[Federal Register Volume 80, Number 197 (Tuesday, October 13, 2015)]
[Notices]
[Pages 61396-61397]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-25909]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID: DoD-2014-HA-0004]


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 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 December 
14, 2015.

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: Department of Defense, Office of the Deputy Chief 
Management Officer, Directorate of Oversight and Compliance, Regulatory 
and Audit Matters Office, 9010 Defense Pentagon, Washington, DC 20301-
9010.
    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.
    Any associated form(s) for this collection may be located within 
this same electronic docket and downloaded for review/testing. Follow 
the instructions at http://www.regulations.gov for submitting comments. 
Please submit comments on any given form identified by docket number, 
form number, and title.

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 Defense Health 
Agency, Medical Benefits and Reimbursement Systems, 16401 East 
Centretech Parkway, ATTN: Elan Green, Aurora, CO 80011-9043, or call 
Defense Health Agency, Medical Benefits and Reimbursement Office, at 
(303) 676-3907.

SUPPLEMENTARY INFORMATION:
    Title; Associated Form; and OMB Number: Application for TRICARE-
Provider Status: Corporation Services Provider; DD Form X644; OMB 
Control Number 0720-0020.
    Needs and Uses: The information collection requirement is necessary 
to allow eligible providers to apply for Corporate Services Provider 
status under the TRICARE program.
    Affected Public: Business or other for profit; Not-for-profit 
institutions.
    Annual Burden Hours: 100.
    Number of Respondents: 300.
    Responses per Respondent: 1.
    Annual Responses: 300.
    Average Burden per Response: 20 minutes.
    Frequency: On occasion.
    On March 10, 1999, TRICARE Management Activity (TMA), formerly 
known as OCHAMPUS, published a final ruse in the Federal Register (64 
FR 11765), creating a fourth class of TRICARE providers consisting of 
freestanding corporations and foundations that render principally 
professional ambulatory or in-home care and technical diagnostic 
procedures. Effective October 1, 2013, the TRICARE Management Activity 
is now the Defense Health Agency (DHA). The intent of the rule was not 
to create additional benefits that ordinarily would not be covered 
under TRICARE if provided by a more traditional healthcare delivery 
system, but rather to allow those services which would otherwise be 
allowed except for an individual provider's affiliation with a 
freestanding corporate facility. The addition of the corporate class 
recognized the current range of

[[Page 61397]]

providers within today's health care delivery structure, and gave 
beneficiaries access to another segment of the health care delivery 
industry. Corporate services providers must be approved for Medicare 
payment, or when Medicare approval status is not required, be 
accredited by a qualified accreditation organization to gain provider 
authorization status under TRICARE. Corporate services providers must 
also enter into a participation agreement which will be sent out as 
part of the initial authorization process. The participation agreement 
will ensure that TRICARE-determined allowable payments, combined with 
the costshare/copayment, deductible, and other health insurance 
amounts, will be accepted by the provider as payment in full. The 
application for TRICARE-Provider Status: Corporate Services Provider, 
will collect the necessary information to ensure that the conditions 
are met for authorization as a TRICARE corporate services provider: 
i.e., the provider (1) is a corporation or a foundation, but not a 
professional corporation or professional association; (2) provides 
services and related supplies of a type rendered by TRICARE individual 
professional providers or diagnostic technical services; (3) is 
approved for Medicare payment or, when Medicare approval status is not 
requested, is accredited by a qualified accreditation organization; and 
(4) has entered into a participation agreement approved by the 
Director, DHA or a designee.
    The collected information will be used by TRICARE contractors to 
process claims and verify authorized provider status. Verification 
involves collecting and reviewing copies of the provider's licenses, 
certificates, accreditation documents, etc. If the criteria are met, 
the provider is granted TRICARE authorization status. The documentation 
and information are collected when: (1) A provider requests permission 
to become a TRICARE-authorized provider; (2) a claim is filed for care 
received from a provider who is not listed on the contractor's computer 
listing of authorized providers; or (3) when a former TRICARE-
authorized provider requests reinstatement. The contractors develop the 
forms used to gather information based on the TRICARE conditions for 
participation listed above. Without the collection of this information, 
contractors cannot determine if the provider meets TRICARE-
authorization requirements for corporate services providers. If the 
contractor is unable to verify that a provider meets these 
authorization requirements, the contractor may not reimburse either the 
provider or the beneficiary for the provider's health care services. To 
reduce the reporting burden to a minimum, TRICARE has carefully 
selected the information requested from respondents. Only that 
information which has been deemed absolutely essential is being 
requested. If necessary, contractors may verify credentials with 
Medicare, JCAHO and other national organizations by telephone. TRICARE 
is also participating with Medicare in the development of a National 
Provider System which will eliminate duplication of provider 
certification and data collection among Federal government agencies. 
TRICARE contractors are required to maintain a computer listing before 
requesting documentation from providers. Since the providers affected 
by this information generally have not previously been eligible to be 
authorized providers, TRICARE contractors will have no information on 
file. The providers will have to submit the information requested on 
the data collection form (Application for TRICARE-Providers Status: 
Corporate Services Provider) in order to obtain provider authorization 
status under TRICARE. The information will usually be collected from 
each respondent only once. It is estimated that there will be 
approximately 300 applicants per year. TRICARE will request the 
provider authorization documentation and information when the provider 
asks to become TRICARE-authorized or when a claim is filed for a new 
provider's services. If after a provider has been authorized by a 
contractor, no claims are filed during two-year period of time, the 
provider's information will be placed in the inactive file. To 
reactivate a file, the provider must verify that the information is 
still correct, or supply new or changed information. The total annual 
reporting burden is estimated to be approximately 100 hours 
(approximately 300 respondents with 20 minutes to complete the form).

    Dated: October 6, 2015.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2015-25909 Filed 10-9-15; 8:45 am]
 BILLING CODE 5001-06-P