Proposed Information Collection (Foreign Medical Program Application and Claim Cover Sheet) Activity: Comment Request, 46104-46105 [2015-18925]
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46104
Federal Register / Vol. 80, No. 148 / Monday, August 3, 2015 / Notices
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, VBA invites
comments on: (1) Whether the proposed
collection of information is necessary
for the proper performance of VBA’s
functions, including whether the
information will have practical utility;
(2) the accuracy of VBA’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: Direct Deposit Enrollment;
International Direct Deposit Enrollment
(24–0296 & 24–0296a).
OMB Control Number: 2900–0564.
Type of Review: Revision of a
currently approved collection.
Abstract: The information collected
on these forms will be used to enroll VA
benefit recipients in the electronic funds
transfer (EFT) program.
Estimated Annual Burden: 1,250
hours.
Estimated Average Burden per
Respondent: 15 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
5,000.
By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office
of Privacy and Records Management,
Department of Veterans Affairs.
[FR Doc. 2015–18924 Filed 7–31–15; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0648]
Proposed Information Collection
(Foreign Medical Program Application
and Claim Cover Sheet) Activity:
Comment Request
Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
mstockstill on DSK4VPTVN1PROD with NOTICES
AGENCY:
The Veterans Health
Administration (VHA) is announcing an
opportunity for public comment on the
proposed collection of certain
SUMMARY:
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18:35 Jul 31, 2015
Jkt 235001
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 information
needed to identify areas for
improvement in clinical training
programs.
Written comments and
recommendations on the proposed
collection of information should be
received on or before October 2, 2015.
ADDRESSES: Submit written comments
on the collection of information through
the Federal Docket Management System
(FDMS) at www.Regulations.gov; or to
Brian McCarthy, Office of Regulatory
and Administrative Affairs, Veterans
Health Administration (10B4),
Department of Veterans Affairs, 810
Vermont Avenue NW., Washington, DC
20420 or email: Brian.McCarthy4@
va.gov. Please refer to ‘‘OMB Control
No. 2900–0648’’ in any correspondence.
During the comment period, comments
may be viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT:
Brian McCarthy at (202) 461–6345.
SUPPLEMENTARY INFORMATION: Under the
PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
3501–3521), Federal agencies must
obtain approval from 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.
Titles:
1. Foreign Medical Program (FMP)
Registration Form.
2. CLAIM COVER SHEET—FOREIGN
MEDICAL PROGRAM (FMP).
OMB Control Number: 2900–0648.
Type of Review: Extension of a
currently approved collection.
DATES:
PO 00000
Frm 00173
Fmt 4703
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Abstracts: This information collection
is needed to carry out the health care
benefits allowed by the Foreign Medical
Program (FMP). It is a federal health
benefits program for Veterans
administered by the Department of
Veterans Affairs (VA) Veterans Health
Administration (VHA). FMP is a Fee for
Service (indemnity plan) program. FMP
provides reimbursement for VA
adjudicated service-connected
conditions. Title 38 CFR 17.35 states
that the VA will provide coverage for
the Veteran’s service-connected
disability when the Veteran is residing
or traveling overseas.
VA Form 10–7959f–1, Foreign
Medical Program (FMP) Registration
Form, is used to register into the Foreign
Medical Program those Veterans with
service-connected disabilities that are
living or traveling overseas. Title 38
CFR 17.125(d) states that requests for
consideration of claim reimbursement
from approved health care providers
and Veterans are to be mailed to VHA
Health Administration Center (HAC).
The VA Form 10–7959f–2, Claim Cover
Sheet—Foreign Medical Program
streamlines the claims submission
process for claimants or physicians
while also reducing the time spent by
VA on processing FMP claims. The
cover sheet will allow foreign providers/
Veterans with a better understanding of
basic information required for the
processing and payment of claims.
Affected Public: Individuals or
households.
Estimated Annual Burden:
a. Foreign Medical Program (FMP)
Registration Form—fill, VA Form 10–
7959f–1—111 hours.
b. CLAIM COVER SHEET—FOREIGN
MEDICAL PROGRAM (FMP)—fill, VA
Form 10–7959f–2—3,652 hours.
Estimated Average Burden per
Respondent:
a. Foreign Medical Program (FMP)
Registration Form—fill, VA Form 10–
7959f–1—4 minutes.
b. CLAIM COVER SHEET—FOREIGN
MEDICAL PROGRAM (FMP)—fill, VA
Form 10–7959f–2—11 minutes.
Frequency of Response:
a. Foreign Medical Program (FMP)
Registration Form—fill, VA Form 10–
7959f–1—Annually
b. CLAIM COVER SHEET—FOREIGN
MEDICAL PROGRAM (FMP)—fill, VA
Form 10–7959f–2 —12 times a year.
Estimated Annual Responses:
a. Foreign Medical Program (FMP)
Registration Form—fill, VA Form 10–
7959f–1—1,660.
b. CLAIM COVER SHEET—FOREIGN
MEDICAL PROGRAM (FMP)—fill, VA
Form 10–7959f–2—19,920.
E:\FR\FM\03AUN1.SGM
03AUN1
Federal Register / Vol. 80, No. 148 / Monday, August 3, 2015 / Notices
By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office
of Privacy and Records Management,
Department of Veterans Affairs.
[FR Doc. 2015–18925 Filed 7–31–15; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0784]
Proposed Information Collection (NCA
PreNeed Burial Planning)
National Cemetery
Administration, Department of Veterans
Affairs
ACTION: Notice.
AGENCY:
In compliance with the
Paperwork Reduction Act (PRA) of 1995
(44 U.S.C. 3501–3521), this notice
announces that the National Cemetery
Administration (NCA), Department of
Veterans Affairs, 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; it includes
the actual data collection instrument.
DATES: Comments must be submitted on
or before September 2, 2015.
ADDRESSES: Submit written comments
on the collection of information through
www.Regulations.gov, or to Office of
Information and Regulatory Affairs,
Office of Management and Budget, Attn:
VA Desk Officer; 725 17th St. NW.,
Washington, DC 20503 or sent through
electronic mail to oira_submission@
omb.eop.gov. Please refer to ‘‘OMB
Control No. 2900–0784’’ in any
correspondence.
FOR FURTHER INFORMATION CONTACT:
Crystal Rennie, Enterprise Records
Service (005R1B), Department of
Veterans Affairs, 810 Vermont Avenue
NW., Washington, DC 20420, (202) 632–
7492 or email crystal.rennie@va.gov.
Please refer to ‘‘OMB Control No. 2900–
0784.’’
SUPPLEMENTARY INFORMATION:
Title: NCA PreNeed Burial Eligibility
Planning, VA Form 40–10007.
OMB Control Number: 2900–0784.
Type of Review: Revision of a
currently approved collection.
Abstract: VA Form Letter 40–10007
will be used to collect information from
Veterans and service members with
terminal illnesses and adult dependent
children in hospitals and other
institutions.
An agency may not conduct or
sponsor, and a person is not required to
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SUMMARY:
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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 80 FR
03446 on February 12, 2015.
Affected Public: Individuals or
households.
Estimated Annual Burden: 2,000
hours.
Estimated Average Burden per
Respondent: 1 minute.
Frequency of Response: One-time.
Estimated Number of Respondents:
8,000.
By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office
of Privacy and Records Management,
Department of Veterans Affairs.
[FR Doc. 2015–18930 Filed 7–31–15; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0090]
Proposed Information Collection
(Application for Voluntary Service VA
Form 10–7055 and Associated Internet
Application) ; Activity: Comment
Request
Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
The Veterans Health
Administration (VHA), Department of
Veterans Affairs (VA), 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 revised
collection, and allow 60 days for public
comment in response to the notice. This
notice solicits comments on the
information needed for Veterans,
Veteran Representatives and health care
providers to request reimbursement
from the federal government for
emergency services at a private
institution.
SUMMARY:
Written comments and
recommendations on the proposed
collection of information should be
received on or before October 2, 2015.
ADDRESSES: Submit written comments
on the collection of information through
Federal Docket Management System
(FDMS) at www.Regulations.gov; or
DATES:
PO 00000
Frm 00174
Fmt 4703
Sfmt 4703
46105
Audrey Revere, Office of Regulatory and
Administrative Affairs, Veterans Health
Administration (10B4), Department of
Veterans Affairs, 810 Vermont Avenue
NW., Washington, DC 20420 or email:
Audrey.revere@va.gov. Please refer to
‘‘OMB Control No. 2900–0090’’ in any
correspondence. During the comment
period, comments may be viewed online
through the FDMS.
FOR FURTHER INFORMATION CONTACT:
Audrey Revere at (202) 461–5694.
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.
Titles: Application for Voluntary
Service VA Form 10–7055 and
Associated Internet Application.
OMB Control Number: 2900–0090.
Type of Review: Revision.
Abstract: This application (VA Form
10–7055 and the associated web form)
will be here-in-after referred to as the
form. The form is used to assist
personnel of volunteer organizations,
which recruit volunteers from their
membership, and the Department of
Veterans Affairs (VA) in the selection,
screening and placement of volunteers
in the nationwide VA Voluntary Service
program. The volunteer program
supplements the medical care and
treatment of veteran patients in all VA
medical centers. This form is necessary
to assist in determining the suitability
and placement of potential volunteers.
The information is collected under the
authority of 38 U.S.C. 7405(a).
Affected Public: Individuals or
Households.
Estimated Annual Burden: 8,000
burden hours.
Estimated Average Burden per
Respondent: 15 minutes.
E:\FR\FM\03AUN1.SGM
03AUN1
Agencies
[Federal Register Volume 80, Number 148 (Monday, August 3, 2015)]
[Notices]
[Pages 46104-46105]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-18925]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0648]
Proposed Information Collection (Foreign Medical Program
Application and Claim Cover Sheet) 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 information needed to identify areas for
improvement in clinical training programs.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before October 2, 2015.
ADDRESSES: Submit written comments on the collection of information
through the Federal Docket Management System (FDMS) at
www.Regulations.gov; or to Brian McCarthy, Office of Regulatory and
Administrative Affairs, Veterans Health Administration (10B4),
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC
20420 or email: Brian.McCarthy4@va.gov. Please refer to ``OMB Control
No. 2900-0648'' in any correspondence. During the comment period,
comments may be viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT: Brian McCarthy at (202) 461-6345.
SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44
U.S.C. 3501-3521), Federal agencies must obtain approval from 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.
Titles:
1. Foreign Medical Program (FMP) Registration Form.
2. CLAIM COVER SHEET--FOREIGN MEDICAL PROGRAM (FMP).
OMB Control Number: 2900-0648.
Type of Review: Extension of a currently approved collection.
Abstracts: This information collection is needed to carry out the
health care benefits allowed by the Foreign Medical Program (FMP). It
is a federal health benefits program for Veterans administered by the
Department of Veterans Affairs (VA) Veterans Health Administration
(VHA). FMP is a Fee for Service (indemnity plan) program. FMP provides
reimbursement for VA adjudicated service-connected conditions. Title 38
CFR 17.35 states that the VA will provide coverage for the Veteran's
service-connected disability when the Veteran is residing or traveling
overseas.
VA Form 10-7959f-1, Foreign Medical Program (FMP) Registration
Form, is used to register into the Foreign Medical Program those
Veterans with service-connected disabilities that are living or
traveling overseas. Title 38 CFR 17.125(d) states that requests for
consideration of claim reimbursement from approved health care
providers and Veterans are to be mailed to VHA Health Administration
Center (HAC). The VA Form 10-7959f-2, Claim Cover Sheet--Foreign
Medical Program streamlines the claims submission process for claimants
or physicians while also reducing the time spent by VA on processing
FMP claims. The cover sheet will allow foreign providers/Veterans with
a better understanding of basic information required for the processing
and payment of claims.
Affected Public: Individuals or households.
Estimated Annual Burden:
a. Foreign Medical Program (FMP) Registration Form--fill, VA Form
10-7959f-1--111 hours.
b. CLAIM COVER SHEET--FOREIGN MEDICAL PROGRAM (FMP)--fill, VA Form
10-7959f-2--3,652 hours.
Estimated Average Burden per Respondent:
a. Foreign Medical Program (FMP) Registration Form--fill, VA Form
10-7959f-1--4 minutes.
b. CLAIM COVER SHEET--FOREIGN MEDICAL PROGRAM (FMP)--fill, VA Form
10-7959f-2--11 minutes.
Frequency of Response:
a. Foreign Medical Program (FMP) Registration Form--fill, VA Form
10-7959f-1--Annually
b. CLAIM COVER SHEET--FOREIGN MEDICAL PROGRAM (FMP)--fill, VA Form
10-7959f-2 --12 times a year.
Estimated Annual Responses:
a. Foreign Medical Program (FMP) Registration Form--fill, VA Form
10-7959f-1--1,660.
b. CLAIM COVER SHEET--FOREIGN MEDICAL PROGRAM (FMP)--fill, VA Form
10-7959f-2--19,920.
[[Page 46105]]
By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office of Privacy and Records
Management, Department of Veterans Affairs.
[FR Doc. 2015-18925 Filed 7-31-15; 8:45 am]
BILLING CODE 8320-01-P