[Federal Register: February 8, 2005 (Volume 70, Number 25)]
[Notices]
[Page 6634-6635]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr08fe05-39]
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DEPARTMENT OF DEFENSE
Office of the Secretary
Proposed Collection; Comment Request
AGENCY: DoD, Office of the Assistant Secretary of Defense for Health
Affairs.
ACTION: Notice.
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In accordance with section 3506(c)(2)(A) of the Paperwork Reduction
act of 1995, the Office of the Assistant Secretary of Defense for
Health Affairs announces a proposed public information collection and
seeks public comment on the provisions thereof. Comments are invited
on: (a) Whether the new collection of information is necessary for the
proper performance of the functions of the
[[Page 6635]]
agency, including whether the information shall have practical utility;
(b) the accuracy of the agency's estimate of the burden of the
information collection; (c) ways to enhance the quality, utility, and
clarity of the information to be collected; and (d) ways to minimize
the burden of the information collection on respondents, including
through the use of automated collection techniques or other forms of
information technology.
DATES: Consideration will be given to all comments received April 11,
2005.
ADDRESSES: Written comments and recommendations on the information
collection should be sent to Office of the Assistant Secretary of
Defense (Health Affairs) TRICARE Management Activity, Skyline Five,
Suite 810, 5111 Leesburg Pike, Falls Church, Virginia 22041-3206, Attn:
Ms. Gita Uppal.
FOR FURTHER INFORMATION CONTACT: To request more information on this
proposed information collection, please write to the above address or
call Ms. Uppal, Office of the Assistant Secretary of Defense (Health
Affairs), TRICARE Management Activity at (703) 681-0039.
Title; Associated Form; and OMB Number: TRICARE Plus Enrollment
Application, DD Form 2853 and TRICARE Plus Disenrollment Request, DD
Form 2854; OMB Number 0720-0028.
Needs and Uses: These collected instruments serve as an application
for enrollment and disenrollment in the Department of Defense's TRICARE
Plus Health Plan established in accordance with Title 10 U.S.C.
sections 1099 (which calls for a healthcare enrollment system) and 1086
(which authorizes TRICARE eligibility of Medicare Eligible Persons and
has resulted in the development of a new enrollment option called
TRICARE Plus) and the Assistant Secretary of Defense for Health Affairs
Policy Memorandum to Establish the TRICARE Plus Program, June 22, 2001.
The information collected hereby provides the TRICARE contractors with
necessary data to determine beneficiary eligibility and to identify the
selection of a health care option.
Affected Public: Individuals or household.
Annual Burden Hours: 2,933.
Number of Respondents: 25,065
Responses Per Respondent: 1.
Average Burden Per Response: 7 minutes.
Frequency: On occasion.
SUPPLEMENTARY INFORMATION:
Summary of Collection
The Department of Defense established TRICARE Plus as an enrollment
option for persons who are eligible for care in Military Treatment
Facilities (MTF) and not enrolled in TRICARE Prime. TRICARE Plus
provides an opportunity to enroll with a primary care provider at a
specific MTF, to the extent capacity exists. This is a way to
facilitate primary care appointments at an MTF when needed. TRICARE
Plus enrollment will help MTFs maintain an adequate clinical case mix
for Graduate Medical Education programs and support readiness-related
medical skills sustainment activities. In order to carry out this
program, it is necessary that certain beneficiaries electing to enroll/
disenroll in TRICARE Plus complete an enrollment application/
disenrollment request. Completion of the enrollment forms is an
essential element of the TRICARE program. There is no lock-in and no
enrollment fee for TRICARE Plus.
Dated: January 19, 2005.
Patricia Toppings,
Alternative OSD Federal Register Liaison Officer, Department of Defense
[FR Doc. 05-2382 Filed 2-7-05; 8:45 am]
BILLING CODE 5001-06-M