Federal Register / Vol. 82, No. 165 / Monday, August 28, 2017 / Notices 40831 

seeking input on these and other data 

fields to be considered and information 

on the costs associated with submitting 

this information. 

Recommendation 4—FMCSA should 

structure a user-friendly version of the 

MCMIS data file used as input to SMS 

without any personally identifiable 

information to facilitate its use by 

external parties, such as researchers, 

and by carriers. In addition, FMCSA 

should make user-friendly computer 

code used to compute SMS elements 

available to individuals in accordance 

with reproducibility and transparency 

guidelines. 

FMCSA Comments 

FMCSA agrees that there could be 

benefits from making MCMIS data 

available to researchers and carriers. 

Through this Federal Register notice, 

FMCSA seeks input on how the MCMIS 

data would be used by researchers and 

others to determine the best method(s) 

for providing the data file. 

The Agency is considering developing 

the programming, screen shots, and 

preview capacity so that changes from 

one month to another are explained to 

motor carriers to help carriers 

understand the implications of 

violations and crashes on their SMS 

data. Input on the information that 

would be helpful in reviewing SMS data 

is requested through this notice. 

Recommendation 5—FMCSA should 

undertake a study to better understand 

the statistical operating characteristics 

of the percentile ranks to support 

decisions regarding the usability of 

public scores. 

FMCSA Comments 

Like NAS, FMCSA has been unable to 

quantify the impacts to motor carriers of 

publicly displaying the SMS 

percentiles. The Agency has only 

anecdotal information about the 

business impacts of the public 

percentiles on the SMS Web site. 

Historically, insurance companies and 

shippers have been reluctant to share 

data on how safety data is used to 

determine rates. And, while the Agency 

has been contacted by companies 

advising that they lost business because 

of SMS, these claims have not been 

validated or assimilated into a usable 

analysis. 

Through this notice, FMCSA seeks 

data from motor carriers, insurance 

companies, and shippers regarding the 

impacts of the public display of SMS 

percentiles and alerts on businesses. 

This information will be used to 

identify next steps for this 

recommendation. 

Recommendation 6—Given that there 

are good reasons for both an absolute 

and a relative metric on safety 

performance, FMCSA should decide on 

the carriers that receive SMS alerts 

using both the SMS percentile ranks and 

the SMS measures, and the percentile 

ranks should be computed both 

conditionally within safety event groups 

and over all motor carriers. 

FMCSA Comments 

The Agency has heard from motor 

carriers with increased measures or 

percentiles due to an increase in 

vehicles or clean inspections. Analysis 

of the number of carriers that received 

higher measures and percentiles 

without a violation or crash indicates 

this happens to a very small number of 

carriers. However, FMCSA agrees that 

the methodology should be revised so 

that a safety event that is not a violation 

or a crash is not the sole reason for an 

increased measure or percentile. 

In addition, FMCSA anticipates 

investigating the use of a hybrid 

measure that combines relative and 

absolute metrics as part of its 

development of the IRT model. FMCSA 

seeks comment from stakeholders on 

this issue, how it could be 

implemented, and when such changes 

would be appropriate. 

Issued under the authority delegated in 49 

CFR 1.87 on: August 21, 2017. 

John Van Steenburg, 

Assistant Administrator/Chief Safety Officer. 

[FR Doc. 2017–18183 Filed 8–25–17; 8:45 am] 

BILLING CODE 4910–EX–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0606] 

Agency Information Collection 

Activity: Regulation for Submission of 

Evidence 

AGENCY: Veterans Health 

Administration, Department of Veterans 

Affairs. 

ACTION: Notice. 

SUMMARY: Veterans Health 

Administration, Department of Veterans 

Affairs (VA), is announcing an 

opportunity for public comment on the 

proposed collection of certain 

information by the agency. Under the 

Paperwork Reduction Act (PRA) of 

1995, Federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension of a currently approved 

collection, and allow 60 days for public 

comment in response to the notice. 

DATES: Written comments and 

recommendations on the proposed 

collection of information should be 

received on or before October 27, 2017. 

ADDRESSES: Submit written comments 

on the collection of information through 

Federal Docket Management System 

(FDMS) at www.Regulations.gov or to 

Brian McCarthy, Veterans Health 

Administration, Office of Regulatory 

and Administrative Affairs (10B4), 

Department of Veterans Affairs, 810 

Vermont Avenue NW., Washington, DC 

20420 or email to Brian.McCarthy4@

va.gov. Please refer to ‘‘OMB Control 

No. 2900–0606’’ in any correspondence. 

During the comment period, comments 

may be viewed online through FDMS. 

FOR FURTHER INFORMATION CONTACT: 

Brian McCarthy at (202) 461–6345. 

SUPPLEMENTARY INFORMATION: Under the 

PRA of 1995, Federal agencies must 

obtain approval from the Office of 

Management and Budget (OMB) for each 

collection of information they conduct 

or sponsor. This request for comment is 

being made pursuant to Section 

3506(c)(2)(A) of the PRA. 

With respect to the following 

collection of information, VHA invites 

comments on: (1) Whether the proposed 

collection of information is necessary 

for the proper performance of VHA’s 

functions, including whether the 

information will have practical utility; 

(2) the accuracy of VHA’s estimate of 

the burden of the proposed collection of 

information; (3) ways to enhance the 

quality, utility, and clarity of the 

information to be collected; and (4) 

ways to minimize the burden of the 

collection of information on 

respondents, including through the use 

of automated collection techniques or 

the use of other forms of information 

technology. 

Authority: U.S. Code: 38 U.S.C. 1729. 

Title: Regulation for Submission of 

Evidence—Title 38 CFR 17.101(a)(4). 

OMB Control Number: 2900–0606. 

Type of Review: Renewal of a 

currently approved collection. 

Abstract: Under the provisions of 38 

CFR, Section 17.101(a)(4), entitled 

‘‘Amount of Recovery or Collection— 

Third Party Liability’’, a third-party 

payer that is liable for reimbursing VA 

for health care VA provided to Veterans 

with non- service-connected conditions 

continues to have the option of paying 

either the billed charges as described in 

Section 17.101 or the amount the health 

plan demonstrates it would pay to 

providers other than entities of the 

United States for the same care or 

services in the same geographic area. If 


asabaliauskas on DSKBBXCHB2PROD with NOTICES
40832 Federal Register / Vol. 82, No. 165 / Monday, August 28, 2017 / Notices 

the amount submitted for payment is 

less than the amount billed, VA will 

accept the submission as payment, 

subject to verification at VA’s 

discretion. A VA employee having 

responsibility for collection of such 

charges may request that the third party 

payer submit evidence or information to 

substantiate the appropriateness of the 

payment amount (e.g., health plan 

policies, provider agreements, medical 

evidence, proof of payment to other 

providers demonstrating the amount 

paid for the same care and services VA 

provided). This information would be 

needed to determine whether the thirdparty payer has met the test of properly 

demonstrating its equivalent private 

sector provider payment amount for the 

same care or services and within the 

same geographic area as provided by 

VA. This form provides for requesting 

patient medical records, health plan 

policies, provider agreements and any 

type or records that provide evidence of 

medical services and proof of payments 

made to others for the same medical 

care and services. 

If VA accepts the submitted payment 

that is less than the billed charges, the 

third party payer can be subject to rate 

verification. In the event that rate 

verification is conducted, the results can 

be used to negotiate better rates, recoup 

underpayments, or amend agreements. 

Absent a third party payer agreement, 

VA should also be reimbursed billed 

charges or the amount third party payers 

would pay to non-government entities. 

Affected Public: Individuals and 

households. 

Estimated Annual Burden: 800 hours. 

Estimated Average Burden per 

Respondent: 120 minutes. 

Frequency of Response: Annually. 

Estimated Number of Respondents: 

400. 

By direction of the Secretary. 

Cynthia Harvey-Pryor, 

Department Clearance Officer Office of 

Quality and Compliance, Department of 

Veterans Affairs. 

[FR Doc. 2017–18158 Filed 8–25–17; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0219] 

Agency Information Collection 

Activity: CHAMP VA Benefits— 

Application, Claim, Other Health 

Insurance & Potential Liability 

AGENCY: Veterans Health 

Administration, Department of Veterans 

Affairs. 

ACTION: Notice. 

SUMMARY: Veterans Health 

Administration, Department of Veterans 

Affairs (VA), is announcing an 

opportunity for public comment on the 

proposed collection of certain 

information by the agency. Under the 

Paperwork Reduction Act (PRA) of 

1995, Federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

revision of a currently approved 

collection, and allow 60 days for public 

comment in response to the notice. 

DATES: Written comments and 

recommendations on the proposed 

collection of information should be 

received on or before October 27, 2017. 

ADDRESSES: Submit written comments 

on the collection of information through 

Federal Docket Management System 

(FDMS) at www.Regulations.gov or to 

Brian McCarthy, Veterans Health 

Administration, Office of Regulatory 

and Administrative Affairs (10B4), 

Department of Veterans Affairs, 810 

Vermont Avenue NW., Washington, DC 

20420 or email to Brian.McCarthy4@

va.gov. Please refer to ‘‘OMB Control 

No. 2900–0219’’ in any correspondence. 

During the comment period, comments 

may be viewed online through FDMS. 

FOR FURTHER INFORMATION CONTACT: 

Brian McCarthy at (202) 461–6345. 

SUPPLEMENTARY INFORMATION: 

Under the PRA of 1995, Federal 

agencies must obtain approval from the 

Office of Management and Budget 

(OMB) for each collection of 

information they conduct or sponsor. 

This request for comment is being made 

pursuant to Section 3506(c)(2)(A) of the 

PRA. 

With respect to the following 

collection of information, VHA invites 

comments on: (1) Whether the proposed 

collection of information is necessary 

for the proper performance of VHA’s 

functions, including whether the 

information will have practical utility; 

(2) the accuracy of VHA’s estimate of 

the burden of the proposed collection of 

information; (3) ways to enhance the 

quality, utility, and clarity of the 

information to be collected; and (4) 

ways to minimize the burden of the 

collection of information on 

respondents, including through the use 

of automated collection techniques or 

the use of other forms of information 

technology. 

Authority: 38 U.S.C. Sections 501 and 

1781, 10 U.S.C. Sections 1079 and 1086, 

42 U.S.C. Sections 2651, 2652 and 2653. 

Title: CHAMP VA Benefits— 

Application, Claim, Other Health 

Insurance & Potential Liability. 

OMB Control Number: 2900–0219. 

Type of Review: Revision of a 

currently approved collection. 

Titles: 

1. VA Form 10–10d, Application for 

CHAMPVA Benefits 

2. VA Form 10–7959a, CHAMPVA 

Claim Form 

3. VA Form 10–7959c, CHAMPVA 

Other Health Insurance (OHI) 

Certification 

4. VA Form 10–7959d, CHAMPVA 

Potential Liability Claim 

5. VA Form 10–7959e, VA Claim for 

Miscellaneous Expenses 

6. Payment (beneficially claims) 

7. Review and Appeal Process 

8. Clinical Review 

OMB Control Number: 2900–0219. 

Type of Review: Revision of a 

currently approved collection. 

Abstracts: 

1. VA Form 10–10d, Application for 

CHAMPVA Benefits, is used to determine 

eligibility of persons applying for healthcare 

benefits under the CHAMPVA program in 

accordance with 38 U.S.C. Sections 501 and 

1781. 

2. VA Form 10–7959a, CHAMPVA Claim 

Form, is used to adjudicate claims for 

CHAMPVA benefits in accordance with 38 

U.S.C. Sections 501 and 1781, and 10 U.S.C. 

Sections 1079 and 1086. This information is 

required for accurate adjudication and 

processing of beneficiary submitted claims. 

The claim form is also instrumental in the 

detection and prosecution of fraud. In 

addition, the claim form is the only 

mechanism to obtain, on an interim basis, 

other health insurance (OHI) information. 

3. Except for Medicaid and health 

insurance policies that are purchased 

exclusively for the purpose of supplementing 

CHAMPVA benefits, CHAMPVA is always 

the secondary payer of healthcare benefits 

(38 U.S.C. Sections 501 and 1781, and 10 

U.S.C. Section 1086). VA Form 10–7959c, 

CHAMPVA—Other Health Insurance (OHI) 

Certification, is used to systematically obtain 

OHI information and to correctly coordinate 

benefits among all liable parties. 

4. The Federal Medical Care Recovery Act 

(42 U.S.C. 2651–2653), mandates recovery of 

costs associated with healthcare services 

related to an injury/illness caused by a third 

party. VA Form 10–7959d, CHAMPVA 

Potential Liability Claim, provides basic 

information from which potential liability 

can be assessed. Additional authority 

includes 38 U.S.C. Section 501; 38 CFR 1.900 

et seq.; 10 U.S.C. Sections 1079 and 1086; 42 

U.S.C. Sections 2651–2653; and Executive 

Order 9397. 

5. VA Form 10–7959e, VA Claim for 

Miscellaneous Expenses, information 

collection is needed to carry out the health 

care programs for certain children of Korea 

and/or Vietnam veterans authorized under 38 


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