[Federal Register Volume 82, Number 38 (Tuesday, February 28, 2017)]
[Notices]
[Pages 12143-12144]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-03869]
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OFFICE OF PERSONNEL MANAGEMENT
Comment Request for Review of a Revised Information Collection:
Multi-State Plan Program External Review Case Intake Form, OPM Form
1840
AGENCY: Office of Personnel Management.
ACTION: Notice.
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SUMMARY: The Office of Personnel Management (OPM) intends to submit to
the Office of Management and Budget (OMB) a request for review of a
revision of a currently approved collection, the Multi-State Plan
Program External Review Intake Form, OPM Form 1840. Approval of the
revised Multi-State Plan
[[Page 12144]]
Program External Review Intake Form is necessary to improve the
collection of information from members of the Multi-State Plan Program
who need to request the external review of a disputed adverse benefit
decision.
DATES: Comments due by May 1, 2017.
ADDRESSES: Send or deliver comments to: Donna Lease Batdorf, Multi-
State Plan Program National Healthcare Operations, Healthcare and
Insurance, Office of Personnel Management, 1900 E Street NW., Room
3468, Washington, DC 20415.
FOR FURTHER INFORMATION CONTACT: FOR INFORMATION REGARDING
ADMINISTRATIVE COORDINATION CONTACT: For copies of this proposal,
contact C.C. ``Corky'' Conyers, Ph.D., C.I.O. P.R.A./Forms Officer at
(202) 606-0125, or via email to [email protected]. Please include
a mailing address with your request.
SUPPLEMENTARY INFORMATION: As required by the Paperwork Reduction Act
of 1995 (Pub. L. 104-13, May 22, 1995), as amended by the Clinger-Cohen
Act (Pub. L. 104-106), OPM is soliciting comments for this collection.
The previous collection (OMB No. 3206-0263) was published in the
Federal Register on November 26, 2013 at 78 FR 70598. Comments are
particularly invited on:
1. Whether this collection of information is necessary for the
proper performance of functions of the Office of Personnel Management,
and whether it will have practical utility;
2. Whether our estimate of the public burden of this collection is
accurate, and based on valid assumptions and methodology; and
3. Ways in which we can minimize the burden of the collection of
information on those who are to respond, through the use of the
appropriate technological collection techniques or other forms of
information technology.
Analysis
Agency: Multi-State Plan Program, National Healthcare Operations,
Healthcare and Insurance, Office of Personnel Management.
Title: External Review Intake Form.
OMB: 3206-0263.
Frequency:
Affected Public: Individuals or Households.
Number of Respondents: 800.
Estimated Time Per Respondent: 60 minutes.
Total Burden Hours: 800 hours.
Kathleen M. McGettigan,
Acting Director, U.S. Office of Personnel Management.
[FR Doc. 2017-03869 Filed 2-27-17; 8:45 am]
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