Notice2026-08803
Proposed Collection; Comment Request
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
May 6, 2026
Issuing agencies
Defense Department
Abstract
In compliance with the Paperwork Reduction Act of 1995, the DHA announces proposed 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.
Full Text
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<title>Federal Register, Volume 91 Issue 87 (Wednesday, May 6, 2026)</title>
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[Federal Register Volume 91, Number 87 (Wednesday, May 6, 2026)]
[Notices]
[Page 24532]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-08803]
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DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID: DOD-2026-HA-0959]
Proposed Collection; Comment Request
AGENCY: The Office of the Assistant Secretary of Defense for Health
Affairs (OASD(HA)), Department of Defense (DoD).
ACTION: 60-Day information collection notice.
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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the
DHA announces proposed 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.
DATES: Consideration will be given to all comments received by July 6,
2026.
ADDRESSES: You may submit comments, identified by docket number and
title, by any of the following methods:
Federal eRulemaking Portal: <a href="http://www.regulations.gov">http://www.regulations.gov</a>. Follow the
instructions for submitting comments.
Mail: Department of War, Office of the Director of Administration
and Management, Privacy, Civil Liberties, and Transparency Directorate,
Regulatory Division, 4800 Mark Center Drive, Mailbox #24, Suite 05F16,
Alexandria, VA 22350-1700.
Instructions: All submissions received must include the agency
name, docket number and title for this Federal Register document. The
general policy for comments and other submissions from members of the
public is to make these submissions available for public viewing on the
internet at <a href="http://www.regulations.gov">http://www.regulations.gov</a> as they are received without
change, including any personal identifiers or contact information.
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 Defense Health
Agency, 7700 Arlington Blvd., Falls Church, VA 22042, Amanda Grifka,
703-681-1771.
SUPPLEMENTARY INFORMATION:
Title; Associated Form; and OMB Number: Third Party Collection
Program (Insurance Information); DD Form 2569; OMB Control Number 0720-
0055.
Needs and Uses: The DoD is authorized to collect ``reasonable
charges'' from third party payers for the cost of inpatient and
outpatient services rendered at military treatment facilities (MTFs) to
military retirees, all dependents, and other eligible beneficiaries who
have private health insurance. The DoD may also collect the cost of
trauma or other medical care provided from civilians (or their
insurers), and/or the average cost of health care provided to
beneficiaries at DoD MTFs from other federal agencies. For DoD to
perform such collections, eligible beneficiaries may elect to provide
DoD with other health insurance information. For civilian
nonbeneficiary and interagency patients, DD Form 2569 is necessary and
serves as an assignment of benefits, approval to submit claims to
payers on behalf of the patient and authorizes the release of medical
information. This form is available to third-party payers upon request.
The collection of personal information from individuals of the public
for use in medical services is authorized by title 10 United States
Code (U.S.C.) 1095, ``Health Care Services Incurred on Behalf of
Covered Beneficiaries: Collection from Third-Party Payers''; Title 32
Code of Federal Regulations part 220, ``Collection From Third Party
Payers of Reasonable Charges for Healthcare Services''; Title 10 U.S.C.
1079b(a), ``Procedures for Charging Fees for Care Provided to
Civilians; Retention and Use of Fees Collected''; and Title 10 U.S.C.
1085, ``Medical and Dental Care from Another Executive Department:
Reimbursement.''
Affected Public: Individuals or households.
Annual Burden Hours: 357,000.
Number of Respondents: 3,570,000.
Responses per Respondent: 1.5.
Annual Responses: 5,355,000.
Average Burden per Response: 4 minutes.
Frequency: On occasion.
Dated: May 1, 2026.
Stephanie J. Bost,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2026-08803 Filed 5-5-26; 8:45 am]
BILLING CODE 6001-FR-P
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</html>Indexed from Federal Register on May 6, 2026.
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