[Federal Register Volume 87, Number 121 (Friday, June 24, 2022)]
[Notices]
[Page 37877]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-13550]



[[Page 37877]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Countermeasures Injury Compensation Program: Electronic 
Submissions

AGENCY: Health Resources and Services Administration (HRSA), Department 
of Health and Human Services.

ACTION: Notice.

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SUMMARY: The Public Readiness and Emergency Preparedness Act (PREP Act) 
authorized the Secretary of Health and Human Services (Secretary) to 
establish the Countermeasures Injury Compensation Program (CICP or 
Program). This Program provides benefits to certain persons who sustain 
serious physical injuries or death as a direct result of administration 
or use of covered countermeasures identified by the Secretary in 
declarations issued under the PREP Act. In addition, the Secretary may 
provide death benefits to certain survivors of individuals who died as 
the direct result of such covered injuries or their health 
complications. In accordance with 42 CFR 110.41, the Department of 
Health and Human Services is issuing this notice to inform the public 
that the CICP is accepting electronic Request for Benefits package 
submissions through the Injury Compensation Programs web-based portal. 
Completed Request for Benefits Forms, Letters of Intent, copies of 
completed Authorization for Use or Disclosure of Health Information 
forms, medical records, and any supporting documentation for CICP 
Request for Benefits packages can be submitted electronically at 
https://injurycompensation.hrsa.gov.

DATES: This notice is effective immediately.

FOR FURTHER INFORMATION CONTACT: Dr. George Reed Grimes, Director, 
Division of Injury Compensation Programs, Health Systems Bureau, HRSA, 
5600 Fishers Lane, 08-N146B, Rockville, MD 20857. Phone calls can be 
directed to 1-855-266-2427 (1-855-266-CICP). This is a toll-free 
number.

SUPPLEMENTARY INFORMATION: Request for Benefits Forms (or Letters of 
Intent) must be filed within 1 year of the date of the administration 
or use of the covered countermeasure that is alleged to have caused the 
injury. The filing date for Request Forms submitted electronically is 
the date the Request Form is submitted electronically at https://injurycompensation.hrsa.gov. 42 CFR 110.42(c). For Request Forms not 
submitted electronically, the filing date is still the postmark date. A 
legibly dated receipt from a commercial carrier, a private courier 
service, or the U.S. Postal Service will be considered equivalent to a 
postmark.
    In addition to the Request for Benefits Forms, requesters are also 
required to submit copies of the Authorization for Use or Disclosure of 
Health Information forms they submitted to their medical providers. 
Requesters must also arrange to have their providers submit the 
following medical records:
    (1) All medical records documenting medical visits, procedures, 
consultations, and test results that occurred on or after the date of 
administration or use of the covered countermeasure; and
    (2) All hospital records, including the admission history and 
physical examination, the discharge summary, all physician subspecialty 
consultation reports, all physician and nursing progress notes, and all 
test results that occurred on or after the date of administration or 
use of the covered countermeasure; and
    (3) All medical records for 1 year prior to administration or use 
of the covered countermeasure as necessary to indicate an injured 
countermeasure recipient's pre-existing medical history.
    To submit documentation online, individuals may navigate to the 
Injury Compensation Programs website (https://injurycompensation.hrsa.gov) and follow the steps on ``How to Create an 
Account'' to create a Login.gov account. Steps to create an account are 
also directly available here: https://injurycompensation.hrsa.gov/DICPSubmit/Interface/Common/LoginAssistance.
    Once an account is created, individuals can submit a new Request 
for Benefits package or upload additional documents for an existing 
request.
    Alternatively, Request for Benefits Forms, medical records, and any 
documentation to supplement a Request for Benefits package can continue 
to be sent by mail to the CICP at the following address: Health 
Resources and Services Administration, Countermeasures Injury 
Compensation Program, 5600 Fishers Lane, 08N186B, Rockville, Maryland 
20857.
    When the CICP receives a Request for Benefits package online or by 
mail, the CICP will send the requester a letter confirming receipt of 
the claim, providing them with a case number, and informing them if any 
additional documentation is required. Additional documentation may be 
submitted by mail or by uploading the documents electronically, 
regardless of the initial filing method used. For more information or 
support, requesters may contact CICP directly by email at <a href="/cdn-cgi/l/email-protection#8cefe5effccce4feffeda2ebe3fa"><span class="__cf_email__" data-cfemail="4b2822283b0b2339382a652c243d">[email protected]</span></a> 
or by phone at 1-855-266-2427 (1-855-266-CICP).

Diana Espinosa,
Deputy Administrator.
[FR Doc. 2022-13550 Filed 6-23-22; 8:45 am]
BILLING CODE 4165-15-P


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