Agency Information Collection Activities: Submission for OMB Review; Comment Request, 41488-41497 [2010-17400]

Download as PDF 41488 Federal Register / Vol. 75, No. 136 / Friday, July 16, 2010 / Notices srobinson on DSKHWCL6B1PROD with NOTICES an NDMC to enrollees upon denial, in whole or in part, of an enrollee’s coverage request. This denial may be subject to a series of administrative review levels, involving defined steps and timeframes. The NDMC was developed to ensure Medicare enrollees have access to information needed to navigate the Medicare beneficiary appeals process. The NDMC meets requirements for both Medicare’s standard and expedited appeals processes. Medicare health plans provide an NDP to enrollees upon denial, in whole or in part, of payment for a service or item that the enrollee received. This denial may be subject to a series of administrative review levels, involving defined steps and timeframes. The NDP was developed to ensure Medicare enrollees have access to information needed to navigate the Medicare beneficiary appeals process. The NDP meets requirements for Medicare’s standard appeals process. Form Number: CMS–10003 (OMB#: 0938– 0829); Frequency: Yearly; Affected Public: Business or other for-profits and Not-for-profit institutions; Number of Respondents: 740; Total Annual Responses: 1,168,368; Total Annual Hours: 194,728. (For policy questions regarding this collection contact Stephanie Simons at 206–615–2420. For all other issues call 410–786–1326.) 3. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Federal Qualification Application (42 CFR 417.140) and Medicare Health Care Prepayment Plan Application (42 CFR 417.800); Use: The application is the collection form used to obtain information to determine if an applicant meets the regulatory requirements to enter into a contract with CMS as a Federal Qualified health maintenance organization (HMO) or to provide health benefits to Medicare beneficiaries as a Medicare Health Care Prepayment Plan contractor. Form Number: CMS–901A & 901D (OMB#: 0938–0470); Frequency: Once; Affected Public: Business or other for-profits and Not-for-profit institutions; Number of Respondents: 20; Total Annual Responses: 20; Total Annual Hours: 800. (For policy questions regarding this collection VerDate Mar<15>2010 18:00 Jul 15, 2010 Jkt 220001 contact Heidi Arndt at 410–786–1607. For all other issues call 410–786–1326.) To obtain copies of the supporting statement and any related forms for the proposed paperwork collections referenced above, access CMS Web site address at https://www.cms.hhs.gov/ PaperworkReductionActof1995, or email your request, including your address, phone number, OMB number, and CMS document identifier, to Paperwork@cms.hhs.gov, or call the Reports Clearance Office on (410) 786– 1326. To be assured consideration, comments and recommendations for the proposed information collections must be received by the OMB desk officer at the address below, no later than 5 p.m. on August 16, 2010. OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk Officer, Fax Number: (202) 395– 6974, E-mail: OIRA_submission @omb.eop.gov. Dated: July 9, 2010. Michelle Shortt, Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2010–17181 Filed 7–15–10; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Agency Information Collection Activities: Submission for OMB Review; Comment Request Periodically, the Substance Abuse and Mental Health Services Administration (SAMHSA) will publish a summary of information collection requests under OMB review, in compliance with the Paperwork Reduction Act (44 U.S.C. Chapter 35). To request a copy of these documents, call the SAMHSA Reports Clearance Officer on (240) 276–1243. Project: Mandatory Guidelines for Federal Workplace Drug Testing Programs (OMB No. 0930–0158)— Revision SAMHSA’s Mandatory Guidelines for Federal Workplace Drug Testing Programs will request OMB approval for PO 00000 Frm 00059 Fmt 4703 Sfmt 4703 the Federal Drug Testing Custody and Control Form for Federal agency and federally regulated drug testing programs which must comply with the HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs (73 FR 71858) dated November 25, 2008, and for the information provided by laboratories for the National Laboratory Certification Program (NLCP). The Federal Drug Testing Custody and Control Form (Federal CCF) is used by all Federal agencies and employers regulated by the Department of Transportation to document the collection and chain of custody of urine specimens at the collection site, for laboratories to report results, and for Medical Review Officers to make a determination. The current Federal CCF approved by OMB has a November 30, 2011 expiration date. SAMHSA has resubmitted the Federal CCF with revisions to the form for OMB approval. • The first change is to add a new item in Step 1 of Copy 1, which lists the acronyms for the Federal testing authorities under which the specimen is collected. The new Step 1 (d) would read as follows: ‘‘D. Specify Testing Authority: HHS, NRC, DOT—Specify DOT Agency: FMCSA, FAA, FRA, FTA, PHMSA, USCG’’ with a checkbox beside each agency name. • The second change is to revise the Federal CCF Copy 1 to permit use by Instrumented Initial Test Facility (IITF), in addition to laboratories. • The third change is to add the new drug analytes required by the revised Guidelines to the Primary Specimen Report section in Step 5(a) on Copy 1. The new drug analytes are methylenedioxymethamphetamine (MDMA), commonly known as ‘‘ecstasy’’; methyleneamphetamine (MDA), and methylenedioxyethylamphetamine (MDEA). MDA and MDEA are both close chemical analogues of MDMA. • The fourth change is to revise the Medical Review Officer (MRO) reporting sections on Copy 2 for primary specimens (Step 6) and for split specimens (Step 7) to facilitate reporting in accordance with the Guidelines. Below is a copy of the revised Federal CCF: BILLING CODE 4162–20–P E:\FR\FM\16JYN1.SGM 16JYN1 VerDate Mar<15>2010 18:00 Jul 15, 2010 Jkt 220001 PO 00000 Frm 00060 Fmt 4703 Sfmt 4725 E:\FR\FM\16JYN1.SGM 16JYN1 41489 EN16JY10.028</GPH> srobinson on DSKHWCL6B1PROD with NOTICES Federal Register / Vol. 75, No. 136 / Friday, July 16, 2010 / Notices VerDate Mar<15>2010 Federal Register / Vol. 75, No. 136 / Friday, July 16, 2010 / Notices 18:00 Jul 15, 2010 Jkt 220001 PO 00000 Frm 00061 Fmt 4703 Sfmt 4725 E:\FR\FM\16JYN1.SGM 16JYN1 EN16JY10.029</GPH> srobinson on DSKHWCL6B1PROD with NOTICES 41490 VerDate Mar<15>2010 18:00 Jul 15, 2010 Jkt 220001 PO 00000 Frm 00062 Fmt 4703 Sfmt 4725 E:\FR\FM\16JYN1.SGM 16JYN1 41491 EN16JY10.030</GPH> srobinson on DSKHWCL6B1PROD with NOTICES Federal Register / Vol. 75, No. 136 / Friday, July 16, 2010 / Notices VerDate Mar<15>2010 Federal Register / Vol. 75, No. 136 / Friday, July 16, 2010 / Notices 18:00 Jul 15, 2010 Jkt 220001 PO 00000 Frm 00063 Fmt 4703 Sfmt 4725 E:\FR\FM\16JYN1.SGM 16JYN1 EN16JY10.031</GPH> srobinson on DSKHWCL6B1PROD with NOTICES 41492 VerDate Mar<15>2010 18:00 Jul 15, 2010 Jkt 220001 PO 00000 Frm 00064 Fmt 4703 Sfmt 4725 E:\FR\FM\16JYN1.SGM 16JYN1 41493 EN16JY10.032</GPH> srobinson on DSKHWCL6B1PROD with NOTICES Federal Register / Vol. 75, No. 136 / Friday, July 16, 2010 / Notices VerDate Mar<15>2010 Federal Register / Vol. 75, No. 136 / Friday, July 16, 2010 / Notices 18:00 Jul 15, 2010 Jkt 220001 PO 00000 Frm 00065 Fmt 4703 Sfmt 4725 E:\FR\FM\16JYN1.SGM 16JYN1 EN16JY10.033</GPH> srobinson on DSKHWCL6B1PROD with NOTICES 41494 VerDate Mar<15>2010 18:00 Jul 15, 2010 Jkt 220001 PO 00000 Frm 00066 Fmt 4703 Sfmt 4725 E:\FR\FM\16JYN1.SGM 16JYN1 41495 EN16JY10.034</GPH> srobinson on DSKHWCL6B1PROD with NOTICES Federal Register / Vol. 75, No. 136 / Friday, July 16, 2010 / Notices VerDate Mar<15>2010 Federal Register / Vol. 75, No. 136 / Friday, July 16, 2010 / Notices 18:00 Jul 15, 2010 Jkt 220001 PO 00000 Frm 00067 Fmt 4703 Sfmt 4725 E:\FR\FM\16JYN1.SGM 16JYN1 EN16JY10.035</GPH> srobinson on DSKHWCL6B1PROD with NOTICES 41496 41497 Federal Register / Vol. 75, No. 136 / Friday, July 16, 2010 / Notices BILLING CODE 4162–20–C Prior to an inspection, a laboratory is required to submit specific information regarding its laboratory procedures. Collecting this information prior to an inspection allows the inspectors to thoroughly review and understand the laboratory’s testing procedures before arriving at the laboratory. The annual total burden estimates for the Federal Drug Testing Custody and Control Form, the NLCP application, the NLCP inspection checklist, and NLCP recordkeeping requirements are shown in the following table. Burden/ response (hrs.) Form/respondent Number of responses Total annual burden (hrs.) 7,096,000 7,096,000 7,096,000 7,096,000 3 100 50 567,680 496,720 354,800 354,800 9 300 12,500 ........................ ........................ 1,786,809 Written comments and recommendations concerning the proposed information collection should be sent by August 16, 2010 to: SAMHSA Desk Officer, Human Resources and Housing Branch, Office of Management and Budget, New Executive Office Building, Room 10235, Washington, DC 20503; due to potential delays in OMB’s receipt and processing of mail sent through the U.S. Postal Service, respondents are encouraged to submit comments by fax to: 202–395–6974. Dated: July 12, 2010. Dennis O. Romero, Deputy Director, Office of Program Services. [FR Doc. 2010–17400 Filed 7–15–10; 8:45 am] BILLING CODE 4162–20–P VerDate Mar<15>2010 18:00 Jul 15, 2010 Jkt 220001 DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Agency Information Collection Activities: Submission for OMB Review; Comment Request Periodically, the Substance Abuse and Mental Health Services Administration (SAMHSA) will publish a summary of information collection requests under OMB review, in compliance with the Paperwork Reduction Act (44 U.S.C. chapter 35). To request a copy of these documents, call the SAMHSA Reports Clearance Officer on (240) 276–1243. PO 00000 Frm 00068 Fmt 4703 Sfmt 4703 Project: Pretesting of Substance Abuse Prevention and Treatment and Mental Health Services Communication Messages—(OMB No. 0930–0196)— Extension As the Federal agency responsible for developing and disseminating authoritative knowledge about substance abuse prevention, addiction treatment, and mental health services and for mobilizing consumer support and increasing public understanding to overcome the stigma attached to addiction and mental illness, the Substance Abuse and Mental Health Services Administration (SAMHSA) is responsible for development and dissemination of a wide range of education and information materials for E:\FR\FM\16JYN1.SGM 16JYN1 EN16JY10.036</GPH> .08 .07 .05 .05 3.00 3.00 250.00 Total ............................................................................................................................... srobinson on DSKHWCL6B1PROD with NOTICES Custody and Control Form: Donor .................................................................................................................................... Collector ................................................................................................................................ Laboratory ............................................................................................................................. Medical Review Officer ......................................................................................................... Laboratory Application ................................................................................................................. Laboratory Inspection Checklist .................................................................................................. Laboratory Recordkeeping ..........................................................................................................

Agencies

[Federal Register Volume 75, Number 136 (Friday, July 16, 2010)]
[Notices]
[Pages 41488-41497]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-17400]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

    Periodically, the Substance Abuse and Mental Health Services 
Administration (SAMHSA) will publish a summary of information 
collection requests under OMB review, in compliance with the Paperwork 
Reduction Act (44 U.S.C. Chapter 35). To request a copy of these 
documents, call the SAMHSA Reports Clearance Officer on (240) 276-1243.

Project: Mandatory Guidelines for Federal Workplace Drug Testing 
Programs (OMB No. 0930-0158)--Revision

    SAMHSA's Mandatory Guidelines for Federal Workplace Drug Testing 
Programs will request OMB approval for the Federal Drug Testing Custody 
and Control Form for Federal agency and federally regulated drug 
testing programs which must comply with the HHS Mandatory Guidelines 
for Federal Workplace Drug Testing Programs (73 FR 71858) dated 
November 25, 2008, and for the information provided by laboratories for 
the National Laboratory Certification Program (NLCP).
    The Federal Drug Testing Custody and Control Form (Federal CCF) is 
used by all Federal agencies and employers regulated by the Department 
of Transportation to document the collection and chain of custody of 
urine specimens at the collection site, for laboratories to report 
results, and for Medical Review Officers to make a determination. The 
current Federal CCF approved by OMB has a November 30, 2011 expiration 
date. SAMHSA has resubmitted the Federal CCF with revisions to the form 
for OMB approval.
     The first change is to add a new item in Step 1 of Copy 1, 
which lists the acronyms for the Federal testing authorities under 
which the specimen is collected. The new Step 1 (d) would read as 
follows: ``D. Specify Testing Authority: HHS, NRC, DOT--Specify DOT 
Agency: FMCSA, FAA, FRA, FTA, PHMSA, USCG'' with a checkbox beside each 
agency name.
     The second change is to revise the Federal CCF Copy 1 to 
permit use by Instrumented Initial Test Facility (IITF), in addition to 
laboratories.
     The third change is to add the new drug analytes required 
by the revised Guidelines to the Primary Specimen Report section in 
Step 5(a) on Copy 1. The new drug analytes are 
methylenedioxymethamphetamine (MDMA), commonly known as ``ecstasy''; 
methyleneamphetamine (MDA), and methylenedioxyethylamphetamine (MDEA). 
MDA and MDEA are both close chemical analogues of MDMA.
     The fourth change is to revise the Medical Review Officer 
(MRO) reporting sections on Copy 2 for primary specimens (Step 6) and 
for split specimens (Step 7) to facilitate reporting in accordance with 
the Guidelines.
    Below is a copy of the revised Federal CCF:
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BILLING CODE 4162-20-C
    Prior to an inspection, a laboratory is required to submit specific 
information regarding its laboratory procedures. Collecting this 
information prior to an inspection allows the inspectors to thoroughly 
review and understand the laboratory's testing procedures before 
arriving at the laboratory.
    The annual total burden estimates for the Federal Drug Testing 
Custody and Control Form, the NLCP application, the NLCP inspection 
checklist, and NLCP recordkeeping requirements are shown in the 
following table.

----------------------------------------------------------------------------------------------------------------
                                                                      Burden/
                         Form/respondent                             response        Number of     Total annual
                                                                      (hrs.)         responses    burden  (hrs.)
----------------------------------------------------------------------------------------------------------------
Custody and Control Form:
    Donor.......................................................             .08       7,096,000         567,680
    Collector...................................................             .07       7,096,000         496,720
    Laboratory..................................................             .05       7,096,000         354,800
    Medical Review Officer......................................             .05       7,096,000         354,800
Laboratory Application..........................................            3.00               3               9
Laboratory Inspection Checklist.................................            3.00             100             300
Laboratory Recordkeeping........................................          250.00              50          12,500
                                                                 -----------------------------------------------
        Total...................................................  ..............  ..............       1,786,809
----------------------------------------------------------------------------------------------------------------

    Written comments and recommendations concerning the proposed 
information collection should be sent by August 16, 2010 to: SAMHSA 
Desk Officer, Human Resources and Housing Branch, Office of Management 
and Budget, New Executive Office Building, Room 10235, Washington, DC 
20503; due to potential delays in OMB's receipt and processing of mail 
sent through the U.S. Postal Service, respondents are encouraged to 
submit comments by fax to: 202-395-6974.

    Dated: July 12, 2010.
Dennis O. Romero,
Deputy Director, Office of Program Services.
[FR Doc. 2010-17400 Filed 7-15-10; 8:45 am]
BILLING CODE 4162-20-P
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