Expanded Access to Non-VA Care Through the Mission Act: Veterans Community Care Program (VCCP)

ICR 202008-2900-001

OMB: 2900-0823

Federal Form Document

ICR Details
2900-0823 202008-2900-001
Received in OIRA 202005-2900-018
VA 2900-0823
Expanded Access to Non-VA Care Through the Mission Act: Veterans Community Care Program (VCCP)
Reinstatement without change of a previously approved collection   No
Regular 03/01/2021
  Requested Previously Approved
36 Months From Approved
22,758,371 0
3,007,560 0
0 0

Section 101 of the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018 requires VA to implement the Veterans Community Care Program (VCCP) to furnish care in the community to covered Veterans through eligible entities and providers, under circumstances as further prescribed in the MISSION Act. VA currently collects information that will be required to implement the Veterans Community Care Program under the Veterans Choice Program, through an OMB approved collection 2900-0823. OMB collection 2900-0823 includes VA Form 10-10143, Election to Receive Authorized Non-VA Care and Selection of Provider for the Veterans Choice Program; VA Form 10-10143a, Health-Care Plan Information for the Veterans Choice Program; VA Form 10-10143b, Submission of Medical Record Information under the Veterans Choice Program; VA Form 10-10143c, Submission of Information on Credentials and Licenses by Eligible Entities and Providers; VA Form 10-10143e, Secondary Authorization Request for VA Community Care; and VA Form 10-10143f, Community Care Document Cover Sheet. A new form is being added to this collection: VA Form 10-10143g, Non-VA Hospital Emergency Notification.

PL: Pub.L. 115 - 182 101 Name of Law: VA MISSION Act of 2018
  
PL: Pub.L. 115 - 182 101 Name of Law: VA MISSION Act of 2018

Not associated with rulemaking

  85 FR 49720 08/14/2020
85 FR 77487 12/02/2020
No

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 22,758,371 0 0 0 0 22,758,371
Annual Time Burden (Hours) 3,007,560 0 0 0 0 3,007,560
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    Yes
No
No
No
Yes
Frances O'Donnell 703 405-2449 fran.odonnell@cathexiscorp.com

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/01/2021


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