[Federal Register Volume 82, Number 105 (Friday, June 2, 2017)]
[Notices]
[Pages 25633-25634]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-11438]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for OMB Review; Comment Request for Review of a 
Revised Information Collection: Multi-State Plan Program External 
Review Case Intake Form, OPM Form 1840

AGENCY: Office of Personnel Management.

ACTION: Notice.

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SUMMARY: The Office of Personnel Management (OPM) has submitted to the 
Office of Management and Budget (OMB) a request for review of a 
revision of a currently approved collection, the Multi-State Plan 
Program External Review Intake Form, OPM Form 1840. This approval is 
necessary to improve the collection of information from members of the 
Multi-State Plan Program who need to request the external review of a 
disputed adverse benefit decision.

DATES: Comments will be accepted until July 3, 2017.

ADDRESSES: Send or deliver comments to: Donna Lease Batdorf, Multi-
State Plan Program, National Healthcare Operations, Healthcare and 
Insurance, Office of Personnel Management, 1900 E Street NW., Room 
3468, Washington, DC 20415; and Charlie Cutshaw, OPM

[[Page 25634]]

Desk Officer, Office of Information & Regulatory Affairs, Office of 
Management and Budget, New Executive Office Building NW., Room 10235, 
Washington, DC 20503.

FOR FURTHER INFORMATION CONTACT: For copies of this proposal, contact 
C.C. ``Corky'' Conyers, Ph.D., C.I.O. P.R.A./Forms Officer at (202) 
606-0125, or via email to [email protected]. Please include a 
mailing address with your request.

SUPPLEMENTARY INFORMATION: As required by the Paperwork Reduction Act 
of 1995 (Pub. L. 104-13, May 22, 1995), as amended by the Clinger-Cohen 
Act (Pub. L. 104-106), OPM is soliciting comments for this collection. 
The previous collection (OMB No. 3206-0263) was published in the 
Federal Register on November 26, 2013 at 78 FR 70598. Approximately 800 
respondents will complete the Multi-State Plan Program External Review 
Intake Form, OPM Form 1840 on a yearly basis. We estimate it will take 
60 minutes to complete the OPM Form 1840. The annual estimated burden 
is 800 hours.
    Comments are particularly invited on:
    1. Whether this collection of information is necessary for the 
proper performance of functions of the Office of Personnel Management, 
and whether it will have practical utility;
    2. Whether our estimate of the public burden of this collection is 
accurate, and based on valid assumptions and methodology; and
    3. Ways in which we can minimize the burden of the collection of 
information on those who are to respond, through the use of the 
appropriate technological collection techniques or other forms of 
information technology.

Analysis

    Agency: Multi-State Plan Program, National Healthcare Operations, 
Healthcare and Insurance, Office of Personnel Management.
    Title: External Review Intake Form.
    OMB: 3206-0263.

Frequency

    Affected Public: Individuals or Households.
    Number of Respondents: 800.
    Estimated Time per Respondent: 60 minutes.
    Total Burden Hours: 800 hours.

Kathleen M. McGettigan,
Acting Director, U.S. Office of Personnel Management.
[FR Doc. 2017-11438 Filed 6-1-17; 8:45 am]
 BILLING CODE 6325-64-P