[Federal Register Volume 66, Number 173 (Thursday, September 6, 2001)]
[Notices]
[Pages 46683-46684]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-22314]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0091]


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 the information needed to apply for VA medical 
care, nursing home, domiciliary and dental benefits.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before November 5, 2001.

ADDRESSES: Submit written comments on the collection of information to 
Ann Bickoff, Veterans Health Administration (193B1), Department of 
Veterans Affairs, 810 Vermont Avenue, NW, Washington, DC 20420 or e-
mail [email protected]. Please refer to ``OMB Control No. 2900-
0091'' in any correspondence.

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

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Public Law 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,

[[Page 46684]]

including through the use of automated collection techniques or the use 
of other forms of information technology.
    Title and Form Number: Application for Medical Benefits, VA Form 
10-10EZ.
    OMB Control Number: 2900-0091.
    Type of Review: Extension of a currently approved collection.
    Abstract: The form is used to establish a system of records on 
veterans applying and/or enrolling for VA medical care benefits. The 
information collected is used to establish basic eligibility for VA 
benefits; enroll veterans into the VA health care enrollment system; 
determine a veteran's marital status, next-of-kin and emergency 
contacts for care management and consent purposes; establish 
eligibility for cost free health care, mileage reimbursement and 
prescription co-payment exemption for certain veterans; identify those 
veterans who have third party health insurance for billing purposes to 
recover the cost of medical care furnished to veterans for treatment of 
nonservice-connected conditions; and establish an individual's 
eligibility for other health services, including but not limited to 
nursing home, dental and domiciliary care.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 1,467,447 hours.
    Estimated Average Burden Per Respondent: 45 minutes.
    Frequency of Response: Annually.
    Estimated Number of Respondents: 2,372,766.

    Dated: August 10, 2001.

    By direction of the Secretary.
 Donald L. Neilson,
Director, Information Management Service.
[FR Doc. 01-22314 Filed 9-5-01; 8:45 am]
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