[Federal Register Volume 77, Number 230 (Thursday, November 29, 2012)]
[Notices]
[Page 71176]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-28878]



[[Page 71176]]

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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID DoD-2012-HA-0147]


Proposed Collection; Comment Request

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

ACTION: Notice.

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    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 a proposed 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 January 
28, 2013.

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, 4800 Mark 
Center Drive, East Tower, Suite 02G09, Alexandria, VA 22350-3100.
    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 the Office of the 
Assistant Secretary of Defense (Health Affairs) TRICARE Management 
Activity, ATTN: Ms. Shane Pham, 7700 Arlington Boulevard, Suite 5101 
Falls Church, VA 22042-5101, or call at (703) 681-8666.
    Title; Associated Form; and OMB Number: TRICARE Plus Enrollment 
Application, DD Form 2853 and TRICARE Plus Disenrollment Request, DD 
Form 2854; OMB Control Number 0720-0028.
    Needs and Uses: These collected instruments serve as an application 
for enrollment and disenrollment in the Department of Defense's TRICARE 
Plus Health Plan established in accordance with Title 10 U.S.C. 
sections 1099 (which calls for a healthcare enrollment system) and 1086 
(which authorizes TRICARE eligibility of Medicare Eligible Persons and 
has resulted in the development of a new enrollment option called 
TRICARE Plus) and the Assistant Secretary of Defense for Health Affairs 
Policy Memorandum to Establish the TRICARE Plus Program, June 22, 2001. 
The information collected hereby provides the TRICARE contractors with 
necessary data to determine beneficiary eligibility and to identify the 
selection of a health care option.
    Affected Public: Individuals or household.
    Annual Burden Hours: 2,924.
    Number of Respondents: 25,065.
    Responses per Respondent: 1.
    Average Burden per Response: 7 minutes.
    Frequency: On occasion.

SUPPLEMENTARY INFORMATION:

Summary of Information Collection

    The Department of Defense established TRICARE Plus as an enrollment 
option for persons who are eligible for care in Military Treatment 
Facilities (MTF) and not enrolled in TRICARE Prime. TRICARE Plus 
provides an opportunity to enroll with a primary care provider at a 
specific MTF, to the extent capacity exists. This is a way to 
facilitate primary care appointments at an MTF when needed. TRICARE 
Plus enrollment will help MTFs maintain an adequate clinical case mix 
for Graduate Medical Education programs and support readiness-related 
medical skills sustainment activities. In order to carry out this 
program, it is necessary that certain beneficiaries electing to enroll/
disenroll in TRICARE Plus complete an enrollment application/
disenrollment request. Completion of the enrollment forms is an 
essential element of the TRICARE program. There is no lock-in and no 
enrollment fee for TRICARE Plus.

    Dated: November 26, 2012.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2012-28878 Filed 11-28-12; 8:45 am]
BILLING CODE 5001-06-P