[Federal Register Volume 89, Number 35 (Wednesday, February 21, 2024)]
[Notices]
[Pages 13106-13107]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-03438]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs

[OMB Control No. 1240-0044]


Proposed Extension of Information Collection; Health Insurance 
Claim Form (OWCP-1500)

AGENCY: Office of Workers' Compensation Programs, 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 Health Claim Insurance Form, OWCP-1500.

[[Page 13107]]


DATES: All comments must be received on or before April 22, 2024.

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 the DOL-OWCP, Office of 
Workers' Compensation Programs, U.S. Department of Labor, 200 
Constitution Avenue NW, Room S3524, Washington, DC 20210.
     OWCP will post your comments as well as any attachments, 
except for information submitted and marked as confidential, in the 
docket at https://www.regulations.gov.
     Because your comment will be made public, you are 
responsible for ensuring that your comment does not include any 
confidential information that you or a third party may not wish to be 
posted, such as your or anyone else's Social Security number or 
confidential business information.
     If your comment includes confidential information that you 
do not wish to be made available to the public, submit the comment as a 
written/paper submission.

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

SUPPLEMENTARY INFORMATION:

I. Background

    The Office of Workers' Compensation Programs (OWCP) is the agency 
responsible for administration of the Federal Employees' Compensation 
Act (FECA), 5 U.S.C. 8101--administered by the Division of Federal 
Employees' Compensation Program; the Black Lung Benefits Act (BLBA), 30 
U.S.C. 901--administered by the Division of Coal Miner Workers' 
Compensation Program; and the Energy Employees Occupational Illness 
Compensation Program Act of 2000 (EEOICPA), 42 U.S.C. 7384 administered 
by the Division of Energy Employees Occupational Illness Compensation 
Programs. All three of these statutes require that OWCP pay for medical 
treatment of beneficiaries; BLBA also requires that OWCP pay for 
medical examinations and related diagnostic services to determine 
eligibility for benefits under that statute. In order to determine 
whether billed amounts are appropriate, OWCP needs to identify the 
patient, the injury or illness that was treated or diagnosed, the 
specific services that were rendered and their relationship to the 
work-related injury or illness. The regulations implementing these 
statutes require the use of Form OWCP-1500 for medical bills submitted 
by certain physicians and other providers (20 CFR 10.801, 20 CFR 
725.704, 30.701, 725.405, 725.406(e), 725.701 and 725.715).

II. Desired Focus of Comments

    OWCP is soliciting comments concerning the proposed information 
collection related to the Health Insurance Claim Form (OWCP-1500).
    OWCP 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, Washington, DC 20210. Questions about the 
information collection requirements may be directed to the person 
listed in the FOR FURTHER INFORMATION section of this notice.

III. Current Actions

    This information collection request concerns the Health Insurance 
Claim Form, OWCP-1500. 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, without change, of a currently approved 
collection.
    Agency: Office of Workers' Compensation Programs.
    OMB Number: 1240-0044.
    Affected Public: Private Sector.
    Number of Respondents: 57,099.
    Frequency: On Occasion.
    Number of Responses: 3,381,232.
    Annual Burden Hours: 394,477.
    Annual Respondent or Recordkeeper Cost: $0.
    OWCP Form: OWCP Form OWCP-1500, Health Insurance Claim Form.
    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. 2024-03438 Filed 2-20-24; 8:45 am]
BILLING CODE 4510-CR-P