Proposed Information Collection (Dental Record Authorization and Invoice for Outpatient Services) Activity: Comment Request, 49918 [E9-23412]

Download as PDF 49918 Federal Register / Vol. 74, No. 187 / Tuesday, September 29, 2009 / Notices jlentini on DSKJ8SOYB1PROD with NOTICES OMB Control Number: 2900–0376. Type of Review: Extension of a currently approved collection. Abstract: VA in an on-going effort to maintain an Agent Orange Registry (AOR) developed a reporting format to facilitate the collection of information obtained from veterans during the Agent Orange registry examination process. VA is required to organize and update the information contained in AOR to be able to notify Vietnam era veterans who served in the Republic of Vietnam of any increased health risks resulting from exposure to dioxin or other toxic agents. VA may also provide, upon request, a health examination, consultation, and counseling veterans who are eligible for listing or inclusion in any health-related registry administrated by VA that is similar to the Persian Gulf War Veterans Health Registry. Registry examinations is provided to veterans who served in Korea in 1968 or 1969, and/or any U.S. veteran who may have been exposed to dioxin, or other toxic substance in a herbicide or defoliant, during the conduct of, or as a result of, the testing, transporting, or spraying of herbicides, and who requests an Agent Orange Registry examination. VA will enter the information obtained from the veteran during the interview on VA Form 10– 9009, Agent Orange Registry Code Sheet. The registry will provide a mechanism that will catalogue prominent symptoms, reproductive health, and diagnoses and to communicate with Agent Orange veterans. VA will inform the veterans on research finding or new compensation policies through periodic newsletters. The registry is not designed or intended to be a research tool and therefore the results cannot be generalized to represent all Agent Orange veterans. Affected Public: Individuals or Households. Estimated Total Annual Burden: 6,667 hours. Estimated Average Burden per Respondent: 20 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: 6,667. Dated: September 24, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–23411 Filed 9–28–09; 8:45 am] BILLING CODE 8320–01–P VerDate Nov<24>2008 16:18 Sep 28, 2009 Jkt 217001 DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0335] Proposed Information Collection (Dental Record Authorization and Invoice for Outpatient Services) Activity: Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Health Administration (VHA) 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. This notice solicits comments on the information needed to determine a veteran’s dental treatment needs, and the fees associated for these services. DATES: Written comments and recommendations on the proposed collection of information should be received on or before November 30, 2009. ADDRESSES: Submit written comments on the collection of information through Federal Docket Management System (FDMS) at http://www.Regulations.gov; or to Mary Stout, Veterans Health Administration (193E1), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420 or e-mail: mary.stout@va.gov. Please refer to ‘‘OMB Control No. 2900–0335’’ in any correspondence. During the comment period, comments may be viewed online through FDMS. FOR FURTHER INFORMATION CONTACT: Mary Stout (202) 461–5867 or FAX (202) 273–9381. SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104–13; 44 U.S.C. 3501–3521), 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; PO 00000 Frm 00071 Fmt 4703 Sfmt 4703 (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. Title: Dental Record Authorization and Invoice for Outpatient Services, VA Form 10–2570d. OMB Control Number: 2900–0335. Type of Review: Extension of a currently approved collection. Abstract: VA Form 10–2570d is essential to the proper administration of VA outpatient fee dental program. The associated instructions make it possible to communicate with clarity the required procedures, peculiarities, and precautions associated with VA authorizations for contracting with private dentists for the provision of dental treatment for eligible veteran beneficiaries. Since most of the veterans who are authorized fee dental care are geographically inaccessible to VA dental clinics, it is necessary to request information as to the veteran’s oral condition, treatment needs and the usual customary fees for these services from the private fee dentist whom the veteran has selected. The form lists the dental treatment needs of the veteran patient, the cost to VA to provide such services, and serves as an invoice for payment. VA uses the data collected to verify the veteran’s eligibility to receive dental benefits. Affected Public: Business and other for profit. Estimated Total Annual Burden: 3,666 hours. Estimated Average Burden per Respondent: 20 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: 11,000. Dated: September 24, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–23412 Filed 9–28–09; 8:45 am] BILLING CODE 8320–01–P E:\FR\FM\29SEN1.SGM 29SEN1

Agencies

[Federal Register Volume 74, Number 187 (Tuesday, September 29, 2009)]
[Notices]
[Page 49918]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-23412]


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

DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0335]


Proposed Information Collection (Dental Record Authorization and 
Invoice for Outpatient Services) Activity: Comment Request

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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

SUMMARY: The Veterans Health Administration (VHA) 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. This notice 
solicits comments on the information needed to determine a veteran's 
dental treatment needs, and the fees associated for these services.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before November 30, 2009.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at http://www.Regulations.gov; or to Mary Stout, Veterans Health Administration 
(193E1), Department of Veterans Affairs, 810 Vermont Avenue, NW., 
Washington, DC 20420 or e-mail: mary.stout@va.gov. Please refer to 
``OMB Control No. 2900-0335'' in any correspondence. During the comment 
period, comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Mary Stout (202) 461-5867 or FAX (202) 
273-9381.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-3521), 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.
    Title: Dental Record Authorization and Invoice for Outpatient 
Services, VA Form 10-2570d.
    OMB Control Number: 2900-0335.
    Type of Review: Extension of a currently approved collection.
    Abstract: VA Form 10-2570d is essential to the proper 
administration of VA outpatient fee dental program. The associated 
instructions make it possible to communicate with clarity the required 
procedures, peculiarities, and precautions associated with VA 
authorizations for contracting with private dentists for the provision 
of dental treatment for eligible veteran beneficiaries. Since most of 
the veterans who are authorized fee dental care are geographically 
inaccessible to VA dental clinics, it is necessary to request 
information as to the veteran's oral condition, treatment needs and the 
usual customary fees for these services from the private fee dentist 
whom the veteran has selected. The form lists the dental treatment 
needs of the veteran patient, the cost to VA to provide such services, 
and serves as an invoice for payment. VA uses the data collected to 
verify the veteran's eligibility to receive dental benefits.
    Affected Public: Business and other for profit.
    Estimated Total Annual Burden: 3,666 hours.
    Estimated Average Burden per Respondent: 20 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 11,000.


    Dated: September 24, 2009.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9-23412 Filed 9-28-09; 8:45 am]
BILLING CODE 8320-01-P