[Federal Register Volume 71, Number 161 (Monday, August 21, 2006)]
[Notices]
[Pages 48540-48541]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-7041]


-----------------------------------------------------------------------

DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket No. DOD-2006-HA-0170]


Proposed Collection; Comment Request

AGENCY: Office of the Assistant Secretary of Defense for Health 
Affairs, DoD.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: In compliance with Section 3506(c)(2)(A) of the Paperwork 
Reduction Act of 1995, the Office of the Assistant Secretary of Defense 
for Health Affairs announces the proposed revision of a public 
information collection and seeks public comment on the provisions 
thereof. Comments are invited on: (a) Whether the proposed collection 
of information is necessary for the proper performance of the functions 
of the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of the burden of the 
proposed information collection; (c) ways to enhance the quality, 
utility, and clarity of the information to be collected; and (d) ways 
to minimize the burden of the information collection on respondents, 
including through the use of automated collection techniques or other 
forms of information technology.

DATES: Consideration will be given to all comments received by October 
20, 2006.

ADDRESSES: You may submit comments, identified by docket number and 
title, by any of the following methods:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
     Mail: Federal Docket Management System Office, 1160 
Defense Pentagon, Washington, DC 20301-1160.
    Instructions: All submissions received must include the agency 
name, docket number and title for this Federal Register document. The 
general policy for comments and other submissions from members of the 
public is to make these submissions available for public viewing on the 
Internet at http://www.regulations.gov as they are received without 
change, including any personal identifiers or contact information.

FOR FURTHER INFORMATION CONTACT: To request more information on this 
proposed information collection or to obtain a copy of the proposal and 
associated collection instruments, please write to the TRICARE 
Management Activity, Attn: Lt. Col. M. Jeanne Yoder, 5111 Leesburg 
Pike, Suite 810, Falls Church, VA 22041-3206, or contact TRICARE 
Management Activity, DHP Management Control and Financial Studies 
Division at 703-681-3492.
    Title; Associated Form; and OMB Number: Third Party Collection 
Program/Medical Services Account/Other Health Insurance, DD Form 2569; 
OMB Number 0704-0323.
    Needs and Uses: The information contained in the DD Form 2569 will 
be used to collect reimbursement from healthcare insurers for medical 
care provided to dependents of Active Duty members, military retirees 
and their dependents, and civilians who present at a Military Treatment 
Facility (MTF) on an emergency basis, and anyone else who is otherwise 
eligible for care at the MTF. Such monetary benefits accruing to the 
MTF will be used to enhance healthcare delivery in the MTF. Information 
will also be used by MTF staff and CHAMPUS Fiscal Intermediaries to 
determine eligibility for care, deductibles, and co-payments and by 
Health Affairs for program planning and management.
    Affected Public: Dependents of Active Duty members, military 
retirees and their dependents, civilians who present at an MTF on an 
emergency basis, and anyone else who is otherwise eligible for care at 
the MTF who have coverage from private insurance for medical care.
    Annual Burden Hours: 140,361 hours.
    Number of Respondents: 2,807,212.

[[Page 48541]]

    Responses per Respondent: 1.
    Average Burden per Response: 3 minutes.
    Frequency: Annually or on occasion when insurance information 
changes.

SUPPLEMENTARY INFORMATION:

Summary of Information Collection

    The administration has placed increased emphasis upon recovery of 
health care expenses under the Third Party Collection Program, as 
authorized by Title 10, Section 1095 and 1097b of the United States 
Code. Completion of this form, while increasing total burden hours, 
will aid in increasing revenues (O&M dollars), services, and operating 
efficiency and effectiveness within the Military Health Services 
System. This information is collected either during the inpatient stay 
admission and/or discharge process or during the visit when a patient 
presents for an outpatient procedure.

    Dated: August 14, 2006.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 06-7041 Filed 8-18-06; 8:45 am]
BILLING CODE 5001-06-M