[Federal Register Volume 68, Number 156 (Wednesday, August 13, 2003)]
[Notices]
[Page 48415]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-20579]



[[Page 48415]]

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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 collection: Claim for Medical 
Reimbursement Form (OWCP-915). 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 October 14, 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, e-mail [email protected]. Please 
use only one method of transmission for comments (mail, FAX, or e-
mail).

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. These Acts require OWCP to pay for 
covered medical treatment that is provided to beneficiaries, and also 
to reimburse beneficiaries for any out-of-pocket covered medical 
expenses they have paid. Respondents under BLBA use similar Form CM-915 
(approved under OMB No. 1215-0052) to seek reimbursement for out-of-
pocket medical expenses they have paid, while respondents under the 
EEOICPA use Form EE-915 (approved under OMB No. 1215-0197). OWCP is now 
seeking an extension of the approval for this collection of information 
for respondents under the BLBA and EEOICPA using a new form (Form OWCP-
915) for all three programs. Clearance of the OWCP-915 for use by 
beneficiaries from all three programs is a vital step in the 
unification of OWCP's separate medical bill processing systems under 
one contractor. The OWCP-915 provides a standardized format for the 
beneficiary to bill OWCP for recovery of fees paid in connection with 
their treatment. This information collection is currently approved for 
use through January 31, 2004.

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 the Acts.
    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title: Claim for Medical Reimbursement Form.
    OMB Number: 1215-0193.
    Agency Number: OWCP-915.
    Affected Public: Individual or households; Business or other for-
profit; Not-for-profit institutions.
    Total Respondents: 33,727.
    Total Responses: 134,908.
    Time per Response: 10 minutes.
    Frequency: Quarterly.
    Estimated Total Burden Hours: 22,394.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $148,000.
    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: August 6, 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. 03-20579 Filed 8-12-03; 8:45 am]
BILLING CODE 4510-CR-P