[Federal Register Volume 81, Number 248 (Tuesday, December 27, 2016)]
[Notices]
[Pages 95121-95122]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-31078]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID: DOD-2016-HA-0119]


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

[[Page 95122]]

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: 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; the accuracy of the agency's 
estimate of the burden of the proposed information collection; ways to 
enhance the quality, utility, and clarity of the information to be 
collected; and 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 February 
27, 2017.

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 for Oversight and Compliance, 
Regulatory and Advisory Committee Division, 4800 Mark Center Drive, 
Mailbox #24, Alexandria, VA 22350-1700.
    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 ATTN: Ms. Shane 
Pham, 7700 Arlington Boulevard, Suite 5101, Falls Church, VA 22042-
5101, or call at (703) 681-8666.

SUPPLEMENTARY INFORMATION: 
    Title; Associated Form; and OMB Number: TRICARE Plus Enrollment 
Application and TRICARE Plus Disenrollment Request; DD Form 2853 and DD 
Form 2854; OMB Control Number 0720-0028.
    Needs and Uses: The information collection requirement is necessary 
for enrollment and disenrollment in the Department of Defense's TRICARE 
Plus Health Plan established in accordance with Title 10 U.S.C. 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 households.
    Annual Burden Hours: 386.
    Number of Respondents: 3305.
    Responses per Respondent: 1.
    Annual Responses: 3305.
    Average Burden per Response: 7 minutes.
    Frequency: On occasion.
    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: December 20, 2016.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2016-31078 Filed 12-23-16; 8:45 am]
 BILLING CODE 5001-06-P