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[Federal Register Volume 77, Number 240 (Thursday, December 13, 2012)]
[Notices]
[Pages 74175-74176]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-30032]

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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID DoD-2012-HA-0160]

Proposed Collection; Comment Request

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

ACTION: Notice.

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    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 (OASD(HA)) announces a proposed public information 
collection and seeks public comment on the provisions thereof. Comments 
are invited on: (a) Whether the proposed

[[Page 74176]]

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 February 
11, 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 Uniform Business 
Office (UBO), OASD(HA)/TRICARE Management Activity/Management Control & 
Financial Studies, 7700 Arlington Boulevard, Suite 5101, Falls Church, 
VA 22042, ATTN: DeLisa E. Prater, Program Manager, 703-681-3492 ext. 
6757 (DSN 761).
    Title; Associated Form; and OMB Number: Third Party Collection 
Program/Medical Services Account/Other Health Insurance; DD Form 2569; 
OMB Control Number 0720-TBD (previously OMB Control Number 0704-0323).
    Needs and Uses: The information collection requirement is necessary 
to obtain health insurance policy information used for coordination of 
health care benefits and billing third-party payers. DoD implemented 
the Third Party Collection Program (TPCP) in FY87 based on the 
authority granted in 10 U.S.C. 1095 and implemented by 32 CFR 220 in 
accordance with the Consolidated Omnibus Budget Reconciliation Act of 
1986 (COBRA) (Pub. L. 99-272, section 2001, April 7, 1986). Under the 
TPCP, DoD is authorized to collect from third-party payers the cost of 
inpatient and outpatient services rendered to DoD beneficiaries who 
have other health insurance. Military treatment facilities are required 
to make this form available to third-party payers upon request. A 
third-party payer may not request any other assignment of benefits form 
from the subscriber.
    Affected Public: Business or other for profit; Not-for-profit 
institutions.
    Annual Burden Hours: 146,845.
    Number of Respondents: 2,936,905.
    Responses per Respondent: 1.
    Average Burden per Response: 3 minutes.
    Frequency: Annually, or on occasion (when insurance information 
changes).

SUPPLEMENTARY INFORMATION:

Summary of Information Collection

    The administration has placed an increased emphasis upon recovery 
of health care expenses under the TPCP, as authorized by 10 U.S.C. 1095 
and 1097b. Completion of this form, while increasing total burden 
hours, will aid in increasing revenue to improve services, operating 
efficiency and effectiveness within the Military Health System. Funds 
collected return directly to the operation and maintenance budget of 
the MTF where the care was delivered and are used to improve the 
quality of healthcare. Often the funds allow the continuation of 
programs or purchasing of equipment at the facilities for which there 
would otherwise not be funding. This information is collected either 
during the admission and/or discharge process for an inpatient stay or 
during the registration process for an outpatient visit.

    Dated: December 7, 2012.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2012-30032 Filed 12-12-12; 8:45 am]
BILLING CODE 5001-06-P
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