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[Federal Register Volume 89, Number 230 (Friday, November 29, 2024)]
[Notices]
[Pages 94765-94766]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-28046]

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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs

[OMB Control No. 1240-0019]

Proposed Revision of a Currently Approved Collection: Uniform 
Billing Form (OWCP-04)

AGENCY: Office of Workers' Compensation Programs, Labor.

ACTION: Request for public comments.

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SUMMARY: The Department of Labor, as part of its continuing effort to 
reduce paperwork and respondent burden, conducts a pre-clearance 
request for comment to provide the general public and Federal agencies 
with an opportunity to comment on proposed collections of information 
in accordance with the Paperwork Reduction Act of 1995. This request 
helps to ensure that: requested data can be provided in the desired 
format; reporting burden (time and financial resources) is minimized; 
collection instruments are clearly understood; and the impact of 
collection requirements on respondents can be properly assessed. 
Currently, the Office of Workers' Compensation Programs (OWCP) is 
soliciting comments on the information collection for Uniform Billing 
Form (OWCP-04).

DATES: All comments must be received on or before January 28, 2025.

ADDRESSES: You may submit comment as follows. Please note that late, 
untimely filed comments will not be considered.
    Written/Paper Submissions: Submit written/paper submissions in the 
following way:
     Mail/Hand Delivery: Mail or visit DOL-OWCP, Office of 
Workers' Compensation Programs, U.S. Department of Labor, 200 
Constitution Avenue NW, Room S3524, Washington, DC 20210.
     OWCP will post your comment as well as any attachments, 
except for information submitted and marked as confidential, in the 
docket at https://www.regulations.gov.

FOR FURTHER INFORMATION CONTACT: Anjanette Suggs, Office of Workers' 
Compensation Programs, at [email protected] (email) or (202) 354-
9660 (voice).

SUPPLEMENTARY INFORMATION:

I. Background

    The Office of Workers' Compensation Programs (OWCP) is the agency 
responsible for administration of the Federal Employees' Compensation 
Act (FECA), 5 U.S.C. 8101, the Black Lung Benefits Act (BLBA), 30 
U.S.C. 901, and

[[Page 94766]]

the Energy Employees Occupational Illness Compensation Program Act of 
2000 (EEOICPA), 42 U.S.C. 7384. All three of these statutes require 
that OWCP pay for medical treatment of beneficiaries; this medical 
treatment can include inpatient/outpatient hospital services, as well 
as services provided by nursing homes and skilled nursing facilities. 
In order to determine whether billed amounts are appropriate, OWCP 
needs to identify the patient, the specific services that were rendered 
and their relationship to the work-related injury or illness. The 
regulations implementing these statutes require the use of Form OWCP-04 
or OWCP-04 for the submission of medical bills from institutional 
providers (20 CFR 10.801, 30.701, 725.405, 725.406, 725.701 and 
725.715).
    The Uniform Billing Form, also known as the paper OWCP-04, has been 
approved by the American Hospital Association. It is used by the 
Centers for Medicare and Medicaid Services (CMS), Tricare, the 
Department of Veterans Affairs (DVA), and the private sector to request 
payment to institutional providers for medical services. The paper 
OWCP-04 has been designed by the National Uniform Billing Committee and 
is neither a government-printed form nor distributed by OWCP; OWCP has, 
however, developed detailed instructions for institutional providers 
that use the OWCP-04 to ensure that they provide the information needed 
to evaluate their requests for payment. The paper OWCP-04 is an ideal 
billing instrument for the provider community that services FECA, BLBA 
and EEOICPA beneficiaries because of its familiarity, its common use, 
and its acceptance by both government and private health service 
payers.

II. Desired Focus of Comments

    OWCP is soliciting comments concerning the proposed information 
collection related to the Uniform Billing Form.
    OWCP is particularly interested in comments that:
     Evaluate whether the collection of information is 
necessary for the proper performance of the functions of the Agency, 
including whether the information has practical utility;
     Evaluate the accuracy of OWCP's estimate of the burden 
related to the information collection, including the validity of the 
methodology and assumptions used in the estimate;
     Suggest methods to enhance the quality, utility, and 
clarity of the information to be collected; and
     Minimize the burden of the information collection on those 
who are to respond, including through the use of appropriate automated, 
electronic, mechanical, or other technological collection techniques or 
other forms of information technology, e.g., permitting electronic 
submission of responses.
    Background documents related to this information collection request 
are available at https://regulations.gov and at DOL-OWCP located at 200 
Constitution Avenue NW, Room S-3524, Washington, DC 20210. Questions 
about the information collection requirements may be directed to the 
person listed in the FOR FURTHER INFORMATION section of this notice.

III. Current Actions

    This information collection request concerns the Uniform Billing 
Form. OWCP has updated the data with respect to the number of 
respondents, responses, burden hours, and burden costs supporting this 
information collection request from the previous information collection 
request.
    Type of Review: Revision of a currently approved collection.
    Agency: Office of Workers' Compensation Programs.
    OMB Number: 1240-0019.
    Affected Public: Private Sector: Business or other for-profits and 
not-for-profit institutions.
    Number of Respondents: 7,549.
    Frequency: On Occasion.
    Number of Responses: 198,830.
    Annual Burden Hours: 16,420.
    OWCP Forms: Uniform Billing Form [OWCP-04], [Uniform Billing Form].
    Comments submitted in response to this notice will be summarized in 
the request for Office of Management and Budget approval of the 
proposed information collection request; they will become a matter of 
public record and will be available at https://www.reginfo.gov.

Anjanette C. Suggs,
Certifying Officer.
[FR Doc. 2024-28046 Filed 11-27-24; 8:45 am]
BILLING CODE 4510-CR-P
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