71176 Federal Register / Vol. 77, No. 230 / Thursday, November 29, 2012 / Notices 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

[Docket ID DoD–2012–HA–0147] 

Proposed Collection; Comment 

Request 

AGENCY: Office of the Assistant 

Secretary of Defense for Health Affairs, 

DoD. 

ACTION: Notice. 

In compliance 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 a proposed 

public information collection and seeks 

public comment on the provisions 

thereof. Comments are invited on: (a) 

Whether the proposed 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 proposed 

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 by January 28, 2013. 

ADDRESSES: You may submit comments, 

identified by docket number and title, 

by any of the following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Mail: Federal Docket Management 

System Office, 4800 Mark Center Drive, 

East Tower, Suite 02G09, Alexandria, 

VA 22350–3100. 

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 or to 

obtain a copy of the proposal and 

associated collection instruments, 

please write to the Office of the 

Assistant Secretary of Defense (Health 

Affairs) TRICARE Management Activity, 

ATTN: Ms. Shane Pham, 7700 Arlington 

Boulevard, Suite 5101 Falls Church, VA 

22042–5101, or call at (703) 681–8666. 

Title; Associated Form; and OMB 

Number: TRICARE Plus Enrollment 

Application, DD Form 2853 and 

TRICARE Plus Disenrollment Request, 

DD Form 2854; OMB Control Number 

0720–0028. 

Needs and Uses: These collected 

instruments serve as an application for 

enrollment and disenrollment in the 

Department of Defense’s TRICARE Plus 

Health Plan established in accordance 

with Title 10 U.S.C. sections 1099 

(which calls for a healthcare enrollment 

system) and 1086 (which authorizes 

TRICARE eligibility of Medicare Eligible 

Persons and has resulted in the 

development of a new enrollment 

option called TRICARE Plus) and the 

Assistant Secretary of Defense for 

Health Affairs Policy Memorandum to 

Establish the TRICARE Plus Program, 

June 22, 2001. The information 

collected hereby provides the TRICARE 

contractors with necessary data to 

determine beneficiary eligibility and to 

identify the selection of a health care 

option. 

Affected Public: Individuals or 

household. 

Annual Burden Hours: 2,924. 

Number of Respondents: 25,065. 

Responses per Respondent: 1. 

Average Burden per Response: 7 

minutes. 

Frequency: On occasion. 

SUPPLEMENTARY INFORMATION: 

Summary of Information Collection 

The Department of Defense 

established TRICARE Plus as an 

enrollment option for persons who are 

eligible for care in Military Treatment 

Facilities (MTF) and not enrolled in 

TRICARE Prime. TRICARE Plus 

provides an opportunity to enroll with 

a primary care provider at a specific 

MTF, to the extent capacity exists. This 

is a way to facilitate primary care 

appointments at an MTF when needed. 

TRICARE Plus enrollment will help 

MTFs maintain an adequate clinical 

case mix for Graduate Medical 

Education programs and support 

readiness-related medical skills 

sustainment activities. In order to carry 

out this program, it is necessary that 

certain beneficiaries electing to enroll/ 

disenroll in TRICARE Plus complete an 

enrollment application/disenrollment 

request. Completion of the enrollment 

forms is an essential element of the 

TRICARE program. There is no lock-in 

and no enrollment fee for TRICARE 

Plus. 

Dated: November 26, 2012. 

Aaron Siegel, 

Alternate OSD Federal Register Liaison 

Officer, Department of Defense. 

[FR Doc. 2012–28878 Filed 11–28–12; 8:45 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

[Docket ID DoD–2012–HA–0149] 

Proposed Collection; Comment 

Request 

AGENCY: TRICARE Management 

Activity, Office of Administration, 

Personnel Security Division. 

ACTION: Notice. 

In compliance 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 

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 

proposed 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 by January 28, 2013. 

ADDRESSES: You may submit comments, 

identified by docket number and title, 

by any of the following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Mail: Federal Docket Management 

System Office, 4800 Mark Center Drive, 

East Tower, 2nd floor, Suite 02G09, 

Alexandria, VA 22350–3100. 

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. 


pmangrum on DSK3VPTVN1PROD with NOTICES