[Federal Register Volume 84, Number 122 (Tuesday, June 25, 2019)]
[Notices]
[Pages 29852-29853]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-13470]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID DOD-2019-HA-0075]


Proposed Collection; Comment Request

AGENCY: Office of the Assistant Secretary of Defense for Health 
Affairs, DoD.

ACTION: Information collection 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: 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 August 
26, 2019.

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 Chief Management 
Officer, Directorate for Oversight and Compliance, 4800 Mark Center 
Drive, Mailbox #24, Suite 08D09, 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.

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 Defense Health 
Agency, TRICARE Health Plan, 16401 East

[[Page 29853]]

Centretech Parkway Aurora, CO 80011-9066, ATTN: Jahanbakhsh Badshah, or 
call 303-676-3881.

SUPPLEMENTARY INFORMATION: 
    Title; Associated Form; and OMB Number: Application for Champus 
Provider Status: Corporate Services Provider, DD Form 3030, 0720-0020.
    Needs and Uses: This information collection requirement is 
necessary to ensure that the conditions are met for authorization as a 
TRICARE/CHAMPUS Corporate Service Provider. Respondents are 
freestanding corporations and foundations seeking authorization under 
the TRICARE/CHAMPUS program to provide otherwise covered professional 
services to eligible TRICARE/CHAMPUS beneficiaries.
    Affected Public: Business or other for-profit.
    Annual Burden Hours: 111.67.
    Number of Respondents: 335.
    Responses per Respondent: 1.
    Annual Responses: 335.
    Average Burden per Response: 20 minutes.
    Frequency: As required.

    Dated: June 20, 2019.
Morgan E. Park,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2019-13470 Filed 6-24-19; 8:45 am]
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