Agency Information Collection Activities; Comment Request; Claim for Medical Reimbursement Form, 8806-8807 [2021-02634]

Download as PDF khammond on DSKJM1Z7X2PROD with NOTICES 8806 Federal Register / Vol. 86, No. 25 / Tuesday, February 9, 2021 / Notices testing or treatment. Black Lung Benefits Act (BLBA), 30 U.S.C. 901, Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA) 42 U.S.C. 7384, and the Federal Employees’ Compensation Act (FECA), 5 U.S.C. 8101 authorize this information collection. This information collection is subject to the PRA. A Federal agency generally cannot conduct or sponsor a collection of information, and the public is generally not required to respond to an information collection, unless it is approved by the OMB under the PRA and displays a currently valid OMB Control Number. In addition, notwithstanding any other provisions of law, no person shall generally be subject to penalty for failing to comply with a collection of information that does not display a valid Control Number. See 5 CFR 1320.5(a) and 1320.6. Interested parties are encouraged to provide comments to the contact shown in the ADDRESSES section. Comments must be written to receive consideration, and they will be summarized and included in the request for OMB approval of the final ICR. In order to help ensure appropriate consideration, comments should mention 1240–0037. Submitted comments will also be a matter of public record for this ICR and posted on the internet, without redaction. The DOL encourages commenters not to include personally identifiable information, confidential business data, or other sensitive statements/information in any comments. The DOL is particularly interested in comments that: • Evaluate whether the proposed collection of information is necessary for the proper performance of the functions of the agency, including whether the information will have practical utility; • Evaluate the accuracy of the agency’s estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used; • Enhance the quality, utility, and clarity of the information to be collected; and • Minimize the burden of the collection of information on those who are to respond, including through the use of appropriate automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses. Agency: DOL–OWCP. Type of Review: Extension. VerDate Sep<11>2014 17:07 Feb 08, 2021 Jkt 253001 Title of Collection: Medical Travel Refund Request. Form: OWCP–957. OMB Control Number: 1240–0037. Affected Public: Individuals or households. Estimated Number of Respondents: 34,703. Frequency: On occasion. Total Estimated Annual Responses: 333,528. Estimated Average Time per Response: 10 minutes. Estimated Total Annual Burden Hours: 55,366 hours. Total Estimated Annual Other Cost Burden: $ 173,435. (Authority: 44 U.S.C. 3506(c)(2)(A)) Anjanette Suggs, Agency Clearance Officer. [FR Doc. 2021–02635 Filed 2–8–21; 8:45 am] BILLING CODE 4510–CR–P DEPARTMENT OF LABOR Office of Workers’ Compensation Programs [Docket No. WCPO–2020–0002] Black Lung Benefits Act SelfInsurance: Withdrawal of Guidance Office of Workers’ Compensation Programs, Labor. ACTION: Withdrawal of notice and request for comments. AGENCY: The Office of Workers’ Compensation Programs (OWCP) is withdrawing a notice and request for comments entitled ‘‘Guidance on Black Lung Benefits Act Self-Insurance,’’ which was published in the Federal Register on January 8, 2021. DATES: The withdrawal is effective February 9, 2021. FOR FURTHER INFORMATION CONTACT: Michael Chance, Director, Division of Coal Mine Workers’ Compensation, Office of Workers’ Compensation Programs, U.S. Department of Labor, 200 Constitution Avenue NW, Room N– 3464, Washington, DC 20210. Telephone: 1–800–347–2502. This is a toll-free number. TTY/TDD callers may dial toll-free 1–800–877–8339 for further information. SUPPLEMENTARY INFORMATION: On January 8, 2021, OWCP published a notice and request for comments entitled ‘‘Guidance on Black Lung Benefits Act Self-Insurance’’ in the Federal Register. 86 FR 1529 (Jan. 8, 2021). The notice informed and invited comment from the public on a preliminary program bulletin related to SUMMARY: PO 00000 Frm 00055 Fmt 4703 Sfmt 4703 coal-mine operators applying to selfinsure their liabilities under the Black Lung Benefits Act. 30 U.S.C. 901–944. The comment period under the notice runs through February 8, 2021. OWCP is now withdrawing the notice and request for comments on the preliminary self-insurance bulletin because the legal bases for publishing the notice—the Department of Labor’s PRO Good Guidance Rule (29 CFR part 89) and Executive Order 13891 (84 FR 55235 (Oct. 15, 2019))—have been rescinded or revoked. See 86 FR 7237 (Jan. 27, 2021) (rescinding 29 CFR part 89); E.O. 13992, 86 FR 7049 (Jan. 20, 2021) (revoking E.O. 13891). OWCP’s action is also consistent with the January 20, 2021 memorandum for the Heads of Executive Departments and Agencies from the Assistant to the President and Chief of Staff entitled ‘‘Regulatory Freeze Pending Review.’’ 86 FR 7424 (Jan. 28, 2021). The memorandum directs agencies to pause or delay certain regulatory actions, including actions related to guidance documents, for the purpose of reviewing questions of fact, law, and policy raised therein. OWCP intends to review the self-insurance bulletin and offer the public an opportunity to comment on self-insurance procedures at a later time. Accordingly, OWCP is withdrawing the notice and request for comments published on January 8, 2021. The withdrawal of the guidance does not change any law, regulation, or other legally binding requirement. Dated: February 3, 2021. Christopher J. Godfrey, Director, Office of Workers’ Compensation Programs. [FR Doc. 2021–02614 Filed 2–8–21; 8:45 am] BILLING CODE 4510–CR–P DEPARTMENT OF LABOR Office of Workers’ Compensation Programs Agency Information Collection Activities; Comment Request; Claim for Medical Reimbursement Form Notice of availability; request for comments. ACTION: The Department of Labor (DOL) is soliciting comments concerning a proposed extension for the authority to conduct the information collection request (ICR) titled, ‘‘Claim for Medical Reimbursement Form.’’ This comment request is part of continuing Departmental efforts to reduce paperwork and respondent burden in SUMMARY: E:\FR\FM\09FEN1.SGM 09FEN1 khammond on DSKJM1Z7X2PROD with NOTICES Federal Register / Vol. 86, No. 25 / Tuesday, February 9, 2021 / Notices accordance with the Paperwork Reduction Act of 1995 (PRA). DATES: Consideration will be given to all written comments received by April 12, 2021. ADDRESSES: A copy of this ICR with applicable supporting documentation; including a description of the likely respondents, proposed frequency of response, and estimated total burden may be obtained free by contacting Anjanette Suggs by telephone at (202) 354–9660 (this is not toll-free number) or by email at suggs.anjanette@dol.gov. Submit written comments about, or requests for a copy of, this ICR by mail or courier to the U.S. Department of Labor, Office of Workers’ Compensation Programs, Room N1301, 200 Constitution Avenue NW, Washington, DC 20210; by email: suggs.anjanette@ dol.gov. FOR FURTHER INFORMATION CONTACT: Contact Anjanette Suggs by telephone at (202) 354–9660 (this is not a toll-free number) or by email at suggs.anjanette@ dol.gov. SUPPLEMENTARY INFORMATION: The DOL, as part of continuing efforts to reduce paperwork and respondent burden, conducts a pre-clearance consultation program to provide the general public and Federal agencies an opportunity to comment on proposed and/or continuing collections of information before submitting them to the OMB for final approval. This program helps to ensure requested data can be provided in the desired format, reporting burden (time and financial resources) is minimized, collection instruments are clearly understood, and the impact of collection requirements can be properly assessed. Form OWCP–915 is used to claim reimbursement for out-of-pocket covered medical expenses paid by a beneficiary, and must be accompanied by required billing data elements (prepared by the medical provider) and by proof of payment by the beneficiary. Employees Compensation Act, 5 U.S.C. 8101, Black Lung Benefits Act, 30 U.S.C. 901, Energy Employees Occupational Illness Compensation Program Act of 2000, 42 U.S.C. 7384 authorize this information collection. This information collection is subject to the PRA. A Federal agency generally cannot conduct or sponsor a collection of information, and the public is generally not required to respond to an information collection, unless it is approved by the OMB under the PRA and displays a currently valid OMB Control Number. In addition, notwithstanding any other provisions of law, no person shall generally be subject VerDate Sep<11>2014 17:07 Feb 08, 2021 Jkt 253001 to penalty for failing to comply with a collection of information that does not display a valid Control Number. See 5 CFR 1320.5(a) and 1320.6. Interested parties are encouraged to provide comments to the contact shown in the ADDRESSES section. Comments must be written to receive consideration, and they will be summarized and included in the request for OMB approval of the final ICR. In order to help ensure appropriate consideration, comments should mention 1240–0007. Submitted comments will also be a matter of public record for this ICR and posted on the internet, without redaction. The DOL encourages commenters not to include personally identifiable information, confidential business data, or other sensitive statements/information in any comments. The DOL is particularly interested in comments that: • Evaluate whether the proposed collection of information is necessary for the proper performance of the functions of the agency, including whether the information will have practical utility; • Evaluate the accuracy of the agency’s estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used; • Enhance the quality, utility, and clarity of the information to be collected; and • Minimize the burden of the collection of information on those who are to respond, including through the use of appropriate automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses. Agency: DOL–OWCP. Type of Review: Extension Title of Collection: Claim for Medical Reimbursement Form. Form: OWCP–915. OMB Control Number: 1240–0007. Affected Public: Individuals or households. Estimated Number of Respondents: 10,260. Frequency: Annually. Total Estimated Annual Responses: 34,564. Estimated Average Time per Response: 10 minutes. Estimated Total Annual Burden Hours: 5,738 hours. Total Estimated Annual Other Cost Burden: $59,450. PO 00000 Frm 00056 Fmt 4703 Sfmt 4703 8807 Authority: 44 U.S.C. 3506(c)(2)(A). Anjanette Suggs, Agency Clearance Officer. [FR Doc. 2021–02634 Filed 2–8–21; 8:45 am] BILLING CODE 4510–CR–P LEGAL SERVICES CORPORATION Pro Bono Innovation Fund Request for Pre-Applications for 2021 Grant Funding Legal Services Corporation. Notice. AGENCY: ACTION: The Legal Services Corporation (LSC) issues this Notice describing the conditions for submitting a Pre-Application for 2021 Pro Bono Innovation Fund grants. DATES: Pre-Applications must be submitted by 11:59 p.m. EST on Monday, March 15, 2021. ADDRESSES: Pre-Applications must be submitted electronically to http:// lscgrants.lsc.gov. FOR FURTHER INFORMATION CONTACT: Mytrang Nguyen, Program Counsel, Office of Program Performance, Legal Services Corporation, 3333 K Street NW, Washington, DC 20007; (202) 295–1564 or nguyenm@lsc.gov. SUPPLEMENTARY INFORMATION: SUMMARY: I. Introduction Since 2014, Congress has provided an annual appropriation to LSC ‘‘for a Pro Bono Innovation Fund.’’ See, e.g., Consolidated Appropriations Act, 2017, Public Law 115–31, 131 Stat. 135 (2017). LSC requested these funds for grants to ‘‘develop, test, and replicate innovative pro bono efforts that can enable LSC grantees to expand clients’ access to high quality legal assistance.’’ LSC Budget Request, Fiscal Year 2014 at 26 (2013). The grants must involve innovations that are either ‘‘new ideas’’ or ‘‘new applications of existing best practices.’’ Id. Each grant would ‘‘either serve as a model for other legal services providers to follow or effectively replicate a prior innovation. Id. The Senate Appropriations Committee explained that these funds ‘‘will support innovative projects that promote and enhance pro bono initiatives throughout the Nation,’’ and the House Appropriations Committee directed LSC ‘‘to increase the involvement of private attorneys in the delivery of legal services to [LSC-eligible] clients.’’ Senate Report 114–239 at 123 (2016), House Report 113–448 at 85 (2014). Since its inception, the Pro Bono Innovation Fund has advanced LSC’s goal of increasing the quantity and E:\FR\FM\09FEN1.SGM 09FEN1

Agencies

[Federal Register Volume 86, Number 25 (Tuesday, February 9, 2021)]
[Notices]
[Pages 8806-8807]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-02634]


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

DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Agency Information Collection Activities; Comment Request; Claim 
for Medical Reimbursement Form

ACTION: Notice of availability; request for comments.

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

SUMMARY: The Department of Labor (DOL) is soliciting comments 
concerning a proposed extension for the authority to conduct the 
information collection request (ICR) titled, ``Claim for Medical 
Reimbursement Form.'' This comment request is part of continuing 
Departmental efforts to reduce paperwork and respondent burden in

[[Page 8807]]

accordance with the Paperwork Reduction Act of 1995 (PRA).

DATES: Consideration will be given to all written comments received by 
April 12, 2021.

ADDRESSES: A copy of this ICR with applicable supporting documentation; 
including a description of the likely respondents, proposed frequency 
of response, and estimated total burden may be obtained free by 
contacting Anjanette Suggs by telephone at (202) 354-9660 (this is not 
toll-free number) or by email at [email protected].
    Submit written comments about, or requests for a copy of, this ICR 
by mail or courier to the U.S. Department of Labor, Office of Workers' 
Compensation Programs, Room N1301, 200 Constitution Avenue NW, 
Washington, DC 20210; by email: [email protected].

FOR FURTHER INFORMATION CONTACT: Contact Anjanette Suggs by telephone 
at (202) 354-9660 (this is not a toll-free number) or by email at 
[email protected].

SUPPLEMENTARY INFORMATION: The DOL, as part of continuing efforts to 
reduce paperwork and respondent burden, conducts a pre-clearance 
consultation program to provide the general public and Federal agencies 
an opportunity to comment on proposed and/or continuing collections of 
information before submitting them to the OMB for final approval. This 
program helps to ensure requested data can be provided in the desired 
format, reporting burden (time and financial resources) is minimized, 
collection instruments are clearly understood, and the impact of 
collection requirements can be properly assessed.
    Form OWCP-915 is used to claim reimbursement for out-of-pocket 
covered medical expenses paid by a beneficiary, and must be accompanied 
by required billing data elements (prepared by the medical provider) 
and by proof of payment by the beneficiary. Employees Compensation Act, 
5 U.S.C. 8101, Black Lung Benefits Act, 30 U.S.C. 901, Energy Employees 
Occupational Illness Compensation Program Act of 2000, 42 U.S.C. 7384 
authorize this information collection.
    This information collection is subject to the PRA. A Federal agency 
generally cannot conduct or sponsor a collection of information, and 
the public is generally not required to respond to an information 
collection, unless it is approved by the OMB under the PRA and displays 
a currently valid OMB Control Number. In addition, notwithstanding any 
other provisions of law, no person shall generally be subject to 
penalty for failing to comply with a collection of information that 
does not display a valid Control Number. See 5 CFR 1320.5(a) and 
1320.6.
    Interested parties are encouraged to provide comments to the 
contact shown in the ADDRESSES section. Comments must be written to 
receive consideration, and they will be summarized and included in the 
request for OMB approval of the final ICR. In order to help ensure 
appropriate consideration, comments should mention 1240-0007.
    Submitted comments will also be a matter of public record for this 
ICR and posted on the internet, without redaction. The DOL encourages 
commenters not to include personally identifiable information, 
confidential business data, or other sensitive statements/information 
in any comments.
    The DOL is particularly interested in comments that:
     Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
     Evaluate the accuracy of the agency's estimate of the 
burden of the proposed collection of information, including the 
validity of the methodology and assumptions used;
     Enhance the quality, utility, and clarity of the 
information to be collected; and
     Minimize the burden of the collection of information on 
those who are to respond, including through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submission of responses.
    Agency: DOL-OWCP.
    Type of Review: Extension
    Title of Collection: Claim for Medical Reimbursement Form.
    Form: OWCP-915.
    OMB Control Number: 1240-0007.
    Affected Public: Individuals or households.
    Estimated Number of Respondents: 10,260.
    Frequency: Annually.
    Total Estimated Annual Responses: 34,564.
    Estimated Average Time per Response: 10 minutes.
    Estimated Total Annual Burden Hours: 5,738 hours.
    Total Estimated Annual Other Cost Burden: $59,450.

    Authority: 44 U.S.C. 3506(c)(2)(A).

Anjanette Suggs,
Agency Clearance Officer.
[FR Doc. 2021-02634 Filed 2-8-21; 8:45 am]
BILLING CODE 4510-CR-P