[Federal Register Volume 72, Number 68 (Tuesday, April 10, 2007)]
[Notices]
[Pages 17877-17878]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 07-1757]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF DEFENSE

Office of the Secretary

[No. DoD-2007-HA-0022]


Proposed Collection; Comment Request

AGENCY: Office of the Assistant Secretary of Defense for Health 
Affairs, DoD.

ACTION: Notice.

-----------------------------------------------------------------------

[[Page 17878]]

    In accordance with Section 3506(c)(2)(A) of the Paperwork Reduction 
Act of 1995, the Office of the Assistant Secretary of Defense for 
Health Affairs announces the proposed extension of a public information 
collection and seeks public comment on the provisions thereof. Comments 
are invited on: (a) Whether the proposed extension of collection of 
information is necessary for the proper performance of the functions of 
the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of the burden of the 
information collection; (c) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (d) ways to minimize 
the burden of the information collection on respondents, including 
through the use of automated collection techniques or other forms of 
information technology.

DATES: Consideration will be given to all comments received June 11, 
2007.

ADDRESSES: You may submit comments, identified by docket number and 
title, by any of the following methods:
    <bullet> Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
    <bullet> Mail: Federal Docket Management System Office, 1160 
Defense Pentagon, Washington, DC 20301-1160.
    Instructions: All submissions received must include the agency 
name, docket number and title for this Federal Register document. The 
general policy for comments and other submissions from members of the 
public is to make these submissions available for public viewing on the 
Internet at http://www.regulations.gov as they are received without 
change, including any personal identifiers or contact information.

FOR FURTHER INFORMATION CONTACT: To request more information on this 
proposed information collection, please write TRICARE Management 
Activity, Office of General Counsel, 16401 E. Centretech Parkway, Attn: 
Helen Hilton, Aurora, CO 80011, or call TRICARE Management Activity, 
Office of General Counsel, at (303) 676-3542.
    Title Associated With Form, and OMB Number: Statement of Personal 
Injury--Possible Third Party Liability, TRICARE Management Activity; DD 
Form 2527; OMB Number 0720-0003.
    Needs and Uses: This information collection is completed by CHAMPUS 
beneficiaries suffering from personal injuries and receiving medical 
care at Government expense. The information is necessary in the 
assertion of the Government's right to recovery under the Federal 
Medical Care Recovery Act. The data is used in the evaluation and 
processing of these claims.
    Affected Public: Individuals or households; Federal government.
    Annual Burden Hours: 33,250.
    Number of Respondents: 133,000.
    Responses per Respondent: 1.
    Average Burden per Response: 20 minutes.
    Frequency: On occasion, only when a beneficiary is injured under 
circumstances creating possible liability in a third party.

SUPPLEMENTARY INFORMATION:

Summary of Information Collection

    The Federal Medical Recovery Act, 42 U.S.C. 2651-2653 as 
implemented by Executive Order No. 11060 and 28 CFR part 43 provides 
for recovery of the reasonable value of medical care provided by the 
United States to a person who is injured or suffers a disease under 
circumstances creating tort liability in some third person. DD Form 
2527 is required for investigating and asserting claims in favor of the 
United States arising out of such incidents.
    When a claim for CHAMPUS benefits is identified as involving 
possible third party liability and the information is not submitted 
with the claim, the TRICARE/CHAMPUS contractor requests that the 
injured party (or a designee) complete DD Form 2527. To protect the 
interests of the Government, the contractor suspends claims processing 
until the requested third party liability information is received. The 
contractor conducts a preliminary evaluation based upon the collection 
of information and refers the case to a designated appropriate legal 
officer of the Uniformed Services. The responsible Uniformed Services 
legal officer uses the information as a basis for asserting and 
settling the Government's claim. When appropriate, the information is 
forwarded to the Department of Justice as the basis for litigation.
    Section 1 of the Form is used to collect general information, such 
as name, address and telephone numbers about the military sponsor and 
the injured beneficiary and the date, time and location where the 
injured occurred.
    Section 2 of the Form is used to collect information about 
accidental injuries. Most of the investigations for third party 
liability involve motor vehicle accidents. Information about insurance 
coverage for the parties involved in the accident is collected. Section 
2 of the Form is also used to collect information about accidents that 
do not involve motor vehicles. Information such as the type of 
accident, the place where the injury occurred, the name of the property 
owner where the injury occurred and cause of the injury is collected. 
The name and address of the employer is collected when the injury was 
work related.
    Section 3 of the Form is used for miscellaneous information such as 
possible medical treatment at a Government hospital, the name and 
address of the beneficiary's attorney, and information regarding any 
possible releases or settlements with another party to the accident. It 
also contains the certification, date and signature of the beneficiary 
(or a designee).

    Dated: April 3, 2007.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 07-1757 Filed 4-9-07; 8:45 am]
BILLING CODE 5001-06-M