Agency Forms Undergoing Paperwork Reduction Act Review, 29246-29247 [2011-12467]
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29246
Federal Register / Vol. 76, No. 98 / Friday, May 20, 2011 / Notices
ESTIMATED ANNUALIZED BURDEN HOURS—Continued
Number of
responses per
respondent
Number of
respondents
Type of respondents
Form name
Average
burden per
response
Low Blood Sugar Survey ...............................
Supplemental .................................................
Tanner Stage .................................................
Retinal Photo ..................................................
Family Conflict ................................................
Pediatric Diabetes QOL Scale .......................
Physical Exam ................................................
Specimen Collection ......................................
SEARCH Clinical Sites: Monitoring ................
Dated: May 16, 2011.
Daniel Holcomb,
Reports Clearance Officer, Centers for Disease
Control and Prevention.
[FR Doc. 2011–12468 Filed 5–19–11; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[30Day-11–11BW]
Agency Forms Undergoing Paperwork
Reduction Act Review
The Centers for Disease Control and
Prevention (CDC) publishes a list of
information collection requests under
review by the Office of Management and
Budget (OMB) in compliance with the
Paperwork Reduction Act (44 U.S.C.
Chapter 35). To request a copy of these
requests, call the CDC Reports Clearance
Officer at (404) 639–5960 or send an email to omb@cdc.gov. Send written
comments to CDC Desk Officer, Office of
Management and Budget, Washington,
DC or by fax to (202) 395–5806. Written
comments should be received within 30
days of this notice.
Proposed Project
Cops and Cars: Reducing Law
Enforcement Officer Deaths in Motor
Vehicle Crashes— NEW—National
Institute for Occupational Safety and
Health (NIOSH), Centers for Disease
Control and Prevention (CDC).
jlentini on DSK4TPTVN1PROD with NOTICES
Background and Brief Description
Occupational hazards facing law
enforcement officers (LEOs) include
psychological, biological, physical, and
chemical stressors. While homicides,
suicides, and stress-related
cardiovascular disease have been well
documented in the literature, much less
VerDate Mar<15>2010
17:22 May 19, 2011
Jkt 223001
5
13
5/60
10/60
5/60
5/60
5/60
5/60
5/60
5/60
Unanticipated Occurrence/Condition Reporting Form.
5/60
is known about work related motor
vehicle incidents in this occupation.
Motor vehicle incidents and crashes are
the leading cause of occupational death
among LEOs. This is not surprising
given that LEOs spend a large amount
of time conducting vehicle patrols, can
be involved in dangerous high-speed
pursuits, and often perform work
alongside interstates and roadways near
speeding motor vehicles. While seatbelt
use significantly reduces the chance of
dying in a motor-vehicle crash, there is
some anecdotal evidence that LEOs do
not wear seatbelts and often for good
reasons. For example, one of the leading
reasons why officers report not wearing
seatbelts was the tendency of the belt to
get caught on their gun holster and
therefore inhibit their safety while in
the field. A better understanding of how
officers view seatbelt usage, ways to
decrease barriers to usage in the field,
and possible gateways to this behavior
change is needed before developing
evidence-based interventions.
The Occupational Safety and Health
Act, Public Law 91–596 (section 20[a]
[1]) authorizes the National Institute for
Occupational Safety and Health
(NIOSH) to conduct research to advance
the health and safety of workers. NIOSH
is proposing to conduct a populationbased, cross-sectional survey among
LEOS in the state of Iowa to measure
motor-vehicle safety practices,
perceptions of these practices, and prior
occupational motor-vehicle crashes.
Enrollment for the study will be
performed at the agency level. A
random sample of Iowa law
enforcement agencies, stratified on size
of department (small, medium, and
large) and type of department (Sheriff’s
Departments and City/Police
Departments) will be drawn using a
publicly available database. Recruitment
packets will be sent to the leadership of
these agencies inviting them to
participate in the study. After agency
PO 00000
Frm 00056
Fmt 4703
Sfmt 4703
leadership had agreed to participate in
the study, survey packets will be mailed
to a contact person in the agency. These
packets will then be distributed to all
sworn officers. Study packets will
consist of an introduction letter and
paper-and-pencil survey. The
questionnaire provides information on
the following categories: sociodemographics, occupation, driving
behaviors, attitudes & knowledge of
policies, and details of prior motorvehicle crashes.
The sample size is estimated to be 162
agencies, with approximately 2,467
police and sheriff patrol officers. This
estimate is derived using a publically
available database of all U.S. law
enforcement agencies. Pilot test data
demonstrated that respondents should
take approximately 20 minutes to
complete the survey, resulting in an
annualized burden estimate of 822
hours. Participation in the study is
completely voluntary.
Distribution of the surveys will also
utilize the time of first-line supervisors
of the participating law enforcement
agencies. The surveys will be mailed to
the leadership of each participating law
enforcement agency. They will be asked
to distribute the surveys to all sworn
officers in their agencies. Depending on
the level of involvement of each agency,
additional work activities delineated to
the leadership could include: collection
of the surveys, verbal and/or written
reminders to the officers, re-distribution
of surveys, and e-mail/phone
communication with NIOSH. Onehundred and sixty-two agencies have
been invited to participate in the study.
We estimate that on average, leadership
at each agency will contribute a total of
one burden hour for a grand total
burden of 162 burden hours. There are
no costs to the respondents other than
their time. The total estimated annual
burden hours are 984.
E:\FR\FM\20MYN1.SGM
20MYN1
29247
Federal Register / Vol. 76, No. 98 / Friday, May 20, 2011 / Notices
ESTIMATED ANNUALIZED BURDEN HOURS
Type of
respondent
Police & Sheriff’s Patrol Officers .....................................................
First-Line Supervisors/Managers of Police & Detectives ................
Dated: May 16, 2011.
Daniel Holcomb,
Acting Reports Clearance Officer, Centers for
Disease Control and Prevention.
[FR Doc. 2011–12467 Filed 5–19–11; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–855(O), CMS–
855(S) and CMS–855(A, B, I, R)]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Centers for Medicare &
Medicaid Services, HHS
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Centers for Medicare & Medicaid
Services (CMS), Department of Health
and Human Services, is publishing the
following summary of proposed
collections for public comment.
Interested persons are invited to send
comments regarding this burden
estimate or any other aspect of this
collection of information, including any
of the following subjects: (1) The
necessity and utility of the proposed
information collection for the proper
performance of the Agency’s function;
(2) the accuracy of the estimated
burden; (3) ways to enhance the quality,
utility, and clarity of the information to
be collected; and (4) the use of
automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
1. Type of Information Collection
Request: New collection; Title of
Information Collection: Medicare
Enrollment Application for Eligible
Ordering and Referring Physicians and
Non-physician Practices Use: CMS is
adding a new CMS–855 Medicare
Enrollment Application (CMS 855O—
Medicare Enrollment Application for
Ordering and Referring Physicians
only). CMS has found that many
providers and suppliers who are not
enrolled in Medicare are ordering and
jlentini on DSK4TPTVN1PROD with NOTICES
AGENCY:
VerDate Mar<15>2010
17:22 May 19, 2011
Jkt 223001
Number of
responses per
respondent
Number of
respondents
2,467
162
referring physicians for Medicare
enrolled providers and suppliers. The
ordering and referring data field on the
CMS 1500 claims submission form
requires an ordering or referring
physician to have a Medicare
identification number. Without an
ordering or referring physician, specific
types of claims submitted by Medicare
approved providers and suppliers are
rejected by Medicare Administrative
Contractors (MAC) as required by
Medicare regulation. Therefore, if an
ordering or referring physician does not
participate in the Medicare program, but
orders or refers his/her patients to a
Medicare provider or supplier, the claim
submitted by the Medicare provider or
supplier for the given ordered or
referred service is automatically rejected
by the MAC. The CMS 855O allows a
physician to receive a Medicare
identification number (without being
approved for billing privileges) for the
sole purpose of ordering and referring
beneficiaries to Medicare approved
providers and suppliers. This new
Medicare application form allows
physicians who do not provide services
to Medicare beneficiaries to be given a
Medicare identification number without
having to supply all the data required
for the submission of Medicare claims.
It also allows the Medicare program to
identify ordering and referring
physicians without having to validate
the amount of data necessary to
determine claims payment eligibility
(such as banking information), while
continuing to identify the physician’s
credentials as valid for ordering and
referring purposes. Form Number:
CMS–855(O) (OMB#: 0938–NEW0685);
Frequency: Yearly; Affected Public:
Private Sector; Business or other forprofit and not-for-profit institutions;
Number of Respondents: 48,000; Total
Annual Responses: 48,000; Total
Annual Hours: 46,000. (For policy
questions regarding this collection
contact Kim McPhillips at 410–786–
5374. For all other issues call 410–786–
1326.)
2. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare
Durable Medical Equipment Supplier
Enrollment Application; Use: The
PO 00000
Frm 00057
Fmt 4703
Sfmt 4703
Average burden
per response
(in hours)
1
1
20/60
1
Total burden
hours
822
162
primary function of the CMS 855S
DMEPOS supplier enrollment
application is to gather information
from a supplier that tells us who it is,
whether it meets certain qualifications
to be a health care supplier, where it
renders its services or supplies, the
identity of the owners of the enrolling
entity, and information necessary to
establish the correct claims payment.
The goal of evaluating and revising the
CMS 855S DMEPOS supplier
enrollment application is to simplify
and clarify the information collection
without jeopardizing our need to collect
specific information. Additionally,
periodic revisions are necessary to
incorporate new regulatory
requirements.
The goal of this revision of the CMS
855S is to incorporate new regulatory
provisions found at 42 CFR 424.57(c) (1
through 30) and 42 CFR 424.58. These
revisions will allow CMS to be in
compliance with the above stated
regulations implementing new quality
standards for DMEPOS suppliers,
including accreditation requirements.
This revision will also incorporate new
supplier standard regulations found in
the final regulation that published on
August 27, 2010 (75 FR 52629–52649).
Form Number: CMS–855(S) (OMB#:
0938–1056); Frequency: Yearly; Affected
Public: Private Sector; Business or other
for-profit and not-for-profit institutions;
Number of Respondents: 140,290; Total
Annual Responses: 140,290; Total
Annual Hours: 331,619. (For policy
questions regarding this collection
contact Kim McPhillips at 410–786–
5374. For all other issues call 410–786–
1326.)
3. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare
Enrollment Application; Use: The
primary function of the CMS–855
Medicare enrollment application is to
gather information from a provider or
supplier that tells us who it is, whether
it meets certain qualifications to be a
health care provider or supplier, where
it practices or renders its services, the
identity of the owners of the enrolling
entity, and other information necessary
to establish correct claims payments.
The goal of this submission is to address
E:\FR\FM\20MYN1.SGM
20MYN1
Agencies
[Federal Register Volume 76, Number 98 (Friday, May 20, 2011)]
[Notices]
[Pages 29246-29247]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-12467]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[30Day-11-11BW]
Agency Forms Undergoing Paperwork Reduction Act Review
The Centers for Disease Control and Prevention (CDC) publishes a
list of information collection requests under review by the Office of
Management and Budget (OMB) in compliance with the Paperwork Reduction
Act (44 U.S.C. Chapter 35). To request a copy of these requests, call
the CDC Reports Clearance Officer at (404) 639-5960 or send an e-mail
to omb@cdc.gov. Send written comments to CDC Desk Officer, Office of
Management and Budget, Washington, DC or by fax to (202) 395-5806.
Written comments should be received within 30 days of this notice.
Proposed Project
Cops and Cars: Reducing Law Enforcement Officer Deaths in Motor
Vehicle Crashes-- NEW--National Institute for Occupational Safety and
Health (NIOSH), Centers for Disease Control and Prevention (CDC).
Background and Brief Description
Occupational hazards facing law enforcement officers (LEOs) include
psychological, biological, physical, and chemical stressors. While
homicides, suicides, and stress-related cardiovascular disease have
been well documented in the literature, much less is known about work
related motor vehicle incidents in this occupation. Motor vehicle
incidents and crashes are the leading cause of occupational death among
LEOs. This is not surprising given that LEOs spend a large amount of
time conducting vehicle patrols, can be involved in dangerous high-
speed pursuits, and often perform work alongside interstates and
roadways near speeding motor vehicles. While seatbelt use significantly
reduces the chance of dying in a motor-vehicle crash, there is some
anecdotal evidence that LEOs do not wear seatbelts and often for good
reasons. For example, one of the leading reasons why officers report
not wearing seatbelts was the tendency of the belt to get caught on
their gun holster and therefore inhibit their safety while in the
field. A better understanding of how officers view seatbelt usage, ways
to decrease barriers to usage in the field, and possible gateways to
this behavior change is needed before developing evidence-based
interventions.
The Occupational Safety and Health Act, Public Law 91-596 (section
20[a] [1]) authorizes the National Institute for Occupational Safety
and Health (NIOSH) to conduct research to advance the health and safety
of workers. NIOSH is proposing to conduct a population-based, cross-
sectional survey among LEOS in the state of Iowa to measure motor-
vehicle safety practices, perceptions of these practices, and prior
occupational motor-vehicle crashes.
Enrollment for the study will be performed at the agency level. A
random sample of Iowa law enforcement agencies, stratified on size of
department (small, medium, and large) and type of department (Sheriff's
Departments and City/Police Departments) will be drawn using a publicly
available database. Recruitment packets will be sent to the leadership
of these agencies inviting them to participate in the study. After
agency leadership had agreed to participate in the study, survey
packets will be mailed to a contact person in the agency. These packets
will then be distributed to all sworn officers. Study packets will
consist of an introduction letter and paper-and-pencil survey. The
questionnaire provides information on the following categories: socio-
demographics, occupation, driving behaviors, attitudes & knowledge of
policies, and details of prior motor-vehicle crashes.
The sample size is estimated to be 162 agencies, with approximately
2,467 police and sheriff patrol officers. This estimate is derived
using a publically available database of all U.S. law enforcement
agencies. Pilot test data demonstrated that respondents should take
approximately 20 minutes to complete the survey, resulting in an
annualized burden estimate of 822 hours. Participation in the study is
completely voluntary.
Distribution of the surveys will also utilize the time of first-
line supervisors of the participating law enforcement agencies. The
surveys will be mailed to the leadership of each participating law
enforcement agency. They will be asked to distribute the surveys to all
sworn officers in their agencies. Depending on the level of involvement
of each agency, additional work activities delineated to the leadership
could include: collection of the surveys, verbal and/or written
reminders to the officers, re-distribution of surveys, and e-mail/phone
communication with NIOSH. One-hundred and sixty-two agencies have been
invited to participate in the study. We estimate that on average,
leadership at each agency will contribute a total of one burden hour
for a grand total burden of 162 burden hours. There are no costs to the
respondents other than their time. The total estimated annual burden
hours are 984.
[[Page 29247]]
Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of Average burden
Type of respondent Number of responses per per response (in Total burden
respondents respondent hours) hours
----------------------------------------------------------------------------------------------------------------
Police & Sheriff's Patrol Officers...... 2,467 1 20/60 822
First-Line Supervisors/Managers of 162 1 1 162
Police & Detectives....................
----------------------------------------------------------------------------------------------------------------
Dated: May 16, 2011.
Daniel Holcomb,
Acting Reports Clearance Officer, Centers for Disease Control and
Prevention.
[FR Doc. 2011-12467 Filed 5-19-11; 8:45 am]
BILLING CODE 4163-18-P