View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0720-0060
ICR Reference No:
201812-0720-003
Status:
Historical Active
Previous ICR Reference No:
201507-0720-001
Agency/Subagency:
DOD/DODOASHA
Agency Tracking No:
0720-0060
Title:
Assistance Reporting Tool (ART)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/15/2019
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/07/2019
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2022
36 Months From Approved
03/31/2019
Responses
174,385
0
169,606
Time Burden (Hours)
43,596
0
42,402
Cost Burden (Dollars)
316,078
0
307,416
Abstract:
The ART is a secure web-based system that captures feedback on and authorizations related to TRICARE benefits. Personal health and personally identifiable information entered into ART is voluntarily provided by individuals via a verbal or written exchange and is only collected to facilitate case resolution, capture medical authorization determinations, and approve line of duty care and care under the Transitional Care for Service-related Conditions benefit. Respondents include individuals who have TRICARE-related questions or issues.
Authorizing Statute(s):
US Code:
10 USC 55
Name of Law: Medical and Dental Care
US Code:
38 USC 17
Name of Law: Hospital, Nursing Home, Domiciliary, and Medical Care
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
83 FR 53619
10/24/2018
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 66683
12/27/2018
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Assistance Reporting Tool (ART)
ICR Summary of Burden
Total Approved
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
174,385
169,606
0
0
4,779
0
Annual Time Burden (Hours)
43,596
42,402
0
0
1,194
0
Annual Cost Burden (Dollars)
316,078
307,416
0
0
8,662
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Total burden has increased due to an estimated 28% rise in caseload processed through the Assistance Reporting Tool (ART).
Annual Cost to Federal Government:
$370,252
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Kira Starks 571 372-4529 danikquia.k.starks.ctr@mail.mil
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
01/07/2019
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