Notice2023-28647
Agency Information Collection Activity Under OMB Review: Foreign Medical Program (FMP) Registration Form and Claim Cover Sheet
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
December 28, 2023
Issuing agencies
Veterans Affairs Department
Abstract
In compliance with the Paperwork Reduction Act (PRA) of 1995, this notice announces that the Veterans Health Administration, Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden and it includes the actual data collection instrument.
Full Text
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<title>Federal Register, Volume 88 Issue 248 (Thursday, December 28, 2023)</title>
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[Federal Register Volume 88, Number 248 (Thursday, December 28, 2023)]
[Notices]
[Pages 89817-89818]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-28647]
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0648]
Agency Information Collection Activity Under OMB Review: 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: In compliance with the Paperwork Reduction Act (PRA) of 1995,
this notice announces that the Veterans Health Administration,
Department of Veterans Affairs, will submit the collection of
information abstracted below to the Office of Management and Budget
(OMB) for review and comment. The PRA submission describes the nature
of the information collection and its expected cost and burden and it
includes the actual data collection instrument.
DATES: Written comments and recommendations for the proposed
information collection should be sent within 30 days of publication of
this notice to <a href="http://www.reginfo.gov/public/do/PRAMain">www.reginfo.gov/public/do/PRAMain</a>. Find this particular
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. Refer to
``OMB Control No. 2900-0648.''
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
<a href="/cdn-cgi/l/email-protection#b9d4d8cbd0dbdcd597d8c9d6d7cddcf9cfd897ded6cf"><span class="__cf_email__" data-cfemail="335e52415a51565f1d52435c5d47567345521d545c45">[email protected]</span></a>. Please refer to ``OMB Control No. 2900-0648'' in
any correspondence.
[[Page 89818]]
SUPPLEMENTARY INFORMATION:
Authority: 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.
An agency may not conduct or sponsor, and a person is not required
to respond to a collection of information unless it displays a
currently valid OMB control number. The Federal Register Notice with a
60-day comment period soliciting comments on this collection of
information was published at 88 FR 203 on October 23, 2023, page 72823.
VA Form 10-7959f-1
Affected Public: Individuals or 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.
Dorothy Glasgow,
VA PRA Clearance Officer, (Alt) Office of Enterprise and Integration,
Data Governance Analytics, Department of Veterans Affairs.
[FR Doc. 2023-28647 Filed 12-27-23; 8:45 am]
BILLING CODE 8320-01-P
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</html>Indexed from Federal Register on December 28, 2023.
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