[Federal Register Volume 62, Number 147 (Thursday, July 31, 1997)] [Notices] [Pages 41084-41085] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 97-20101] ----------------------------------------------------------------------- DEPARTMENT OF LABOR Employment Standards Administration Proposed Collection; Comment Request ACTION: Notice. ----------------------------------------------------------------------- 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 [[Page 41085]] 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: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; 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; Enhance the quality, utility and clarity of the information to be collected; and 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