); or by email: OIRA_ see the related notice published in the SUMMARY: The Department of Labor
submission@omb.eop.gov. Commenters Federal Register on July 7, 2015 (80 FR (DOL) is submitting the Office of
mstockstill on DSK4VPTVN1PROD with NOTICES
are encouraged, but not required, to 38749). Workers’ Compensation Programs
send a courtesy copy of any comments Interested parties are encouraged to (OWCP) sponsored information
by mail or courier to the U.S. send comments to the OMB, Office of collection request (ICR) titled, ‘‘Health
Department of Labor—OASAM, Office Information and Regulatory Affairs at Insurance Claim Form,’’ to the Office of
of the Chief Information Officer, Attn: the address shown in the ADDRESSES Management and Budget (OMB) for
Departmental Information Compliance section within thirty (30) days of review and approval for continued use,
Management Program, Room N1301, publication of this notice in the Federal without change, in accordance with the
200 Constitution Avenue NW., Register. In order to help ensure Paperwork Reduction Act (PRA) of 1995
VerDate Sep<11>2014 18:07 Feb 24, 2016 Jkt 238001 PO 00000 Frm 00095 Fmt 4703 Sfmt 4703 E:\FR\FM\25FEN1.SGM 25FEN1](https://thefederalregister.org/doc/81_FR_9550/page/1.svg)
Document Created: 2018-02-02 14:35:24
Document Modified: 2018-02-02 14:35:24
| 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 | The OMB will consider all written comments that agency receives on or before March 28, 2016. | |
| Contact | Michel Smyth by telephone at 202-693- 4129, TTY 202-693-8064, (these are not toll-free numbers) or sending an email to [email protected] | |
| FR Citation | 81 FR 9513 |
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