[Federal Register Volume 81, Number 37 (Thursday, February 25, 2016)]
[Notices]
[Page 9513]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-03986]


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DEPARTMENT OF LABOR

Office of the Secretary


Agency Information Collection Activities; Submission for OMB 
Review; Comment Request; Provider Enrollment Form

ACTION: Notice.

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SUMMARY: The Department of Labor (DOL) is submitting the Office of 
Workers' Compensation Programs (OWCP) sponsored information collection 
request (ICR) revision titled, ``Provider Enrollment Form,'' to the 
Office of Management and Budget (OMB) for review and approval for use 
in accordance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 
3501 et seq.). Public comments on the ICR are invited.

DATES: The OMB will consider all written comments that agency receives 
on or before March 28, 2016.

ADDRESSES: A copy of this ICR with applicable supporting documentation; 
including a description of the likely respondents, proposed frequency 
of response, and estimated total burden may be obtained free of charge 
from the RegInfo.gov Web site at http://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=201601-1240-007 or by contacting Michel Smyth by 
telephone at 202-693-4129, TTY 202-693-8064, (these are not toll-free 
numbers) or sending an email to [email protected].
    Submit comments about this request by mail or courier to the Office 
of Information and Regulatory Affairs, Attn: OMB Desk Officer for DOL-
OWCP, Office of Management and Budget, Room 10235, 725 17th Street NW., 
Washington, DC 20503; by Fax: 202-395-5806 (this is not a toll-free 
number); or by email: [email protected]. Commenters are 
encouraged, but not required, to send a courtesy copy of any comments 
by mail or courier to the U.S. Department of Labor--OASAM, Office of 
the Chief Information Officer, Attn: Departmental Information 
Compliance Management Program, Room N1301, 200 Constitution Avenue NW., 
Washington, DC 20210; or by email: [email protected].

FOR FURTHER INFORMATION CONTACT: Michel Smyth by telephone at 202-693-
4129, TTY 202-693-8064, (these are not toll-free numbers) or sending an 
email to [email protected].

    Authority: 44 U.S.C. 3507(a)(1)(D).


SUPPLEMENTARY INFORMATION: This ICR seeks approval under the PRA for 
revisions to the Provider Enrollment Form, Form OWCP-1168, information 
collection that requests profile information on a provider enrolling in 
one or more OWCP benefit programs, so the OWCP can pay for services 
rendered to beneficiaries using an automated bill processing system. 
This information collection has been classified as a revision, because 
while not affecting burden estimates, the agency has updated Form OWCP-
1168 including the provider letter, Privacy Act statement, and several 
items on the form and instructions. Federal Employees' Compensation Act 
section 9, Black Lung Benefits Act section 413, and Energy Employees 
Occupational Illness Compensation Program Act of 2000 section 3629(c) 
authorize this information collection. See 5 U.S.C. 8103, 30 U.S.C. 
936, and 42 U.S.C. 7384t.
    This information collection is subject to the PRA. A Federal agency 
generally cannot conduct or sponsor a collection of information, and 
the public is generally not required to respond to an information 
collection, unless it is approved by the OMB under the PRA and displays 
a currently valid OMB Control Number. In addition, notwithstanding any 
other provisions of law, no person shall generally be subject to 
penalty for failing to comply with a collection of information that 
does not display a valid Control Number. See 5 CFR 1320.5(a) and 
1320.6. The DOL obtains OMB approval for this information collection 
under Control Number 1240-0021. The DOL notes that existing information 
collection requirements submitted to the OMB receive a month-to-month 
extension while they undergo review. New requirements would only take 
effect upon OMB approval. For additional substantive information about 
this ICR, see the related notice published in the Federal Register on 
July 7, 2015 (80 FR 38749).
    Interested parties are encouraged to send comments to the OMB, 
Office of Information and Regulatory Affairs at the address shown in 
the ADDRESSES section within thirty (30) days of publication of this 
notice in the Federal Register. In order to help ensure appropriate 
consideration, comments should mention OMB Control Number 1240-0021. 
The OMB is particularly interested in comments that:
     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 submission of responses.
    Agency: DOL-OWCP.
    Title of Collection: Provider Enrollment Form.
    OMB Control Number: 1240-0021.
    Affected Public: Private Sector--businesses or other for profits.
    Total Estimated Number of Respondents: 31,979.
    Total Estimated Number of Responses: 31,979.
    Total Estimated Annual Time Burden: 4,252 hours.
    Total Estimated Annual Other Costs Burden: $16,629.

     Dated: February 17, 2016.
Michel Smyth,
Departmental Clearance Officer.
[FR Doc. 2016-03986 Filed 2-24-16; 8:45 am]
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