89 FR 57 pgs. 20537-20538 - Agency Information Collection Activity: VA Health Benefits: Application, Update, Hardship Determination
Type: NOTICEVolume: 89Number: 57Pages: 20537 - 20538
Pages: 20537, 20538Docket number: [OMB Control No. 2900–0091]
FR document: [FR Doc. 2024–06065 Filed 3–21–24; 8:45 am]
Agency: Veterans Affairs Department
Official PDF Version: PDF Version
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0091]
Agency Information Collection Activity: VA Health Benefits: Application, Update, Hardship Determination
AGENCY:
Veterans Health Administration, Department of Veterans Affairs.
ACTION:
Notice.
SUMMARY:
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:
Written comments and recommendations on the proposed collection of information should be received on or before May 21, 2024.
ADDRESSES:
Submit written comments on the collection of information through Federal Docket Management System (FDMS) at www.Regulations.gov or to Grant Bennett, Office of Regulations, Appeals, and Policy (10BRAP), Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420 or email to Grant.Bennett@va.gov. Please refer to "OMB Control No. 2900-0091" in any correspondence. During the comment period, comments may be viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT:
Dorothy Glasgow, Office of Enterprise and Integration, Data Governance Analytics (008), 810 Vermont Avenue NW, Washington, DC 20420, (202) 461-1084 or email dorothy.glasgow@va.gov. Please refer to "OMB Control No. 2900-0091" in any correspondence.
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.
Authority: Public Law 104-13; 44 U.S.C. 3501-3521.
Title: VA Health Benefits: Application, Update, Hardship Determination (VA Forms 10-10EZ, 10-10EZR and 10-10HS).
OMB Control Number: 2900-0091.
Type of Review: Revision of a currently approved collection.
[top] Abstract: Title 38 U.S.C. chapter 17 authorizes VA to provide hospital care, medical services, domiciliary care, and nursing home care to eligible Veterans. Title 38 U.S.C. 1705 requires VA to design, establish, and operate a system of annual patient enrollment in accordance with a series of stipulated priorities. Title 38 U.S.C. 1722 establishes eligibility assessment procedures for cost-free VA medical care, based on income levels, which determines whether nonservice-connected and 0% service-connected non-compensable Veterans are able to defray the necessary expenses of care for nonservice-connected conditions. Further, when the Veteran projects that their attributable income for the current calendar year would be substantially below the applicable income thresholds, the Veteran would be considered unable
This collection of information is required to properly administer health benefits to eligible Veterans.
a. VA Form 10-10EZ, Application for Health Benefits, is used to collect Veteran information during the initial application process for VA medical care, nursing home, domiciliary, dental benefits, etc. Updates were made to this form pursuant to section 103 of the PACT Act to collect additional information in the Military Service section for the expanded TERA health care eligibility benefit. Corresponding changes were made to the Instructions and Definitions sections.
b. VA Form 10-10EZR, Health Benefits Update Form, is used to update a Veteran's personal information, such as marital status, address, health insurance and financial information, for renewal of health benefits. Updates were made to this form pursuant to section 103 of the PACT Act to collect additional information in the Military Service section for the expanded TERA health care eligibility benefit. Corresponding changes were made to the Instructions and Definitions sections.
c. VA Form 10-10HS, Request for Hardship Determination, is used to collect information from Veterans who are in a copay required status for hospital care and medical services, but due to a loss of income project their income for the current year will be substantially below the VA means test limits. No updates were made to this form.
These forms collect information to enroll a Veteran for health benefits, establish basic eligibility, determine TERA benefit eligibility, identify 3rd party health insurance coverage, identify prescription copayment, provide for income verification, and serve as a mechanism to make changes upon admission for benefits or yearly financial updates.
Total Annual Burden: 703,300 hours.
Total Annual Responses: 1,406,000.
VA Form 10-10EZ
Affected Public: Individuals and households.
Estimated Annual Burden: 315,000 hours.
Estimated Average Burden per Respondent: 35 minutes.
Frequency of Response: Annually.
Estimated Number of Respondents: 540,000.
VA Form 10-10EZR
Affected Public: Individuals and households.
Estimated Annual Burden: 386,550 hours.
Estimated Average Burden per Respondent: 27 minutes.
Frequency of Response: Annually.
Estimated Number of Respondents: 859,000.
VA Form 10-10HS
Affected Public: Individuals and households.
Estimated Annual Burden: 1,750 hours.
Estimated Average Burden per Respondent: 15 minutes.
Frequency of Response: Annually.
Estimated Number of Respondents: 7,000.
By direction of the Secretary.
Maribel Aponte,
VA PRA Clearance Officer, Office of Enterprise and Integration/Data Governance Analytics, Department of Veterans Affairs.
[FR Doc. 2024-06065 Filed 3-21-24; 8:45 am]
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