Proposed Collection; Comment Request [Notices] [07/31/1997]
Proposed Collection; Comment Request [07/31/1997]
Volume 62, Number 147, Page 41084-41085[DOCID:fr31jy97-128]
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DEPARTMENT OF LABOR
Employment Standards Administration
Proposed Collection; Comment Request
ACTION: Notice.
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SUMMARY: The Department of Labor, as part of its continuing effort to
reduce paperwork and respondent burden, conducts a preclearance
consultation program to provide the general public and Federal agencies
with an opportunity to comment on proposed and/or continuing
collections of information in accordance with the Paperwork Reduction
Act of 1995 (PRA95) (44 U.S.C. 3506(c)(2)(A)). This program helps to
ensure that requested data can be provided in the desired format,
reporting burden (time and financial resources) is minimized,
collection instruments are clearly understood, and the impact of
collection requirements on respondents can be properly assessed.
Currently, the
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Employment Standards Administration is soliciting comments concerning a
proposed extension information collection, the Uniform Health Insurance
Claim Form.
Copies of the proposed information collection requests can be
obtained by contacting the office listed below in the addressee section
of this notice.
DATES: Written comments must be submitted to the office listed in the
addressee section below on or before September 30, 1997. The Department
of Labor is particularly interested in comments which:
<bullet> Evaluate whether the proposed collection of information is
necessary for the proper performance of the functions of the agency,
including whether the information will have practical utility;
<bullet> Evaluate the accuracy of the agency's estimate of the
burden of the proposed collection of information, including the
validity of the methodology and assumptions used;
<bullet> Enhance the quality, utility and clarity of the
information to be collected; and
<bullet> Minimize the burden of the collection of information on
those who are to respond, including through the use of appropriate
automated, electronic, mechanical, or other technological collection
techniques or other forms of information technology, e.g., permitting
electronic submissions of responses.
ADDRESSES: Ms. Margaret Sherrill, U.S. Department of Labor, 200
Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone
(202) 219-7601. (This is not a toll-free number.) Fax 202-219-6592.
SUPPLEMENTARY INFORMATION:
I. Background
The Office of Workers' Compensation has responsibility for
administering the Federal Employees' Compensation Act (FECA--5 USC 8101
et. seq.) and the Federal Black Lung Benefits Act (FBLBA) provisions of
the Federal Mine Safety and Health Act (30 USC 901 et. seq.). These
statutes provide for payment to medical institutions for certain
medical treatment and diagnostic services for employment-related
injuries and illnesses. To determine appropriate payment of medical
bills submitted by such provider(s), both FECA and FBLA programs
require the billing institution(s) to identify the claimant/beneficiary
and to specify (1) the type of injury/illness being treated, (2) the
need for the medical services rendered, (3) the specific procedure(s)
performed, and (4) the relationship to the accepted industrial injury/
illness for FECA claimants and to coal mine workers' pneumoconiosis for
Black Lung claimants.
II. Current Actions
The Department of Labor (DOL) seeks extension of approval to
collect this information to carry out its responsibility to insure that
providers of medical services to FECA and BLBA beneficiaries receive
appropriate payment for injuries and illnesses covered under the Acts.
Failure to request this information will prohibit the Department's
ability to fulfill this mandate.
Type of Review: Extension.
Agency: Employment Standards Administration.
Title: Uniform Health Insurance Claim Form.
OMB Number: 1215-0176.
Agency Numbers: UB-92.
Affected Public: Individuals or households, State or local
governments, Businesses or other for profit, Federal agencies or
employees, Not-for-profit institutions, Small businesses or
organizations.
Total Repondents: 138,382.
Frequency: On occasion.
Total Responses: 138,382.
Average Time Per Response:
UB-92 FECA--17 minutes
UB-92 FBLBA--7 minutes
EOB FECA--7 minutes
Estimated Total Burden Hours: 31,889.
Total Burden Cost (capital/startup): $0.
Total Burden Cost (operating/maintenance): $0.
Comments submitted in response to this notice will be summarized
and/or included in the request for Office of Management and Budget
approval of the information collection requests; they will also become
a matter of public record.
Dated: July 24, 1997.
Margaret J. Sherrill,
Management Analysis Officer, Division Financial Management, Office of
Management, Administration and Planning, Employment Standards
Administration.
[FR Doc. 97-20101 Filed 7-30-97; 8:45 am]
BILLING CODE 4510-27-M
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