Federal Register / Vol. 81, No. 19 / Friday, January 29, 2016 / Notices 5013 

Dated: January 26, 2016. 

Todd A. Stevenson, 

Secretary, Consumer Product Safety 

Commission. 

[FR Doc. 2016–01699 Filed 1–28–16; 8:45 am] 

BILLING CODE 6355–01–P 

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 

ACTION: Notice. 

SUMMARY: In compliance with the 

Paperwork Reduction Act of 1995, the 

Office of the Assistant Secretary of 

Defense for Health Affairs announces a 

proposed 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 March 29, 2016. 

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: Department of Defense, Office 

of the Deputy Chief Management 

Officer, Directorate of Oversight and 

Compliance, Regulatory and Audit 

Matters Office, 9010 Defense Pentagon, 

Washington, DC 20301–9010. 

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. 

Any associated form(s) for this 

collection may be located within this 

same electronic docket and downloaded 

for review/testing. Follow the 

instructions at http://

www.regulations.gov for submitting 

comments. Please submit comments on 

any given form identified by docket 

number, form number, and title. 

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 Defense Health 

Agency Uniform Business Office, 

Defense Health Headquarters, 7700 

Arlington Blvd., Falls Church, Virginia 

22042, ATTN: DeLisa E. Prater, Program 

Manager, 703–681–3492. ext. 6757 (DSN 

761). 

SUPPLEMENTARY INFORMATION: 

Title; Associated Form; and OMB 

Number: Third Party Collection 

Program/Medical Services Account/

Other Health Insurance; DD Form 2569; 

OMB Control Number 0720–0055. 

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 and other federal agencies 

for health care provided to their 

beneficiaries and also to civilian nonUniformed Service beneficiaries for 

health care provided to them. 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 thirdparty payers the cost of inpatient and 

outpatient services rendered to DoD 

beneficiaries who have other health 

insurance. Military treatment facilities 

(MTFs) 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. Also, for 

civilian non-Uniformed Services 

beneficiary and interagency patients, DD 

Form 2569 is necessary and serves as an 

assignment of benefits, approval to 

submit claims to payers on behalf of the 

patient and authorization to release 

medical information. 

Affected Public: Individuals or 

households. 

Annual Burden Hours: 260,000. 

Number of Respondents: 3,900,000. 

Responses per Respondent: 1. 

Annual Responses: 3,900,000. 

Average Burden per Response: 4 

minutes. 

Frequency: Annually, on occasion. 

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, and also from civilians and other 

federal agencies as authorized by 10 

U.S.C. 1079b and 1085. 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 or as soon as practical thereafter. 

Dated: January 26, 2016. 

Morgan E. Park, 

Alternate OSD Federal Register, Liaison 

Officer, Department of Defense. 

[FR Doc. 2016–01702 Filed 1–28–16; 8:45 am] 

BILLING CODE 5001–06–P 

ENVIRONMENTAL PROTECTION 

AGENCY 

[ER–FRL–9025–3] 

Environmental Impact Statements; 

Notice of Availability 

Responsible Agency: Office of Federal 

Activities, General Information (202) 

564–7146 or http://www2.epa.gov/nepa. 

Weekly receipt of Environmental 

Impact Statements (EISs), Filed 01/18/

2016 Through 01/22/2016, Pursuant to 

40 CFR 1506.9. 

Notice 

Section 309(a) of the Clean Air Act 

requires that EPA make public its 

comments on EISs issued by other 

Federal agencies. EPA’s comment letters 

on EISs are available at: https://

cdxnodengn.epa.gov/cdx-nepa-public/

action/eis/search. 

EIS No. 20160016, Final, FHWA, TX, 

SH 249 Extension, Contact: Carlos 

Swonke 512–416–2734, Under MAP– 

21 Section 1319 FHWA has issued a 

single FEIS and ROD. Therefore, the 

30-day wait/review period under 

NEPA does not apply to this action. 

EIS No. 20160017, Draft, USFS, AK, 

Shoreline II Oufitter/Guide (formerly 


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