Skip to Content


Proposed Collection, Comment Request

Document Details

Information about this document as published in the Federal Register.

Published Document

This document has been published in the Federal Register. Use the PDF linked in the document sidebar for the official electronic format.

Start Preamble


Office of the Assistant Secretary of Defense for Health Affairs, DoD.



In accordance with Section 3506(c) of the Paperwork Reduction Act of 1995, the Office of the Assistant Secretary of Defense for Health Affairs announces the proposed extension of a public information collection and seeks public comment on the provisions thereof. Comments are invited on: (a) Whether the proposed extension of collection of information is necessary for the proper performance of the functions of the 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.


Considerations will be given to all comments received on or before July 2, 2007.


You may submit comments, identified by docket number and title, by any of the following methods:

  • Federal eRulemaking Portal: http://www/​ Follow the instructions for submitting comments.
  • Mail: Federal Docket Management System Office, 1160 Defense Pentagon, Washington, DC 20301-1160.

Instructions: All submissions received must include the agency name, docket number and title for this Federal Register document. The general policy for comments and other submissions from members of the public is to make these submissions available for public viewing on the Internet at as they are received, without change, including any personal identifiers or contact information.

Start Further Info


To request more information on this proposed information collection, please write to the TRICARE Management Activity—Aurora, Appeals, Hearings and Claims Collection Division, 16401 E. Centretech Pkwy, Attn: Donald F. Wagner, Aurora, CO 80011-9066, or Start Printed Page 24570telephone Donald F. Wagner, TRICARE Management Activity, Appeals, Hearings and Claims Collection Division at (303) 676-3411.

Title, Associated Form, and OMB Number: Professional Qualifications Medical/Peer Reviewers; CHAMPUS Form 780; OMB Number 0720-0005.

Needs and Uses: The information collection requirement is necessary to obtain and record the professional qualifications of medical and peer reviewers utilized within TRICARE. The form is included as an exhibit in an appeal or hearing case file as evidence of the reviewer's professional qualifications to review the medical documentation contained in the case file.

Affected Public: Business or other for-profit.

Annual Burden Hours: 15.

Annual Number of Respondents: 60.

Responses per Respondent: 1.

Average Burden per Response: 15 minutes.

Frequency: On occasion.

End Further Info End Preamble Start Supplemental Information


Summary of Information Collection

Respondents are medical professionals who provide medical and peer review of cases appealed to the Office of Appeals, Hearings and Claims Collection Division, TRICARE Management Activity. CHAMPUS Form 780 records the professional qualifications of the medical/peer reviewer. The completed form is included as an exhibit in the appeal or hearing case file, and documents, for anyone reviewing the file, the professional qualifications of the medical professional who reviews the case. If the form is not included in the case file, individuals reviewing the file will not have ready access to the qualifications of the reviewing medical professional. Having qualified professionals provide medical and peer review is essential in maintaining the integrity of the appeal and hearing process.

Start Signature

Dated: April 23, 2007.

Patricia L. Toppings,

Alternate OSD Federal Register Liaison Officer, Department of Defense.

End Signature End Supplemental Information

[FR Doc. 07-2165 Filed 5-2-07; 8:45 am]