Proposed Collection; Comment Request, 60417-60418 [2010-24530]
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mstockstill on DSKH9S0YB1PROD with NOTICES6
Federal Register / Vol. 75, No. 189 / Thursday, September 30, 2010 / Notices
reasonable value of medical care
provided by the United States to a
person who is injured or suffers a
disease under circumstances creating
tort liability in a third person. DD Form
2527 is required for investigating and
asserting claims in favor of the United
States arising out of such incidents.
When a claim for TRICARE benefits is
identified as involving possible third
party liability and the information is not
submitted with the claim, the TRICARE
contractor requests that the injured
party (or a designee) complete DD Form
2527. To protect the interests of the
Government, the contractor suspends
claims processing until the requested
third party liability information is
received. The contractor conducts a
preliminary evaluation based upon the
collection of information and refers the
case to a designated appropriate legal
officer of the Uniformed Services. The
responsible Uniformed Services legal
officer uses the information as a basis
for asserting and settling the
Government’s claim. When appropriate,
the information is forwarded to the
Department of Justice as the basis for
litigation.
Section 1 of the Form is used to
collect general information, such as
name, address and telephone numbers
about the military sponsor and the
injured beneficiary and the date, time
and location where the injured
occurred.
Section 2 of the Form is used to
collect information about accidental
injuries. Most of the investigations for
third party liability involve motor
vehicle accidents. Information about
insurance coverage for the parties
involved in the accident is collected.
Section 2 of the Form is also used to
collect information about accidents not
involving motor vehicles. Information
such as the type of accident, the place
where the injury occurred, the name of
the property owner where the injury
occurred and cause of the injury is
collected. The name and address of the
employer is collected when the injury
was work related.
Section 3 of the Form is used for
miscellaneous information such as
possible medical treatment at a
Government hospital, the name and
address of the beneficiary’s attorney,
and information regarding any possible
releases or settlements with another
party to the accident. It also contains the
certification, date and signature of the
beneficiary (or a designee).
VerDate Mar<15>2010
17:48 Sep 29, 2010
Jkt 220001
Dated: September 17, 2010.
Patricia L. Toppings,
OSD Federal Register Liaison Officer,
Department of Defense.
[FR Doc. 2010–24529 Filed 9–29–10; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID: DoD–2010–HA–0133]
Proposed Collection; Comment
Request
Office of the Assistant
Secretary of Defense for Health Affairs,
DoD.
ACTION: Notice.
AGENCY:
In compliance with Section
3506(c)(2)(A) of the Paperwork
Reduction Act of 1995, the Office of the
Assistant Secretary of Defense for
Health Affairs announces the proposed
extension of a public information
collection and seeks public comment on
the provisions thereof. Comments are
invited on: (a) Whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden of the
proposed information collection; (c)
ways to enhance the quality, utility, and
clarity of the information to be
collected; and (d) ways to minimize the
burden of the information collection on
respondents, including through the use
of automated collection techniques or
other forms of information technology.
DATES: Consideration will be given to all
comments received by November 29,
2010.
ADDRESSES: You may submit comments,
identified by docket number and title,
by any of the following methods:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Federal Docket Management
System Office, 1160 Defense Pentagon,
Room 3C843, Washington, DC 20301–
1160.
Instructions: All submissions received
must include the agency name, docket
number and title for this Federal
Register document. The general policy
for comments and other submissions
from members of the public is to make
these submissions available for public
viewing on the Internet at https://
www.regulations.gov as they are
received without change, including any
personal identifiers or contact
information.
SUMMARY:
PO 00000
Frm 00014
Fmt 4703
Sfmt 4703
60417
To
request more information on this
proposed information collection or to
obtain a copy of the proposal and
associated collection instruments,
please write to the TRICARE
Management Activity, Medical Benefits
and Reimbursement Branch, Ann N.
Fazzini, Aurora, CO 80011 or phone
303–676–3803.
Title; Associated Form; and OMB
Number: Diagnosis Related Groups
(DRG) Reimbursement; OMB Control
Number 0720–0017.
Needs and Uses: The TRICARE/
CHAMPUS contractors will use the
information collected to reimburse
hospitals for TRICARE/CHAMPUS share
of capital and direct medical education
costs. Respondents are institutional
providers.
Affected Public: Business or other forprofit.
Annual Burden Hours: 4,993.
Number of Respondents: 4,993.
Responses per Respondent: 1.
Average Burden per Response: 1 hour.
Frequency: On occasion.
SUPPLEMENTARY INFORMATION:
FOR FURTHER INFORMATION CONTACT:
Summary of Information Collection
The Department of Defense
Authorization Act, 1984, Public Law
98–94 amended Title 10, section
1079(j)(2)(A) of the U.S.C. and provided
the Civilian Health and Medical
Program of the Uniform Services
(CHAMPUS) with the statutory
authority to reimburse institutional
providers based on diagnosis-related
groups (DRGs). The CHAMPUS DRGbased payment system, except for
children’s hospitals (whose capital and
direct medical education costs are
incorporated in the children’s hospital
differential), who want to be reimbursed
for allowed capital and direct medical
education costs must submit a request
for payment to the TRICARE/CHAMPUS
contractor. The request allows TRICARE
to collect the information necessary to
properly reimburse hospitals for its
share of these costs. The information
can be submitted in any form, most
likely in the form of a letter. The
contractor will calculate the TRICARE/
CHAMPUS share of capital and direct
medical educations costs and make a
lump-sum payment to the hospital. The
TRICARE/CHAMPUS DRG-based
payment system is modeled on the
Medicare Prospective Payment System
(PPS) and was implemented on October
1, 1987. Initially, under 42 CFR 412.46
of the Medicare regulations, physicians
were required to sign attestation and
acknowledgment statements. These
requirements were implemented to
ensure a means of holding hospitals and
E:\FR\FM\30SEN1.SGM
30SEN1
60418
Federal Register / Vol. 75, No. 189 / Thursday, September 30, 2010 / Notices
physicians accountable for the
information they submit on the
Medicare claim forms. Being modeled
on the Medicare PPS, CHAMPUS also
adopted these requirements. The
physicians attestation and physician
acknowledgment required by Medicare
under 42 CFR 412.46 are also required
for CHAMPUS as a condition for
payment and may be satisfied by the
same statements as required for
Medicare, with substitution or addition
of ‘‘CHAMPUS’’ when the word
‘‘Medicare’’ is used. Physicians sign a
physician acknowledgement,
maintained by the institution, at the
time the physician is granted admitting
privileges. This acknowledgement
indicates the physician understands the
importance of a correct medical record,
and misrepresentation may be subject to
penalties.
Dated: September 10, 2010.
Patricia L. Toppings,
OSD Federal Register Liaison Officer,
Department of Defense.
[FR Doc. 2010–24530 Filed 9–29–10; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID: DoD–2010–HA–0132]
Proposed Collection; Comment
Request
Office of the Assistant
Secretary of Defense for Health Affairs,
DoD.
AGENCY:
mstockstill on DSKH9S0YB1PROD with NOTICES6
ACTION:
Notice.
In compliance with Section
3506(c)(2)(A) of the Paperwork
Reduction Act of 1995, the Office of the
Assistant Secretary of Defense for
Health Affairs announces the proposed
extension of a public information
collection and seeks public comment on
the provisions thereof. Comments are
invited on: (a) Whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden of the
proposed information collection; (c)
ways to enhance the quality, utility, and
clarity of the information to be
collected; and (d) ways to minimize the
burden of the information collection on
respondents, including through the use
of automated collection techniques or
other forms of information technology.
VerDate Mar<15>2010
17:48 Sep 29, 2010
Jkt 220001
Consideration will be given to all
comments received by November 29,
2010.
ADDRESSES: You may submit comments,
identified by docket number and title,
by any of the following methods:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Federal Docket Management
System Office, 1160 Defense Pentagon,
Room 3C843, Washington, DC 20301–
1160.
Instructions: All submissions received
must include the agency name, docket
number and title for this Federal
Register document. The general policy
for comments and other submissions
from members of the public is to make
these submissions available for public
viewing on the Internet at https://
www.regulations.gov as they are
received without change, including any
personal identifiers or contact
information.
FOR FURTHER INFORMATION CONTACT: To
request more information on this
proposed information collection or to
obtain a copy of the proposal and
associated collection instruments,
please write to TRICARE Management
Activity, Contract Operations Branch,
16401 E. Centretech Parkway, Attn:
Kenneth Zimmerman, Aurora, CO
80011, or call TRICARE Management
Activity, Contract Operations Branch, at
(303–676–3502).
Title; Associated Form; and OMB
Number: TRICARE Retiree Dental
Program Enrollment Application Form;
OMB Number 0720–0015.
Needs and Uses: This information
collection is completed by Uniformed
Services members entitled to retired pay
and their eligible family members who
are seeking enrollment in the TRICARE
Retiree Dental Program (TRDP). The
information is necessary to enable the
DoD-contracted third party
administrator of the program to identify
the program’s applicants, determine
their eligibility for TRDP enrollment,
establish the premium payment amount,
and to verify by the applicant’s
signature that the applicant understands
the benefits and rules of the program.
Affected Public: Individuals or
household.
Annual Burden Hours: 17,833.
Number of Respondents: 71,332.
Responses Per Respondent: 1.
Average Burden Per Response: 15
minutes.
Frequency: Annually.
SUPPLEMENTARY INFORMATION:
DATES:
Summary of Information Collection
The TRICARE Retiree Dental Program
(32 CFR 199.22) was implemented in
PO 00000
Frm 00015
Fmt 4703
Sfmt 4703
1998 based on the authority of 10 U.S.C.
1076c. Dental coverage under the
program is available on a voluntary
basis to retirees of the Uniformed
Services entitled to retired pay and their
family members.
The information collection
requirements under this proposed
extension are similar to those under the
current collection. Information on the
applicant, such as name, address,
telephone numbers, date of birth, and
retiree’s social security number, is
necessary for identification purposes, as
is information on the family members to
be enrolled. The form also contains
information on premium payment
enrollment options and a certification
statement for the applicant to sign and
date. The primary change in the
proposed extension of the information
collection is to update the expiration
date of the Enrollment Application.
Dated: September 10, 2010.
Patricia L. Toppings,
OSD Federal Register Liaison Officer,
Department of Defense.
[FR Doc. 2010–24531 Filed 9–29–10; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID: DoD–2010–HA–0134]
Proposed Collection; Comment
Request
Uniformed Services University
of the Health Sciences, Graduate School
of Nursing, DoD.
ACTION: Notice.
AGENCY:
In compliance with Section
3506 (c)(2)(A) of the Paperwork
Reduction Act of 1995, the Uniformed
Services University of the Health
Sciences proposes a new public
information collection. Comments are
invited on: (a) Whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden of the
proposed information collection; (c)
ways to enhance the quality, utility, and
clarity of the information to be
collected; and (d) ways to minimize the
burden of the information collection on
respondents, including through the use
of automated collection techniques or
other forms of information technology.
DATES: Consideration will be given to all
comments received by November 29,
2010.
SUMMARY:
E:\FR\FM\30SEN1.SGM
30SEN1
Agencies
[Federal Register Volume 75, Number 189 (Thursday, September 30, 2010)]
[Notices]
[Pages 60417-60418]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-24530]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID: DoD-2010-HA-0133]
Proposed Collection; Comment Request
AGENCY: Office of the Assistant Secretary of Defense for Health
Affairs, DoD.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In compliance with Section 3506(c)(2)(A) of the Paperwork
Reduction Act of 1995, the Office of the Assistant Secretary of Defense
for Health Affairs announces the proposed extension of a public
information collection and seeks public comment on the provisions
thereof. Comments are invited on: (a) Whether the proposed collection
of information is necessary for the proper performance of the functions
of the agency, including whether the information shall have practical
utility; (b) the accuracy of the agency's estimate of the burden of the
proposed information collection; (c) ways to enhance the quality,
utility, and clarity of the information to be collected; and (d) ways
to minimize the burden of the information collection on respondents,
including through the use of automated collection techniques or other
forms of information technology.
DATES: Consideration will be given to all comments received by November
29, 2010.
ADDRESSES: You may submit comments, identified by docket number and
title, by any of the following methods:
Federal eRulemaking Portal: https://www.regulations.gov.
Follow the instructions for submitting comments.
Mail: Federal Docket Management System Office, 1160
Defense Pentagon, Room 3C843, Washington, DC 20301-1160.
Instructions: All submissions received must include the agency
name, docket number and title for this Federal Register document. The
general policy for comments and other submissions from members of the
public is to make these submissions available for public viewing on the
Internet at https://www.regulations.gov as they are received without
change, including any personal identifiers or contact information.
FOR FURTHER INFORMATION CONTACT: To request more information on this
proposed information collection or to obtain a copy of the proposal and
associated collection instruments, please write to the TRICARE
Management Activity, Medical Benefits and Reimbursement Branch, Ann N.
Fazzini, Aurora, CO 80011 or phone 303-676-3803.
Title; Associated Form; and OMB Number: Diagnosis Related Groups
(DRG) Reimbursement; OMB Control Number 0720-0017.
Needs and Uses: The TRICARE/CHAMPUS contractors will use the
information collected to reimburse hospitals for TRICARE/CHAMPUS share
of capital and direct medical education costs. Respondents are
institutional providers.
Affected Public: Business or other for-profit.
Annual Burden Hours: 4,993.
Number of Respondents: 4,993.
Responses per Respondent: 1.
Average Burden per Response: 1 hour.
Frequency: On occasion.
SUPPLEMENTARY INFORMATION:
Summary of Information Collection
The Department of Defense Authorization Act, 1984, Public Law 98-94
amended Title 10, section 1079(j)(2)(A) of the U.S.C. and provided the
Civilian Health and Medical Program of the Uniform Services (CHAMPUS)
with the statutory authority to reimburse institutional providers based
on diagnosis-related groups (DRGs). The CHAMPUS DRG-based payment
system, except for children's hospitals (whose capital and direct
medical education costs are incorporated in the children's hospital
differential), who want to be reimbursed for allowed capital and direct
medical education costs must submit a request for payment to the
TRICARE/CHAMPUS contractor. The request allows TRICARE to collect the
information necessary to properly reimburse hospitals for its share of
these costs. The information can be submitted in any form, most likely
in the form of a letter. The contractor will calculate the TRICARE/
CHAMPUS share of capital and direct medical educations costs and make a
lump-sum payment to the hospital. The TRICARE/CHAMPUS DRG-based payment
system is modeled on the Medicare Prospective Payment System (PPS) and
was implemented on October 1, 1987. Initially, under 42 CFR 412.46 of
the Medicare regulations, physicians were required to sign attestation
and acknowledgment statements. These requirements were implemented to
ensure a means of holding hospitals and
[[Page 60418]]
physicians accountable for the information they submit on the Medicare
claim forms. Being modeled on the Medicare PPS, CHAMPUS also adopted
these requirements. The physicians attestation and physician
acknowledgment required by Medicare under 42 CFR 412.46 are also
required for CHAMPUS as a condition for payment and may be satisfied by
the same statements as required for Medicare, with substitution or
addition of ``CHAMPUS'' when the word ``Medicare'' is used. Physicians
sign a physician acknowledgement, maintained by the institution, at the
time the physician is granted admitting privileges. This
acknowledgement indicates the physician understands the importance of a
correct medical record, and misrepresentation may be subject to
penalties.
Dated: September 10, 2010.
Patricia L. Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2010-24530 Filed 9-29-10; 8:45 am]
BILLING CODE 5001-06-P