[Federal Register Volume 77, Number 166 (Monday, August 27, 2012)]
[Notices]
[Pages 51828-51829]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-20957]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Proposed Extension of Existing Collection; Comment Request

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 Office of Workers' Compensation Programs is soliciting 
comments concerning the proposed extension of the existing collection: 
Health Insurance Claim Form (OWCP-1500). 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 October 26, 2012.

ADDRESSES: Ms. Yoon Ferguson, U.S. Department of Labor, 200 
Constitution Ave. NW., Room S-3201, Washington, DC 20210, telephone 
(202) 693-0701, fax (202) 693-2447, Email [email protected]. Please 
use only one method of transmission for comments (mail, fax, or Email).

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: BLBA also requires that OWCP 
pay for medical examinations and related diagnostic services to 
determine eligibility for benefits under that statute. Form OWCP-1500 
is used by OWCP and contractor bill processing staff to process bills 
for medical services provided by medical professionals other than 
medical services provided by hospitals, pharmacies and certain other 
medical providers. To consider the appropriateness of the requested 
payment in a timely fashion, it is essential that provider bills be 
submitted on a standard form that will capture the critical data 
elements needed to evaluate the bill, such as procedure and diagnosis 
codes. This information collection is currently approved for use 
through November 30, 2012.
    II. Review Focus: The Department of Labor is particularly 
interested in comments which:
     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;

[[Page 51829]]

     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 the approval of 
the extension of this currently approved information collection in 
order to carry out its responsibility to provide payment for certain 
covered medical services to eligible employees who are covered under 
FECA, BLBA or EEOICPA.
    Type of Review: Extension.
    Agency: Office of Workers' Compensation Programs.
    Title: Health Insurance Claim Form.
    OMB Number: 1240-0044.
    Agency Number: OWCP-1500.
    Affected Public: Individuals or households, businesses or other 
for-profit.
    Total Respondents: 71,304.
    Total Responses: 3,036,067.
    Time per Response: 1--7 minutes.
    Estimated Total Burden Hours: 322,838.
    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: August 21, 2012.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs, 
U.S. Department of Labor.
[FR Doc. 2012-20957 Filed 8-24-12; 8:45 am]
BILLING CODE 4510-CR-P