Proposed Information Collection Activity; Comment Request (Expanded Access to Non-VA Care Through the Veterans Choice Program), 33738-33739 [2016-12574]

Download as PDF 33738 Federal Register / Vol. 81, No. 103 / Friday, May 27, 2016 / Notices Estimated Total Annual Burden Hours: 1. Brenda Simms, Treasury PRA Clearance Officer. [FR Doc. 2016–12626 Filed 5–26–16; 8:45 am] BILLING CODE 4810–31–P DEPARTMENT OF THE TREASURY Proposed Collections; Comment Requests Departmental Offices; Department of the Treasury. ACTION: Notice and request for comments. AGENCY: The Department of the Treasury, as part of its continuing effort to reduce paperwork burdens, invites the general public and other Federal agencies to comment on revisions of an information collection that are proposed for approval by the Office of Management and Budget. The Office of International Affairs within the Department of the Treasury is soliciting comments concerning Treasury International Capital Forms CQ–1 and CQ–2, ‘‘Financial and Commercial Liabilities to, and Claims on, Unaffiliated Foreign Residents.’’ DATES: Written comments should be received on or before July 26, 2016 to be assured of consideration. ADDRESSES: Direct all written comments to Dwight Wolkow, International Portfolio Investment Data Systems, Department of the Treasury, Room 5422, 1500 Pennsylvania Avenue NW., Washington, DC 20220. In view of possible delays in mail delivery, please also notify Mr. Wolkow by email (comments2TIC@treasury.gov), fax (202–622–2009) or telephone (202–622– 1276). FOR FURTHER INFORMATION CONTACT: Copies of the proposed forms and instructions are available on the Treasury’s TIC Web page for forms, http://www.treasury.gov/resourcecenter/data-chart-center/tic/Pages/ forms.aspx. Requests for additional information should be directed to Mr. Wolkow. SUPPLEMENTARY INFORMATION: Title: Treasury International Capital Form CQ–1, ‘‘Financial Liabilities to, and Claims on, Unaffiliated Foreign Residents;’’ and Treasury International Capital Form CQ–2, ‘‘Commercial Liabilities to, and Claims on, Unaffiliated Foreign Residents.’’ OMB Number: 1505–0024. Abstract: Forms CQ–1 and CQ–2 are part of the Treasury International Capital (TIC) reporting system, which is sradovich on DSK3TPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 18:00 May 26, 2016 Jkt 238001 required by law (22 U.S.C. 286f; 22 U.S.C. 3103; E.O. 10033; 31 CFR part 128), and is designed to collect timely information on international portfolio capital movements. Forms CQ–1 and CQ–2 are quarterly reports filed by nonfinancial enterprises in the U.S. to report their international portfolio transactions with unaffiliated foreign residents. This information is necessary for compiling the U.S. balance of payments accounts and the U.S. international investment position, and for use in formulating U.S. international financial and monetary policies. Current Actions: No changes are proposed at this time. Type of Review: Extension of a currently approved data collection. Affected Public: Business or other forprofit organizations. Forms: CQ–1 and CQ–2 (1505–0024). Estimated Number of Respondents: 148. Estimated Average Time per Respondent: Six and nine-tenths (6.9) hours per respondent per filing. This average time varies from 13 hours for the approximately 12 major data reporters to 6.5 hours for the other reporters. Estimated Total Annual Burden Hours: 4,085 hours, based on 4 reporting periods per year. Request For Comments: Comments submitted in response to this notice will be summarized and/or included in the request for Office of Management and Budget approval. All comments will become a matter of public record. The public is invited to submit written comments concerning: (a) Whether Forms CQ–1 and CQ–2 are necessary for the proper performance of the functions of the Office, including whether the information will have practical uses; (b) the accuracy of the above estimate of the burdens; (c) ways to enhance the quality, usefulness and clarity of the information to be collected; (d) ways to minimize the reporting and/or record keeping burdens on respondents, including the use of information technologies to automate the collection of the data; and (e) estimates of capital or start-up costs of operation, maintenance and purchase of services to provide information. Dwight Wolkow, Administrator, International Portfolio Investment Data Systems. [FR Doc. 2016–12273 Filed 5–26–16; 8:45 am] BILLING CODE 4810–25–P PO 00000 Frm 00085 Fmt 4703 Sfmt 4703 DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0823] Proposed Information Collection Activity; Comment Request (Expanded Access to Non-VA Care Through the Veterans Choice Program) 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 extension 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 July 26, 2016. ADDRESSES: Submit written comments on the collection of information through Federal Docket Management System (FDMS) at www.Regulations.gov; or 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. 2900–0823’’ in any correspondence. During the comment period, comments may be viewed online through the FDMS. DATES: FOR FURTHER INFORMATION CONTACT: Brian McCarthy at (202) 461–6345. 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 SUPPLEMENTARY INFORMATION: E:\FR\FM\27MYN1.SGM 27MYN1 Federal Register / Vol. 81, No. 103 / Friday, May 27, 2016 / Notices sradovich on DSK3TPTVN1PROD with NOTICES 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: Election to Receive Authorized Non-VA Care and Selection of Provider for the Veterans Choice Program (VA Form 10–10143). OMB Control Number: 2900–0823. Type of Review: Extension. Abstract: Section 17.1515 requires eligible veterans to notify VA whether the veteran elects to receive authorized non-VA care through the Veterans Choice Program, be placed on an electronic waiting list, or be scheduled for an appointment with a VA health care provider. Section 17.1515(b)(1) also allows eligible veterans to specify a particular non-VA entity or health care provider, if that entity or provider meets certain requirements. Affected Public: Individuals or Households. Estimated Annual Burden: 928,606 burden hours. Estimated Average Burden per Respondent: 10 minutes. Frequency of Response: 12.64 times per year. Estimated Number of Respondents: 440,794 respondents. Titles: Health-Care Plan Information for the Veterans Choice Program (VA Form 10–10143a). OMB Control Number: 2900–0823. Type of Review: Extension. Abstract: Section 17.1510(d) requires eligible veterans to submit to VA VerDate Sep<11>2014 18:00 May 26, 2016 Jkt 238001 information about their health-care plan to participate in the Veterans Choice Program. Affected Public: Individuals or Households. Estimated Annual Burden: 88,159 burden hours. Estimated Average Burden per Respondent: 10 minutes. Frequency of Response: 1.2 times per year. Estimated Number of Respondents: 440,794 respondents. Titles: Submission of Medical Record Information Under the Veterans Choice Program (VA Form 10–10143b). OMB Control Number: 2900–0823. Type of Review: Extension. Abstract: Participating eligible entities and providers are required to submit a copy of any medical record related to hospital care or medical services furnished under this Program to an eligible veteran. Affected Public: Individuals or Households. Estimated Annual Burden: 464,428 burden hours. Estimated Average Burden per Respondent: 5 minutes. Frequency of Response: 29.80 times per year. Estimated Number of Respondents: 187,000 respondents. Titles: Submission of Information on Credentials and Licenses by Eligible Entities or Providers (VA Form 10– 10143c). OMB Control Number: 2900–0823. Type of Review: Extension. Abstract: Section 17.1530 requires eligible entities and providers to submit verification that the entity or provider maintains at least the same or similar credentials and licenses as those required of VA’s health care providers, as determined by the Secretary. Affected Public: Individuals or Households. PO 00000 Frm 00086 Fmt 4703 Sfmt 9990 33739 Estimated Annual Burden: 15,583 burden hours. Estimated Average Burden per Respondent: 5 minutes. Frequency of Response: Once annually. Estimated Number of Respondents: 187,000 respondents. Titles: Secondary Authorization Request for VA Community Care (VA Form 10–10143e). OMB Control Number: 2900–0823. Type of Review: New. Abstract: VA Form 10–10143e would require non-VA health care providers to submit requests for additional services supporting the original authorized plan of care to the agency. A copy of all medical and dental records (including but not limited to images, test results, and notes or other records of what care was provided and why) related to a Veteran’s care provided under this Program must be submitted to VA for entry into the veteran’s electronic medical record. Providers will be required to submit records produced as a result of care authorized after the beginning of the Program. Affected Public: Individuals or Households. Estimated Annual Burden: 289,826 burden hours. Estimated Average Burden per Respondent: 20 minutes. Frequency of Response: 4.56 times per year. Estimated Number of Respondents: 190,675 respondents. 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. 2016–12574 Filed 5–26–16; 8:45 am] BILLING CODE 8320–01–P E:\FR\FM\27MYN1.SGM 27MYN1

Agencies

[Federal Register Volume 81, Number 103 (Friday, May 27, 2016)]
[Notices]
[Pages 33738-33739]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-12574]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0823]


Proposed Information Collection Activity; Comment Request 
(Expanded Access to Non-VA Care Through the Veterans Choice Program)

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: 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 extension 
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.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before July 26, 2016.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at www.Regulations.gov; 
or 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. 2900-0823'' 
in any correspondence. During the comment period, comments may be 
viewed online through the 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 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

[[Page 33739]]

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: Election to Receive Authorized Non-VA Care and Selection of 
Provider for the Veterans Choice Program (VA Form 10-10143).
    OMB Control Number: 2900-0823.
    Type of Review: Extension.
    Abstract: Section 17.1515 requires eligible veterans to notify VA 
whether the veteran elects to receive authorized non-VA care through 
the Veterans Choice Program, be placed on an electronic waiting list, 
or be scheduled for an appointment with a VA health care provider. 
Section 17.1515(b)(1) also allows eligible veterans to specify a 
particular non-VA entity or health care provider, if that entity or 
provider meets certain requirements.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 928,606 burden hours.
    Estimated Average Burden per Respondent: 10 minutes.
    Frequency of Response: 12.64 times per year.
    Estimated Number of Respondents: 440,794 respondents.

    Titles: Health-Care Plan Information for the Veterans Choice 
Program (VA Form 10-10143a).
    OMB Control Number: 2900-0823.
    Type of Review: Extension.
    Abstract: Section 17.1510(d) requires eligible veterans to submit 
to VA information about their health-care plan to participate in the 
Veterans Choice Program.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 88,159 burden hours.
    Estimated Average Burden per Respondent: 10 minutes.
    Frequency of Response: 1.2 times per year.
    Estimated Number of Respondents: 440,794 respondents.

    Titles: Submission of Medical Record Information Under the Veterans 
Choice Program (VA Form 10-10143b).
    OMB Control Number: 2900-0823.
    Type of Review: Extension.
    Abstract: Participating eligible entities and providers are 
required to submit a copy of any medical record related to hospital 
care or medical services furnished under this Program to an eligible 
veteran.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 464,428 burden hours.
    Estimated Average Burden per Respondent: 5 minutes.
    Frequency of Response: 29.80 times per year.
    Estimated Number of Respondents: 187,000 respondents.

    Titles: Submission of Information on Credentials and Licenses by 
Eligible Entities or Providers (VA Form 10-10143c).
    OMB Control Number: 2900-0823.
    Type of Review: Extension.
    Abstract: Section 17.1530 requires eligible entities and providers 
to submit verification that the entity or provider maintains at least 
the same or similar credentials and licenses as those required of VA's 
health care providers, as determined by the Secretary.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 15,583 burden hours.
    Estimated Average Burden per Respondent: 5 minutes.
    Frequency of Response: Once annually.
    Estimated Number of Respondents: 187,000 respondents.

    Titles: Secondary Authorization Request for VA Community Care (VA 
Form 10-10143e).
    OMB Control Number: 2900-0823.
    Type of Review: New.
    Abstract: VA Form 10-10143e would require non-VA health care 
providers to submit requests for additional services supporting the 
original authorized plan of care to the agency. A copy of all medical 
and dental records (including but not limited to images, test results, 
and notes or other records of what care was provided and why) related 
to a Veteran's care provided under this Program must be submitted to VA 
for entry into the veteran's electronic medical record. Providers will 
be required to submit records produced as a result of care authorized 
after the beginning of the Program.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 289,826 burden hours.
    Estimated Average Burden per Respondent: 20 minutes.
    Frequency of Response: 4.56 times per year.
    Estimated Number of Respondents: 190,675 respondents.

    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. 2016-12574 Filed 5-26-16; 8:45 am]
BILLING CODE 8320-01-P