Federal Register: November 3, 2009 (Volume 74, Number 211)
DOCID: fr03no09-39 FR Doc E9-26407
DEPARTMENT OF DEFENSE
Defense Department
Docket ID: [Docket ID DOD-2009-HA-0159]
NOTICE: NOTICES
DOCID: fr03no09-39
DOCUMENT ACTION: Notice.
SUBJECT CATEGORY:
Extension of a Currently Approved Collection
DATES: Consideration will be given to all comments received by January 4, 2010.
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 Department of Defense established TRICARE Prime as a managed care option, similar to a civilian HMO (health maintenance organization). Active duty service members are required to be enrolled in TRICARE Prime or TRICARE Prime Remote. They must take action to enroll by filling out the appropriate enrollment form and submitting it to the Managed Care Support Contractor (MCSC). TRICARE Prime is also available to other TRICARE beneficiaries who are also required to fill out the appropriate enrollment or disenrollment forms. TRICARE Prime enrollee's health care is coordinated by a primary care manager (PCM) whom could be a part of a military treatment facility, a civilian network or TRICARE Prime Remote where eligible. In order to carry out this program, it is necessary that certain beneficiaries electing to enroll/disenroll in TRICARE Prime, TRICARE Prime Remote or change a PCM complete an enrollment application request. Completion of the enrollment forms is an essential element of the TRICARE Prime program.
Dated: October 29, 2009.
Mitchell S. Bryman,
Alternate OSD Federal Register Liaison Officer, Department of Defense. [FR Doc. E926407 Filed 11209; 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 the Office of the Assistant Secretary of Defense for Health Affairs (OASD), TRICARE Operations Division, Attn: Ms. Shane Pham, 5111 Leesburg Pike, Suite 810(A), Falls Church, VA 220413206, or call TRICARE Operations Division, at 7036810039 ext. 8666.
Title; Associated Form; and OMB Number: TRICARE Prime Enrollment Application/PCM Change Form DD Form 2876, and TRICARE Prime Disenrollment Application; DD Form 2877; OMB Number 07200008.
Needs and Uses: This information is collected in accordance with
the National Defense Authorization Act for Fiscal Year 1001 (Pub. L. 106398),
[[Page 56823]]
section 723(b)(E). These collection instruments serve as applications
for the Enrollment, Primary Care Manager (PCM) Change and Disenrollment
for the Department of Defense's TRICARE Prime program established in
accordance with title 10 U.S.C. 1099 (which calls for a healthcare
enrollment system). Monthly payment options for retiree enrollment fees
for TRICARE Prime are established in accordance with title 10 U.S.C.
1097a(c). The information collected on the TRICARE Prime Enrollment
Application/PCM Change Form provides the necessary data to determine
beneficiary eligibility, to identify the selection of a health care
option, and to change the designated PCM when the beneficiary is
relocating or merely requests a local PCM change. The information
collected on the TRICARE Prime Disenrollment Form provides the
necessary data to disenroll a beneficiary from TRICARE Prime. The
Disenrollment Application is needed to implement disenrollment from
TRICARE Prime, TRICARE Prime Remote or the Uniformed Services Family
Health Plan as requested by the enrollee. Failure to provide
information will result in continued enrollment and beneficiaries' responsibility for payment of an enrollment fee.
Affected Public: Individuals or Households.
Annual Burden Hours: 22,317.
Number of Respondents: 72,905.
Responses per Respondent: 1.
Average Burden per Response: TRICARE Prime Enrollment Application/ PCM Change Form: 20 minutes or .33% of an hour/TRICARE Prime Disenrollment5 minutes or .083%. (average burden per response for completing both forms is 18.36 minutes or .30% of an hour).
Frequency: On occasion.