[Federal Register Volume 64, Number 246 (Thursday, December 23, 1999)]
[Notices]
[Pages 72144-72145]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-33249]
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0335]
Proposed Information Collection Activity: Proposed Collection;
Comment Request
AGENCY: Veterans Health Administration, Department of Veterans Affairs.
ACTION: Notice.
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SUMMARY: The Veterans Health Administration (VHA) 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 reinstatement, without change, of a previously approved
collection for which approval has expired, and allow 60 days for public
comment in response to the notice. This notice solicits comments on the
information needed to authorize a veteran to seek a private dentist for
dental examination and treatment plan and to authorize payment for such
dental services.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before February 22, 2000.
ADDRESSES: Submit written comments on the collection of information to
Ann Bickoff, Veterans Health Administration (191A1), Department of
Veterans Affairs, 810 Vermont Avenue, NW, Washington, DC 20420. Please
refer to ``OMB Control No. 2900-0335'' in any correspondence.
FOR FURTHER INFORMATION CONTACT: Ann Bickoff at (202) 273-8310.
SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44
U.S.C., 3501-3520), 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 and Form Number: Dental Record Authorization and Invoice for
Outpatient Services, VA Form 10-2570d.
OMB Control Number: 2900-0335.
Type of Review: Reinstatement, without change, of a previously
approved collection for which approval has expired.
Abstract: VA Form 10-2570d is used to serve the following multi-
purposes: (1) VA authorization to the veteran to seek a private dentist
for examination; (2) Fee dentist's record of examination
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findings; (3) Dentist's treatment plan and listing of services needed;
(4) Listing of dentist's usual and customary fees for specific services
involved in treatment plan; (5) VA review, verification and
authorization of treatment to the fee dentist; (6) Dentist's
certification of services completed; (7) VA's permanent record of
treatment provided for veterans and statement of exhaustion of
benefits, if indicated; VA's approval of dental services and total fees
for payment; and (8) Fiscal approval and certification of payment and
amount. Without this information, veterans' dental treatment needs
could not be identified, fees for services could not be established,
the veterans could not receive treatment, and the fee dentist could not
be reimbursed.
Affected Public: Business or other for profit.
Estimated Total Annual Burden: 14,333 hours.
Estimated Average Burden Per Respondent: 20 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 43,000.
Dated: December 3, 1999.
By direction of the Secretary.
Sandra McIntyre,
Program Analyst, Information Management Service.
[FR Doc. 99-33249 Filed 12-22-99; 8:45 am]
BILLING CODE 8320-01-P
