[Federal Register Volume 74, Number 119 (Tuesday, June 23, 2009)]
[Notices]
[Page 29721]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-14688]



[[Page 29721]]

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DEPARTMENT OF LABOR

Employment Standards Administration


Proposed Extension of the Approval of Information Collection 
Requirements

ACTION: Notice.

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SUMMARY: The Department of Labor, as part of its continuing effort to 
reduce paperwork and respondent burden, conducts a preclearance 
consultation program to provide the general public and Federal agencies 
with an opportunity to comment on proposed and/or continuing 
collections of information in accordance with the Paperwork Reduction 
Act of 1995 (PRA95) [44 U.S.C. 3506(c)(2)(A)]. This program helps to 
ensure that requested data can be provided in the desired format, 
reporting burden (time and financial resources) is minimized, 
collection instruments are clearly understood, and the impact of 
collection requirements on respondents can be properly assessed. 
Currently, the Employment Standards Administration is soliciting 
comments concerning its proposal to extend the Office of Management and 
Budget (OMB) approval of the Information Collection: Uniform Billing 
Form (OWCP-04). A copy of the proposed information collection request 
can be obtained by contacting the office listed below in the ADDRESSES 
section of this Notice.

DATES: Written comments must be submitted to the office listed in the 
addresses section below on or before August 24, 2009.

ADDRESSES: Mr. Steven D. Lawrence, U.S. Department of Labor, 200 
Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone 
(202) 693-0292, fax (202) 693-1451, E-mail [email protected]. 
Please use only one method of transmission for comments (mail, fax, or 
E-mail).

SUPPLEMENTARY INFORMATION:
    I. Background: The Office of Workers' Compensation Programs (OWCP) 
is the agency responsible for administration of the Federal Employees' 
Compensation Act (FECA), 5 U.S.C. 8101 et seq., the Black Lung Benefits 
Act (BLBA), 30 U.S.C. 901 et seq., and the Energy Employees 
Occupational Illness Compensation Program Act of 2000 (EEOICPA), 42 
U.S.C. 7384 et seq. All three of these statutes require that OWCP pay 
for medical treatment of beneficiaries; this medical treatment can 
include inpatient/outpatient hospital services, as well as services 
provided by nursing homes and skilled nursing facilities. In order to 
determine whether billed amounts are appropriate, OWCP needs to 
identify the patient, the specific services that were rendered and 
their relationship to the work-related injury or illness. The 
regulations implementing these statutes require the use of Form OWCP-04 
(which includes the first page of the private sector Form UB-04) for 
the submission of medical bills from institutional providers (20 CFR 
10.801, 30.701, 725.405, 725.406, 725.701 and 725.704).
    The Uniform Billing Form, known as the paper UB-04, has been 
approved by the American Hospital Association, the Centers for Medicare 
and Medicaid Services, the Civilian Health and Medical Program of the 
Uniformed Services (CHAMPUS), by various other government health care 
programs, and by the private sector, to request payment to 
institutional providers of medical services. The paper UB-04 has been 
designed by the National Uniform Billing Committee and is neither a 
government-printed form nor distributed by OWCP; OWCP has, however, 
developed detailed instructions to ensure that it obtains the 
information it needs to consider requests for payment from 
institutional providers using this form. This information collection is 
currently approved for use through January 31, 2010.
    II. Review Focus: The Department of Labor is particularly 
interested in comments that:
     Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
     Evaluate the accuracy of the agency's estimate of the 
burden of the proposed collection of information, including the 
validity of the methodology and assumptions used;
     Enhance the quality, utility, and clarity of the 
information to be collected; and
     Minimize the burden of the collection of information on 
those who are to respond, including through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submissions of responses.
    III. Current Actions: The Department of Labor seeks approval for 
the extension of this information collection in order to carry out its 
responsibility to provide payment covered medical services to injured 
employees who are covered under the FECA, BLBA and the EEOICPA.
    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title: Uniform Billing Form (OWCP-04).
    OMB Number: 1215-0176.
    Affected Public: Individuals or households; Business or other for-
profit; Not-for-profit institutions.
    Total Respondents: 5,481.
    Total Annual responses: 21,924.
    Estimated Total Burden Hours: 2,558.
    Estimated Time Per Response: 7 minutes.
    Frequency: Annually.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $0.
    Comments submitted in response to this notice will be summarized 
and/or included in the request for Office of Management and Budget 
approval of the information collection request; they will also become a 
matter of public record.

    Dated: June 18, 2009.
Steven D. Lawrence,
Acting Chief, Branch of Management Review and Internal Control, 
Division of Financial Management, Office of Management, Administration 
and Planning, Employment Standards Administration.
[FR Doc. E9-14688 Filed 6-22-09; 8:45 am]
BILLING CODE 4510-CH-P