[Federal Register Volume 78, Number 127 (Tuesday, July 2, 2013)]
[Notices]
[Pages 39832-39833]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-15811]
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0091]
Proposed Information Collection Activity: Proposed Collection;
Comment Request
AGENCY: Veterans Health Administration, Department of Veterans Affairs.
ACTION: Notice.
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SUMMARY: The Veterans Health Administration (VHA) is announcing an
opportunity for public comment on the proposed collection of certain
information by the agency. Under the Paperwork Reduction Act (PRA) of
1995, Federal agencies are required to publish notice in the Federal
Register concerning each proposed collection of information, including
each proposed revision of a currently approved collection, and allow 60
days for public comment in response to the notice. This notice solicits
comments on the information needed to enroll veterans into the VA
health care system and to update an existing enrollee's personal data.
[[Page 39833]]
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before September 3, 2013.
ADDRESSES: Submit written comments on the collection of information
through www.Regulations.gov; or to Cynthia Harvey-Pryor, Veterans
Health Administration (10B4), Department of Veterans Affairs, 810
Vermont Avenue NW., Washington, DC 20420 or email [email protected]. Please refer to ``OMB Control No. 2900-0091'' in any
correspondence. During the comment period, comments may be viewed
online through the Federal Docket Management System (FDMS) at
www.Regulations.gov.
FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor at (202) 461-
5870.
SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44
U.S.C. 3501-3521), Federal agencies must obtain approval from the
Office of Management and Budget (OMB) for each collection of
information they conduct or sponsor. This request for comment is being
made pursuant to Section 3506(c)(2)(A) of the PRA.
With respect to the following collection of information, VHA
invites comments on: (1) Whether the proposed collection of information
is necessary for the proper performance of VHA's functions, including
whether the information will have practical utility; (2) the accuracy
of VHA's estimate of the burden of the proposed collection of
information; (3) ways to enhance the quality, utility, and clarity of
the information to be collected; and (4) way to minimize the burden of
the collection of information on respondents, including through the use
of automated collection techniques or the use of other forms of
information technology.
Titles:
a. Application for Health Benefits, VA Form 10-10EZ.
b. Health Benefits Renewal Form, VA Form 10-10EZR.
c. VA Form 10-10HS.
OMB Control Number: 2900-0091.
Type of Review: Revision of a currently approved collection.
Abstract:
a. Veterans complete VA Form 10-10EZ to enroll in VA health care
system. VA will use the information collected to determine the
Veteran's eligibility for medical benefits.
b. Veterans currently enrolled in VA health care system complete VA
Form 10-10EZR to update their personal information such as martial
status, address, health insurance and financial information.
c. VA Form 10-10HS collects information only from Veterans who are
in a copay required status for hospital care and medical services, but
due to a loss of income project their income for the current year will
be substantially below the VA means test threshold.
Affected Public: Individuals or households.
Estimated Annual Burden: 1,017,000 hours.
a. VA Form 10-10EZ--250,000.
b. VA Form 10-10EZR--204,000.
c. VA Form 10-10HS--1750.
Estimated Average Burden Per Respondent:
a. VA Form 10-10EZ--30 minutes.
b. VA Form 10-10EZR--24 minutes.
c. VA Form 10-10HS--15 minutes.
Frequency of Response: Annually.
Estimated Number of Respondents: 1,017,000.
a. VA Form 10-10EZ--500,000.
b. VA Form 10-10EZR--510,000.
c. VA Form 10-10HS--7,000.
Dated: June 27, 2013.
By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, U.S. Department of Veterans Affairs.
[FR Doc. 2013-15811 Filed 7-1-13; 8:45 am]
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