Division of Energy Employees
Occupational Illnesses Compensation (DEEOIC) Authorization Request
Forms
New
collection (Request for a new OMB Control Number)
No
Regular
04/15/2021
Requested
Previously Approved
36 Months From Approved
66,770
0
11,129
0
0
0
The Office of Workers’ Compensation
Programs (OWCP) is the primary agency responsible for
administration of the Energy Employees Occupational Illness
Compensation Program Act of 2000, as amended (EEOICPA), 42 U.S.C. §
7384 et seq. EEOICPA provides for the payment of compensation to
covered employees and, where applicable, survivors of deceased
employees, who sustained either an “occupational illness” or a
“covered illness” in the performance of duty for the Department of
Energy and certain of its contractors and subcontractors. One
element of the compensation provided to covered employees is
medical benefits for the treatment of their occupational or covered
illnesses that are accepted as compensable. OWCP contracts with a
private sector bill processing agent that handles many of the tasks
associated with paying bills for medical treatment provided to
covered employees under EEOICPA. This bill processing agent uses an
automated system that matches incoming bills with the authorized
medical treatment of covered employees before it issues payments,
and a provider of medical treatment, supplies or services to
covered employees must provide the bill processing agent with
information necessary for creation of an authorization within the
agent’s automated system before a bill can be paid. The collection
of this information is authorized by 20 CFR 30.400(a) and (c),
30.403, 30.404(b) and 30.700. The information collected by these
forms will be used by both OWCP and its bill processing agent in
connection with the automated payment of bills submitted by
providers of medical treatment, supplies or services. The
information submitted, along with other supporting documentation,
is used to determine the correct amount to be paid to a provider of
medical treatment, supplies or services to beneficiaries under
EEOICPA.
US Code:
42
USC 7384 Name of Law: Energy Employees Occupational Illness
Compensation Program Act of 2000
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Form EE-32 EE-32 (Home Health Care Authorization Request)
Supporting Statement 1240-0NEW 4.12.21.docx
1240-0NEW 30-day FRN published.pdf
EE-32 (Home Health Care Authorization Request)