[Federal Register Volume 65, Number 218 (Thursday, November 9, 2000)]
[Notices]
[Pages 67409-67410]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-28797]


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DEPARTMENT OF LABOR

Office of the Secretary


Submission for OMB Review; Comment Request

November 1, 2000.
    The Department of Labor (DOL) has submitted the following public 
information collection requests (ICRs) to the Office of Management and 
Budget (OMB) for review and approval in accordance with the Paperwork 
Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C. Chapter 35). A copy of 
each individual ICR, with applicable supporting documentation, may be 
obtained by calling the Department of Labor. To obtain documentation 
for BLS, ETA, PWBA, and OASAM contact Karin Kurz ((202) 693-4127 or by 
e-mail to [email protected]). To obtain documentation for ESA, MSHA, 
OSHA, and VETS contact Darrin King ((202) 693-4129 or by e-mail to 
[email protected]).
    Comments should be sent to Office of Information and Regulatory 
Affairs, Attn: OMB Desk Officer for BLS, DM, ESA, ETA, MSHA, OSHA, 
PWBA, or VETS, Office of Management and Budget, Room 10235, Washington, 
DC 20503 ((202) 395-7316), within 30 days from the date of this 
publication in the Federal Register.

    The OMB 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 submission of responses.
    Type of Review: Extension of a currently approved collection.
    Agency: Employment Standards Administration (ESA).
    Title: Uniform Health Insurance Claim Form--UB-92.
    OMB Number: 1215-0176.
    Affected Public: Business or other for-profit; not-for-profit 
institutions; Federal

[[Page 67410]]

Government; and individuals or households.
    Frequency: On occasion.
    Number of Respondents: 166,622.
    Number of Annual Responses: 166,622.
    Estimated Time Per Response: 10 minutes.
    Total Burden Hours: 28,538.
    Total Annualized Capital/Startup Costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $0.
    Description: The Office of Workers Compensation Programs (OWCP) 
requests hospitals providing medical services to beneficiaries covered 
under the Federal Employee Compensation Act and the Federal Black Lung 
Benefits Act to bill on the standard form UB-92. This form identifies 
the injured worker, the name of the services provided, the conditions 
being treated and billed amounts. This information is required by OWCP 
to enable reimbursement for covered services.

Ira L. Mills,
Departmental Clearance Officer.
[FR Doc. 00-28797 Filed 11-8-00; 8:45 am]
BILLING CODE 4510-47-M