[Federal Register Volume 75, Number 247 (Monday, December 27, 2010)]
[Notices]
[Page 81241]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-32394]



[[Page 81241]]

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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID DOD-2010-HA-0176]


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 February 
25, 2011.

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, Room 3C843, 
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 Appeals, Hearings 
and Claims Collection Division, Office of General Counsel, 
TRICARE[supreg] Management Activity, Attn: Mark P. Donahue, 16401 East 
Centretech Parkway, Aurora, CO 80011-9066, or via telephone at (303) 
676-3411.
    Title; Associated Form; and OMB Number: Professional Qualifications 
Medical/Peer Reviewers, CHAMPUS Form 780, OMB Number 0720-0005.
    Needs and Uses: The information collection requirement is necessary 
to obtain and record the professional qualifications of medical and 
peer reviewers utilized within TRICARE[supreg]. The form is included as 
an exhibit in an appeal or hearing case file as evidence of the 
reviewer's professional qualifications to review the medical 
documentation contained in the case file.
    Affected Public: Business or other for profit.
    Annual Burden Hours: 20.
    Number of Respondents: 60.
    Responses per Respondent: 1.
    Average Burden per Response: 20 minutes.
    Frequency: On occasion.

SUPPLEMENTARY INFORMATION:

Summary of Information Collection

    Respondents are medical professionals who provide medical and peer 
review of cases appealed to the Appeals, Hearings and Claims Collection 
Division, Office of General Counsel, TRICARE[supreg] Management 
Activity. CHAMPUS Form 780 records the professional qualifications of 
the medical or peer reviewer. The completed form is included as an 
exhibit in the appeal or hearing case file to document the professional 
qualifications of the medical professional who reviewed the case. If 
the form is not included in the case file, individuals reviewing the 
file cannot confirm the qualifications of the reviewing medical 
professional. Having qualified professionals provide medical and peer 
review is essential in maintaining the integrity of the appeal and 
hearing process.

    Dated: December 20, 2010.
Morgan F. Park,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2010-32394 Filed 12-23-10; 8:45 am]
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