[Federal Register Volume 75, Number 189 (Thursday, September 30, 2010)]
[Notices]
[Pages 60416-60417]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-24529]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID DoD-2010-HA-0131]


Proposed Collection; Comment Request

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

ACTION: Notice.

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SUMMARY: In compliance 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 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 
proposed 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 by November 
29, 2010.

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, Room 3C843, 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, Office of General Counsel, 61401 E. Centretech Parkway, Attn: 
Michael Bibbo, Aurora, CO 80011, or call TRICARE Management Activity, 
Office of General Counsel, at (303) 676-3705.
    Title; Associated Form; and OMB Number: Statement of Personal 
Injury--Possible Third Party Liability, TRICARE Management Activity; DD 
Form 2527; OMB Control Number 0720-0003.
    Needs and Uses: This information collection is completed by TRICARE 
(formerly CHAMPUS) beneficiaries suffering from personal injuries and 
receiving medical care at Government expense. The information is 
necessary in the assertion of the Government's right to recovery under 
the Federal Medical Care Recovery Act. The data is used in the 
evaluation and processing of these claims.
    Affected Public: Individuals or households; Federal Government.
    Annual Burden Hours: 56,100.
    Number of Respondents: 224,399.
    Responses per Respondent: 1.
    Average Burden per Response: 15 minutes.
    Frequency: On occasion.

SUPPLEMENTARY INFORMATION: 

Summary of Information Collection

    The Federal Medical Recovery Act, 42 U.S.C. 2651-2653 as 
implemented by Executive Order No. 11060 and 28 CFR part 43 provides 
for recovery of the

[[Page 60417]]

reasonable value of medical care provided by the United States to a 
person who is injured or suffers a disease under circumstances creating 
tort liability in a third person. DD Form 2527 is required for 
investigating and asserting claims in favor of the United States 
arising out of such incidents.
    When a claim for TRICARE benefits is identified as involving 
possible third party liability and the information is not submitted 
with the claim, the TRICARE contractor requests that the injured party 
(or a designee) complete DD Form 2527. To protect the interests of the 
Government, the contractor suspends claims processing until the 
requested third party liability information is received. The contractor 
conducts a preliminary evaluation based upon the collection of 
information and refers the case to a designated appropriate legal 
officer of the Uniformed Services. The responsible Uniformed Services 
legal officer uses the information as a basis for asserting and 
settling the Government's claim. When appropriate, the information is 
forwarded to the Department of Justice as the basis for litigation.
    Section 1 of the Form is used to collect general information, such 
as name, address and telephone numbers about the military sponsor and 
the injured beneficiary and the date, time and location where the 
injured occurred.
    Section 2 of the Form is used to collect information about 
accidental injuries. Most of the investigations for third party 
liability involve motor vehicle accidents. Information about insurance 
coverage for the parties involved in the accident is collected. Section 
2 of the Form is also used to collect information about accidents not 
involving motor vehicles. Information such as the type of accident, the 
place where the injury occurred, the name of the property owner where 
the injury occurred and cause of the injury is collected. The name and 
address of the employer is collected when the injury was work related.
    Section 3 of the Form is used for miscellaneous information such as 
possible medical treatment at a Government hospital, the name and 
address of the beneficiary's attorney, and information regarding any 
possible releases or settlements with another party to the accident. It 
also contains the certification, date and signature of the beneficiary 
(or a designee).

    Dated: September 17, 2010.
Patricia L. Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2010-24529 Filed 9-29-10; 8:45 am]
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