60418 Federal Register / Vol. 75, No. 189 / Thursday, September 30, 2010 / Notices 

physicians accountable for the 

information they submit on the 

Medicare claim forms. Being modeled 

on the Medicare PPS, CHAMPUS also 

adopted these requirements. The 

physicians attestation and physician 

acknowledgment required by Medicare 

under 42 CFR 412.46 are also required 

for CHAMPUS as a condition for 

payment and may be satisfied by the 

same statements as required for 

Medicare, with substitution or addition 

of ‘‘CHAMPUS’’ when the word 

‘‘Medicare’’ is used. Physicians sign a 

physician acknowledgement, 

maintained by the institution, at the 

time the physician is granted admitting 

privileges. This acknowledgement 

indicates the physician understands the 

importance of a correct medical record, 

and misrepresentation may be subject to 

penalties. 

Dated: September 10, 2010. 

Patricia L. Toppings, 

OSD Federal Register Liaison Officer, 

Department of Defense. 

[FR Doc. 2010–24530 Filed 9–29–10; 8:45 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

[Docket ID: DoD–2010–HA–0132] 

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 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 November 29, 

2010. 

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, 1160 Defense Pentagon, 

Room 3C843, 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 or to 

obtain a copy of the proposal and 

associated collection instruments, 

please write to TRICARE Management 

Activity, Contract Operations Branch, 

16401 E. Centretech Parkway, Attn: 

Kenneth Zimmerman, Aurora, CO 

80011, or call TRICARE Management 

Activity, Contract Operations Branch, at 

(303–676–3502). 

Title; Associated Form; and OMB 

Number: TRICARE Retiree Dental 

Program Enrollment Application Form; 

OMB Number 0720–0015. 

Needs and Uses: This information 

collection is completed by Uniformed 

Services members entitled to retired pay 

and their eligible family members who 

are seeking enrollment in the TRICARE 

Retiree Dental Program (TRDP). The 

information is necessary to enable the 

DoD-contracted third party 

administrator of the program to identify 

the program’s applicants, determine 

their eligibility for TRDP enrollment, 

establish the premium payment amount, 

and to verify by the applicant’s 

signature that the applicant understands 

the benefits and rules of the program. 

Affected Public: Individuals or 

household. 

Annual Burden Hours: 17,833. 

Number of Respondents: 71,332. 

Responses Per Respondent: 1. 

Average Burden Per Response: 15 

minutes. 

Frequency: Annually. 

SUPPLEMENTARY INFORMATION: 

Summary of Information Collection 

The TRICARE Retiree Dental Program 

(32 CFR 199.22) was implemented in 

1998 based on the authority of 10 U.S.C. 

1076c. Dental coverage under the 

program is available on a voluntary 

basis to retirees of the Uniformed 

Services entitled to retired pay and their 

family members. 

The information collection 

requirements under this proposed 

extension are similar to those under the 

current collection. Information on the 

applicant, such as name, address, 

telephone numbers, date of birth, and 

retiree’s social security number, is 

necessary for identification purposes, as 

is information on the family members to 

be enrolled. The form also contains 

information on premium payment 

enrollment options and a certification 

statement for the applicant to sign and 

date. The primary change in the 

proposed extension of the information 

collection is to update the expiration 

date of the Enrollment Application. 

Dated: September 10, 2010. 

Patricia L. Toppings, 

OSD Federal Register Liaison Officer, 

Department of Defense. 

[FR Doc. 2010–24531 Filed 9–29–10; 8:45 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

[Docket ID: DoD–2010–HA–0134] 

Proposed Collection; Comment 

Request 

AGENCY: Uniformed Services University 

of the Health Sciences, Graduate School 

of Nursing, DoD. 

ACTION: Notice. 

SUMMARY: In compliance with Section 

3506 (c)(2)(A) of the Paperwork 

Reduction Act of 1995, the Uniformed 

Services University of the Health 

Sciences proposes a new public 

information collection. 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 November 29, 

2010. 

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