[Federal Register Volume 75, Number 81 (Wednesday, April 28, 2010)]
[Page 22438]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-9807]



[OMB Control No. 2900-New (10-0505)]

Proposed Information Collection (Health Resource Center Medical 
Center Payment Form) Activity: Comment Request

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.


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 new collection, and allow 60 days for public comment in 
response to the notice. This notice solicits comments on information 
needed to allow claimants to pay their medical care copayment online.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before June 28, 2010.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at 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--New (10-0505)'' in any correspondence. During 
the comment period, comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Mary Stout (202) 461-5867 or FAX (202) 

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.
    Title: Health Resource Center Medical Center Payment Form, VA Form 
    OMB Control Number: 2900--New (10-0505).
    Type of Review: New collection.
    Abstract: Data collected on VA Form 10-0505 will be used to allow 
claimants with medical care copayment debts to pay online with a credit 
card or Automated Clearing House transaction.
    Affected Public: Individuals or households.
    Estimated Total Annual Burden: 48,000.
    Estimated Average Burden per Respondent: 4 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 60,000.
    Estimated Number of Responses: 720,000.

    Dated: April 23, 2010.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2010-9807 Filed 4-27-10; 8:45 am]