Proposed Collection; Comment Request, 81242-81243 [2010-32392]
Download as PDF
<![CDATA[
81242
Federal Register / Vol. 75, No. 247 / Monday, December 27, 2010 / Notices
Attn; John J.M. Leininger, Aurora, CO
80011–9066 or call TRICARE
Management Activity—Aurora,
Performance Evaluation and Transition
Management Branch, at (303) 676–3613.
Title, Associated Form and OMB
Number: Health Insurance Claim Form,
CMS–1500, OMB Control Number
0720–0001.
Needs and Uses: This information
collection requirement is used by
TRICARE to determine reimbursement
for health care services or supplies
rendered by individual professional
providers to TRICARE beneficiaries. The
requested information is used to
determine beneficiary eligibility,
appropriateness and costs of care, other
health insurance liability and whether
services received are benefits. Use of
this form continues TRICARE’s
commitment to use the national
standard claim form for reimbursement
of services/supplies provided by
individual professional providers.
Affected Public: Business or other for
profit institutions, not-for-profit
institutions, Federal government, state,
local or tribal government.
Annual Burden Hours: 21,500,000.
Number of Respondents: 86,000,000.
Responses per Respondent: 1.
Average Burden per Response: 15
minutes.
Frequency: On occasion.
SUPPLEMENTARY INFORMATION:
erowe on DSK5CLS3C1PROD with NOTICES
Summary of Information Collection
This collection instrument is for use
by health care providers under the
TRICARE Program. TRICARE is a health
benefits entitlement program for active
duty, the dependents of active duty
Uniformed Services members and
deceased sponsors, retirees and their
dependents, dependents of Department
of Homeland Security (Coast Guard)
sponsors, and certain North Atlantic
Treaty Organizations, National Oceanic
and Atmospheric Administration, and
Public Health Service eligible
beneficiaries. The CMS–1500 Form is
used by individual professional health
care or health care related providers to
file for reimbursement of civilian health
care services or supplies provided to
TRICARE beneficiaries. This is the
national standard claim form accepted
by all major commercial and
government payers.
Dated: December 20, 2010.
Morgan F. Park,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 2010–32393 Filed 12–23–10; 8:45 am]
BILLING CODE 5001–06–P
VerDate Mar<15>2010
15:15 Dec 23, 2010
Jkt 223001
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID DOD–2010–HA–0177]
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 Naval Health
Research Center (NHRC), Department of
the Navy, announces a new proposed
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 February 25,
2011.
SUMMARY:
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, Room 3C843, 1160
Defense Pentagon, 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: Commanding Officer,
Naval Health Research Center, ATTN:
Michael Galarneau, MS, NREMT, Code
ADDRESSES:
PO 00000
Frm 00039
Fmt 4703
Sfmt 4703
161, 140 Sylvester Road, San Diego, CA
92106, or call at (619) 553–841 (this is
not a toll-free number).
Title; Associated Form; and OMB
Number: Traumatic Brain Injury, PostTraumatic Stress Disorder, and LongTerm Quality of Life Outcomes in
Injured Tri-Service U.S. Military
Personnel; OMB Control Number 0720–
TBD.
Needs and Uses: The information
collection requirement is necessary for
the Naval Health Research Center
(NHRC) to carry out the research study
it has been tasked to perform. This
research study will assess the long-term
health impact of injury on quality of life
outcomes in injured tri-service U.S.
military personnel, with a special focus
on the effects of traumatic brain injury
(TBI) and Post-traumatic Stress Disorder
(PTSD).
Information collected will be used to
investigate the long-term effects of
injury, TBI, and PTSD on the overall
physical and psychological health of
military personnel injured in overseas
contingency operations. Participants
will respond to a health-related
questionnaire bi-annually for three to
six years. Respondents to this study will
include both active-duty and separated
members of all branches of the U.S.
Armed Forces that have been injured
and that have indicated a desire to
participate through an Institutional
Review Board (IRB)-approved informed
consent process.
Affected Public: Current and former
members of the U.S. Armed Forces that
have been injured in overseas
contingency operations and that have
indicated a desire to participate.
Annual Burden Hours: 3,065 hours.
Number of Respondents: Approx.
4,644.
Responses per Respondent: 2.
Average Burden per Response: 20
minutes.
Frequency: Bi-annual.
SUPPLEMENTARY INFORMATION:
Summary of Information Collection
This information collection is
necessary for the Naval Health Research
Center (NHRC) to carry out the research
study ‘‘TRAUMATIC BRAIN INJURY,
POST-TRAUMATIC STRESS
DISORDER, AND LONG-TERM
QUALITY OF LIFE OUTCOMES IN
INJURED TRI-SERVICE U.S. MILITARY
PERSONNEL.’’ NHRC has been tasked
by the office of Congressionally Directed
Medical Research Programs (CDMRP) to
conduct this longitudinal
epidemiological study. The NHRC team
will collect information about physical
and psychological health from members
of the U.S. Armed Forces that have been
E:\FR\FM\27DEN1.SGM
27DEN1
Federal Register / Vol. 75, No. 247 / Monday, December 27, 2010 / Notices
injured in overseas contingency
operations by administering a voluntary
web, phone, or mail survey bi-annually
for a period of three (3) to six (6) years.
In all cases, informed consent will be
obtained prior to survey administration.
The information collected will be used
to ascertain the long-term effects of
traumatic brain injury (TBI), Posttraumatic Stress Disorder (PTSD), and
other injuries on quality of life
outcomes. Pinpointing the effects of
these injuries will allow for the
development of more effective
treatments and early interventions in
the management of TBI, PTSD, and
other injuries sustained by U.S. military
personnel in overseas contingency
operations.
Dated: December 20, 2010.
Morgan F. Park,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID DOD–2010–OS–0172]
Proposed Collection; Comment
Request
Office of the Under Secretary of
Defense (Personnel and Readiness),
DoD.
AGENCY:
Notice.
In compliance with Section
3506(c)(2)(A) of the Paperwork
Reduction Act of 1995, the Office of the
Under Secretary of Defense (Personnel
and Readiness) announces the following
proposed 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 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 the use of
automated collection techniques or
other forms of information technology.
erowe on DSK5CLS3C1PROD with NOTICES
SUMMARY:
Consideration will be given to all
comments received by February 25,
2011.
DATES:
VerDate Mar<15>2010
15:15 Dec 23, 2010
Jkt 223001
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 Office of the Under
Secretary of Defense (Personnel and
Readiness), Department of Defense
Education Activity, (Human Resources
Regional Service Center, Staffing
Section), ATTN: Ms. Patti Ross, 4040
North Fairfax Drive, Arlington, VA
22203, or call (703) 588–3915.
Title, Associated Form, and OMB
Control Number: Department of Defense
Education Activity, Student Teacher
Application, DoDEA Form 5308.1–F1,
and OMB Number 0704–TBD.
Needs and Uses: This information
collection requirement, including the
Social Security Number (SSN), will be
used by security personnel for National
Crime Information Center, State
Criminal Histories, and Federal Bureau
of Investigation record checks to
determine eligibility to serve as a
student teacher volunteer. The
information will also be used to ensure
that the student teacher is not in a pay
status as a Department of Defense
Education (DoDEA) employee at the
time of the student teaching experience.
Affected Public: Individuals or
households.
Annual Burden Hours: 50 hours.
Number of Respondents: 150.
Responses per Respondent: 1.
Average Burden per Response: 20
minutes.
Frequency: One-time. Filling out a
new application only occurs when a
student teacher volunteer changes from
one school to another school or if the
student teacher volunteer has a 2-year
break in school volunteer service.
SUPPLEMENTARY INFORMATION:
FOR FURTHER INFORMATION CONTACT:
[FR Doc. 2010–32392 Filed 12–23–10; 8:45 am]
ACTION:
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, Room 3C843, 1160
Defense Pentagon, 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.
ADDRESSES:
PO 00000
Frm 00040
Fmt 4703
Sfmt 4703
81243
Summary of Information Collection
The data collection is necessary to
collect information from applicants for
student teaching positions from which
to determine eligibility for appointment
as a student teacher volunteer.
Information collection is necessary to
determine if a student teacher applicant
is suitable for a position involving
extensive, frequent, or recurring
unsupervised interaction with a student
or students under the age of 18. The
DoDEA Form 5308.1–F1, ‘‘Student
Teacher Application,’’ records the name,
SSN, address, phone numbers, and email address of the student teacher
applicant.
Dated: December 20, 2010.
Morgan F. Park,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 2010–32390 Filed 12–23–10; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID DOD–2010–OS–0173]
Proposed Collection; Comment
Request
Office of the Under Secretary of
Defense (Personnel and Readiness),
DoD.
ACTION: Notice.
AGENCY:
In compliance with Section
3506(c)(2)(A) of the Paperwork
Reduction Act of 1995, the Office of the
Under Secretary of Defense (Personnel
and Readiness) announces the following
proposed 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 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 February 25,
2011.
SUMMARY:
You may submit comments,
identified by docket number and title,
by any of the following methods:
ADDRESSES:
E:\FR\FM\27DEN1.SGM
27DEN1
]]>Agencies
[Federal Register Volume 75, Number 247 (Monday, December 27, 2010)]
[Notices]
[Pages 81242-81243]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-32392]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID DOD-2010-HA-0177]
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 Naval Health Research Center (NHRC),
Department of the Navy, announces a new proposed 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 February
25, 2011.
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, Room 3C843,
1160 Defense Pentagon, 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: Commanding Officer,
Naval Health Research Center, ATTN: Michael Galarneau, MS, NREMT, Code
161, 140 Sylvester Road, San Diego, CA 92106, or call at (619) 553-841
(this is not a toll-free number).
Title; Associated Form; and OMB Number: Traumatic Brain Injury,
Post-Traumatic Stress Disorder, and Long-Term Quality of Life Outcomes
in Injured Tri-Service U.S. Military Personnel; OMB Control Number
0720-TBD.
Needs and Uses: The information collection requirement is necessary
for the Naval Health Research Center (NHRC) to carry out the research
study it has been tasked to perform. This research study will assess
the long-term health impact of injury on quality of life outcomes in
injured tri-service U.S. military personnel, with a special focus on
the effects of traumatic brain injury (TBI) and Post-traumatic Stress
Disorder (PTSD).
Information collected will be used to investigate the long-term
effects of injury, TBI, and PTSD on the overall physical and
psychological health of military personnel injured in overseas
contingency operations. Participants will respond to a health-related
questionnaire bi-annually for three to six years. Respondents to this
study will include both active-duty and separated members of all
branches of the U.S. Armed Forces that have been injured and that have
indicated a desire to participate through an Institutional Review Board
(IRB)-approved informed consent process.
Affected Public: Current and former members of the U.S. Armed
Forces that have been injured in overseas contingency operations and
that have indicated a desire to participate.
Annual Burden Hours: 3,065 hours.
Number of Respondents: Approx. 4,644.
Responses per Respondent: 2.
Average Burden per Response: 20 minutes.
Frequency: Bi-annual.
SUPPLEMENTARY INFORMATION:
Summary of Information Collection
This information collection is necessary for the Naval Health
Research Center (NHRC) to carry out the research study ``TRAUMATIC
BRAIN INJURY, POST-TRAUMATIC STRESS DISORDER, AND LONG-TERM QUALITY OF
LIFE OUTCOMES IN INJURED TRI-SERVICE U.S. MILITARY PERSONNEL.'' NHRC
has been tasked by the office of Congressionally Directed Medical
Research Programs (CDMRP) to conduct this longitudinal epidemiological
study. The NHRC team will collect information about physical and
psychological health from members of the U.S. Armed Forces that have
been
[[Page 81243]]
injured in overseas contingency operations by administering a voluntary
web, phone, or mail survey bi-annually for a period of three (3) to six
(6) years. In all cases, informed consent will be obtained prior to
survey administration. The information collected will be used to
ascertain the long-term effects of traumatic brain injury (TBI), Post-
traumatic Stress Disorder (PTSD), and other injuries on quality of life
outcomes. Pinpointing the effects of these injuries will allow for the
development of more effective treatments and early interventions in the
management of TBI, PTSD, and other injuries sustained by U.S. military
personnel in overseas contingency operations.
Dated: December 20, 2010.
Morgan F. Park,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2010-32392 Filed 12-23-10; 8:45 am]
BILLING CODE 5001-06-P
