[Federal Register Volume 88, Number 207 (Friday, October 27, 2023)]
[Notices]
[Pages 73942-73943]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-23784]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-NEW]


Agency Information Collection Activity: Veteran Reimbursement 
Claim Form

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: Veterans Health Administration (VHA), Department of Veterans 
Affairs (VA), is announcing an opportunity for public comment on the 
proposed collection of certain information by the agency. Under the 
Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to 
publish notice in the Federal Register concerning each proposed 
collection of information, including each proposed extension of a 
currently approved collection, and allow 60 days for public comment in 
response to the notice.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before December 26, 2023.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at www.Regulations.gov 
or to Grant Bennett, Office of Regulations, Appeals, and Policy 
(10BRAP), Department of Veterans Affairs, 810 Vermont Avenue NW, 
Washington, DC 20420 or email to [email protected]. Please refer to 
``OMB Control No. 2900-NEW'' in any correspondence. During the comment 
period, comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Maribel Aponte, Office of Enterprise 
and Integration, Data Governance Analytics (008), 810 Vermont Avenue 
NW, Washington, DC 20420, (202) 266-4688 or email 
[email protected]. Please refer to ``OMB Control No. 2900-NEW'' in 
any correspondence.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995, Federal agencies must 
obtain approval from the Office of Management and Budget (OMB) for each 
collection of information they conduct or sponsor. This request for 
comment is being made pursuant to Section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VHA 
invites comments on: (1) whether the proposed collection of information 
is necessary for the proper performance of VHA's functions, including 
whether the information will have practical utility; (2) the accuracy 
of VHA's estimate of the burden of the proposed collection of 
information; (3) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (4) ways to minimize the burden of 
the collection of information on respondents, including through the use 
of automated collection techniques or the use of other forms of 
information technology.
    Authority: Public Law 104-13; 44 U.S.C. 3501-3521.
    Title: Veteran Reimbursement Claim Form (VA Form 10-320).
    OMB Control Number: 2900-NEW.
    Type of Review: New collection.
    Abstract: Veterans may claim reimbursement for certain medical 
costs, as authorized by 38 U.S.C. 1728. The new Veteran Reimbursement 
Claim Form, VA Form 10-320, will be utilized by Veterans requesting 
reimbursement for various out-of-pocket expenses that occurred as a 
result of non-VA medical services that may be eligible for payment 
under 38 CFR 17.4025 (Veterans Community Care Program), 38 CFR 17.120 
(Unauthorized), 38 CFR 17.1002 (Millennium Bill), and 38 CFR 17.1200--
17.1230 (COMPACT Act). In order for VA to process and repay these 
expenses, Veterans must submit necessary information to support their 
request and justify reimbursement.
    VA Form 10-320 will be used to collect information from Veterans 
seeking reimbursement for certain medical expenses. This claim form 
will be used to support payment of certain unauthorized non-VA medical 
services. Veterans may use this form to submit claims for reimbursement 
for a variety of services, such as pharmacy costs, training classes, 
emergent suicide care, and other medical expenses.
    Affected Public: Individuals or households.

[[Page 73943]]

    Estimated Annual Burden: 14,283 hours.
    Estimated Average Burden per Respondent: 10 minutes.
    Frequency of Response: Once annually.
    Estimated Number of Respondents: 85,700.

    By direction of the Secretary.
Maribel Aponte,
VA PRA Clearance Officer, Office of Enterprise and Integration/Data 
Governance Analytics, Department of Veterans Affairs.
[FR Doc. 2023-23784 Filed 10-26-23; 8:45 am]
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