60-day FRN - 2900-0219 - CHAMPVA Benefits Forms - pub 08302024

60-day FRN_2900-0219_CHAMPVA Benefits - Forms_published 08302024.pdf

CHAMPVA Benefits - Application, Claim, Other Health Insurance, Potential Liability & Misc Expenses

60-day FRN - 2900-0219 - CHAMPVA Benefits Forms - pub 08302024

OMB: 2900-0219

Document [pdf]
Download: pdf | pdf
70692

Federal Register / Vol. 89, No. 169 / Friday, August 30, 2024 / Notices

TABLE 3—INCREMENTAL ANNUAL BURDEN ASSOCIATED WITH IMPLEMENTING THE IDENTITY VERIFICATION, RECORDKEEPING, AND CONSULTING GOVERNMENT LISTS REQUIREMENTS FOR ALL COVERED FINANCIAL INSTITUTIONS—Continued
Number of
financial
institutions

Type of financial institution
0026
0033
0034

New accounts
opened per
year

Time per new
account
(minutes)

Total burden
in minutes

Total burden
converted to
hours

Banks .............................................................................................................
Mutual Funds .................................................................................................
Brokers-dealers .............................................................................................

10,400
1,400
3,478

53,615,000
16,150,000
28,000,000

3
3
3

160,845,000
48,450,000
84,000,000

2,680,750
807,500
1,400,000

Total ...................................................................................................................

16,232

98,322,000

......................

294,966,000

4,916,100

FinCEN is utilizing the same fully
loaded composite hourly wage rate of
$106.30 utilized in other OMB control

number renewals and notices of
proposed rulemakings (NPRMs) recently
opened to public review and comment.

The total estimated cost of the annual
PRA burden is $541,561,508, as
reflected in table 4 below:

TABLE 4—TOTAL COST OF ANNUAL PRA BURDEN
Task

Hourly cost

Total cost

Maintaining and updating the CIP (10 hours per FI) ..................................................................
Customer notification of CIP (1 hour per FI) ...............................................................................
Implementing the CIP (identifying and verifying customer information, maintain records, and
consulting government lists) (2 minutes per account ..............................................................

162,320
16,232

$106.30
106.30

$17,254,616
1,725,462

4,916,100

106.30

522,581,430

Total ......................................................................................................................................

5,094,652

........................

$541,561,508

Authority: 44 U.S.C. 3501 et seq.
Spencer W. Clark,
Treasury PRA Clearance Officer.
[FR Doc. 2024–19593 Filed 8–29–24; 8:45 am]
BILLING CODE 4810–02–P

DEPARTMENT OF THE TREASURY
Agency Information Collection
Activities; Submission for OMB
Review; Comment Request; Clean
Energy Storytelling Program
Departmental Offices,
Department of the Treasury.
ACTION: Notice of information collection;
request for comment.
AGENCY:

The Department of the
Treasury will submit the following
information collection request to the
Office of Management and Budget
(OMB) for review and clearance in
accordance with the Paperwork
Reduction Act of 1995, on or after the
date of publication of this notice. The
public is invited to submit comments on
this request.
DATES: Comments should be received on
or before September 30, 2024 to be
assured of consideration.
ADDRESSES: Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
SUMMARY:

ddrumheller on DSK120RN23PROD with NOTICES1

Hours

VerDate Sep<11>2014

20:35 Aug 29, 2024

Jkt 262001

for Public Comments’’ or by using the
search function.
FOR FURTHER INFORMATION CONTACT:
Copies of the submissions may be
obtained from Spencer W. Clark by
emailing [email protected], calling
(202) 927–5331, or viewing the entire
information collection request at
www.reginfo.gov.
SUPPLEMENTARY INFORMATION:
Title: Clean Energy Storytelling
Program.
OMB Control Number: 1505–NEW.
Type of Review: Request for a new
OMB Control Number.
Description: Treasury’s Inflation
Reduction Act Program Office proposes
to establish a Clean Energy Storytelling
Program that would engage the public
and enable more effective
communication of their Inflation
Reduction Act (IRA) incentive and
program-related stories.
The goal would be to increase
awareness of the IRA’s tax incentives
and other impacts so that more
Americans, companies, and non-profits
are aware of and understand the benefits
now available to them, thereby
promoting uptake, and the IRA’s
broader purpose. Located on the
Treasury.gov/IRA website, the Clean
Energy Storytelling Program would
feature a participation consent form and
a series of questions. These forms are
designed to offer a voluntary way for
members of the public to share
information about their experience with
claiming IRA-related clean energy
incentives or using IRS modernization

PO 00000

Frm 00102

Fmt 4703

Sfmt 4703

programs and resources, and enable
Treasury officials to communicate their
stories to the broader American public.
Form: Clean Energy Storytelling
Program Consent and Participation
Forms.
Affected Public: Individuals &
Households, Businesses.
Estimated Number of Respondents:
1,000.
Frequency of Response: Once.
Estimated Total Number of Annual
Responses: 1,000.
Estimated Time per Response: 30
minutes.
Estimated Total Annual Burden
Hours: 500.
Authority: 44 U.S.C. 3501 et seq.
Spencer W. Clark,
Treasury PRA Clearance Officer.
[FR Doc. 2024–19474 Filed 8–29–24; 8:45 am]
BILLING CODE 4810–AK–P

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0219]

Agency Information Collection
Activity: CHAMPVA Benefits—
Application, Claim, Other Health
Insurance, Potential Liability &
Miscellaneous Expenses
Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:

E:\FR\FM\30AUN1.SGM

30AUN1

Federal Register / Vol. 89, No. 169 / Friday, August 30, 2024 / Notices
Veterans Health
Administration (VHA), 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: Comments must be received on
or before October 29, 2024.
ADDRESSES: Comments must be
submitted through www.regulations.gov.
FOR FURTHER INFORMATION CONTACT:
Program-specific information:
Rebecca Mimnall, 202–695–9434,
[email protected].
VA PRA information: Maribel Aponte,
202–461–8900, vacopaperworkreduact@
va.gov.
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.
Title: CHAMPVA Benefits—
Application, Claim, Other Health
Insurance, Potential Liability &
Miscellaneous Expenses.
OMB Control Number: 2900–0219.
https://www.reginfo.gov/public/do/
PRASearch. (Once at this link, you can
enter the OMB Control Number to find
the historical versions of this
Information Collection.)
Type of Review: Revision of a
currently approved collection.
Abstract: This information collection
includes several forms, as well as a
review and appeal process, which are
used to administer the Civilian Health
and Medical Program of the Department

ddrumheller on DSK120RN23PROD with NOTICES1

SUMMARY:

VerDate Sep<11>2014

20:35 Aug 29, 2024

Jkt 262001

of Veterans Affairs (CHAMPVA).
Although the burden numbers have not
changed since the last PRA clearance,
the collection is being revised to include
a portal for submission of the
information in the 10–10d program
application form, which is expected to
be completed by the end of calendar
year 2024. This portal will allow
applicants to complete and submit VA
Form 10–10d electronically rather than
by submission of a hard copy form,
which has been the standard application
process prior to technological
advancement allowing electronic
submission and processing. This portal
represents a separate avenue for
applicants to submit VA Form 10–10d;
however, it does not affect the burden
of collection for applicants or VA.
VA Form 10–10d: Application for
CHAMPVA Benefits
VA Form 10–7959a: CHAMPVA Claim
Form
VA Form 10–7959c: CHAMPVA Other
Health Insurance (OHI) Certification
VA Form 10–7959d: CHAMPVA
Potential Liability Claim
VA Form 10–7959e: VA Claim for
Miscellaneous Expenses
Review and Appeal Process
Clinical Review
a. 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. 501 and 1781.
b. VA Form 10–7959a, CHAMPVA
Claim Form, is used to adjudicate
claims for CHAMPVA benefits in
accordance with 38 U.S.C. 501 and
1781, and 10 U.S.C. 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.
c. 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. 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.
501 and 1781, and 10 U.S.C. 1086).
d. VA Form 10–7959d, CHAMPVA
Potential Liability Claim, provides basic
information from which potential third

PO 00000

Frm 00103

Fmt 4703

Sfmt 4703

70693

party liability can be assessed. 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. Additional authority
includes 38 U.S.C. 501; 38 CFR 1.900 et
seq.; 10 U.S.C. 1079 and 1086; 42 U.S.C.
2651–2653; and Executive Order 9397.
e. VA Form 10–7959e, VA Claim for
Miscellaneous Expenses, is used to
adjudicate claims for certain children of
Korea, Vietnam, and Thailand veterans
authorized under 38 U.S.C., chapter 18,
as amended by section 401, Public Law
106–419 and section 102, Public Law
108–183. VA’s medical regulations 38
CFR part 17 (17.900 through 17.905)
establish regulations regarding
provision of health care for certain
children of Korea, Vietnam, and
Thailand veterans and women Vietnam
veterans’ children born with spina
bifida and certain other covered birth
defects. These regulations also specify
the information to be included in
requests for preauthorization and claims
from approved health care providers.
f. Review and Appeal Process pertains
to the approval of health care, or
approval for payment relating to the
provision of health care, under the
Veteran Family Member Programs. The
provisions of the Veterans Appeals
Improvement and Modernization Act of
2017 (AMA, Pub. L. 115–55), chapter 51
of 38 U.S.C., or legacy claims under 38
CFR 17.277 and 38 CFR 17.904 establish
a review process regarding
disagreements by an eligible beneficiary
of a Veteran Family Member Program,
provider, veteran, or other
representative of the veteran or
beneficiary, with a determination
concerning provision of health care or a
health care provider’s disagreement
with a determination regarding
payment. The person or entity
requesting reconsideration of such
determination is required to submit
such a request in writing (including
electronic where available). If such
person or entity remains dissatisfied
with the determination, the person or
entity is permitted to submit a written
request for additional review (VHA
Notice 2024–07).
g. Clinical Review pertains to the
requirement of VHA to preauthorize
certain medical services under 38 CFR
17.273 and 38 CFR 17.902. Clinical
review determines if services are
medically necessary and appropriate to
allow under the Veteran Family Member
Programs. The person requesting the
services must submit medical
documentation or applicable supporting
material for review.

E:\FR\FM\30AUN1.SGM

30AUN1

70694

Federal Register / Vol. 89, No. 169 / Friday, August 30, 2024 / Notices

Affected Public: Individuals or
Households.
Estimated Annual Burden: 34,548
total hours.
VA Form 10–10d—8,963 hours.
VA Form 10–7959a—9,167 hours.
VA Form 10–7959c—8,947 hours.
VA Form 10–7959d—239 hours.
VA Form 10–7959e—200 hours.
Review and Appeal Process—6,255
hours.
Clinical Review—777 hours.
Estimated Average Burden Per
Respondent:
VA Form 10–10d—10 minutes.
VA Form 10–7959a—10 minutes.
VA Form 10–7959c—10 minutes.
VA Form 10–7959d—7 minutes.
VA Form 10–7959e—15 minutes.
Review and Appeal Process—30
minutes.
Clinical Review—20 minutes.
Frequency of Response: Once
annually.
Estimated Number of Respondents:
180,142 total.
VA Form 10–10d—53,775.
VA Form 10–7959a—55,000.
VA Form 10–7959c—53,680.
VA Form 10–7959d—2,045.
VA Form 10–7959e—800.
Review and Appeal Process—12,510.
Clinical Review—2,332.
Authority: 44 U.S.C. 3501 et seq.
Maribel Aponte,
VA PRA Clearance Officer, Office of
Enterprise and Integration/Data Governance
Analytics, Department of Veterans Affairs.
[FR Doc. 2024–19505 Filed 8–29–24; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
Geriatric and Gerontology Advisory
Committee, Notice of Meeting

ddrumheller on DSK120RN23PROD with NOTICES1

The Department of Veterans Affairs
(VA) gives notice under the Federal
Advisory Committee Act (5 U.S.C. ch.
10), that the Geriatric and Gerontology
Advisory Committee will be held
virtually Tuesday, September 17–
Wednesday, September 18, 2024. The
meeting sessions will begin and end as
shown in the following table:
Date

Time

September 17, 2024 .......

9:00 a.m.–4:00 p.m.
Eastern Daylight Time
(EDT)
9:00 a.m.–12:00 noon
EDT

September 18, 2024 .......

This meeting sessions are open to the
public.
The purpose of the Committee is to
provide advice to the Secretary of VA
and the Under Secretary for Health on

VerDate Sep<11>2014

20:35 Aug 29, 2024

Jkt 262001

all matters pertaining to geriatrics and
gerontology. The Committee assesses
the capability of VA health care
facilities and programs to meet the
medical, psychological, and social
needs of older Veterans, and evaluates
VA programs designated as Geriatric
Research, Education, and Clinical
Centers.
During this meeting, the Committee
will receive briefings on the activities of
the Office of Geriatrics and Extended
Care, updates on the provision of GEC
long term services and supports to
Veterans, and presentations from VHA
Program Offices, administrators and
investigators relevant to the care of
older Veterans. The meeting will also
feature updates on accomplishments of
the VHA Geriatric Research, Education
and Clinical Centers Programs, the 20
geriatric Centers of Excellence located
throughout the U.S. The specific agenda
will be available by request for
registered attendees prior to the
meeting.
Time will be allocated for receiving
public comments on September 18,
2024, at 11:00 a.m. (Eastern Daylight
Time). Individuals wishing to present
public comments should contact
Marianne Shaughnessy, Ph.D.,
AGPCNP–BC, GS–C, FAAN., Designated
Federal Officer, Veterans Health
Administration by email at
[email protected] or at
202–407–6798 no later than close of
business on September 6, 2024. Only
those members of the public (first 6
public comment registrants) who have
confirmed registrations to present
public comment will be allowed to
speak at this meeting. In the interest of
time, each speaker will be held to 5minute time limit. Individuals who are
unable to attend but would like to have
comment included in the meeting
record may send them to
[email protected] by close
of business on September 6, 2024. All
individuals wishing to present public
comments must provide a written
summary of the comment for inclusion
in the meeting record that includes
name and organization/association of
persons they represent.
Any member of the public wishing to
attend virtually or seeking additional
information should email
[email protected] or call
202–407–6798, no later than close of
business on September 6, 2024, to
provide their name, professional
affiliation, email address and phone
number. The WebEx link for September
17, 2024: https://veteransaffairs.webex.
com/veteransaffairs/
j.php?MTID=mb2cfe77035d60ecea
3b7362847586a78, meeting number

PO 00000

Frm 00104

Fmt 4703

Sfmt 4703

(access code): 2823 778 6846, meeting
password: ZnpustA?283 or September
18, 2024: https://
veteransaffairs.webex.com/
veteransaffairs/j.php?MTID=
m1e390eaafa645f70a4fd1e27617951d7,
meeting number (access code): 2819 443
9243, meeting password: vxRvGr6u@46
or to join by phone either day: 1–404–
397–1596.
Dated: August 26, 2024.
LaTonya L. Small,
Federal Advisory Committee Management
Officer.
[FR Doc. 2024–19472 Filed 8–29–24; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
Advisory Committee on Tribal and
Indian Affairs, Notice of Meeting
The Department of Veterans Affairs
(VA) gives notice under the Federal
Advisory Committee Act, 5 U.S.C. ch.
10., that the Advisory Committee on
Tribal and Indian Affairs will meet on
September 24 through September 26,
2024 at the VA Central Office, 811
Vermont Ave NW, Washington, DC
20571. The meeting sessions will begin,
and end as follows:
Dates

Times

September 24, 2024 ..

9:00 a.m. to 5:00 p.m.—
Eastern Daylight Time
(EDT).
9:00 a.m. to 5:00 p.m. EDT.
9:00 a.m. to 12:00 p.m.
EDT.

September 25, 2024 ..
September 26, 2024 ..

The meeting sessions will be open to
the public.
The purpose of the Committee is to
advise the Secretary on all matters
relating to Indian tribes, tribal
organizations, Native Hawaiian
organizations, and Native American
Veterans. This includes advising the
Secretary on the administration of
healthcare services and benefits to
American Indian/Alaska Natives (AI/
AN) and Native Hawaiian Veterans;
thereby assessing those needs and
whether VA is meeting them.
On September 24, 2024, the agenda
will include opening remarks from the
Committee Chair, Executive Sponsor,
and other VA officials. There will be
remarks by the VA Deputy Secretary
Tanya Bradsher, updates from the VA
Office of Tribal Government Relations,
VA Office of Tribal Health, VA Office of
Behavioral Health/Suicide Prevention,
panel discussions with Veteran
advocates and Federal partners, and an
update from the VA Tribal
Representation Expansion Project. To

E:\FR\FM\30AUN1.SGM

30AUN1


File Typeapplication/pdf
File Modified2024-08-30
File Created2024-08-30

© 2024 OMB.report | Privacy Policy