[Federal Register: May 3, 1999 (Volume 64, Number 84)]
[Notices]               
[Page 23609-23610]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr03my99-39]

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DEPARTMENT OF DEFENSE

Office of the Secretary

 
Submission for OMB Review; Comment Request

ACTION: Notice.

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    The Department of Defense has submitted to OMB for clearance, the 
following proposal for collection of information under the provisions 
of the Paperwork Reduction Act (44 U.S.C. Chapter 35).
    Title, Associated Form, and OMB Number: Statement of Personal 
Injury--Possible Third Party Liability CHAMPUS; DD Form 2527; OMB 
Number 0720-0003.
    Type of Request: Reinstatement.
    Number of Respondents: 29,500.
    Responses Per Respondent: 1.
    Annual Responses: 29,500.
    Average Burden Per Response: 20 minutes.
    Annual Burden Hours: 9,833.
    Needs and Uses: The Federal Medical Care Recovery Act, 42 U.S.C. 
2651-2653 as implemented by Executive Order Number 11060 and 28 CFR 43 
provides for recovery of the reasonable value of medical care provided 
by the United States to a person who is injured or

[[Page 23610]]

suffers a disease under circumstances creating tort liability in some 
third person. DD Form 2527 is required for investigating and asserting 
claims in favor of the United States arising out of such incidents. 
When a claim for CHAMPUS benefits is identified as involving possible 
third person liability and the information is not submitted with the 
claim, the TRICARE/CHAMPUS contractor requests that the injured party 
(or a designee) complete DD Form 2527. To protect the interests of the 
Government, the contractor suspends claims processing until the 
requested third party liability information is received. The contractor 
conducts a preliminary evaluation based upon the collection of 
information and refers the case to a designated legal officer of the 
Uniformed Services. The responsible legal officer uses the information 
as a basis for asserting and settling the Government's claim. When 
appropriate, the information is forwarded to the Department of Justice 
as a basis for litigation.
    Affected Public: Individuals or households.
    Frequency: On occasion.
    Respondent's Obligation: Required to Obtain or Retain Benefits.
    OMB Desk Officer: Ms. Allison Eydt.
    Written comments and recommendations on the proposed information 
collection should be sent to Ms. Eydt at the Office of Management and 
Budget, Desk Officer for DoD (Health Affairs), Room 10235, New 
Executive Office Building, Washington, DC 20503.
    DOD Clearance Officer: Mr. Robert Cushing.
    Written requests for copies of the information collection proposal 
should be sent to Mr. Cushing, WHS/DIOR, 1215 Jefferson Davis Highway, 
Suite 1204, Arlington, VA 22202-2402.

    Dated: April 26, 1999.
Patricia L. Toppings,
Alternate OSD Federal Register Liaision Officer, Department of Defense.
[FR Doc. 99-10939 Filed 4-30-99; 8:45 am]
BILLING CODE 5001-10-M