[Federal Register Volume 74, Number 149 (Wednesday, August 5, 2009)]
[Notices]
[Page 39146]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-18626]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0648]


Agency Information Collection Activities (FMP) Under OMB Review

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C. 3501-3521), this notice announces that the Veterans Health 
Administration (VHA), Department of Veterans Affairs, will submit the 
collection of information abstracted below to the Office of Management 
and Budget (OMB) for review and comment. The PRA submission describes 
the nature of the information collection and its expected cost and 
burden and includes the actual data collection instrument.

DATES: Comments must be submitted on or before September 4, 2009.

ADDRESSES: Submit written comments on the collection of information 
through http://www.Regulations.gov; or to VA's OMB Desk Officer, OMB 
Human Resources and Housing Branch, New Executive Office Building, Room 
10235, Washington, DC 20503 (202) 395-7316. Please refer to ``OMB 
Control No. 2900-0648'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, 
NW., Washington, DC 20420, (202) 461-7485, fax (202) 273-0443 or e-mail 
<a href="/cdn-cgi/l/email-protection#cca8a9a2a5bfa9e2a1afa0ada1ae8ca1ada5a0e2baade2aba3ba"><span class="__cf_email__" data-cfemail="076362696e7462296a646b666a65476a666e6b29716629606871">[email protected]</span></a>. Please refer to ``OMB Control No. 2900-
0648.''

SUPPLEMENTARY INFORMATION:
    Titles:
    a. Foreign Medical Program (FMP) Registration Form, VA Form 10-
7959f-1.
    b. Claim Cover Sheet--Foreign Medical Program (FMP), VA Form 10-
7959f-2.
    OMB Control Number: 2900-0648.
    Type of Review: Extension of a currently approve collection.
    Abstracts:
    a. Veterans with service connected disabilities living or traveling 
overseas complete VA Form 10-7959f-1 to enroll in the Foreign Medical 
Program.
    b. Healthcare providers complete VA Form 10-7959f-2 to submit 
claims for payments or reimbursement of expenses relating to veterans 
living or traveling overseas (except for the Philippines) with service-
connected disability. VA will accept provider's generated billing 
statement, Uniform Billing-Forms (UB) 04, and Medicare Health Insurance 
Claims Form, CMS 1500 for payments or reimbursements.
    An agency may not conduct or sponsor, and a person is not required 
to respond to a collection of information unless it displays a 
currently valid OMB control number. The Federal Register Notice with a 
60-day comment period soliciting comments on this collection of 
information was published on May 22, 2009 at pages 24076-20477.
    Estimated Total Annual Burden:
    a. Foreign Medical Program, VA Form 10-7959f-1--110 hours.
    b. Claim Cover Sheet, VA Form 10-7959f-2--3,652 hours.
    Estimated Average Burden per Respondent:
    a. Foreign Medical Program, VA Form 10-7959f-1--4 minutes.
    b. Claim Cover Sheet, VA Form 10-7959f-2--11 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. Foreign Medical Program, VA Form 10-7959f-1--1,660.
    b. Claim Cover Sheet, VA Form 10-7959f-2--19,920.

    Dated: July 30, 2009.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9-18626 Filed 8-4-09; 8:45 am]
BILLING CODE 8320-01-P


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