21586 Federal Register / Vol. 60, No. 84 / Tuesday, May 2, 1995 / Notices

DEPARTMENT OF VETERANS

AFFAIRS

Information Collections Under OMB

Review

AGENCY: Department of Veterans Affairs.

ACTION: None.

The Department of Veterans Affairs

has submitted to OMB the following

proposals for the collection of

information under the provisions of the

Paperwork Reduction Act (44 U.S.C.

Chapter 35). This document lists the

type of information collection and the

following: (1) The title of the

information collection, and the

Department form number(s), if

applicable; (2) a description of the need

and its use; (3) who will be required or

asked to respond; (4) an estimate of the

total annual reporting hours, and

recordkeeping burden, if applicable; (5)

the estimated average burden hours per

respondent; (6) the frequency of

response; and (7) an estimated number

of respondents.

ADDRESSES: Copies of the proposed

information collections and supporting

documents may be obtained from Trish

Fineran, Veterans Benefits

Administration (20M30), Department of

Veterans Affairs, 810 Vermont Avenue

NW., Washington, DC 20420, (202) 273–

6886.

Comments and questions about the

items on the list should be directed to

VA’s OMB Desk Officer, Joseph Lackey,

NEOB, Room 10102, Washington, DC

20503, (202) 395–7316. Do not send

requests for benefits to this address.

DATES: Comments on the information

collections should be directed to the

OMB Desk Officer on or before June 1,

1995.

Dated: April 24, 1995.

By direction of the Secretary.

Donald L. Neilson,

Director, Information Management Service.

Extension

1. Application for Reimbursement

from Accrued Amounts Due a Deceased

Beneficiary, VA form 21–601.

2. The form is used to file a claim for

accrued benefits available at the time of

the veteran’s death. The information is

used by Veterans Benefits

Administration to determine the

appropriate claimant eligible for

accrued benefits.

3. Individuals or households.

4. 1,875 hours.

5. 30 minutes.

6. On occasion.

7. 3,750 respondents.

Extension

1. Report and Certification of Loan

Disbursement, VA Form 26–1820.

2. This form is completed by lenders

closing VA loans under the automatic or

prior approval procedure subsequent to

issuance of guaranty.

3. Individuals or households.

4. 150,000 hours.

5. 30 minutes.

6. On occasion.

7. 300,000 respondents.

Reinstatement

1. Application for Conversion, VA

Form 29–0152.

2. The form is used by the insured to

apply for conversion of a term policy to

a permanent plan of insurance. The

information is used by Veterans Benefits

Administration to initiate the processing

of the insured’s request to convert his/

her term insurance.

3. Individuals or households.

4. 1,125 hours.

5. 15 minutes.

6. On occasion.

7. 4,500 respondents.

Reinstatement

1. Designation of Beneficiary, VA

Form 29–336.

2. The form is used by the insured to

designate a beneficiary and select an

optional settlement to be used when the

insurance matures by death. The

information is requested to determine

the claimants eligibility to receive the

proceeds.

3. Individuals or households.

4. 13,917 hours.

5. 10 minutes.

6. On occasion.

7. 83,500 respondents.

Reinstatement

1. Application of Surviving Spouse or

Child for REPS Benefits (Restored

Entitlement Program for Survivors), VA

Form 21–8924.

2. The form is used by dependents of

deceased veterans for the sole purpose

of making a claim for REPS benefits.

The information is used by Veterans

Benefits Administration to determine

whether the claimant is eligible for

REPS benefits.

3. Individuals or households.

4. 2,500 hours.

5. 20 minutes.

6. On occasion.

7. 7,000 respondents.

[FR Doc. 95–10691 Filed 5–1–95; 8:45 am]

BILLING CODE 8320–01–M

Privacy Act of 1974; Report of

Matching Programs

AGENCY: Department of Veterans Affairs

(VA).

ACTION: Notice of renewal—VA/IRS

Match Program.

SUMMARY: Notice is hereby given that

the Department of Veterans Affairs (VA),

Veterans Health Administration (VHA),

intends to renew the computer matching

program comparing Internal Revenue

Service (IRS) and Social Security

Administration (SSA) income records

with VA patient income data which is

contained in the patient medical

records.

The goal of these matches is to

compare income, social security

number, and employment status as

reported to VHA with income records

maintained by IRS and SSA. For the

information of all concerned, a

summary report of the VHA matching

program describing the computer

matches follows. In accordance with 5

U.S.C. 552a(o)(2), copies of the

computer matching report are being sent

to both houses of Congress. These

matches are expected to commence on

or about May 1, 1995, but start no

sooner than 30 days after publication of

this notice in the Federal Register, or 40

days after copies of this notice and the

agreement are submitted to Congress

and the Office of Management and

Budget. These matches may be extended

by the involved Data Integrity Boards for

a twelve month period provided all

agencies involved certify to the Data

Integrity Boards, within three months of

the termination date of the original

match, that the matching program will

be conducted without change and the

matching programs have been

conducted in compliance with the

original matching agreements. The

matches will not continue past the

legislative authorized date to obtain this

information. However, expiration of this

agreement is December 31, 1995.

ADDRESSES: Interested individuals may

comment on the matches by writing to

the Associate Chief Medical Director for

Administration (161D), Veterans Health

Administration, Department of Veterans

Affairs, 810 Vermont Avenue NW.,

Washington, DC 20420.

FOR FURTHER INFORMATION CONTACT:

Janice E. Wheeler (202) 273–6276,

Program Analyst, Income Verification

Match Policy Service.

SUPPLEMENTARY INFORMATION: Further

information regarding the matching

program is provided below. This

information is required by Title 5 U.S.C.

552a(e)(12), the Privacy Act of 1974, as
Federal Register / Vol. 60, No. 84 / Tuesday, May 2, 1995 / Notices 21587

amended. A copy of this notice has been

provided to both houses of Congress and

the Office of Management and Budget.

Approved: April 25, 1995.

Jesse Brown,

Secretary of Veterans Affairs.

Report of Matching Program

Department of Veterans Affairs Patient

Medical Records With Income Records

Maintained by the Internal Revenue

Service and the Social Security

Administration

a. Authority: Title 38, U.S.C. 5106 and

5317; Pub. L. 101–508 as amended by

Pub. L. 102–568.

b. Program Description:

(1) Purpose: (a) the Department of

Veterans Affairs (VA), Veterans Health

Administration (VHA) plans to match

the household income information

contained in the medical records of

certain nonservice-connected veterans,

with the income records for those

persons maintained by the Internal

Revenue Service (IRS) and the Social

Security Administration (SSA). Those

nonservice-connected veterans subject

to income verification matching are

those veterans who are receiving VA

medical care in a mandatory eligibility

category due to a finding of low income

subsequent to means testing.

(b) Currently, information about a

veterans household income (i.e.,

veterans and spouses receipt of wage,

self-employment and other income as

well as employment status, health

insurance coverage and number of

dependents) is obtained when the

veteran makes application for medical

care at a VA medical care facility. The

household income and dependent data

is evaluated in a ‘‘means test’’ which

takes into account deductions of certain

income not counted as such for Veterans

Health Administration eligibility

purposes. Once a net income for the

veteran is established, it is applied

against means test thresholds, or levels

of income establishing mandatory or

discretionary eligibility for medical

care. If the veteran’s net income falls

below the applicable means test

threshold, he or she is eligible for

mandatory care (i.e., no-cost care);

however, if the net income falls over the

applicable threshold, the veteran is

given a discretionary eligibility.

Veterans who are eligible for

discretionary care are provided care if

the VA medical facility has the

resources to treat discretionary veterans,

and if the veteran agrees to make a copayment for such care. The proposed

matching programs will enable VA to

verify the accuracy of reported income

and employment status and therefore

more accurately determine eligibility for

medical care.

(2) Procedures: VA’s Veterans Health

Administration has established an

Income Verification Match (IVM)

Center. The IVM Center will

electronically extract demographic and

income data from each VA medical care

facility’s database on nonserviceconnected veterans found eligible for

mandatory care based solely on low

income. The VHA IVM extract file will

be matched against IRS and SSA income

records. If a VHA record and SSA or IRS

record match on social security number

and name, the IVM Center will begin an

extensive case development and

verification process. This process will

assure the validity of the matched cases

by verifying the IRS/SSA reported

income amount with the payer(s) and

recipients of the income. Each veteran

and/or spouse identified by the match

will be contacted in order to notify the

veteran and/or spouse of any income

discrepancy identified by the match, to

verify the discrepancy, and to advise

him or her of potential changes to the

veteran’s medical care eligibility at the

VA medical center, and the potential

billing action for co-payments. Before

any adverse action is taken, the

individual(s) identified by the match

will be given the opportunity to contest

the findings. Where there are reasonable

grounds to believe that there has been

a violation of criminal laws, the matter

will be referred for prosecution

consideration in accordance with

existing VA policies.

c. Records to be Matched: The VA

records involved in the match are

patient medical records maintained in

the ‘‘Patient Medical Record-VA

(24VA136)’’ published at 40 FR 38095

(8/26/75) and amended at 40 FR 52125

(11/7/75), 41 FR 2881 (1/20/76), 41 FR

11631 (3/19/76), 42 FR 30557 (6/15/72),

44 FR 31058 (5/30/79), 45 FR 77220 (11/

21/80), 46 FR 2766 (1/12/81), 47 FR

28522 (6/30/82), 47 FR 51841 (11/17/

82), 50 FR 11610 (3/22/85), 51 FR 25968

(7/17/86), 51 FR 44406 (12/9/86), 52 FR

381 (1/5/87), 53 FR 49818 (12/13/90), 55

FR 5112 (2/13/90), 55 FR 37604 (9/12/

90), 55 FR 42534 (10/19/90), 56 FR 1054

(1/10/91), 57 FR 28003 (6/23/92), 57 FR

4519 (10/1/92), 58 FR 29853 (5/24/93),

58 FR 40852 (7/30/93) and 58 FR 57674

(10/26/93). The IRS records are from the

Wage and Information Returns (IRP)

Master File, Privacy Act system Treas/

IRS 22.061. The SSA records are from

the Earnings Recording and SelfEmployment Income system, HHS/SSA/

OSR 09–60–0059.

d. Period of Match: The initial date

exchanges are expected to begin 40 days

after the matching agreements are

signed by the Data Integrity Boards

(DIB’s) and Congressional Offices and

OMB have been notified, and 30 days

from the date of publication of notice in

the Federal Register or 40 days from the

date this notice is approved, whichever

is later. These matches may be extended

by the involved DIB’s for a twelvemonth period provided the agencies

participating in the match certify to the

DIB’s, within three months of the

termination date of the original match,

that the matching program will be

conducted without change and the

matching programs have been

conducted in compliance with the

original matching agreements. The

matches will not continue past the date

legislative authority to obtain this

information expires.

[FR Doc. 95–10692 Filed 5–1–95; 8:45 am]

BILLING CODE 8320–01–M