[Federal Register Volume 65, Number 130 (Thursday, July 6, 2000)]
[Notices]
[Pages 41731-41732]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-17035]


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DEPARTMENT OF LABOR

Employment Standards Administration


Proposed Collection; Comment Request

ACTION: Notice.

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SUMMARY: The Department of Labor, as part of its continuing effort to 
reduce paperwork and respondent burden, conducts a preclearance 
consultation program to provide the general public and Federal agencies 
with an opportunity to comment on proposed and/or continuing 
collections of information in accordance with the Paperwork Reduction 
Act of 1995 (PRA95) [44 U.S.C. 3506(c)(2)(A)]. This program helps to 
ensure that requested data can be provided in the desired format, 
reporting burden (time and financial resources) is minimized, 
collection instruments are clearly understood, and the impact of 
collection requirements on respondents can be properly assessed. 
Currently, the Employment Standards Administration is soliciting 
comments concerning the proposed extension collection of the following 
information collection: Uniform Health Insurance Claim Form (UB-92). 
Copies of the proposed information collection request can be obtained 
by contacting the office listed below in the addressee section of this 
Notice.

DATES: Written comments must be submitted to the office listed in the 
addressee section below on or before September 5, 2000.

ADDRESSES: Ms. Patricia A. Forkel, U.S. Department of Labor, 200 
Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone 
(202) 693-0339 (this is not a toll-free number), fax (202) 693-1451.

SUPPLEMENTARY INFORMATION:

I. Background

    The Office of Workers' Compensation Programs (OWCP) administers the 
Federal Employees' Compensation Act (FECA) (5 U.S.C. 8101, et seq.) and 
the Federal Black Lung Benefits Act (FBLBA) ( 30 U.S.C. 901 et seq). 
These statutes provide, in addition to compensation for employment-
related injury and/or disability, payment to provider institutions for 
certain medical treatment and diagnostic services related to the injury 
or disability. The Uniform Health Insurance Claim Form (UB-92), has 
been approved by the American Hospital Association, the Health Care 
Financing Administration, and the Civilian Health and Medical Program 
of the Uniformed Services (CHAMPUS), by various other government health 
care programs, and the private sector, for the purpose of payment to 
institutional providers of medical services. The UB-92 has detailed 
instructions developed by OWCP that provide the information necessary 
to providers who file claims for services that may be payable under 
FECA or FBLA.

II. Review Focus

    The Department of Labor is particularly interested in comments 
which:
     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 submissions of responses.

III. Current Action

    The Department of Labor seeks the extension of approval to collect 
this information in order to carry out its rersponsibility to provide 
payment for certain covered medical services to injured employees who 
are covered under the FECA and the FBLBA.
    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title: Uniform Health Insurance Claim Form.
    OMB Number: 1215-0176.
    Agency Number: UB-92.
    Affected Public: Individuals or households, Businesses or other 
for-

[[Page 41732]]

profit; Not-for-profit institutions; Federal Government.
    Total Respondents: 185,550.
    Frequency: On occasion.
    Total Responses: 185,550.
    Time per Response: 6-10.5 minutes.
    Estimated Total Burden Hours: 30,430.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $6,665.
    Comments submitted in response to this notice will be summarized 
and/or included in the request for Office of Management and Budget 
approval of the information collection request; they will also become a 
matter of public record.

    Dated: June 29, 2000.
Margaret J. Sherrill,
Chief, Branch of Management Review and Internal Control, Division of 
Financial Management, Office of Management, Administration and 
Planning, Employment Standards Administration.
[FR Doc. 00-17035 Filed 7-5-00; 8:45 am]
BILLING CODE 4510-47-M