[Federal Register Volume 62, Number 250 (Wednesday, December 31, 1997)]
[Notices]
[Pages 68359-68360]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-34133]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0188]


Proposed Information Collection Activity: Proposed Collection; 
Comment Request

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: The Veterans Health Administration (VHA) is announcing an 
opportunity for public comment on the proposed collection of certain 
information by the agency. Under the Paperwork Reduction Act (PRA) of 
1995, Federal agencies are required to publish notice in the Federal 
Register concerning each proposed collection of information, including 
each proposed extension of a currently approved collection, and allow 
60 days for public comment in response to the notice. This notice 
solicits comments on information needed to determine eligibility, 
prescribe, and authorize prosthetic devices; obtain repair estimates 
and allow for the direct purchase of prosthetic devices; and obtain 
follow-up information on loaned items.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before March 2, 1998.

ADDRESSES: Submit written comments on the collection of information to 
Ann Bickoff, Veterans Health Administration (161A1), Department of 
Veterans Affairs, 810 Vermont Avenue, NW, Washington, DC 20420. Please 
refer to ``OMB Control No. 2900-0188'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Ann Bickoff at (202) 273-8310.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C., 3501 `` 3520), 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) way 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.
    Title: Prescription, Authorization, Application, Procurement, 
Repair and Loan of Prosthetic Items.
    Form Numbers:
    a. VA Form 10-2421, Prosthetic Authorization for Items or Service.
    b. VA Form 10-2520, Prosthetic Service Card Invoice.
    c. VA Form 10-2914, Prescription and Authorization for Eyeglasses.
    d. Form Letter 10-90, Request to Submit Estimate.
    e. Form Letter 10-426, Loan Follow-up Letter.
    f. VA Form 10-1394, Loan Follow-up Letter.
    OMB Control Number: 2900-0188.
    Type of Review: Extension of a currently approved collection.
    Abstract:
    a. VA Form 10-2421 is used for the direct procurement of new 
prosthetic appliances and/or services and standardizes the direct 
procurement authorization process. The form eliminates the need for 
separate purchase orders, expedites patient treatment and improves the 
delivery of prosthetic services. Without this form the delivery time 
for prosthetic appliances and services would be drastically increased.
    b. VA Form 10-2520 is used by the commercial vendors, after 
completing repairs authorized for veterans, to request payment by VA. 
The use of the form standardizes repair/treatment invoices for 
prosthetic services rendered and standardizes the verification of these 
invoices. The veteran certifies that the repairs were necessary and 
satisfactory. This form is furnished to vendors upon request.
    c. VA Form 10-2914 is used as a combination prescription, 
authorization and invoice. It allows veterans to purchase their 
eyeglasses directly. If the form is not used, the provisions of 
providing eyeglasses to eligible veterans may be delayed.
    d. Form Letter 10-90 is issued to a contractor of the veteran's 
choice in order to solicit a price quote for a prosthetic device.
    e. Form Letter 10-426 is used for the issuance of prosthetic 
devices that are loaned to eligible veterans. If the information is not 
collected or maintained, VA would have no information regarding 
equipment loaned to veterans; i.e., status, recovery, replacement and 
disposition.
    f. VA Form 10-1394 is used to determine eligibility/entitlement and 
reimbursement of individual claims for automotive adaptive equipment.
    Affected Public: Business or other for-profit--Individuals or 
households.
    Estimated Total Annual Burden: 36,496 hours.
    a. VA Form 10-2421--16,667 hours.
    b. VA Form 10-2520--3,334 hours.
    c. VA Form 10-2914--11,667 hours.
    d. Form Letter 10-90--1,875 hours.
    e. Form Letter 10-426--242 hours.
    f. VA Form 10-1394--2,711 hours.
    Estimated Average Burden Per Respondent:
    a. VA Form 10-2421--4 minutes.

[[Page 68360]]

    b. VA Form 10-2520--5 minutes.
    c. VA Form 10-2914--4 minutes.
    d. Form Letter 10-90--5 minutes.
    e. Form Letter 10-426--1 minute.
    f. VA Form 10-1394--15 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 512,844.
    a. VA Form 10-2421--250,000.
    b. VA Form 10-2520--40,000.
    c. VA Form 10-2914--175,000.
    d. Form Letter 10-90--22,500.
    e. Form Letter 10-426--14,500.
    f. VA Form 10-1394--10,844.

    Dated: December 2, 1997.

    By direction of the Secretary.
Donald L. Neilson,
Director, Information Management Service.
[FR Doc. 97-34133 Filed 12-30-97; 8:45 am]
BILLING CODE 8320-01-P