[Federal Register Volume 89, Number 107 (Monday, June 3, 2024)]
[Notices]
[Pages 47684-47685]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-12119]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0091]


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

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995, 
this notice announces that the Veterans Health Administration (VHA), 
Department of Veterans Affairs (VA), will submit the collection of 
information abstracted below to the Office of Management and Budget 
(OMB) for review and comment. The PRA submission describes the nature 
of the information collection and its expected cost and burden, and it 
includes the actual data collection instrument.

DATES: Comments and recommendations for the proposed information 
collection should be sent within 30 days of publication of this notice 
by clicking on the following link www.reginfo.gov/public/do/PRAMain, 
select ``Currently under Review--Open for Public Comments,'' then 
search the list for the information collection by Title or ``OMB 
Control No. 2900-0091.''

FOR FURTHER INFORMATION CONTACT: VA PRA information: Maribel Aponte, 
202-461-8900, [email protected].

SUPPLEMENTARY INFORMATION: 
    Title: VA Health Benefits: Application, Update, Hardship 
Determination (VA Forms 10-10EZ, 10-10EZR and 10-10HS).
    OMB Control Number: 2900-0091 https://www.reginfo.gov/public/do/PRASearch.
    Type of Review: Extension 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

[[Page 47685]]

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 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.
    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.
    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 that their income for the current year will be substantially 
below the VA means test limits.
    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.
    An agency may not conduct or sponsor, and a person is not required 
to respond to, a collection of information unless it displays a 
currently valid OMB control number. The Federal Register Notice with a 
60-day comment period soliciting comments on this collection of 
information was published at 89 FR 20537, March 22, 2024.
    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.
    Authority: 44 U.S.C. 3501 et seq.

Maribel Aponte,
VA PRA Clearance Officer, Office of Enterprise and Integration, Data 
Governance Analytics, Department of Veterans Affairs.
[FR Doc. 2024-12119 Filed 5-31-24; 8:45 am]
BILLING CODE 8320-01-P