[Federal Register Volume 74, Number 20 (Monday, February 2, 2009)]
[Notices]
[Page 5825]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-2201]



[[Page 5825]]

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

DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID: DoD-2009-HA-0012]


Proposed Collection; Comment Request

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

ACTION: Notice.

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

SUMMARY: 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 public 
information 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 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 April 3, 
2009.

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 TRICARE Management 
Activity (TMA), Dental Care Branch, ATTN: CAPT Robert Mitton, Skyline 
5, Suite 810, 5111 Leesburg Pike, Falls Church, VA 22041, or call TMA, 
Dental Care Branch, at 703-681-0039.
    Title Associated with Form, and OMB Number: TRICARE Dental Program 
(TDP) Dentist's Claim Form DD 5578 G 9/05 and TRICARE Dental Program 
Dentist's Claim Form DD 5678 F 10/05 OCONUS; OMB No. 0720-0035.
    Needs and Uses: The TDP Claim Form(s) CONUS/OCONUS are required to 
gather information to make payment for legitimate dental claims and to 
assist in contractor surveillance and program integrity investigations 
and to audit financial transactions where the Department of Defense has 
a financial stake. The information from the claim form is also used to 
provide important cost-share explanations to the beneficiary.
    Affected Public: Business or other for-profit.
    Annual Burden Hours: 1,006,415.
    Number of Respondents: 64,930.
    Responses per Respondent: 62.
    Annual Responses: 4,025,660.
    Average Burden per Response: 15 minutes.
    Frequency: Occasion.

SUPPLEMENTARY INFORMATION:

Summary of Information Collection

    The TRICARE Management Activity (TMA) under the authority of the 
Office of the Assistant Secretary of Defense (Health Affairs)/TMA 
Office of the Deputy Assistant Secretary of Defense has the 
responsibility for management of the TRICARE Dental Program (TDP) as 
established in Title 10, United States Code, Section 1076a. The 
information collected to make payment for covered dental procedures 
provided by a licensed dentist to an eligible beneficiary can be sent 
to the TDP contractor electronically, fax or mail. Approximately 35% of 
all TDP network dental claims are filed electronically. Dental offices 
and patients can download the TDP claim form from the contractor's Web 
site.
    For non-network dentists, to include those in overseas locations, 
the use of the TDP Claim Form is highly encouraged. However, dental 
claims will be paid if all the required information is provided on a 
similar claim form.

    Dated: January 27, 2009.
Patricia L. Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
 [FR Doc. E9-2201 Filed 1-30-09; 8:45 am]
BILLING CODE 5001-06-P