[Federal Register Volume 69, Number 58 (Thursday, March 25, 2004)]
[Notices]
[Page 15437]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-6627]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0578]


Agency Information Collection Activities Under OMB Review

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C. 3501-21), this notice announces that the Veterans Health 
Administration (VHA), Department of Veterans Affairs, has submitted the 
collection of information abstracted below to the Office of Management 
and Budget (OMB) for review and comment. The PRA submission describes 
the nature of the information collection and its expected cost and 
burden and includes the actual data collection instrument.

DATES: Comments must be submitted on or before April 26, 2004.

FOR FURTHER INFORMATION OR A COPY OF THE SUBMISSION CONTACT: Denise 
McLamb, Records Management Service (005E3), Department of Veterans 
Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 273-8030, 
FAX (202) 273-5981 or e-mail to: [email protected]. Please 
refer to ``OMB Control No. 2900-0578.''
    Send comments and recommendations concerning any aspect of the 
information collection to VA's OMB Desk Officer, OMB Human Resources 
and Housing Branch, New Executive Office Building, Room 10235, 
Washington, DC 20503, (202) 395-7316. Please refer to ``OMB Control No. 
2900-0578'' in any correspondence.

SUPPLEMENTARY INFORMATION:
    Titles:
    a. Health Care for Certain Children of Vietnam Veterans--Spina 
Bifida and Covered Birth Defects--Regulation.
    b. Claim for Miscellaneous Expenses, VA Form 10-7959e.
    OMB Control Number: 2900-0578.
    Type of Review: Extension of a currently approved collection.
    Abstract: VA's medical regulations 38 CFR part 17 (17.900 through 
17.905) established regulations regarding provision of health care for 
women Vietnam veterans' children born with spina bifida and certain 
other covered birth defects. The information collected will be used to 
determine whether to approve requests for preauthorization of certain 
health care services and benefits for children of Vietnam veterans; the 
appropriateness of billings for such services; and to make decisions 
during the review and appeal process.
    Beneficiaries complete VA Form 10-7959e to claim payment/
reimbursement of expenses related to spina bifida and certain covered 
birth defects. Health care providers complete standard billing forms 
such as: Uniform Billing-Forms (UB) 92, and HCFA 1500, Medicare Health 
Insurance Claims Form. Without the requested information VA will be 
unable to determine the correct amount to reimburse providers for their 
services or beneficiaries for covered expenses.
    An agency may not conduct or sponsor, and a person is not required 
to respond to a collection of information unless it displays a 
currently valid OMB control number. The Federal Register Notice with a 
60-day comment period soliciting comments on this collection of 
information was published on December 10, 2003, at page 68972.
    Affected Public: Individuals or households.
    Estimated Total Annual Burden: 3,400 hours.
    Estimated Average Burden Per Respondent: 6\1/2\ minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 31,400.

    Dated: March 15, 2004.

    By direction of the Secretary.
Loise Russell,
Director, Records Management Service.
[FR Doc. 04-6627 Filed 3-24-04; 8:45 am]
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