[Federal Register Volume 69, Number 59 (Friday, March 26, 2004)]
[Notices]
[Pages 15886-15887]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-6740]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

    Periodically, the Health Resources and Services Administration 
(HRSA)

[[Page 15887]]

publishes abstracts of information collection requests under review by 
the Office of Management and Budget, in compliance with the Paperwork 
Reduction Act of 1995 (44 U.S.C. chapter 35). To request a copy of the 
clearance requests submitted to OMB for review, call the HRSA Reports 
Clearance Office on (301) 443-1129.
    The following request has been submitted to the Office of 
Management and Budget for review under the Paperwork Reduction Act of 
1995:

Proposed Project: The Health Education Assistance Loan (HEAL) Program: 
Physician's Certification of Borrower's Total and Permanent Disability 
Form (OMB No. 0915-0204)--Revision

    The Health Education Assistance (HEAL) program provided federally-
insured loans to students in schools of allopathic medicine, 
osteopathic medicine, dentistry, veterinary medicine, optometry, 
podiatric medicine, pharmacy, public health, allied health, or 
chiropractic, and graduate students in health administration or 
clinical psychology through September 30, 1998. Eligible lenders, such 
as banks, savings and loan associations, credit unions, pension funds, 
State agencies, HEAL schools, and insurance companies, make new 
refinanced HEAL loans which are insured by the Federal Government 
against loss due to borrower's death, disability, bankruptcy, and 
default. The basic purpose of the program was to assure the 
availability of funds for loans to eligible students who needed to 
borrow money to pay for their educational loans. Currently, the program 
refinances previous HEAL loans, monitors the Federal liability, and 
assists in default prevention activities. The HEAL borrower, the 
borrower's physician, and the holder of the loan completes the 
Physician's Certification form to certify that the HEAL borrower meets 
the total and permanent disability provisions.
    The Department uses this form to obtain detailed information about 
disability claims which includes the following: (1) The borrower's 
consent to release medical records to the Department of Health and 
Human Services and to the holder of the borrower's HEAL loans, (2) 
pertinent information supplied by the certifying physician, (3) the 
Physician's Certification that the borrower is unable to engage in any 
substantial gainful activity because of a medically determinable 
impairment that is expected to continue for a long and indefinite 
period of time or to result in death, and (4) information from the 
lender on the unpaid balance. Failure to submit the required 
documentation will result in disapproval of a disability claim.
    The estimate of burden for the Physician's Certification form is as 
follows:

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                                     Number of     Responses per       Total        Minutes per    Total burden
       Type of respondent           respondents     respondent       responses       response          hours
----------------------------------------------------------------------------------------------------------------
Borrower *......................              94               1              94               5               8
Physician.......................              94               1              94              30              47
Lender..........................              23               4              94              10              16
                                 ----------------                ----------------                ---------------
    Total.......................             211  ..............             282  ..............             71
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* Includes 2 categories of borrowers requesting disability waivers: (1) whose loans have previously defaulted
  and (2) whose loans have not defaulted.

    Written comments and recommendations concerning the proposed 
information collection should be sent within 30 days of this notice to: 
Desk Officer, Health Resources and Services Administration, Human 
Resources and Housing Branch, Office of Management and Budget, New 
Executive Office Building, Room 10235, Washington, DC 20503.

    Dated: March 15, 2004.
Tina M. Cheatham,
Director, Division of Policy Review and Coordination.
[FR Doc. 04-6740 Filed 3-25-04; 8:45 am]
BILLING CODE 4165-15-P