[Federal Register Volume 72, Number 46 (Friday, March 9, 2007)]
[Notices]
[Pages 10715-10716]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 07-1110]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[No. DoD-2007-HA-0021]


Proposed Collection; Comment Request

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

ACTION: Notice.

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    In accordance 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 extension of a currently approved 
collection and seeks public comment on the provisions thereof. Comments 
are invited on: (a) Whether the proposed extension of 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

[[Page 10716]]

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 May 8, 
2007.

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, please write to the TRICARE Management 
Activity--Aurora, Office of Program Requirements Division, 16401 E. 
Centretech Parkway, ATTN: John J.M. Leininger, Aurora, CO 80011-9066, 
or call TRICARE Management Activity, Office of Program Requirements 
Division at (303) 676-3613.
    Title, Associated Form, and OMB Number: Health Insurance Claim 
Form; CMS-1500; OMB Control Number 0720-0001.
    Needs and Uses:This information collection requirement is used by 
TRICARE to determine reimbursement for health care services or supplies 
rendered by individual professional providers to TRICARE beneficiaries. 
The requested information is used to determine beneficiary eligibility, 
appropriateness and costs of care, other health insurance liability and 
whether services received are benefits. Use of this form continues 
TRICARE commitments to use the national standard claim form for 
reimbursement of services/supplies provided by individual professional 
providers.
    Affected Public: Business or other for-profit; not-for-profit 
institutions; Federal government; state, local or tribal government.
    Annual Burden Hours: 6,000,000.
    Number of Respondents: 24,000,000.
    Responses per Respondent: 1.
    Average Burden per Response: 15 minutes.
    Frequency: On occasion.

SUPPLEMENTARY INFORMATION:

Summary of Information Collection

    This collection instrument is for use by health care providers 
under the TRICARE Program. TRICARE is a health benefits entitlement 
program for the dependents of active duty Uniformed Services member and 
deceased sponsors, retirees and their dependents, dependents of 
Department of Homeland Security (Coast Guard) sponsors, and certain 
North Atlantic Treaty Organizations, National Oceanic and Atmospheric 
Administration, and Public Health Service eligible beneficiaries. The 
CMS-1500 form is used by individual professional health care or health 
care related providers to file for reimbursement of civilian health 
care services or supplies provided to TRICARE beneficiaries. This is 
the national standard claim form accepted by all major commercial and 
government payers.

    Dated: March 2, 2007.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 07-1110 Filed 3-8-07; 8:45 am]
BILLING CODE 5001-06-M