[Federal Register Volume 81, Number 172 (Tuesday, September 6, 2016)]
[Notices]
[Pages 61255-61256]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-21451]


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DEPARTMENT OF LABOR

Office of the Secretary


Agency Information Collection Activities; Submission for OMB 
Review; Comment Request; Authorization Request Forms/Certification/
Letter of Medical Necessity

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) proposal titled, ``Authorization Request Forms/
Certification/Letter of Medical Necessity,'' 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 October 6, 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=201606-1240-003 (this link will only become active 
on the day following publication of this notice) or by contacting 
Michel Smyth by telephone at 202-693-4129 (this is not a toll-free 
number) or by email at [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: Contact Michel Smyth by telephone at 
202-693-4129 (this is not a toll-free number) or by email at 
[email protected].

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


SUPPLEMENTARY INFORMATION: This ICR seeks PRA authority for the 
Authorization Request Forms/Certification/Letter of Medical Necessity 
information collection consisting of Forms CA-26 (Authorization Request 
Form and Certification/Letter of Medical Necessity for Compounded 
Drugs) and CA-27 (Authorization Request Form and Certification/Letter 
of Medical Necessity for Opioid Medications). The Federal Employee's 
Compensation Act (FECA) provides that the OWCP furnish to a Federal 
employee who is injured while in the performance of duty the services, 
appliances, and supplies prescribed or recommended by a qualified 
physician that the OWCP considers likely to cure, give relief, reduce 
the degree or the period of disability, or aid in lessening the amount 
of the monthly compensation. See 5 U.S.C. 8103. Forms CA-26 and CA-27 
require an injured worker's treating physician to answer questions 
about the prescribed opioids and/or compounded drugs and certify they 
are medically necessary to treat the work-related injury. Responses to 
the questions are intended to ensure treating physicians have 
considered non-opioid and non-compounded drug alternatives and are only 
prescribing the most cost effective and medically necessary drugs. The 
forms will also permit the OWCP more easily to track the volume, type, 
and characteristics of opioids and compounded drugs authorized by the 
FECA program. The forms will serve as a means for injured workers to 
continue receiving opioids and compounded drugs only where medically 
necessary and simultaneously give the OWCP greater oversight in 
monitoring their appropriate use and gather additional data about their 
use. FECA section 36(a)(2) authorizes this information collection. See 
5 U.S.C. 8124(a)(2).
    This proposed 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 if the collection of information does not display a valid 
Control Number. See 5 CFR 1320.5(a) and 1320.6. For additional 
information, see the related notice published in the Federal Register 
on June 22, 2016 (81 FR 40721).
    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 ICR Reference Number 201606-
1240-003. 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.

[[Page 61256]]

    Title of Collection: Authorization Request Forms/Certification/
Letter of Medical Necessity.
    OMB ICR Reference Number: 2016006-1240-003.
    Affected Public: Individuals or Households.
    Total Estimated Number of Respondents: 86,000.
    Total Estimated Number of Responses: 71,275.
    Total Estimated Annual Time Burden: 43,000 hours.
    Total Estimated Annual Other Costs Burden: $0.

    Dated: September 1, 2016.
Michel Smyth,
Departmental Clearance Officer.
[FR Doc. 2016-21451 Filed 9-2-16; 8:45 am]
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