[Federal Register Volume 68, Number 130 (Tuesday, July 8, 2003)]
[Notices]
[Pages 40642-40643]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-17128]


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DEPARTMENT OF DEFENSE

Office of the Secretary


Submission for OMB Review; Comment Request

ACTION: Notice.

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    The Department of Defense has submitted to OMB for clearance, the 
following proposal for collection of information under the provisions 
of the Paperwork Reduction Act (44 U.S.C. chapter 35).

DATES: Consideration will be given to all comments received by August 
7, 2003.
    Title and OMB Number: Application for CHAMPUS-Provider Status: 
Corporate Services Provider; OMB Number 0720-0020.
    Type of Request: Reinstatement.
    Number of Respondents: 1,000.
    Responses Per Respondent: 1.
    Annual Responses: 1,000.
    Average Burden Per Response: 20 minutes.
    Annual Burden Hours: 333.
    Needs and Uses: The information collection will allow eligible 
providers to apply for Corporate Services Provider status under the 
TRICARE Program. The collected information will be used by TRICARE 
contractors to process claims and verify authorized provider status. 
The Application for TRICARE-Provider Status: Corporate Services 
Provider, will collect the necessary information to ensure that the 
conditions are met for authorization as a TRICARE corporate services 
provider: ie., The provider (1) is a corporation or a foundation, but 
not a professional corporation or professional foundation; (2) provides 
services and related supplies of a type of rendered by TRICARE 
individual professional providers or diagnostic technical services; (3) 
is approved for Medicare

[[Page 40643]]

payment or when Medicare approval status is not required, is 
accredited, by a qualified accreditation organization; and, (4) has 
entered into a participation agreement approved by the Executive 
Director, TRICARE Management Activity or a designee.
    Affected Public: Business or Other For-Profit; Not-For-Profit 
Institutions.
    Frequency: On Occasion.
    Respondent's Obligation: Required to Obtain or Retain Benefits.
    OMB Desk Officer: Ms. Cristal Thomas.
    Written comments and recommendations on the proposed information 
collection should be sent to Ms. Thomas at the Office of Management and 
Budget, Desk Officer for DoD Health Affairs, Room 10235, New Executive 
Office Building, Washington, DC 20503.
    DoD Clearance Officer: Mr. Robert Cushing.
    Written requests for copies of the information collection proposal 
should be sent to Mr. Cushing, WHS/DIOR, 1215 Jefferson Davis Highway, 
Suite 1204, Arlington, VA 22202-4302.

    Dated: June 30, 2003.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 03-17128 Filed 7-7-03; 8:45 am]
BILLING CODE 5001-08-M