Proposed Information Collection (Payment and Reimbursement for Emergency Services for Non Service-Connected Conditions in Non-VA Facilities); Comment Request, 63353 [2011-26286]
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jlentini on DSK4TPTVN1PROD with NOTICES
Federal Register / Vol. 76, No. 197 / Wednesday, October 12, 2011 / Notices
received on or before December 12,
2011.
ADDRESSES: Submit written comments
on the collection of information through
the Federal Docket Management System
(FDMS) at https://www.Regulations.gov;
or to Cynthia Harvey Pryor, Veterans
Health Administration (10P7BFP),
Department of Veterans Affairs, 810
Vermont Avenue, NW., Washington, DC
20420 or e-mail: cynthia.harveypryor@va.gov. Please refer to ‘‘2900–
0722’’ in any correspondence. During
the comment period, comments may be
viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT:
Cynthia Harvey-Pryor (202) 461–5870 or
fax (202) 273–9387.
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: Health Surveillance for a New
Generation of U.S. Veterans Survey.
OMB Control Number: 2900–0722.
Type of Review: Extension of a
currently approved collection.
Abstract: The Health Surveillance for
a New Generation of U.S. Veterans
survey will be used to collect data from
Operation Iraqi Freedom and Operation
Enduring Freedom veterans regarding
their current health status and concerns,
exposures of concern in the theater,
health care preferences, and health
behaviors and attitudes, and to gain
knowledge on veterans who have not
used VA health care since returning
from the current conflict. The data
collected will help VA to plan and
provide better health care to Operation
Iraqi Freedom and Operation Enduring
Freedom veterans, as well as
understanding the long-term
consequences of military deployment.
VerDate Mar<15>2010
17:43 Oct 11, 2011
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Affected Public: Individuals or
households.
Estimated Annual Burden: 24,858
hours.
Estimated Average Burden Per
Respondent: 39 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
38,300.
Dated: October 6, 2011.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011–26285 Filed 10–11–11; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0620]
Proposed Information Collection
(Payment and Reimbursement for
Emergency Services for Non ServiceConnected Conditions in Non-VA
Facilities); Comment Request
Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
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 for information
needed to determine a claimant’s
eligibility for reimbursement or
payment for emergency medical
treatment at a non-VA facility.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before December 12,
2011.
ADDRESSES: Submit written comments
on the collection of information through
the Federal Docket Management System
(FDMS) at www.Regulations.gov; or to
Cynthia Harvey-Pryor, Veterans Health
Administration (10P7BFP), Department
of Veterans Affairs, 810 Vermont
Avenue, NW., Washington, DC 20420 or
e-mail: cynthia.harvey-pryor@va.gov.
Please refer to ‘‘OMB Control No. 2900–
0620’’ in any correspondence. During
the comment period, comments may be
viewed online through FDMS.
SUMMARY:
PO 00000
Frm 00076
Fmt 4703
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63353
FOR FURTHER INFORMATION CONTACT:
Cynthia Harvey-Pryor (202) 461–5870 or
FAX (202) 273–9387.
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: Payment and Reimbursement
for Emergency Services for Non ServiceConnected Conditions in Non-VA
Facilities, 38 U.S.C. 1725.
OMB Control Number: 2900–0620.
Type of Review: Extension of a
currently approved collection.
Abstract: Veterans enrolled in VA’s
health-care system are personally liable
for emergency treatment rendered at
non-VA health facilities. Veterans or
their representative, and the health care
provider of the emergency treatment
furnished to the veteran must submit a
claim in writing or complete a Health
Insurance Claim Form CMS 1500 or
Medical Uniform Institutional Provider
Bill Form UB–04 to request payment or
reimbursement for such treatment. VA
uses the data collected to determine the
claimant’s eligibility for payment or
reimbursement.
Affected Public: Business or other forprofit.
Estimated Total Annual Burden:
82,690 hours.
Estimated Average Burden Per
Respondent: 15 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
330,759.
Dated: October 6, 2011.
By direction of the Secretary:
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011–26286 Filed 10–11–11; 8:45 am]
BILLING CODE 8320–01–P
E:\FR\FM\12OCN1.SGM
12OCN1
Agencies
[Federal Register Volume 76, Number 197 (Wednesday, October 12, 2011)]
[Notices]
[Page 63353]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-26286]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0620]
Proposed Information Collection (Payment and Reimbursement for
Emergency Services for Non Service-Connected Conditions in Non-VA
Facilities); 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 for information needed to determine a claimant's
eligibility for reimbursement or payment for emergency medical
treatment at a non-VA facility.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before December 12, 2011.
ADDRESSES: Submit written comments on the collection of information
through the Federal Docket Management System (FDMS) at
www.Regulations.gov; or to Cynthia Harvey-Pryor, Veterans Health
Administration (10P7BFP), Department of Veterans Affairs, 810 Vermont
Avenue, NW., Washington, DC 20420 or e-mail: cynthia.harvey-
pryor@va.gov. Please refer to ``OMB Control No. 2900-0620'' in any
correspondence. During the comment period, comments may be viewed
online through FDMS.
FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor (202) 461-5870 or
FAX (202) 273-9387.
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: Payment and Reimbursement for Emergency Services for Non
Service-Connected Conditions in Non-VA Facilities, 38 U.S.C. 1725.
OMB Control Number: 2900-0620.
Type of Review: Extension of a currently approved collection.
Abstract: Veterans enrolled in VA's health-care system are
personally liable for emergency treatment rendered at non-VA health
facilities. Veterans or their representative, and the health care
provider of the emergency treatment furnished to the veteran must
submit a claim in writing or complete a Health Insurance Claim Form CMS
1500 or Medical Uniform Institutional Provider Bill Form UB-04 to
request payment or reimbursement for such treatment. VA uses the data
collected to determine the claimant's eligibility for payment or
reimbursement.
Affected Public: Business or other for-profit.
Estimated Total Annual Burden: 82,690 hours.
Estimated Average Burden Per Respondent: 15 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 330,759.
Dated: October 6, 2011.
By direction of the Secretary:
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011-26286 Filed 10-11-11; 8:45 am]
BILLING CODE 8320-01-P