[Federal Register Volume 63, Number 65 (Monday, April 6, 1998)]
[Page 16864]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-8889]



[OMB Control No. 2900-0188]

Agency Information Collection 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 et seq.), this notice announces that the Veterans 
Health Administration (VHA), Department of Veterans Affairs, has 
submitted 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; it includes the actual data collection 

DATES: Comments must be submitted on or before May 6, 1998.

Taylor, Information Management Service (045A4), Department of Veterans 
Affairs, 810 Vermont Avenue, NW, Washington, DC 20420, (202)273-8015 or 
FAX (202)273-5981. Please refer to ``OMB Control No. 2900-0188.''

    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.
    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 
    f. VA Form 10-1394 is used to determine eligibility/entitlement and 
reimbursement of individual claims for automotive adaptive equipment.
    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 on December 31, 1997 at page 68359.
    Affected Public: Business or other for-profit--Individuals or 
    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.
    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.
    Send comments and recommendations concerning any aspect of the 
information collection to VA's OMB Desk Officer, Allison Eydt, OMB 
Human Resources and Housing Branch, New Executive Office Building, Room 
10235, Washington, DC 20503 (202) 395-4650. Please refer to ``OMB 
Control No. 2900-0188'' in any correspondence.

    By direction of the Secretary.

    Dated: March 10, 1998.
Barbara H. Epps,
Management Analyst, Information Management Service.
[FR Doc. 98-8889 Filed 4-3-98; 8:45 am]