Federal Register / Vol. 86, No. 25 / Tuesday, February 9, 2021 / Notices 8805 

number) or by email at suggs.anjanette@

dol.gov. 

SUPPLEMENTARY INFORMATION: The DOL, 

as part of continuing efforts to reduce 

paperwork and respondent burden, 

conducts a pre-clearance consultation 

program to provide the general public 

and Federal agencies an opportunity to 

comment on proposed and/or 

continuing collections of information 

before submitting them to the OMB for 

final approval. This program helps to 

ensure 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 can be properly 

assessed. 

Form OWCP–1500 is used by OWCP 

and contractor bill payment staff to 

process bills for medical services 

provided by medical professionals other 

than medical services provided by 

hospitals, pharmacies and certain other 

medical providers. This information is 

required to pay health care providers for 

services rendered to injured employees 

covered under the Office of Workers’ 

Compensation Programs—administered 

programs. Appropriate payment cannot 

be made without documentation of the 

medical services that were provided by 

the health care provider that is billing 

OWCP. The information obtained to 

complete claims under these programs 

is used to identify the patient and 

determine their eligibility. It is also used 

to decide if the services and supplies 

received are covered by these programs 

and to assure that proper payment is 

made. Energy Employees Occupational 

Illness Compensation Program Act of 

2000, 42 U.S.C., Black Lung Benefits 

Act, 30 U.S.C. 901, and the Federal 

Employees Compensation Act, 5 U.S.C. 

8101 authorize this information 

collection. 

This information collection is subject 

to the PRA. A Federal agency generally 

cannot conduct or sponsor a collection 

of information, and the public is 

generally not required to respond to an 

information collection, unless it is 

approved by the OMB under the PRA 

and displays a currently valid OMB 

Control Number. In addition, 

notwithstanding any other provisions of 

law, no person shall generally be subject 

to penalty for failing to comply with a 

collection of information that does not 

display a valid Control Number. See 5 

CFR 1320.5(a) and 1320.6. 

Interested parties are encouraged to 

provide comments to the contact shown 

in the ADDRESSES section. Comments 

must be written to receive 

consideration, and they will be 

summarized and included in the request 

for OMB approval of the final ICR. In 

order to help ensure appropriate 

consideration, comments should 

mention 1240–0044. 

Submitted comments will also be a 

matter of public record for this ICR and 

posted on the internet, without 

redaction. The DOL encourages 

commenters not to include personally 

identifiable information, confidential 

business data, or other sensitive 

statements/information in any 

comments. 

The DOL is particularly interested in 

comments that: 

• 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 submission of 

responses. 

Agency: DOL–OWCP. 

Type of Review: Extension. 

Title of Collection: Health Insurance 

Claim Form. 

Form: OWCP–1500. 

OMB Control Number: 1240–0044. 

Affected Public: Private Sector— 

businesses or other for-profits. 

Estimated Number of Respondents: 

57,099. 

Frequency: On occasion. 

Total Estimated Annual Responses: 

3,381,232. 

Estimated Average Time per 

Response: 7 minutes. 

Estimated Total Annual Burden 

Hours: 321,455 hours. 

Total Estimated Annual Other Cost 

Burden: $0. 

Authority: 44 U.S.C. 3506(c)(2)(A). 

Anjanette Suggs, 

Agency Clearance Officer. 

[FR Doc. 2021–02636 Filed 2–8–21; 8:45 am] 

BILLING CODE 4510–CR–P 

DEPARTMENT OF LABOR 

Office of Workers’ Compensation 

Programs 

Agency Information Collection 

Activities; Comment Request; Medical 

Travel Refund Request 

ACTION: Notice of availability; request 

for comments. 

SUMMARY: The Department of Labor 

(DOL) is soliciting comments 

concerning a proposed extension for the 

authority to conduct the information 

collection request (ICR) titled, ‘‘Medical 

Travel Refund Request.’’ This comment 

request is part of continuing 

Departmental efforts to reduce 

paperwork and respondent burden in 

accordance with the Paperwork 

Reduction Act of 1995 (PRA). 

DATES: Consideration will be given to all 

written comments received by April 12, 

2021. 

ADDRESSES: A copy of this ICR with 

applicable supporting documentation; 

including a description of the likely 

respondents, proposed frequency of 

response, and estimated total burden 

may be obtained free by contacting 

Anjanette Suggs by telephone at (202) 

354–9660, or by email at 

suggs.anjanette@dol.gov. 

Submit written comments about, or 

requests for a copy of, this ICR by mail 

or courier to the U.S. Department of 

Labor, Office of Workers’ Compensation 

Programs, Room S–3323, 200 

Constitution Avenue NW, Washington, 

DC 20210; by email: suggs.anjanette@

dol.gov. 

FOR FURTHER INFORMATION CONTACT: 

Anjanette Suggs by telephone at (202) 

354–9660 (this is not a toll-free number) 

or by email at suggs.anjanette@dol.gov. 

SUPPLEMENTARY INFORMATION: The DOL, 

as part of continuing efforts to reduce 

paperwork and respondent burden, 

conducts a pre-clearance consultation 

program to provide the general public 

and Federal agencies an opportunity to 

comment on proposed and/or 

continuing collections of information 

before submitting them to the OMB for 

final approval. This program helps to 

ensure 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 can be properly 

assessed. 

Form OWCP–957 is used to request 

reimbursement for out-of-pocket 

expenses incurred when traveling to 

medical providers for covered medical 


khammond on DSKJM1Z7X2PROD with NOTICES
8806 Federal Register / Vol. 86, No. 25 / Tuesday, February 9, 2021 / Notices 

testing or treatment. Black Lung Benefits 

Act (BLBA), 30 U.S.C. 901, Employees 

Occupational Illness Compensation 

Program Act of 2000 (EEOICPA) 42 

U.S.C. 7384, and the Federal Employees’ 

Compensation Act (FECA), 5 U.S.C. 

8101 authorize this information 

collection. 

This information collection is subject 

to the PRA. A Federal agency generally 

cannot conduct or sponsor a collection 

of information, and the public is 

generally not required to respond to an 

information collection, unless it is 

approved by the OMB under the PRA 

and displays a currently valid OMB 

Control Number. In addition, 

notwithstanding any other provisions of 

law, no person shall generally be subject 

to penalty for failing to comply with a 

collection of information that does not 

display a valid Control Number. See 5 

CFR 1320.5(a) and 1320.6. 

Interested parties are encouraged to 

provide comments to the contact shown 

in the ADDRESSES section. Comments 

must be written to receive 

consideration, and they will be 

summarized and included in the request 

for OMB approval of the final ICR. In 

order to help ensure appropriate 

consideration, comments should 

mention 1240–0037. 

Submitted comments will also be a 

matter of public record for this ICR and 

posted on the internet, without 

redaction. The DOL encourages 

commenters not to include personally 

identifiable information, confidential 

business data, or other sensitive 

statements/information in any 

comments. 

The DOL is particularly interested in 

comments that: 

• 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 submission of 

responses. 

Agency: DOL–OWCP. 

Type of Review: Extension. 

Title of Collection: Medical Travel 

Refund Request. 

Form: OWCP–957. 

OMB Control Number: 1240–0037. 

Affected Public: Individuals or 

households. 

Estimated Number of Respondents: 

34,703. 

Frequency: On occasion. 

Total Estimated Annual Responses: 

333,528. 

Estimated Average Time per 

Response: 10 minutes. 

Estimated Total Annual Burden 

Hours: 55,366 hours. 

Total Estimated Annual Other Cost 

Burden: $ 173,435. 

(Authority: 44 U.S.C. 3506(c)(2)(A)) 

Anjanette Suggs, 

Agency Clearance Officer. 

[FR Doc. 2021–02635 Filed 2–8–21; 8:45 am] 

BILLING CODE 4510–CR–P 

DEPARTMENT OF LABOR 

Office of Workers’ Compensation 

Programs 

[Docket No. WCPO–2020–0002] 

Black Lung Benefits Act SelfInsurance: Withdrawal of Guidance 

AGENCY: Office of Workers’ 

Compensation Programs, Labor. 

ACTION: Withdrawal of notice and 

request for comments. 

SUMMARY: The Office of Workers’ 

Compensation Programs (OWCP) is 

withdrawing a notice and request for 

comments entitled ‘‘Guidance on Black 

Lung Benefits Act Self-Insurance,’’ 

which was published in the Federal 

Register on January 8, 2021. 

DATES: The withdrawal is effective 

February 9, 2021. 

FOR FURTHER INFORMATION CONTACT: 

Michael Chance, Director, Division of 

Coal Mine Workers’ Compensation, 

Office of Workers’ Compensation 

Programs, U.S. Department of Labor, 

200 Constitution Avenue NW, Room N– 

3464, Washington, DC 20210. 

Telephone: 1–800–347–2502. This is a 

toll-free number. TTY/TDD callers may 

dial toll-free 1–800–877–8339 for 

further information. 

SUPPLEMENTARY INFORMATION: On 

January 8, 2021, OWCP published a 

notice and request for comments 

entitled ‘‘Guidance on Black Lung 

Benefits Act Self-Insurance’’ in the 

Federal Register. 86 FR 1529 (Jan. 8, 

2021). The notice informed and invited 

comment from the public on a 

preliminary program bulletin related to 

coal-mine operators applying to selfinsure their liabilities under the Black 

Lung Benefits Act. 30 U.S.C. 901–944. 

The comment period under the notice 

runs through February 8, 2021. 

OWCP is now withdrawing the notice 

and request for comments on the 

preliminary self-insurance bulletin 

because the legal bases for publishing 

the notice—the Department of Labor’s 

PRO Good Guidance Rule (29 CFR part 

89) and Executive Order 13891 (84 FR 

55235 (Oct. 15, 2019))—have been 

rescinded or revoked. See 86 FR 7237 

(Jan. 27, 2021) (rescinding 29 CFR part 

89); E.O. 13992, 86 FR 7049 (Jan. 20, 

2021) (revoking E.O. 13891). 

OWCP’s action is also consistent with 

the January 20, 2021 memorandum for 

the Heads of Executive Departments and 

Agencies from the Assistant to the 

President and Chief of Staff entitled 

‘‘Regulatory Freeze Pending Review.’’ 

86 FR 7424 (Jan. 28, 2021). The 

memorandum directs agencies to pause 

or delay certain regulatory actions, 

including actions related to guidance 

documents, for the purpose of reviewing 

questions of fact, law, and policy raised 

therein. OWCP intends to review the 

self-insurance bulletin and offer the 

public an opportunity to comment on 

self-insurance procedures at a later time. 

Accordingly, OWCP is withdrawing 

the notice and request for comments 

published on January 8, 2021. The 

withdrawal of the guidance does not 

change any law, regulation, or other 

legally binding requirement. 

Dated: February 3, 2021. 

Christopher J. Godfrey, 

Director, Office of Workers’ Compensation 

Programs. 

[FR Doc. 2021–02614 Filed 2–8–21; 8:45 am] 

BILLING CODE 4510–CR–P 

DEPARTMENT OF LABOR 

Office of Workers’ Compensation 

Programs 

Agency Information Collection 

Activities; Comment Request; Claim 

for Medical Reimbursement Form 

ACTION: Notice of availability; request 

for comments. 

SUMMARY: The Department of Labor 

(DOL) is soliciting comments 

concerning a proposed extension for the 

authority to conduct the information 

collection request (ICR) titled, ‘‘Claim 

for Medical Reimbursement Form.’’ This 

comment request is part of continuing 

Departmental efforts to reduce 

paperwork and respondent burden in 


khammond on DSKJM1Z7X2PROD with NOTICES