Federal Register: October 29, 2009 (Volume 74, Number 208)
DOCID: fr29oc09-59 FR Doc E9-26029
DEPARTMENT OF DEFENSE
Defense Department
Docket ID: [Docket ID: DoD-2009-HA-0154]
NOTICE: NOTICES
DOCID: fr29oc09-59
DOCUMENT ACTION: Notice.
SUBJECT CATEGORY:
Proposed Collection; Comment Request
DATES: Consideration will be given to all comments received by December 28, 2009.
DOCUMENT SUMMARY:
In compliance with section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the Office of the Assistant Secretary of Defense for Health Affairs announces the proposed extension of a public information collection and seeks public comment on the provisions thereof. Comments are invited on: 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; the accuracy of the agency's estimate of the burden of the proposed information collection; ways to enhance the quality, utility, and clarity of the information to be collected; and 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.
SUMMARY:
Agency Information Collection Activities; Proposals, Submissions, and Approvals
SUPPLEMENTAL INFORMATION
Summary of Information Collection
The administration has placed increased emphasis upon recovery of
health care expenses under Third Party Collection Program, as
authorized by title 10, section 1095 and 1097b of the United States
Code. Completion of this form, while increasing total burden hours,
will aid in increasing revenues (O&M dollars), services and operating
efficiency and effectiveness within the Military Health Services
system. This information is collected either during the inpatient stay
admission and/or discharge process or during the visit when a patient presents for an outpatient procedure.
Dated: October 23, 2009.
Patricia L. Toppings,
OSD Federal Register Liaison Officer, Department of Defense. [FR Doc. E926029 Filed 102809; 8:45 am]
BILLING CODE 500106P
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: TMA Uniform Business Office, OASD(HA)/TMA/Management Control & Financial Studies, 5111 Leesburg Pike, Falls Church, Virginia 22041, Skyline 5, Suite 407ATTN: DeLisa E. Prater, Program Manager, at 7036813492 ext.6757 (DSN 761).
Title; Associated Form; and OMB Number: Third Party Collection Program/Medical Services Account/Other Health Insurance; DD FORM 2569; OMB Control Number 07040323.
Needs and Uses: DoD implemented the Coordination of Benefits Program in FY87 based on authority of 10 U.S.C. 1095, enacted as section 2001 of Public Law 99272, Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA), April 7, 1986, and Uniform Business Office (UBO) Manual 6010.15M, Military Treatment Facility UBO Manual, April 1997. Under this program, DoD is required to collect from third party payers the cost of inpatient and outpatient services rendered to military retirees, all dependents, and others who have private health insurance. Part 220 of Title 32 of the Code of Federal Regulations, implements 10 U.S.C. 1095. Specifically, 32 CFR 220.2(d) states that the form must be available to thirdparty payers upon request. A third party payer may not request any other assignment of benefits form from the subscriber.
Affected Public: Business or other for profit; Notforprofit institutions.
Annual Burden Hours: 175,370.
Number of Respondents: 3,507,390.
Responses per Respondent: 1.
Average Burden per Response: 3 minutes.
Frequency: Annually or On occasion (when insurance information changes).