[Federal Register Volume 80, Number 115 (Tuesday, June 16, 2015)]
[Notices]
[Page 34459]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-14678]


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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 August 17, 2015.

ADDRESSES: Ms. Yoon Ferguson, U.S. Department of Labor, 200 
Constitution Ave. NW., Room S-3201, Washington, DC 20210, telephone/fax 
(202) 354-9647, 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 December 31, 2015.

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;
    * 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: 58,923.
    Total Responses: 2,777,034.
    Time per Response: 1-7 minutes.
    Estimated Total Burden Hours: 260,873.
    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: June 8, 2015.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs, US 
Department of Labor.
[FR Doc. 2015-14678 Filed 6-15-15; 8:45 am]
 BILLING CODE 4510-CR-P