[Federal Register Volume 79, Number 195 (Wednesday, October 8, 2014)]
[Notices]
[Page 60896]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-23995]
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-NEW]
VA Meds by Mail Order Form, VA Form 10-0426
Activity: 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 revised collection, and allow 60 days for public comment
in response to the notice. This notice solicits comments on information
needed to obtain an accurate and comprehensive assessment of
satisfaction of patients who receive mental health care services and on
outcomes for Veterans who seek mental health treatment from VHA. Data
will allow the program office to ensure that the target audience is
being reached, effective treatments are being offered, and tangible,
quantitative results are being measured and tracked for continual
program improvement.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before. December 8, 2014.
ADDRESSES: Submit written comments on the collection of information
through the Federal Docket Management System (FDMS) at
www.Regulations.gov; or to Audrey Revere, Office of Regulatory and
Administrative Affairs, 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-NEW, VA Meds by Mail Order Form, VA Form 10-0426'' in any
correspondence. During the comment period, comments may be viewed
online through FDMS.
FOR FURTHER INFORMATION CONTACT: Audrey Revere at (202) 461-5694.
SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44
U.S.C. 3501-3521), Federal agencies must obtain approval from 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) ways 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.
Title: Meds By Mail Order Form, VA Form 10-0426.
OMB Control Number: 2900-NEW.
Type of Review: New Collection (Request for a new OMB Control
Number).
Abstract: VA Form 10-0426, Meds by Mail (MbM) Order Form, is used
by eligible CHAMPVA and Spina Bifida beneficiaries (also referred to as
patient) in accordance with 38 CFR Sections 17.270, 17.271 and 17.272
when submitting a paper prescription written by their medical provider
for fulfillment through the Meds by Mail Program. Information collected
on this form is necessary for proper patient identification and medical
record review.
The provisions of VHA Handbook 1108.05, Outpatient Pharmacy
Services, require that, as a condition for dispensing a prescription,
the prescription must contain the following patient identifiers:
(1) Patient's Full Name
(2) Social Security Number
(3) Patient's Current Address
Local Meds by Mail Desk Procedure utilizes date of birth as an
additional patient identifier.
The provisions of VHA Handbook 1108.05, Outpatient Pharmacy
Services require pharmacists to review the patient medical record for
the presence of allergy information and the potential for adverse drug
events prior to the dispensing of medication to the patient.
Affected Public: Individuals or Households.
Estimated Total Annual Burden: 18,333 hours.
Estimated Average Burden per Respondent: 5 minutes.
Frequency of Response: Yearly.
Estimated Number of Respondents: 110,000.
Dated: October 3, 2014.
By direction of the Secretary.
Crystal Rennie,
Department Clearance Officer, U.S. Department of Veterans Affairs.
[FR Doc. 2014-23995 Filed 10-7-14; 8:45 am]
BILLING CODE 8320-01-P