Agency Information Collection Activity: Expanded Access to Non-VA Care Through the MISSION Act: Veterans Community Care Program, 49720-49721 [2020-17764]
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Federal Register / Vol. 85, No. 158 / Friday, August 14, 2020 / Notices
In this regard, the responsibility of the
FTA is to ensure that Federallysupported transit services and benefits
are distributed by applicants, recipients,
and subrecipients of FTA assistance in
a manner consistent with Title VI. The
employment practices of a grant
applicant, recipient, or sub-recipient are
also covered under Title VI if the
primary purpose of the FTA-supported
program is to provide employment or if
those employment practices would
result in discrimination against
beneficiaries of FTA-assisted services
and benefits.
FTA policies and requirements are
designed to clarify and strengthen Title
VI (service equity) procedures for FTA
grant recipients by requiring submission
of written plans and approval of such
plans by the agency. All project
sponsors receiving financial assistance
pursuant to an FTA-funded project shall
not discriminate in the provision of
services because of race, color, or
national origin. Experience has
demonstrated that a program
requirement at the application stage is
necessary to assure that benefits and
services are equitably distributed by
grant recipients. The requirements
prescribed by the Office of Civil Rights
are designed to accomplish this
objective and diminish possible vestiges
of discrimination among FTA grant
recipients. FTA’s assessment of the
requirements indicated that the
formulation and implementation of the
Title VI Program should occur with a
decrease in costs to such applicants and
recipients.
Respondents: Transit agencies, States,
and Metropolitan Planning
Organizations.
Estimated Annual Burden on
Respondents: 284 (45 hours for each of
the 100 more specific Title VI Program
submissions; 1 hour for each of the 183
general Title VI Program submissions).
Estimated Total Annual Burden:
4,684 hours.
Frequency: Annual.
Nadine Pembleton,
Director Office of Management Planning.
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DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0823]
Agency Information Collection
Activity: Expanded Access to Non-VA
Care Through the MISSION Act:
Veterans Community Care Program
Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
Veterans Health
Administration, 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 proposed
extension of a currently approved
collection, and allow 60 days for public
comment in response to the notice.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before October 13, 2020.
ADDRESSES: Submit written comments
on the collection of information through
Federal Docket Management System
(FDMS) at www.Regulations.gov or to
Brian McCarthy, Office of Regulatory
and Administrative Affairs (10B4),
Department of Veterans Affairs, 810
Vermont Avenue NW, Washington, DC
20420 or email to 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 FDMS.
FOR FURTHER INFORMATION CONTACT:
Brian McCarthy at (202) 615–9241.
SUPPLEMENTARY INFORMATION: Under the
PRA of 1995, 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
SUMMARY:
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collection of information on
respondents, including through the use
of automated collection techniques or
the use of other forms of information
technology.
Authority: Public Law 104–13; 44
U.S.C. 3501–3521.
Title: Expanded Access to Non-VA
Care through the MISSION Act:
Veterans Community Care Program, VA
Forms 10–10143, 10–10143a, 10–
10143b, 10–10143c, 10–10143e, 10–
10143f and 10–10143g.
OMB Control Number: 2900–0823.
Type of Review: Revision and
extension of a currently approved
collection.
Abstract: Section 101 of the VA
Maintaining Internal Systems and
Strengthening Integrated Outside
Networks (MISSION) Act of 2018
requires VA to implement the Veterans
Community Care Program to furnish
care in the community to covered
Veterans through eligible entities and
providers, under circumstances as
further prescribed in the MISSION Act.
VA currently collects information that
will be required to implement the
Veterans Community Care Program
(VCCP) under the Veterans Choice
Program, through an OMB approved
collection 2900–0823.
OMB Collection 2900–0823 now
includes VA Form 10–10143, Election to
Receive Authorized Non-VA Care and
Selection of Provider for the Veterans
Community Care Program; VA Form 10–
10143a, Veterans Community Care
Health Insurance Certification; VA Form
10–10143b, Submission of Medical
Record Information under the Veterans
Community Care Program; VA Form 10–
10143c, Submission of Information on
Credentials and Licenses by Eligible
Entities and Providers; and VA Form
10–10143e, Secondary Authorization
Request for VA Community Care. In
addition, two new forms that received
emergency PRA clearances from OMB in
2020 are included in 2900–0823: VA
Form 10–10143f, Community Care
Document Cover Sheet; and VA Form
10–10143g, Non-VA Hospital
Emergency Notification.
VA seeks to update OMB collection
2900–0823 to implement the Veterans
Community Care Program by updating
the title of VA forms and any associated
statutory citations to be consistent with
the new program and the MISSION Act,
by adding a new cover sheet to use
when submitting documentation from
providers of non-VA emergent care, by
adding a new 72-hour notification form
to be used when a Veteran receives
emergent care from a non-VA provider,
and by updating burden hours to
account for estimated increased use of
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Federal Register / Vol. 85, No. 158 / Friday, August 14, 2020 / Notices
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community care under the new
program.
This collection of information is
required to properly adjudicate and
implement the requirements of the
MISSION Act.
a. VA Form 10–10143 will collect
Veteran information on whether covered
Veterans would elect to receive
authorized care under the Veterans
Community Care Program (VCCP) if
certain conditions are met, as required
by 38 U.S.C. 1703(d)(3). This form also
will allow a covered Veteran to specify
a particular non-VA entity or provider.
b. VA Form 10–10143a will collect
other health insurance information from
covered Veterans who elect to
participate in the VCCP, as required by
38 U.S.C. 1705A. This information also
is required by 38 U.S.C. 1703(j), which
requires VA to recover or collect
reasonable charges for community care
that is furnished from a health care plan
contract described in 38 U.S.C. 1729.
c. VA Form 10–10143b will collect
health records of covered Veterans from
non-VA health care entities and
providers for care authorized under the
VCCP, as required by 38 U.S.C.
1703(a)(2)(A), which requires VA to
establish a mechanism to receive
medical records from non-VA providers.
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 the VCCP must be submitted to
VA, including any claims for payment
for the furnishing of such care.
d. VA Form 10–10143c will collect
information from non-VA entities and
providers concerning relevant
credentials and licenses as required for
such entities or providers to furnish care
and services generally. This information
is authorized by section 133 of the
MISSION Act, which requires VA to
establish competency standards for nonVA providers, as well as 38 U.S.C.
1703C(a)(1), which requires VA to
establish certain standards of quality for
furnishing care and services (including
through non-VA providers).
e. VA Form 10–10143e will collect
secondary authorization requests from
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49721
non-VA entities and providers to
furnish care and services in addition to
or supporting the original authorization
for care. This information is required by
38 U.S.C. 1703(a)(3), which establishes
that a covered Veteran may only receive
care or services under the VCCP upon
VA’s authorization of such care or
services.
f. VA Form 10–10143f will allow for
the submission of paper documents in
support of a non-VA provider claim for
emergency care rendered in the
community when not accompanied by a
paper Health Care Claim form. This
Community Care Document Cover Sheet
will be used exclusively for the
submission of medical documentation
for unauthorized emergent services for
patients otherwise covered by VA.
g. VA Form 10–10143g will be used
to provide 72-hour notification to VA
when a Veteran receives emergent care
from a non-VA provider. This form
should be completed by the non-VA
provider within 72 hours of the
beginning of treatment.
Frequency of Response: Average of 34
times annually.
Estimated Number of Respondents:
366,823.
VA Form 10–10143
Affected Public: Individuals or
households.
Estimated Annual Burden: 610,833
hours.
Estimated Average Burden per
Respondent: 10 minutes.
Frequency of Response: Once
annually.
Estimated Number of Respondents:
3,665,000.
VA Form 10–10143f
VA Form 10–10143a
Affected Public: Individuals or
households.
Estimated Annual Burden: 610,833
hours.
Estimated Average Burden per
Respondent: 10 minutes.
Frequency of Response: Once
annually.
Estimated Number of Respondents:
3,665,000.
VA Form 10–10143b
Affected Public: Private Sector.
Estimated Annual Burden: 1,039,332
hours.
Estimated Average Burden per
Respondent: 5 minutes.
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VA Form 10–10143c
Affected Public: Private Sector.
Estimated Annual Burden: 10,190
hours.
Estimated Average Burden per
Respondent: 5 minutes.
Frequency of Response: Once
annually.
Estimated Number of Respondents:
122,274.
VA Form 10–10143e
Affected Public: Private Sector.
Estimated Annual Burden: 611,372
hours.
Estimated Average Burden per
Respondent: 20 minutes.
Frequency of Response: Average of 5
times annually.
Estimated Number of Respondents:
366,823.
Affected Public: Private Sector.
Estimated Annual Burden: 41,667
hours.
Estimated Average Burden per
Respondent: 5 minutes.
Frequency of Response: Once
annually.
Estimated Number of Respondents:
500,000.
VA Form 10–10143g
Affected Public: Private Sector.
Estimated Annual Burden: 83,333
hours.
Estimated Average Burden per
Respondent: 10 minutes.
Frequency of Response: Once
annually.
Estimated Number of Respondents:
500,000.
By direction of the Secretary.
Danny S. Green,
VA Clearance Officer, Office of Quality,
Performance and Risk (OQPR). Department
of Veterans Affairs.
[FR Doc. 2020–17764 Filed 8–13–20; 8:45 am]
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Agencies
[Federal Register Volume 85, Number 158 (Friday, August 14, 2020)]
[Notices]
[Pages 49720-49721]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-17764]
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0823]
Agency Information Collection Activity: Expanded Access to Non-VA
Care Through the MISSION Act: Veterans Community Care Program
AGENCY: Veterans Health Administration, Department of Veterans Affairs.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: Veterans Health Administration, 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 proposed extension of a currently approved
collection, and allow 60 days for public comment in response to the
notice.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before October 13, 2020.
ADDRESSES: Submit written comments on the collection of information
through Federal Docket Management System (FDMS) at www.Regulations.gov
or to Brian McCarthy, Office of Regulatory and Administrative Affairs
(10B4), Department of Veterans Affairs, 810 Vermont Avenue NW,
Washington, DC 20420 or email to [email protected]. Please refer
to ``OMB Control No. 2900-0823'' in any correspondence. During the
comment period, comments may be viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT: Brian McCarthy at (202) 615-9241.
SUPPLEMENTARY INFORMATION: Under the PRA of 1995, 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.
Authority: Public Law 104-13; 44 U.S.C. 3501-3521.
Title: Expanded Access to Non-VA Care through the MISSION Act:
Veterans Community Care Program, VA Forms 10-10143, 10-10143a, 10-
10143b, 10-10143c, 10-10143e, 10-10143f and 10-10143g.
OMB Control Number: 2900-0823.
Type of Review: Revision and extension of a currently approved
collection.
Abstract: Section 101 of the VA Maintaining Internal Systems and
Strengthening Integrated Outside Networks (MISSION) Act of 2018
requires VA to implement the Veterans Community Care Program to furnish
care in the community to covered Veterans through eligible entities and
providers, under circumstances as further prescribed in the MISSION
Act. VA currently collects information that will be required to
implement the Veterans Community Care Program (VCCP) under the Veterans
Choice Program, through an OMB approved collection 2900-0823.
OMB Collection 2900-0823 now includes VA Form 10-10143, Election to
Receive Authorized Non-VA Care and Selection of Provider for the
Veterans Community Care Program; VA Form 10-10143a, Veterans Community
Care Health Insurance Certification; VA Form 10-10143b, Submission of
Medical Record Information under the Veterans Community Care Program;
VA Form 10-10143c, Submission of Information on Credentials and
Licenses by Eligible Entities and Providers; and VA Form 10-10143e,
Secondary Authorization Request for VA Community Care. In addition, two
new forms that received emergency PRA clearances from OMB in 2020 are
included in 2900-0823: VA Form 10-10143f, Community Care Document Cover
Sheet; and VA Form 10-10143g, Non-VA Hospital Emergency Notification.
VA seeks to update OMB collection 2900-0823 to implement the
Veterans Community Care Program by updating the title of VA forms and
any associated statutory citations to be consistent with the new
program and the MISSION Act, by adding a new cover sheet to use when
submitting documentation from providers of non-VA emergent care, by
adding a new 72-hour notification form to be used when a Veteran
receives emergent care from a non-VA provider, and by updating burden
hours to account for estimated increased use of
[[Page 49721]]
community care under the new program.
This collection of information is required to properly adjudicate
and implement the requirements of the MISSION Act.
a. VA Form 10-10143 will collect Veteran information on whether
covered Veterans would elect to receive authorized care under the
Veterans Community Care Program (VCCP) if certain conditions are met,
as required by 38 U.S.C. 1703(d)(3). This form also will allow a
covered Veteran to specify a particular non-VA entity or provider.
b. VA Form 10-10143a will collect other health insurance
information from covered Veterans who elect to participate in the VCCP,
as required by 38 U.S.C. 1705A. This information also is required by 38
U.S.C. 1703(j), which requires VA to recover or collect reasonable
charges for community care that is furnished from a health care plan
contract described in 38 U.S.C. 1729.
c. VA Form 10-10143b will collect health records of covered
Veterans from non-VA health care entities and providers for care
authorized under the VCCP, as required by 38 U.S.C. 1703(a)(2)(A),
which requires VA to establish a mechanism to receive medical records
from non-VA providers. 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 the VCCP must be submitted to VA, including any claims
for payment for the furnishing of such care.
d. VA Form 10-10143c will collect information from non-VA entities
and providers concerning relevant credentials and licenses as required
for such entities or providers to furnish care and services generally.
This information is authorized by section 133 of the MISSION Act, which
requires VA to establish competency standards for non-VA providers, as
well as 38 U.S.C. 1703C(a)(1), which requires VA to establish certain
standards of quality for furnishing care and services (including
through non-VA providers).
e. VA Form 10-10143e will collect secondary authorization requests
from non-VA entities and providers to furnish care and services in
addition to or supporting the original authorization for care. This
information is required by 38 U.S.C. 1703(a)(3), which establishes that
a covered Veteran may only receive care or services under the VCCP upon
VA's authorization of such care or services.
f. VA Form 10-10143f will allow for the submission of paper
documents in support of a non-VA provider claim for emergency care
rendered in the community when not accompanied by a paper Health Care
Claim form. This Community Care Document Cover Sheet will be used
exclusively for the submission of medical documentation for
unauthorized emergent services for patients otherwise covered by VA.
g. VA Form 10-10143g will be used to provide 72-hour notification
to VA when a Veteran receives emergent care from a non-VA provider.
This form should be completed by the non-VA provider within 72 hours of
the beginning of treatment.
VA Form 10-10143
Affected Public: Individuals or households.
Estimated Annual Burden: 610,833 hours.
Estimated Average Burden per Respondent: 10 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 3,665,000.
VA Form 10-10143a
Affected Public: Individuals or households.
Estimated Annual Burden: 610,833 hours.
Estimated Average Burden per Respondent: 10 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 3,665,000.
VA Form 10-10143b
Affected Public: Private Sector.
Estimated Annual Burden: 1,039,332 hours.
Estimated Average Burden per Respondent: 5 minutes.
Frequency of Response: Average of 34 times annually.
Estimated Number of Respondents: 366,823.
VA Form 10-10143c
Affected Public: Private Sector.
Estimated Annual Burden: 10,190 hours.
Estimated Average Burden per Respondent: 5 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 122,274.
VA Form 10-10143e
Affected Public: Private Sector.
Estimated Annual Burden: 611,372 hours.
Estimated Average Burden per Respondent: 20 minutes.
Frequency of Response: Average of 5 times annually.
Estimated Number of Respondents: 366,823.
VA Form 10-10143f
Affected Public: Private Sector.
Estimated Annual Burden: 41,667 hours.
Estimated Average Burden per Respondent: 5 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 500,000.
VA Form 10-10143g
Affected Public: Private Sector.
Estimated Annual Burden: 83,333 hours.
Estimated Average Burden per Respondent: 10 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 500,000.
By direction of the Secretary.
Danny S. Green,
VA Clearance Officer, Office of Quality, Performance and Risk (OQPR).
Department of Veterans Affairs.
[FR Doc. 2020-17764 Filed 8-13-20; 8:45 am]
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