Agency Information Collection Activities Under OMB Review

DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0188]

Agency Information Collection Activities Under OMB Review

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995

(44 U.S.C., 3501 et seq.), this notice announces that the Veterans

Health Administration (VHA), Department of Veterans Affairs, has

submitted the collection of information abstracted below to the Office

of Management and Budget (OMB) for review and comment. The PRA

submission describes the nature of the information collection and its

expected cost and burden; it includes the actual data collection

instrument.

DATES: Comments must be submitted on or before May 6, 1998.

FOR FURTHER INFORMATION OR A COPY OF THE SUBMISSION CONTACT: Ron

Taylor, Information Management Service (045A4), Department of Veterans

Affairs, 810 Vermont Avenue, NW, Washington, DC 20420, (202)273-8015 or

FAX (202)273-5981. Please refer to ``OMB Control No. 2900-0188.''

SUPPLEMENTARY INFORMATION:

Title: Prescription, Authorization, Application, Procurement,

Repair and Loan of Prosthetic Items.

Form Numbers:

a. VA Form 10-2421, Prosthetic Authorization for Items or Service.

b. VA Form 10-2520, Prosthetic Service Card Invoice.

c. VA Form 10-2914, Prescription and Authorization for Eyeglasses.

d. Form Letter 10-90, Request to Submit Estimate.

e. Form Letter 10-426, Loan Follow-up Letter.

f. VA Form 10-1394, Loan Follow-up Letter.

OMB Control Number: 2900-0188.

Type of Review: Extension of a currently approved collection.

Abstract:

a. VA Form 10-2421 is used for the direct procurement of new

prosthetic appliances and/or services and standardizes the direct

procurement authorization process. The form eliminates the need for

separate purchase orders, expedites patient treatment and improves the

delivery of prosthetic services. Without this form the delivery time

for prosthetic appliances and services would be drastically increased.

b. VA Form 10-2520 is used by the commercial vendors, after

completing repairs authorized for veterans, to request payment by VA.

The use of the form standardizes repair/treatment invoices for

prosthetic services rendered and standardizes the verification of these

invoices. The veteran certifies that the repairs were necessary and

satisfactory. This form is furnished to vendors upon request.

c. VA Form 10-2914 is used as a combination prescription,

authorization and invoice. It allows veterans to purchase their

eyeglasses directly. If the form is not used, the provisions of

providing eyeglasses to eligible veterans may be delayed.

d. Form Letter 10-90 is issued to a contractor of the veteran's

choice in order to solicit a price quote for a prosthetic device.

e. Form Letter 10-426 is used for the issuance of prosthetic

devices that are loaned to eligible veterans. If the information is not

collected or maintained, VA would have no information regarding

equipment loaned to veterans; i.e., status, recovery, replacement and

disposition.

f. VA Form 10-1394 is used to determine eligibility/entitlement and

reimbursement of individual claims for automotive adaptive equipment.

An agency may not conduct or sponsor, and a person is not required

to respond to a collection of information unless it displays a

currently valid OMB control number. The Federal Register Notice with a

60-day comment period soliciting comments on this collection of

information was published on December 31, 1997 at page 68359.

Affected Public: Business or other for-profit--Individuals or

households.

Estimated Total Annual Burden: 36,496 hours.

a. VA Form 10-2421--16,667 hours.

b. VA Form 10-2520--3,334 hours.

c. VA Form 10-2914--11,667 hours.

d. Form Letter 10-90--1,875 hours.

e. Form Letter 10-426--242 hours.

f. VA Form 10-1394--2,711 hours.

Estimated Average Burden Per Respondent:

a. VA Form 10-2421--4 minutes.

b. VA Form 10-2520--5 minutes.

c. VA Form 10-2914--4 minutes.

d. Form Letter 10-90--5 minutes.

e. Form Letter 10-426--1 minute.

f. VA Form 10-1394--15 minutes.

Frequency of Response: On occasion.

Estimated Number of Respondents: 512,844.

a. VA Form 10-2421--250,000.

b. VA Form 10-2520--40,000.

c. VA Form 10-2914--175,000.

d. Form Letter 10-90--22,500.

e. Form Letter 10-426--14,500.

f. VA Form 10-1394--10,844.

Send comments and recommendations concerning any aspect of the

information collection to VA's OMB Desk Officer, Allison Eydt, OMB

Human Resources and Housing Branch, New Executive Office Building, Room

10235, Washington, DC 20503 (202) 395-4650. Please refer to ``OMB

Control No. 2900-0188'' in any correspondence.

By direction of the Secretary.

Dated: March 10, 1998.

Barbara H. Epps,

Management Analyst, Information Management Service.

[FR Doc. 98-8889 Filed 4-3-98; 8:45 am]

BILLING CODE 8320-01-M