[Federal Register Volume 71, Number 157 (Tuesday, August 15, 2006)]
[Page 46982]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-13297]



[OMB Control No. 2900-0648]

Agency Information Collection Activities Under OMB Review

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.


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 September 14, 2006.

For Further Information Or A Copy Of The Submission Contact: Denise 
McLamb, Records Management Service (005G2), Department of Veterans 
Affairs, 8l0 Vermont Avenue, NW., Washington, DC 20420, (202) 565-8374 
or fax (202) 565-7045, or e-mail: [email protected]. Please 
refer to ``OMB Control No. 2900-0648.
    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. 
2900-0648 in any correspondence.

    Title: 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 will accept provider's generated 
billing statement, Uniform Billing-Forms (UB) 92, and Medicare Health 
Insurance Claims Form, HCFA 1500 for payments or reimbursements.
    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 June 1, 2006, at pages 31261-31262.
    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: 3,320.
    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: August 7, 2006.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Records Management Service.
[FR Doc. E6-13297 Filed 8-14-06; 8:45 am]