[Federal Register Volume 74, Number 98 (Friday, May 22, 2009)]
[Notices]
[Pages 24076-24077]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-11944]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0648]


Proposed Information Collection (FMP); Comment Request

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: The Veterans Health Administration (VHA) is announcing an 
opportunity for public comment on the proposed collection of certain 
information by the agency. Under the Paperwork Reduction Act (PRA) of 
1995, Federal agencies are required to publish notice in the Federal 
Register concerning each proposed collection of information, including 
each proposed extension of a currently approved collection, and allow 
60 days for public comment in response to the notice. This notice 
solicits comments on information needed to reimburse healthcare 
providers for medical services provided to veterans with service-
connected disabilities living or traveling overseas.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before July 21, 2009.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) http://www.Regulations.gov; or to Mary Stout, Veterans Health Administration 
(193E1), Department of Veterans Affairs, 810 Vermont Avenue, NW., 
Washington, DC 20420 or e-mail: [email protected]. Please refer to 
``OMB Control No. 2900-0648'' in any correspondence. During the comment 
period, comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Mary Stout at (202) 461-5867 or FAX 
(202) 273-9381.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501--3521), Federal agencies must obtain approval from the 
Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. This request for comment is being 
made pursuant to Section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VHA 
invites comments on: (1) Whether the proposed collection of information 
is necessary for the proper performance of VHA's functions, including 
whether the information will have practical utility; (2) the accuracy 
of VHA's estimate of the burden of the proposed collection of 
information; (3) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (4) ways to minimize the burden of 
the collection of information on respondents, including through the use 
of automated collection techniques or the use of other forms of 
information technology.
    Titles:
    a. Foreign Medical Program (FMP) Registration Form, VA Form 10-
7959f-1.
    b. Claim Cover Sheet--Foreign Medical Program (FMP), VA Form 10-
7959f-2.
    OMB Control Number: 2900-0648.
    Type of Review: Extension of a currently approved collection.
    Abstracts:
    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 the Philippines) with service-
connected disability. VA will accept provider's generated billing 
statement, Uniform Billing--Forms (UB) 04, and Medicare Health 
Insurance Claims Form, CMS 1500 for payments or reimbursements.
    Affected Public: Individuals or households.
    Estimated Total Annual Burden:
    a. Foreign Medical Program, VA Form 10-7959f-1--110 hours.
    b. Claim Cover Sheet, VA Form 10-7959f-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 10-7959f-2--11 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. Foreign Medical Program, VA Form 10-7959f-1--1,660.
    b. Claim Cover Sheet, VA Form 10-7959f-2--19,920.

    Dated: May 18, 2009.


[[Page 24077]]


    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
 [FR Doc. E9-11944 Filed 5-21-09; 8:45 am]
BILLING CODE 8320-01-P