[Federal Register Volume 71, Number 105 (Thursday, June 1, 2006)]
[Notices]
[Pages 31261-31262]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-8413]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0648]


Proposed Information Collection Activity: Proposed Collection; 
Comment Request

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: The Veterans Health Administration (VHA) is announcing an 
opportunity for public comment on the proposed collection of certain 
information by the agency. Under the Paperwork Reduction Act (PRA) of 
1995, Federal agencies are required to publish notice in the Federal 
Register concerning each proposed collection of information, including 
each proposed revision of a currently approved collection, and allow 60 
days for public comment in response to the notice. This notice solicits 
comments on information needed to reimburse healthcare providers for 
medical services provided to veterans with service-connected 
disabilities living or traveling overseas.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before July 31, 2006.

[[Page 31262]]


ADDRESSES: Submit written comments on the collection of information to 
Ann Bickoff, Veterans Health Administration (193B1), Department of 
Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420 or e-
mail [email protected]. Please refer to ``OMB Control No. 2900-
0648'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Ann Bickoff at (202) 273-8310.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Public Law 104-13; 44 
U.S.C. 3501-3521), Federal agencies must obtain approval from the 
Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. This request for comment is being 
made pursuant to Section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VHA 
invites comments on: (1) Whether the proposed collection of information 
is necessary for the proper performance of VHA's functions, including 
whether the information will have practical utility; (2) the accuracy 
of VHA's estimate of the burden of the proposed collection of 
information; (3) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (4) ways to minimize the burden of 
the collection of information on respondents, including through the use 
of automated collection techniques or the use of other forms of 
information technology.
    Title and Form Number: Foreign Medical Program, VA Form 10-7959f-1 
and 10-7959f-2.
    OMB Control Number: 2900-0648.
    Type of Review: Revision of a currently approved collection.
    Abstract:
    a. Veterans with service connected disabilities living or traveling 
overseas complete VA Form 10-7959f-1 to enroll in the Foreign Medical 
Program.
    b. Healthcare providers complete VA Form 10-7959f-2 to submit 
claims for payments or reimbursement of expenses relating to veterans 
living or traveling overseas (except for Canada and the Philippines) 
with service-connected disability. VA accepts provider generated 
billing statement, Uniform Billing-Forms (UB) 92, and Medicare Health 
Insurance Claims Form, HCFA 1500 for payments or reimbursements.
    Affected Public: Individuals or households, Business or other for 
profit, and Not for profit institutions.
    Estimated Total Annual Burden: 3,763 hours.
    a. Foreign Medical Program, VA Form 10-7959f-1--111 hours.
    b. Claim Cover Sheet, VA Form 10-7959-2--3,652 hours.
    Estimated Average Burden Per Respondent:
    a. Foreign Medical Program, VA Form 10-7959f-1--4 minutes.
    b. Claim Cover Sheet, VA Form 10-7959-2--11 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 3320.
    a. Foreign Medical Program, VA Form 10-7959f-1--1,660.
    b. Claim Cover Sheet, VA Form 10-7959f-2--1,660.
    Estimated Total Annual Responses: 21,580.
    a. Foreign Medical Program, VA Form 10-7959-1--1,660.
    b. Claim Cover Sheet, VA Form 10-7959-2--19,920.

    Dated: May 17, 2006.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Records Management Service.
[FR Doc. E6-8413 Filed 5-31-06; 8:45 am]
BILLING CODE 8320-01-P