[Federal Register Volume 89, Number 29 (Monday, February 12, 2024)]
[Notices]
[Pages 9869-9870]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-02745]


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DEPARTMENT OF LABOR

Office of the Worker's Compensation Programs

[OMB Control No. 1240-0007]


Proposed Extension of Information Collection; Claim for Medical 
Reimbursement Form (OWCP-915)

AGENCY: Office of Workers' Compensation (OWCP), Labor.

ACTION: Request for public comments.

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SUMMARY: The Department of Labor, as part of its continuing effort to 
reduce paperwork and respondent burden, conducts a pre-clearance 
request for comment to provide the general public and Federal agencies 
with an opportunity to comment on proposed collections of information 
in accordance with the Paperwork Reduction Act of 1995. This request 
helps to ensure that: requested data can be provided in the desired 
format; reporting burden (time and financial resources) is minimized; 
collection instruments are clearly understood; and the impact of 
collection requirements on respondents can be properly assessed. 
Currently, OWCP is soliciting comments on the information collection 
for Claim for Medical Reimbursement (OWCP-915).

DATES: All comments must be received on or before April 12, 2024.

[[Page 9870]]


ADDRESSES: You may submit comment as follows. Please note that late, 
untimely filed comments will not be considered.
    Written/Paper Submissions: Submit written/paper submissions in the 
following way:
     Mail/Hand Delivery: Mail or visit DOL-OWCP, Office of 
Workers' Compensation Programs, U.S. Department of Labor, 200 
Constitution Ave. NW, Room S-3215, Washington, DC 20210.
     OWCP will post your comment as well as any attachments, 
except for information submitted and marked as confidential, in the 
docket at https://www.regulations.gov.

FOR FURTHER INFORMATION CONTACT: Anjanette Suggs, Office of Workers' 
Compensation Programs, OWCP, at [email protected] (email); (202) 
354-9660.

SUPPLEMENTARY INFORMATION:

I. Background

    The Office of Workers' Compensation Programs (OWCP) administers the 
Federal Employees' Compensation Act (FECA), 5 U.S.C. 8101 et seq., the 
Black Lung Benefits Act (BLBA), 30 U.S.C. 901 et seq., and the Energy 
Employees Occupational Illness Compensation Program Act of 2000 
(EEOICPA), 42 U.S.C. 7384 et seq. All three statutes require OWCP to 
pay for covered medical treatment that is provided to beneficiaries, 
and to reimburse beneficiaries for any out-of-pocket covered medical 
expenses they have paid. Form OWCP-915, Claim for Medical 
Reimbursement, is used for this purpose and collects the necessary 
beneficiary and medical provider data in a standard format. 
Beneficiaries must also attach billing information prepared by the 
medical provider (Form OWCP-1500 for professional medical services, 
Form OWCP-04 for institutional providers and hospitals, or a paper bill 
for medications dispensed in the physician's office. The hour and cost 
burdens to collect the billing information from medical providers in 
the required attachments to Form OWCP-915 are accounted for in OMB Nos. 
1240-0019, 1240-0044, and 1240-0050. This is the same billing 
information a medical provider reports when it bills OWCP directly. 
Regulations implementing the FECA, BLBA and EEOICPA programs require 
the collection of information that is needed to determine if 
reimbursement claims submitted by beneficiaries can be paid.

II. Desired Focus of Comments

    OWCP is soliciting comments concerning the proposed information 
collection (ICR) titled, ``Claim for Medical Reimbursement'' (OWCP-
915). OWCP/DFELHWC is particularly interested in comments that:
     Evaluate whether the collection of information is 
necessary for the proper performance of the functions of the Agency, 
including whether the information has practical utility;
     Evaluate the accuracy of OWCP's estimate of the burden 
related to the information collection, including the validity of the 
methodology and assumptions used in the estimate;
     Suggest methods to enhance the quality, utility, and 
clarity of the information to be collected; and
     Minimize the burden of the information collection 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.
    Background documents related to this information collection request 
are available at https://regulations.gov and at DOL-OWCP located at 200 
Constitution Avenue NW, Room S-3215, Washington, DC 20210. Questions 
about the information collection requirements may be directed to the 
person listed in the FOR FURTHER INFORMATION CONTACT section of this 
notice.

III. Current Actions

    This information collection request concerns Claim for 
Reimbursement OWCP-915. OWCP has updated the data with respect to the 
number of respondents, responses, burden hours, and burden costs 
supporting this information collection request from the previous 
information collection request.
    Type of Review: Extension, with change, of a currently approved 
collection.
    Agency: Office of Workers' Compensation Programs, OWCP.
    OMB Number: 1240-0007.
    Affected Public: Individuals or households.
    Number of Respondents: 18,023.
    Frequency: Annually.
    Number of Responses: 7.
    Annual Burden Hours: 4 hours.

OWCP-915, Claim for Reimbursement

    Comments submitted in response to this notice will be summarized in 
the request for Office of Management and Budget approval of the 
proposed information collection request; they will become a matter of 
public record and will be available at https://www.reginfo.gov.

Anjanette Suggs,
Certifying Officer.
[FR Doc. 2024-02745 Filed 2-9-24; 8:45 am]
BILLING CODE 4510-CR-P