Proposed Collection; Comment Request, 61396-61397 [2015-25909]
Download as PDF
61396
Federal Register / Vol. 80, No. 197 / Tuesday, October 13, 2015 / Notices
www.regulations.gov for submitting
comments. Please submit comments on
any given form identified by docket
number, form number, and title.
Dated: October 6, 2015.
Aaron Siegel,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
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) (Military Personnel Policy),
ATTN: MAJ Justin DeVantier, 4000
Defense Pentagon, Washington, DC
20301–4000 or call at (703) 695–5527.
[FR Doc. 2015–25874 Filed 10–9–15; 8:45 am]
SUPPLEMENTARY INFORMATION:
AGENCY:
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FOR FURTHER INFORMATION CONTACT:
Title; Associated Form; and OMB
Number: Request for Reference; DD
Form 370; OMB Control Number 0704–
0167.
Needs and Uses: The information
collection requirement is necessary to
obtain personal reference data, in order
to request a waiver, on a military
applicant who has committed a civil or
criminal offense and would otherwise
be disqualified for entry into the Armed
Forces of the United States. The DD
Form 370 is used to obtain references
information evaluating the character,
work habits, and attitudes of an
applicant from a person of authority or
standing within the community.
Affected Public: Business or other for
profit; Not-for-profit institutions;
Individuals or Households; State, Local,
or Tribal government.
Annual Burden Hours: 1,083.
Number of Respondents: 6,500.
Responses per Respondent: 1.
Annual Responses: 6,500.
Average Burden per Response: 10
minutes.
Frequency: On occasion.
This information is collected to
provide Armed Services with specific
background information on an
applicant. History of criminal activity,
arrests, or confinement is disqualifying
for military service. An applicant, with
such a disqualifier, is required to submit
references from community leaders who
will attest to his or her character,
attitudes or work habits. The DD Form
370 is the method of information
collection which requests an evaluation
and reference from a specific individual,
within the community, who has the
knowledge of the applicant’s habits,
behavior, personality, and character.
The information will be used to
determine suitability of the applicant for
military service and the issuance of a
waiver for acceptance.
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BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID: DoD–2014–HA–0004]
Proposed Collection; Comment
Request
Office of the Assistant
Secretary of Defense for Health Affairs,
DoD.
ACTION: Notice.
In compliance with the
Paperwork Reduction Act of 1995, the
Office of the Assistant Secretary of
Defense for Health Affairs announces a
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 December 14,
2015.
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: Department of Defense, Office
of the Deputy Chief Management
Officer, Directorate of Oversight and
Compliance, Regulatory and Audit
Matters Office, 9010 Defense Pentagon,
Washington, DC 20301–9010.
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
ADDRESSES:
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Frm 00063
Fmt 4703
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personal identifiers or contact
information.
Any associated form(s) for this
collection may be located within this
same electronic docket and downloaded
for review/testing. Follow the
instructions at https://
www.regulations.gov for submitting
comments. Please submit comments on
any given form identified by docket
number, form number, and title.
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 Defense Health
Agency, Medical Benefits and
Reimbursement Systems, 16401 East
Centretech Parkway, ATTN: Elan Green,
Aurora, CO 80011–9043, or call Defense
Health Agency, Medical Benefits and
Reimbursement Office, at (303) 676–
3907.
SUPPLEMENTARY INFORMATION:
Title; Associated Form; and OMB
Number: Application for TRICAREProvider Status: Corporation Services
Provider; DD Form X644; OMB Control
Number 0720–0020.
Needs and Uses: The information
collection requirement is necessary to
allow eligible providers to apply for
Corporate Services Provider status
under the TRICARE program.
Affected Public: Business or other for
profit; Not-for-profit institutions.
Annual Burden Hours: 100.
Number of Respondents: 300.
Responses per Respondent: 1.
Annual Responses: 300.
Average Burden per Response: 20
minutes.
Frequency: On occasion.
On March 10, 1999, TRICARE
Management Activity (TMA), formerly
known as OCHAMPUS, published a
final ruse in the Federal Register (64 FR
11765), creating a fourth class of
TRICARE providers consisting of
freestanding corporations and
foundations that render principally
professional ambulatory or in-home care
and technical diagnostic procedures.
Effective October 1, 2013, the TRICARE
Management Activity is now the
Defense Health Agency (DHA). The
intent of the rule was not to create
additional benefits that ordinarily
would not be covered under TRICARE
if provided by a more traditional
healthcare delivery system, but rather to
allow those services which would
otherwise be allowed except for an
individual provider’s affiliation with a
freestanding corporate facility. The
addition of the corporate class
recognized the current range of
E:\FR\FM\13OCN1.SGM
13OCN1
mstockstill on DSK4VPTVN1PROD with NOTICES
Federal Register / Vol. 80, No. 197 / Tuesday, October 13, 2015 / Notices
providers within today’s health care
delivery structure, and gave
beneficiaries access to another segment
of the health care delivery industry.
Corporate services providers must be
approved for Medicare payment, or
when Medicare approval status is not
required, be accredited by a qualified
accreditation organization to gain
provider authorization status under
TRICARE. Corporate services providers
must also enter into a participation
agreement which will be sent out as part
of the initial authorization process. The
participation agreement will ensure that
TRICARE-determined allowable
payments, combined with the costshare/
copayment, deductible, and other health
insurance amounts, will be accepted by
the provider as payment in full. The
application for TRICARE-Provider
Status: Corporate Services Provider, will
collect the necessary information to
ensure that the conditions are met for
authorization as a TRICARE corporate
services provider: i.e., the provider (1) is
a corporation or a foundation, but not a
professional corporation or professional
association; (2) provides services and
related supplies of a type rendered by
TRICARE individual professional
providers or diagnostic technical
services; (3) is approved for Medicare
payment or, when Medicare approval
status is not requested, is accredited by
a qualified accreditation organization;
and (4) has entered into a participation
agreement approved by the Director,
DHA or a designee.
The collected information will be
used by TRICARE contractors to process
claims and verify authorized provider
status. Verification involves collecting
and reviewing copies of the provider’s
licenses, certificates, accreditation
documents, etc. If the criteria are met,
the provider is granted TRICARE
authorization status. The documentation
and information are collected when: (1)
A provider requests permission to
become a TRICARE-authorized
provider; (2) a claim is filed for care
received from a provider who is not
listed on the contractor’s computer
listing of authorized providers; or (3)
when a former TRICARE-authorized
provider requests reinstatement. The
contractors develop the forms used to
gather information based on the
TRICARE conditions for participation
listed above. Without the collection of
this information, contractors cannot
determine if the provider meets
TRICARE-authorization requirements
for corporate services providers. If the
contractor is unable to verify that a
provider meets these authorization
requirements, the contractor may not
VerDate Sep<11>2014
21:23 Oct 09, 2015
Jkt 238001
reimburse either the provider or the
beneficiary for the provider’s health care
services. To reduce the reporting burden
to a minimum, TRICARE has carefully
selected the information requested from
respondents. Only that information
which has been deemed absolutely
essential is being requested. If
necessary, contractors may verify
credentials with Medicare, JCAHO and
other national organizations by
telephone. TRICARE is also
participating with Medicare in the
development of a National Provider
System which will eliminate
duplication of provider certification and
data collection among Federal
government agencies. TRICARE
contractors are required to maintain a
computer listing before requesting
documentation from providers. Since
the providers affected by this
information generally have not
previously been eligible to be
authorized providers, TRICARE
contractors will have no information on
file. The providers will have to submit
the information requested on the data
collection form (Application for
TRICARE-Providers Status: Corporate
Services Provider) in order to obtain
provider authorization status under
TRICARE. The information will usually
be collected from each respondent only
once. It is estimated that there will be
approximately 300 applicants per year.
TRICARE will request the provider
authorization documentation and
information when the provider asks to
become TRICARE-authorized or when a
claim is filed for a new provider’s
services. If after a provider has been
authorized by a contractor, no claims
are filed during two-year period of time,
the provider’s information will be
placed in the inactive file. To reactivate
a file, the provider must verify that the
information is still correct, or supply
new or changed information. The total
annual reporting burden is estimated to
be approximately 100 hours
(approximately 300 respondents with 20
minutes to complete the form).
Dated: October 6, 2015.
Aaron Siegel,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 2015–25909 Filed 10–9–15; 8:45 am]
BILLING CODE 5001–06–P
PO 00000
Frm 00064
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61397
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID: DoD–2015–HA–0039]
Submission for OMB Review;
Comment Request
ACTION:
Notice.
The Department of Defense
has submitted to OMB for clearance, the
following proposal for collection of
information under the provisions of the
Paperwork Reduction Act.
DATES: Consideration will be given to all
comments received by November 12,
2015.
SUMMARY:
FOR FURTHER INFORMATION CONTACT:
Fred
Licari, 571–372–0493.
SUPPLEMENTARY INFORMATION:
Title, Associated Form And OMB
Number: Diagnosis Related Groups
(DRG) Reimbursement; OMB Control
Number 0720–0017.
Type of Request: Reinstatement, with
change, of a previously approved
collection for which approval has
expired.
Number of Respondents: 5,600.
Responses per Respondent: 1.
Annual Responses: 5,600.
Average Burden per Response: 1.5
hours.
Annual Burden Hours: 8,400.
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.
Affected Public: Business or other forprofit; individuals or households.
Frequency: On occasion.
Respondent’s Obligation: Voluntary.
OMB Desk Officer: Ms. Meredith
DeDona.
Comments and recommendations on
the proposed information collection
should be emailed to Ms. Meredith
DeDona, DoD Desk Officer, at Oira_
submission@omb.eop.gov. Please
identify the proposed information
collection by DoD Desk Officer and the
Docket ID number and title of the
information collection.
You may also submit comments and
recommendations, identified by Docket
ID number and title, by the following
method:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
Instructions: All submissions received
must include the agency name, Docket
ID number and title for this Federal
Register document. The general policy
for comments and other submissions
E:\FR\FM\13OCN1.SGM
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Agencies
[Federal Register Volume 80, Number 197 (Tuesday, October 13, 2015)]
[Notices]
[Pages 61396-61397]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-25909]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID: DoD-2014-HA-0004]
Proposed Collection; Comment Request
AGENCY: Office of the Assistant Secretary of Defense for Health
Affairs, DoD.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the
Office of the Assistant Secretary of Defense for Health Affairs
announces a 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 December
14, 2015.
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: Department of Defense, Office of the Deputy Chief
Management Officer, Directorate of Oversight and Compliance, Regulatory
and Audit Matters Office, 9010 Defense Pentagon, Washington, DC 20301-
9010.
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.
Any associated form(s) for this collection may be located within
this same electronic docket and downloaded for review/testing. Follow
the instructions at https://www.regulations.gov for submitting comments.
Please submit comments on any given form identified by docket number,
form number, and title.
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 Defense Health
Agency, Medical Benefits and Reimbursement Systems, 16401 East
Centretech Parkway, ATTN: Elan Green, Aurora, CO 80011-9043, or call
Defense Health Agency, Medical Benefits and Reimbursement Office, at
(303) 676-3907.
SUPPLEMENTARY INFORMATION:
Title; Associated Form; and OMB Number: Application for TRICARE-
Provider Status: Corporation Services Provider; DD Form X644; OMB
Control Number 0720-0020.
Needs and Uses: The information collection requirement is necessary
to allow eligible providers to apply for Corporate Services Provider
status under the TRICARE program.
Affected Public: Business or other for profit; Not-for-profit
institutions.
Annual Burden Hours: 100.
Number of Respondents: 300.
Responses per Respondent: 1.
Annual Responses: 300.
Average Burden per Response: 20 minutes.
Frequency: On occasion.
On March 10, 1999, TRICARE Management Activity (TMA), formerly
known as OCHAMPUS, published a final ruse in the Federal Register (64
FR 11765), creating a fourth class of TRICARE providers consisting of
freestanding corporations and foundations that render principally
professional ambulatory or in-home care and technical diagnostic
procedures. Effective October 1, 2013, the TRICARE Management Activity
is now the Defense Health Agency (DHA). The intent of the rule was not
to create additional benefits that ordinarily would not be covered
under TRICARE if provided by a more traditional healthcare delivery
system, but rather to allow those services which would otherwise be
allowed except for an individual provider's affiliation with a
freestanding corporate facility. The addition of the corporate class
recognized the current range of
[[Page 61397]]
providers within today's health care delivery structure, and gave
beneficiaries access to another segment of the health care delivery
industry. Corporate services providers must be approved for Medicare
payment, or when Medicare approval status is not required, be
accredited by a qualified accreditation organization to gain provider
authorization status under TRICARE. Corporate services providers must
also enter into a participation agreement which will be sent out as
part of the initial authorization process. The participation agreement
will ensure that TRICARE-determined allowable payments, combined with
the costshare/copayment, deductible, and other health insurance
amounts, will be accepted by the provider as payment in full. The
application for TRICARE-Provider Status: Corporate Services Provider,
will collect the necessary information to ensure that the conditions
are met for authorization as a TRICARE corporate services provider:
i.e., the provider (1) is a corporation or a foundation, but not a
professional corporation or professional association; (2) provides
services and related supplies of a type rendered by TRICARE individual
professional providers or diagnostic technical services; (3) is
approved for Medicare payment or, when Medicare approval status is not
requested, is accredited by a qualified accreditation organization; and
(4) has entered into a participation agreement approved by the
Director, DHA or a designee.
The collected information will be used by TRICARE contractors to
process claims and verify authorized provider status. Verification
involves collecting and reviewing copies of the provider's licenses,
certificates, accreditation documents, etc. If the criteria are met,
the provider is granted TRICARE authorization status. The documentation
and information are collected when: (1) A provider requests permission
to become a TRICARE-authorized provider; (2) a claim is filed for care
received from a provider who is not listed on the contractor's computer
listing of authorized providers; or (3) when a former TRICARE-
authorized provider requests reinstatement. The contractors develop the
forms used to gather information based on the TRICARE conditions for
participation listed above. Without the collection of this information,
contractors cannot determine if the provider meets TRICARE-
authorization requirements for corporate services providers. If the
contractor is unable to verify that a provider meets these
authorization requirements, the contractor may not reimburse either the
provider or the beneficiary for the provider's health care services. To
reduce the reporting burden to a minimum, TRICARE has carefully
selected the information requested from respondents. Only that
information which has been deemed absolutely essential is being
requested. If necessary, contractors may verify credentials with
Medicare, JCAHO and other national organizations by telephone. TRICARE
is also participating with Medicare in the development of a National
Provider System which will eliminate duplication of provider
certification and data collection among Federal government agencies.
TRICARE contractors are required to maintain a computer listing before
requesting documentation from providers. Since the providers affected
by this information generally have not previously been eligible to be
authorized providers, TRICARE contractors will have no information on
file. The providers will have to submit the information requested on
the data collection form (Application for TRICARE-Providers Status:
Corporate Services Provider) in order to obtain provider authorization
status under TRICARE. The information will usually be collected from
each respondent only once. It is estimated that there will be
approximately 300 applicants per year. TRICARE will request the
provider authorization documentation and information when the provider
asks to become TRICARE-authorized or when a claim is filed for a new
provider's services. If after a provider has been authorized by a
contractor, no claims are filed during two-year period of time, the
provider's information will be placed in the inactive file. To
reactivate a file, the provider must verify that the information is
still correct, or supply new or changed information. The total annual
reporting burden is estimated to be approximately 100 hours
(approximately 300 respondents with 20 minutes to complete the form).
Dated: October 6, 2015.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2015-25909 Filed 10-9-15; 8:45 am]
BILLING CODE 5001-06-P