[Federal Register Volume 89, Number 57 (Friday, March 22, 2024)]
[Notices]
[Pages 20537-20538]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-06065]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0091]


Agency Information Collection Activity: VA Health Benefits: 
Application, Update, Hardship Determination

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 May 21, 2024.

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. 2900-0091'' in any correspondence. During the comment 
period, comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Dorothy Glasgow, Office of Enterprise 
and Integration, Data Governance Analytics (008), 810 Vermont Avenue 
NW, Washington, DC 20420, (202) 461-1084 or email 
[email protected]. Please refer to ``OMB Control No. 2900-0091'' 
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: VA Health Benefits: Application, Update, Hardship 
Determination (VA Forms 10-10EZ, 10-10EZR and 10-10HS).
    OMB Control Number: 2900-0091.
    Type of Review: Revision of a currently approved collection.
    Abstract: Title 38 U.S.C. chapter 17 authorizes VA to provide 
hospital care, medical services, domiciliary care, and nursing home 
care to eligible Veterans. Title 38 U.S.C. 1705 requires VA to design, 
establish, and operate a system of annual patient enrollment in 
accordance with a series of stipulated priorities. Title 38 U.S.C. 1722 
establishes eligibility assessment procedures for cost-free VA medical 
care, based on income levels, which determines whether nonservice-
connected and 0% service-connected non-compensable Veterans are able to 
defray the necessary expenses of care for nonservice-connected 
conditions. Further, when the Veteran projects that their attributable 
income for the current calendar year would be substantially below the 
applicable income thresholds, the Veteran would be considered unable

[[Page 20538]]

to defray the expenses of care and VA may exempt the Veteran from the 
requirement to pay copayments for hospital or outpatient care. In 
addition, section 103 of Public Law 117-168, titled the Sergeant First 
Class Heath Robinson Honoring our Promise to Address Comprehensive 
Toxics (PACT) Act of 2022, amended title 38 U.S.C. 1710(e)(3) by 
expanding the health care eligibility benefit for Veterans who 
participated in a toxic exposure risk activity (TERA) while serving on 
active duty, active duty for training, or inactive duty training.
    This collection of information is required to properly administer 
health benefits to eligible Veterans.
    a. VA Form 10-10EZ, Application for Health Benefits, is used to 
collect Veteran information during the initial application process for 
VA medical care, nursing home, domiciliary, dental benefits, etc. 
Updates were made to this form pursuant to section 103 of the PACT Act 
to collect additional information in the Military Service section for 
the expanded TERA health care eligibility benefit. Corresponding 
changes were made to the Instructions and Definitions sections.
    b. VA Form 10-10EZR, Health Benefits Update Form, is used to update 
a Veteran's personal information, such as marital status, address, 
health insurance and financial information, for renewal of health 
benefits. Updates were made to this form pursuant to section 103 of the 
PACT Act to collect additional information in the Military Service 
section for the expanded TERA health care eligibility benefit. 
Corresponding changes were made to the Instructions and Definitions 
sections.
    c. VA Form 10-10HS, Request for Hardship Determination, is used to 
collect information from Veterans who are in a copay required status 
for hospital care and medical services, but due to a loss of income 
project their income for the current year will be substantially below 
the VA means test limits. No updates were made to this form.
    These forms collect information to enroll a Veteran for health 
benefits, establish basic eligibility, determine TERA benefit 
eligibility, identify 3rd party health insurance coverage, identify 
prescription copayment, provide for income verification, and serve as a 
mechanism to make changes upon admission for benefits or yearly 
financial updates.
    Total Annual Burden: 703,300 hours.
    Total Annual Responses: 1,406,000.

VA Form 10-10EZ

    Affected Public: Individuals and households.
    Estimated Annual Burden: 315,000 hours.
    Estimated Average Burden per Respondent: 35 minutes.
    Frequency of Response: Annually.
    Estimated Number of Respondents: 540,000.

VA Form 10-10EZR

    Affected Public: Individuals and households.
    Estimated Annual Burden: 386,550 hours.
    Estimated Average Burden per Respondent: 27 minutes.
    Frequency of Response: Annually.
    Estimated Number of Respondents: 859,000.

VA Form 10-10HS

    Affected Public: Individuals and households.
    Estimated Annual Burden: 1,750 hours.
    Estimated Average Burden per Respondent: 15 minutes.
    Frequency of Response: Annually.
    Estimated Number of Respondents: 7,000.

    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. 2024-06065 Filed 3-21-24; 8:45 am]
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