[Federal Register Volume 71, Number 135 (Friday, July 14, 2006)]
[Notices]
[Pages 40152-40153]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-11081]


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DEPARTMENT OF LABOR

Office of the Secretary


Submission for OMB Review: Comment Request

July 10, 2006.
    The Department of Labor (DOL) has submitted the following public 
information collection request (ICR) to the Office of Management and 
Budget (OMB) for review and approval in accordance with the Paperwork 
Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C. chapter 35). A copy of 
this ICR, with applicable supporting documentation, may be obtained by 
contacting Darrin King on 202-693-4129 (this is not a toll-free number) 
or e-mail: [email protected].
    Comments should be sent to Office of Information and Regulatory 
Affairs, Attn: OMB Desk Officer for the Employment Standards 
Administration (ESA), Office of Management and Budget, Room 10235, 
Washington, DC 20503, 202-395-7316 (this is not a toll-free number), 
within 30 days from the date of this publication in the Federal 
Register.
    The OMB is particularly interested in comments which:
     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;
     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;
     Enhance the quality, utility, and clarity of the 
information to be collected; and
     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 submission of responses.
    Agency: Employment Standards Administration.
    Type of Review: Extension of currently approved collection.
    Title: Health Insurance Claim Form.
    OMB Number: 1215-0055.
    Form Number: OWCP-1500.
    Frequency: On occasion.
    Type of Response: Reporting.
    Affected Public: Business or other for-profit; Note-for-profit 
institutions; and Individuals or households.
    Number of Respondents: 735,000.
    Estimated Annual Responses: 2,940,000.
    Average Response Time: 7 minutes.
    Annual Burden Hours: 342,908.
    Total Annualized capital/startup costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $0.
    Description: The Office of Workers' Compensation Programs (OWCP) is 
the agency responsible for administration of 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. All three of these statutes require that OWCP pay 
for medical treatment of beneficiaries; BLBA also requires that OWCP 
pay for medical examinations and related diagnostic services to 
determine eligibility for benefits under that statute. In order to 
determine whether billed amounts are appropriate, OWCP needs to 
identify the patient, the injury or illness that was treated or 
diagnosed, the specific services that are rendered and their 
relationship to the work-related injury or illness. The regulations 
implementing these statutes require the use of Form OWCP-1500 for 
medical bills submitted by certain

[[Page 40153]]

physicians and other providers (20 CFR 10.801, 30.701, 725.405, 
725.406, 725.701 and 725.704). The OWCP-1500 is used by OWCP and 
contractor bill payment staff to process bills for medical services 
provided by medical professionals other than medical services provided 
by hospitals, pharmacies, and certain other providers.

Darrin A. King,
Acting Departmental Clearance Officer.
 [FR Doc. E6-11081 Filed 7-13-06; 8:45 am]
BILLING CODE 4510-23-P