Agency Information Collection Activity: Foreign Medical Program (FMP) Registration Form and Claim Cover Sheet, 72823 [2023-23297]

Agencies

• DEPARTMENT OF VETERANS AFFAIRS

[Federal Register Volume 88, Number 203 (Monday, October 23, 2023)]
[Notices]
[Page 72823]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-23297]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0648]


Agency Information Collection Activity: Foreign Medical Program 
(FMP) Registration Form and Claim Cover Sheet

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: 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 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 December 22, 2023.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at www.Regulations.gov 
or to Grant Bennett, Office of Regulations, Appeals, and Policy 
(10BRAP), Department of Veterans Affairs, 810 Vermont Avenue NW, 
Washington, DC 20420 or email to [email protected]. 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: Maribel Aponte, Office of Enterprise 
and Integration, Data Governance Analytics (008), 810 Vermont Avenue 
NW, Washington, DC 20420, (202) 266-4688 or email 
[email protected]. Please refer to ``OMB Control No. 2900-0648'' in 
any correspondence.

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: Foreign Medical Program (FMP) Registration Form and Claim 
Cover Sheet, VA Forms 10-7959f-1 and 10-7959f-2.
    OMB Control Number: 2900-0648.
    Type of Review: Extension of a currently approved collection.
    Abstract: The Foreign Medical Program (FMP) is a federal health 
benefits program for Veterans, which is administered by the Department 
of Veterans Affairs (VA) Veterans Health Administration (VHA). The FMP 
is a Fee for Service (indemnity plan) program and provides 
reimbursement for VA adjudicated service-connected conditions. Title 38 
CFR 17.35 states that VA will provide coverage for the Veteran's 
service-connected disability when the Veteran is residing or traveling 
overseas. Title 38 CFR 17.125(c) states that requests for consideration 
of claim reimbursement from approved health care providers and Veterans 
are to be mailed to VHA Health Administration Center. VA currently 
collects information for FMP reimbursement through an OMB approved 
collection under 2900-0648, using VA Form 10-7959f-1, Foreign Medical 
Program (FMP) Registration Form, and VA Form 10-7959f-2, Foreign 
Medical Program (FMP) Claim Cover Sheet. This collection of information 
is necessary to continue to reimburse Veterans or providers under the 
FMP.
    a. VA Form 10-7959f-1 will collect information used to register 
into the FMP those Veterans with service-connected disabilities who are 
living or traveling overseas.
    b. VA Form 10-7959f-2 will collect information to streamline the 
FMP claims submission process for claimants or providers, while also 
reducing the time spent by VA on processing FMP claims. The cover sheet 
will explain to foreign providers and Veterans the basic information 
required for the processing and payment of claims.

VA Form 10-7959f-1

    Affected Public: Individuals and households.
    Estimated Annual Burden: 111 hours.
    Estimated Average Burden per Respondent: 4 minutes.
    Frequency of Response: Once annually.
    Estimated Number of Respondents: 1,660.

VA Form 10-7959f-2

    Affected Public: Individuals or households; private sector.
    Estimated Annual Burden: 3,652 hours.
    Estimated Average Burden per Respondent: 11 minutes.
    Frequency of Response: 12 times annually.
    Estimated Number of Respondents: 1,660.

    By direction of the Secretary.
Maribel Aponte,
VA PRA Clearance Officer, Office of Enterprise and Integration/Data 
Governance Analytics, Department of Veterans Affairs.
[FR Doc. 2023-23297 Filed 10-20-23; 8:45 am]
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