[Federal Register Volume 69, Number 61 (Tuesday, March 30, 2004)]
[Notices]
[Pages 16530-16531]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-7048]


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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 April 
29, 2004.
    Title, Form, and OMB Number: Professional Qualifications, Medical 
and Peer Reviews; CHAMPUS Form 780; OMB Number 0720-0005.
    Type of Request: Reinstatement.
    Number of Respondents: 60.
    Responses Per Respondents: 60.
    Responses Per Respondent: 1.
    Annual Responses: 60.
    Average Burden Per Response: 15 minutes.
    Annual Burden Hours: 15.
    Needs and Uses: The information collection requirement is necessary 
to obtain and record the professional qualifications of medical and 
peer reviewers utilized within CHAMPUS. The form is included as an 
exhibit in an appeal or hearing case file as evidence of the reviewer's 
professional qualifications to review the medical documentation 
contained in the case file. Respondents are medical professionals who 
provide medical and peer review of cases appealed to the Office of 
Appeals, Hearings and Claims Collection Division, TRICARE Management 
Activity.
    Affected Public: Individuals or households; business or other for-
profit.
    Frequency: On occasion.
    Respondent's Obligation: Voluntary.

    OMB Desk Officer: Mr. John Kraemer.
    Written comments and recommendations on the proposed information 
collection should be sent to Mr. Kraemer at the Office of Management 
and Budget, Desk Officer for DoD Health Affairs, Room 10236, 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/ESCD/Information Management 
Division, 1225 Jefferson Davis Highway, Suite 504, Arlington, VA 22202-
4326.


[[Page 16531]]


    Dated: March 24, 2004.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 04-7048 Filed 3-29-04; 8:45 am]
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