[Federal Register Volume 68, Number 109 (Friday, June 6, 2003)]
[Notices]
[Pages 34008-34009]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-14290]


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DEPARTMENT OF LABOR

Employment Standards Administration


Proposcd 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 collection: Health Insurance Claim 
Form (OWCP-1500). A copy 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 August 5, 2003.

ADDRESSES: Ms. Hazel M. Bell, U.S. Department of Labor, 200 
Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone 
(202) 693-0418, fax (202) 693-1451, Email esa.gov">[email protected]esa.gov. 
Please use only one method of transmission for comments (mail, fax, or 
Email).

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.), 
the Black Lung Benefits Act (BLBA) (30 U.S.C. 901 et seq.) and the 
Energy Employees Occupational Illness Compensation Program Act of 2000 
(EEOICPA), 42 U.S.C. 7384 et seq. All three of these statutes require 
that OWCP pay for medical treatment of beneficiaries; BLBA also 
requires that OWCP pay for medical examinations and related diagnostic 
services to determine eligibility for benefits under that statute. The 
OWCP-1500 is a form

[[Page 34009]]

used by bill payment staff to process requests for payment for medical 
services provided by medical professionals other than hospitals, 
pharmacies, and certain other providers. This information collection is 
currently approved for use through November 30, 2003.

II. Review Focus

    The Department of Labor is particularly interested in comments 
which:
    [sbull] 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;
    [sbull] 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;
    [sbull] Enhance the quality, utility and clarity of the information 
to be collected; and
    [sbull] 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 Actions

    The Department of Labor seeks approval for the extension of this 
information collection in order to carry out its responsibility to 
provide payment for certain covered medical services to injured 
employees who are covered under FECA, BLBA and EEOICPA.
    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title: Health Insurance Claim Form.
    OMB Number: 1215-0055.
    Agency Number: OWCP-1500.
    Affected Public: Individual or households; business or other for-
profit; not-for-profit institutions.
    Total Respondents: 533,427.
    Total Responses: 2,133,708.
    Time per Response: 7 minutes.
    Frequency: On occasion.
    Estimated Total Burden Hours: 248,812.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $0.
    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 2, 2003.
Bruce Bohanon,
Chief, Branch of Management Review and Internal Control, Division of 
Financial Management, Office of Management, Administration and 
Planning,Employment Standards Administration.
[FR Doc. 03-14290 Filed 6-5-03; 8:45 am]
BILLING CODE 4510-CH-P