99-14939. Submission for OMB Review; Comment Request

[Federal Register Volume 64, Number 113 (Monday, June 14, 1999)]
[Notices]
[Pages 31826-31827]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-14939]


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DEPARTMENT OF DEFENSE

Office of the Secretary


Submission for OMB Review; Comment Request

ACTION: Notice.

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    The Department of Defense has submitted to OMB for clearance, the 
following proposal for collection of information under the provisions 
of the Paperwork Reduction Act (44 U.S.C. Chapter 35).
    Title, Form Number, and OMB Number: TRICARE Senior Prime Enrollment 
Application Form; OMB Number 0720-0018.
    Type of Request: Reinstatement.
    Number of Respondents: 12,000.
    Responses Per Respondent: 1.
    Annual Responses: 12,000.
    Average Burden Per Response: 20 minutes.
    Annual Burden Hours: 4,000.
    Needs and Uses: This information collection is a requirement for 
TRICARE Senior Prime, a joint demonstration project of military managed 
health care conducted by the Department of Defenses (DoD) and the 
Department of Health and Human Services (HHS). Under this 
demonstration, authorized by the Balanced Budget Act of 1997, DoD will 
offer Medicare-eligible military retirees and their dependents 
enrollment in a DoD-operated managed health care program. Medicare-
eligible beneficiaries will be offered the

[[Page 31827]]

opportunity to enroll at selected Medical Treatment Facilities (MTFs) 
in a managed care program modeled after the existing TRICARE Prime 
benefit. Medicare will reimburse DoD on a capitated basis for health 
care services it provides to the enrolled beneficiaries. Dual-eligible 
beneficiaries seeking enrollment in the program will be required to 
fill out an enrollment application which will provide information 
pertaining to eligibility for the program, personal information for 
identification purposes, and information on other health insurance.
    Affected Public: Individuals or households.
    Frequency: On occasion.
    Respondents Obligation: Required to obtain or retain benefits.
    OMB Desk Officer: Ms. Allison Eydt.
    Wrtten comments and recommendations on the proposed information 
collection should be sent to Ms. Eydt at the Office of Management and 
Budget, Desk Officer for DoD Health Affairs, Room 10235, New Executive 
Office Building, Washington, DC 20503.
    DOD Clearance Officer: Mr. Robert Cushing.
    Written requests for copies of the information collection proposal 
should be sent to Mr. Cushing, WHS/DIOR, 1215 Jefferson Davis Highway, 
Suite 1204, Arlington, VA 22202-4302.

    Dated: June 7, 1999.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 99-14939 Filed 6-11-99; 8:45 am]
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