30-day FRN - FMP Registration Form & Claim Cover Sheet - published

30-day FRN_FMP Registration Form & Claim Cover Sheet_11182020.pdf

Foreign Medical Program (FMP) Registration Form and Claim Cover Sheet

30-day FRN - FMP Registration Form & Claim Cover Sheet - published

OMB: 2900-0648

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73596

Federal Register / Vol. 85, No. 223 / Wednesday, November 18, 2020 / Notices

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exemptions are applicable as of
December 10, 2020, and will expire on
December 10, 2022.
As of December 20, 2020, and in
accordance with 49 U.S.C. 31136(e) and
31315, the following two individuals
have satisfied the renewal conditions for
obtaining an exemption from the vision
requirement in the FMCSRs for
interstate CMV drivers (77 FR 64839; 77
FR 75494; 79 FR 73393; 81 FR 96180;
84 FR 2326):
Noah E. Bowen (OH); and Emin Toric
(GA)
The drivers were included in docket
number FMCSA–2012–0280. Their
exemptions are applicable as of
December 20, 2020, and will expire on
December 20, 2022.
As of December 25, 2020, and in
accordance with 49 U.S.C. 31136(e) and
31315, the following two individuals
have satisfied the renewal conditions for
obtaining an exemption from the vision
requirement in the FMCSRs for
interstate CMV drivers (79 FR 69985; 80
FR 8927; 81 FR 96180; 84 FR 2326):
Thurman T. Clayton (LA); and Tig G.
Cornell (ID)
The drivers were included in docket
number FMCSA–2014–0298. Their
exemptions are applicable as of
December 25, 2020, and will expire on
December 25, 2022.
As of December 30, 2020, and in
accordance with 49 U.S.C. 31136(e) and
31315, the following individual has
satisfied the renewal conditions for
obtaining an exemption from the vision
requirement in the FMCSRs for
interstate CMV drivers (81 FR 86063; 82
FR 12683; 84 FR 2326):
Michal Golebiowski (IL)
The driver was included in docket
number FMCSA–2016–0212. Their
exemption is applicable as of December
30, 2020, and will expire on December
30, 2022.
V. Conditions and Requirements
The exemptions are extended subject
to the following conditions: (1) Each
driver must undergo an annual physical
examination (a) by an ophthalmologist
or optometrist who attests that the
vision in the better eye continues to
meet the requirements in 49 CFR
391.41(b)(10), and (b) by a certified
medical examiner (ME), as defined by
§ 390.5, who attests that the driver is
otherwise physically qualified under
§ 391.41; (2) each driver must provide a
copy of the ophthalmologist’s or
optometrist’s report to the ME at the
time of the annual medical examination;
and (3) each driver must provide a copy
of the annual medical certification to
the employer for retention in the

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driver’s qualification file or keep a copy
of his/her driver’s qualification if he/her
is self-employed. The driver must also
have a copy of the exemption when
driving, for presentation to a duly
authorized Federal, State, or local
enforcement official. The exemption
will be rescinded if: (1) The person fails
to comply with the terms and
conditions of the exemption; (2) the
exemption has resulted in a lower level
of safety than was maintained before it
was granted; or (3) continuation of the
exemption would not be consistent with
the goals and objectives of 49 U.S.C.
31136(e) and 31315(b).
VI. Preemption
During the period the exemption is in
effect, no State shall enforce any law or
regulation that conflicts with this
exemption with respect to a person
operating under the exemption.
VII. Conclusion
Based upon its evaluation of the 63
exemption applications, FMCSA renews
the exemptions of the aforementioned
drivers from the vision requirement in
391.41(b)(10), subject to the
requirements cited above. In accordance
with 49 U.S.C. 31136(e) and 31315(b),
each exemption will be valid for 2 years
unless revoked earlier by FMCSA.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2020–25358 Filed 11–17–20; 8:45 am]
BILLING CODE 4910–EX–P

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0648]

Agency Information Collection Activity
Under OMB Review: Foreign Medical
Program (FMP) Registration Form and
Claim Cover Sheet
Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:

In compliance with the
Paperwork Reduction Act (PRA) of
1995, this notice announces that the
Veterans Health Administration,
Department of Veterans Affairs, will
submit 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, and it includes the
actual data collection instrument.

SUMMARY:

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Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function. Refer to ‘‘OMB Control
No. 2900–0648.
FOR FURTHER INFORMATION CONTACT:
Danny S. Green, Office of Quality,
Performance and Risk (OQPR),
Department of Veterans Affairs, 810
Vermont Avenue NW, Washington, DC
20420, (202) 421–1354 or email
danny.green2@va.gov Please refer to
‘‘OMB Control No. 2900–0648’’ in any
correspondence.
DATES:

SUPPLEMENTARY INFORMATION:

Authority: 44 U.S.C. 3501–21.
Title: Foreign Medical Program (FMP)
Registration Form and Claim Cover
Sheet (VA Forms 10–7959f–1, 10–
7959f–2)
OMB Control Number: 2900–0648.
Type of Review: Reinstatement
without change of a previously
approved collection.
Abstract: The Foreign Medical
Program (FMP) is a federal health
benefits program for Veterans, which is
administered by the Department of
Veterans Affairs (VA) Veterans Health
Administration (VHA). The FMP is a
Fee for Service (indemnity plan)
program and provides reimbursement
for VA adjudicated service-connected
conditions. Title 38 CFR 17.35 states
that VA will provide coverage for the
Veteran’s service-connected disability
when the Veteran is residing or
traveling overseas. Title 38 CFR
17.125(c) states that requests for
consideration of claim reimbursement
from approved health care providers
and Veterans are to be mailed to VHA
Health Administration Center.
VA currently collects information for
FMP reimbursement through an OMB
approved collection under 2900–0648,
using VA Form 10–7959f–1, Foreign
Medical Program (FMP) Registration
Form, and VA Form 10–7959f–2,
Foreign Medical Program Claim Cover
Sheet. This collection of information is
necessary to continue to reimburse
Veterans or providers under the FMP.
a. VA Form 10–7959f–1 will collect
information used to register into the
FMP those Veterans with serviceconnected disabilities who are living or
traveling overseas.
b. VA Form 10–7959f–2 will collect
information to streamline the FMP
claims submission process for claimants
or providers, while also reducing the

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Federal Register / Vol. 85, No. 223 / Wednesday, November 18, 2020 / Notices

khammond on DSKJM1Z7X2PROD with NOTICES

time spent by VA on processing FMP
claims. The cover sheet will explain to
foreign providers and Veterans the basic
information required for the processing
and payment of claims.
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 at 85 FR
82 on April 28, 2020, pages 23603 and
23604.

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VA Form 10–7959f–1
Affected Public: Individuals and
households.
Estimated Annual Burden: 111 hours.
Estimated Average Burden per
Respondent: 4 minutes.
Frequency of Response: Once
annually.
Estimated Number of Respondents:
1,660.
VA Form 10–7959f–2
Affected Public: Individuals or
households; private sector.

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73597

Estimated Annual Burden: 3,652
hours.
Estimated Average Burden per
Respondent: 11 minutes.
Frequency of Response: 12 times
annually.
Estimated Number of Respondents:
1,660.
By direction of the Secretary.
Danny S. Green,
Interim VA Clearance Officer, Office of
Quality, Performance and Risk (OQPR),
Department of Veterans Affairs.
[FR Doc. 2020–25404 Filed 11–17–20; 8:45 am]
BILLING CODE 8320–01–P

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