Agency Information Collection Activities: Proposed Collection: Comment Request, 1214-1216 [2013-00031]
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Federal Register / Vol. 78, No. 5 / Tuesday, January 8, 2013 / Notices
Email address:
OPREinfocollection@acf.hhs.gov. All
requests should be identified by the title
of the information collection.
The Department specifically requests
comments on (a) Whether the proposed
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
proposed collection of information; (c)
the quality, utility, and clarity of the
information to be collected; and (d)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques or
other forms of information technology.
Consideration will be given to
comments and suggestions submitted
within 60 days of this publication.
Steven M. Hammer,
Reports Clearance Officer; Office of Planning,
Research and Evaluation
[FR Doc. 2012–31714 Filed 1–7–13; 8:45 am]
BILLING CODE 4184–09–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Submission for OMB Review;
Comment Request
Title: Head Start Grant Application
and Budget Instruments.
OMB No.: 0970–0207.
Description: The Office of Head Start
is proposing to renew, without changes,
the Head Start Grant Application and
Budget Instrument, which standardizes
the grant application information that is
requested from all Head Start and Early
Head Start grantees applying for
continuation grants. The application
and budget forms are available in a
password-protected, web-based system.
Completed applications can be
transmitted electronically to Regional
and Central Offices. The Administration
for Children and Families believes that
this application form makes the process
of applying for Head Start program
grants more efficient for applicants.
Respondents: Head Start and Early
Head Start grantees.
Respondents
ANNUAL BURDEN ESTIMATES
Instrument
Number of
respondents
Number of
responses per
respondent
Average
burden hours
per response
Total burden
hours
HS grant and budget instrument .....................................................................
1,600
1
33
52,800
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Additional Information
Copies of the proposed collection may
be obtained by writing to the
Administration for Children and
Families, Office of Planning, Research
and Evaluation, 370 L’Enfant
Promenade, SW., Washington, DC
20447, Attn: ACF Reports Clearance
Officer. All requests should be
identified by the title of the information
collection. Email address:
infocollection@acf.hhs.gov.
srobinson on DSK4SPTVN1PROD with
Estimated Total Annual Burden
Hours: 52,800.
Health Resources and Services
Administration
OMB Comment
OMB is required to make a decision
concerning the collection of information
between 30 and 60 days after
publication of this document in the
Federal Register. Therefore, a comment
is best assured of having its full effect
if OMB receives it within 30 days of
publication. Written comments and
recommendations for the proposed
information collection should be sent
directly to the following: Office of
Management and Budget, Paperwork
Reduction Project, Fax: 202–395–7285,
Email: OIRA_SUBMISSION@OMB.
EOP.GOV, Attn: Desk Officer for the
Administration for Children and
Families.
Robert Sargis,
Reports Clearance Officer.
[FR Doc. 2013–00127 Filed 1–7–13; 8:45 am]
BILLING CODE 4184–01–P
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Agency Information Collection
Activities: Proposed Collection:
Comment Request
ACTION:
Notice.
In compliance with the
requirement for opportunity for public
comment on proposed data collection
projects (section 3506(c)(2)(A) of Title
44, United States Code, as amended by
the Paperwork Reduction Act of 1995,
Pub. L. 104–13), the Health Resources
and Services Administration (HRSA)
publishes periodic summaries of
proposed projects being developed for
submission to the Office of Management
and Budget (OMB) under the Paperwork
Reduction Act of 1995. To request more
information on the proposed project or
to obtain a copy of the data collection
plans and draft instruments, email
paperwork@hrsa.gov or call the HRSA
Reports Clearance Officer at (301) 443–
1984.
HRSA especially requests comments
on: (1) The necessity and utility of the
proposed information collection for the
proper performance of the agency’s
functions, (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
SUMMARY:
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Fmt 4703
Sfmt 4703
use of automated collection techniques
or other forms of information
technology to minimize the information
collection burden.
Information Collection Request Title:
National Practitioner Data Bank for
Adverse Information on Physicians and
Other Health Care Practitioners—45
CFR Part 60 Regulations and Forms
OMB No. 0915–0126—Revision
Abstract: This is a request for a
revision of OMB approval of the
information collections contained in
regulations found at 45 CFR Part 60
governing the National Practitioner Data
Bank (NPDB) and the forms to be used
in registering with, reporting
information to, and requesting
information from the NPDB. Section
6403 of the Patient Protection and
Affordable Care Act of 2010 (Affordable
Care Act) Public Law 111–148 requires
the transfer of all data in the Healthcare
Integrity and Protection Data Bank
(HIPDB) to the NPDB. Data collection
will not change; however, the merger
will consolidate forms from OMB No.
0915–0239 for HIPDB under OMB No.
0915–0126 for NPDB. Responsibility for
NPDB implementation and operation
resides in the Bureau of Health
Professions, Health Resources and
Services Administration (HRSA),
Department of Health and Human
Services (HHS). Operation of the HIPDB
was delegated by the HHS Office of the
Inspector General to HRSA. This rule
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Federal Register / Vol. 78, No. 5 / Tuesday, January 8, 2013 / Notices
eliminates duplicative data reporting
and access requirements between the
HIPDB [established through the Health
Insurance Portability and
Accountability Act of 1996 (HIPPA)
under Section 1128(b)(5) of the Social
Security Act (42 U.S.C. 1320a–7e)] and
the NPDB [established through the
Health Care Quality Improvement Act of
1986 under Title IV (42 U.S.C. 11101 et
seq.) and expanded by Section 1921 of
the Social Security Act (42 U.S.C.
1396r–2)]. Information previously
collected and disclosed through the
HIPDB will be collected and disclosed
through the NPDB. Section 6403 of the
Affordable Care Act consolidates the
collection and disclosure of information
from both data banks under Title 45 part
60 of the Code of Federal Regulations
(CFR). The Department of Health and
Human Services (HHS) will
subsequently remove Title 45 part 61,
which implemented the HIPDB.
The intent of NPDB is to improve the
quality of health care by encouraging
hospitals, state licensing boards,
professional societies, and other entities
providing health care services, to
identify and discipline those who
engage in unprofessional behavior; and
to restrict the ability of incompetent
health care practitioners, providers, or
suppliers to move from state to state
without disclosure of previous
damaging or incompetent performance.
It also serves as a fraud and abuse
clearinghouse for the reporting and
disclosing of certain final adverse
actions (excluding settlements in which
no findings of liability have been made)
taken against health care practitioners,
providers, or suppliers by health plans,
federal agencies, and state agencies.
The NPDB acts primarily as a flagging
system; its principal purpose is to
facilitate comprehensive review of
practitioners’ professional credentials
and background. Information is
collected from, and disseminated to,
eligible entities (entities that are entitled
to query and/or report to the NPDB
under the three aforementioned
statutory authorities) on the following:
(1) Medical malpractice payments, (2)
licensure actions taken by Boards of
Medical Examiners, (3) state licensure
and certification actions, (4) federal
licensure and certification actions, (5)
negative actions or findings taken by
peer review organizations or private
accreditation entities, (6) adverse
actions taken against clinical privileges,
(7) federal or state criminal convictions
related to the delivery of a health care
item or service, (8) civil judgments
related to the delivery of a health care
item or service, (9) exclusions from
participation in federal or state health
care programs, and (10) other
adjudicated actions or decisions. It is
intended that NPDB information should
Number of
respondents
Form name
Number of
responses per
respondent
be considered with other relevant
information in evaluating credentials of
health care practitioners, providers, and
suppliers.
The reporting forms and the request
for information forms (query forms) are
accessed, completed, and submitted to
the NPDB electronically through the
NPDB Web site at https://www.npdbhipdb.hrsa.gov/. All reporting and
querying is performed through this
secure Web site.
Burden Statement: Burden in this
context means the time expended by
persons to generate, maintain, retain,
disclose, or provide the information
requested. This includes the time
needed to review instructions, to
develop, acquire, install and utilize
technology and systems for the purpose
of collecting, validating and verifying
information, processing and
maintaining information, and disclosing
and providing information, to train
personnel and to be able to respond to
a collection of information, to search
data sources, to complete and review
the collection of information, and to
transmit or otherwise disclose the
information. The total annual burden
hours estimated for this Information
Collection Request are summarized in
the table below.
The annual estimate of burden is as
follows:
Total
responses
Average
burden per
response
(in hours)
Total
burden
hours
856
12,748
4,460,926
64,187
862
67
62,178
497
16,243
2,592
515
10
1,253
13,326
10
2055
20
83
276
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
856
12,748
4,460,926
64,187
862
67
62,178
497
16,243
2,592
515
10
1,253
13,326
10
2055
20
83
276
1
1
0.1
0.4
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.25
0.25
.25
0.25
856
12,748
446,093
25,675
647
50
46,634
373
12,182
1,944
386
8
940
9,995
8
514
5
21
69
100
1
100
1
100
TOTAL ..........................................................................
srobinson on DSK4SPTVN1PROD with
Entity Registration (initial) ....................................................
Entity Registration (renewal) ................................................
Individual Subject Query ......................................................
Individual Self Query ............................................................
Title IV Clinical Privileges Action .........................................
Professional Society Membership Action ............................
State Licensure Action .........................................................
DEA/Federal Licensure Action .............................................
Exclusion/Debarment ...........................................................
Government and Administrative Action ...............................
Health Plan Action ...............................................................
Civil Judgment .....................................................................
Criminal Conviction ..............................................................
Medical Malpractice Payment ..............................................
Private Accreditation Entity and Peer Review Organization
Authorized Agent Designation Form (Add & Edit) ...............
Account Discrepancy Report ...............................................
Report Review Request Form .............................................
Electronic Transfer Funds Authorization .............................
Subject Statement and Dispute Initiation Form (Individual
& Organization) ................................................................
4,641,704
........................
4,641,704
........................
561,395
Submit your comments to
paperwork@hrsa.gov or mail the HRSA
Reports Clearance Officer, Room 10–29,
ADDRESSES:
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Parklawn Building, 5600 Fishers Lane,
Rockville, MD 20857.
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Deadline: Comments on this
Information Collection Request must be
received within 60 days of this notice.
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Federal Register / Vol. 78, No. 5 / Tuesday, January 8, 2013 / Notices
Dated: December 21, 2012.
Bahar Niakan,
Director, Division of Policy and Information
Coordination.
[FR Doc. 2013–00031 Filed 1–7–13; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Center for Scientific Review; Notice of
Closed Meetings
srobinson on DSK4SPTVN1PROD with
Pursuant to section 10(d) of the
Federal Advisory Committee Act, as
amended (5 U.S.C. App.), notice is
hereby given of the following meetings.
The meetings will be closed to the
public in accordance with the
provisions set forth in sections
552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,
as amended. The grant applications and
the discussions could disclose
confidential trade secrets or commercial
property such as patentable material,
and personal information concerning
individuals associated with the grant
applications, the disclosure of which
would constitute a clearly unwarranted
invasion of personal privacy.
Name of Committee: Emerging
Technologies and Training Neurosciences
Integrated Review Group Bioengineering of
Neuroscience, Vision and Low Vision
Technologies Study Section.
Date: February 7, 2013.
Time: 8:00 a.m. to 6:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: Westin St. Francis Hotel, 335 Powell
Street, San Francisco, CA 94102.
Contact Person: Robert C Elliott, Ph.D.,
Scientific Review Officer, Center for
Scientific Review, National Institutes of
Health, 6701 Rockledge Drive, Room 5190,
MSC 7846, Bethesda, MD 20892, 301–435–
3009, elliotro@csr.nih.gov.
Name of Committee: Surgical Sciences,
Biomedical Imaging and Bioengineering
Integrated Review Group, Biomedical
Imaging Technology A Study Section.
Date: February 7–8, 2013.
Time: 8:00 a.m. to 5:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: Serrano Hotel, 405 Taylor Street,
San Francisco, CA 94102.
Contact Person: Behrouz Shabestari, Ph.D.,
Scientific Review Officer, Center for
Scientific Review, National Institutes of
Health, 6701 Rockledge Drive, Room 5126,
MSC 7854, Bethesda, MD 20892, (301) 435–
2409, shabestb@csr.nih.gov.
Name of Committee: Endocrinology,
Metabolism, Nutrition and Reproductive
Sciences Integrated Review Group, Cellular
Aspects of Diabetes and Obesity Study
Section.
Date: February 7, 2013.
Time: 8:00 a.m. to 6:00 p.m.
VerDate Mar<15>2010
19:11 Jan 07, 2013
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Agenda: To review and evaluate grant
applications.
Place: Hyatt Regency Bethesda, One
Bethesda Metro Center, 7400 Wisconsin
Avenue, Bethesda, MD 20814.
Contact Person: Robert Garofalo, Ph.D.,
Scientific Review Officer, Center for
Scientific Review, National Institute of
Health, 6701 Rockledge Drive, Room 6156,
MSC 7892, Bethesda, MD 20892, 301–435–
1043, garofalors@csr.nih.gov.
Name of Committee: Emerging
Technologies and Training Neurosciences
Integrated Review Group Neuroscience and
Ophthalmic Imaging Technologies Study
Section.
Date: February 7, 2013.
Time: 8:00 a.m. to 6:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: Renaissance Washington DC,
Dupont Circle, 1143 New Hampshire Avenue
NW., Washington, DC 20037.
Contact Person: Yvonne Bennett, Ph.D.,
Scientific Review Officer, Center for
Scientific Review, National Institutes of
Health, 6701 Rockledge Drive, Room 5199,
MSC 7846, Bethesda, MD 20892, 301–379–
3793, bennetty@csr.nih.gov.
Name of Committee: Oncology 2—
Translational Clinical Integrated Review
Group Chemo/Dietary Prevention Study
Section.
Date: February 7–8, 2013.
Time: 8:00 a.m. to 5:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: Sheraton Silver Spring, 8777
Georgia Avenue, Silver Spring, MD 20910.
Contact Person: Sally A Mulhern, Ph.D.,
Scientific Review Officer, Center for
Scientific Review, National Institutes of
Health, 6701 Rockledge Drive, Room 6198,
MSC 7804, Bethesda, MD 20892, (301) 408–
9724, mulherns@csr.nih.gov.
Name of Committee: Interdisciplinary
Molecular Sciences and Training Integrated
Review Group Enabling Bioanalytical and
Imaging Technologies Study Section.
Date: February 7–8, 2013.
Time: 8:00 a.m. to 6:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: Renaissance Mayflower Hotel, 1127
Connecticut Avenue NW., Washington, DC
20036.
Contact Person: Dennis Hlasta, Ph.D.,
Scientific Review Officer, Center for
Scientific Review, National Institutes of
Health, 6701 Rockledge Drive, Room 6185,
MSC, Bethesda, MD 20892, 301–435–1047,
dennis.hlasta@nih.gov.
Name of Committee: Endocrinology,
Metabolism, Nutrition and Reproductive
Sciences Integrated Review Group, Clinical
and Integrative Diabetes and Obesity Study
Section.
Date: February 7, 2013.
Time: 8:00 a.m. to 6:00 p.m.
Agenda: To review and evaluate grant
applications
Place: Residence Inn Bethesda, 7335
Wisconsin Avenue, Bethesda, MD 20814.
Contact Person: Nancy Sheard, SCD,
Scientific Review Officer, Center for
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Scientific Review, National Institutes of
Health, 6701 Rockledge Drive, Room 6046–E,
MSC 7892, Bethesda, MD 20892, 301–408–
9901, sheardn@csr.nih.gov.
(Catalogue of Federal Domestic Assistance
Program Nos. 93.306, Comparative Medicine;
93.333, Clinical Research, 93.306, 93.333,
93.337, 93.393–93.396, 93.837–93.844,
93.846–93.878, 93.892, 93.893, National
Institutes of Health, HHS)
Dated: January 2, 2013.
Anna Snouffer,
Deputy Director, Office of Federal Advisory
Committee Policy.
[FR Doc. 2013–00088 Filed 1–7–13; 8:45 am]
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DEPARTMENT OF HEALTH AND
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National Institutes of Health
Office of the Director, National
Institutes of Health; Notice of Meeting
Pursuant to section 10(a) of the
Federal Advisory Committee Act, as
amended (5 U.S.C. App.), notice is
hereby given of a meeting of the
Recombinant DNA Advisory Committee.
The meeting will be open to the
public, with attendance limited to space
available. Individuals who plan to
attend and need special assistance, such
as sign language interpretation or other
reasonable accommodations, should
notify the Contact Person listed below
in advance of the meeting.
Name of Committee: Recombinant DNA
Advisory Committee.
Date: January 24, 2013.
Time: 9:00 a.m. to 4:00 p.m.
Agenda: The NIH Recombinant DNA
Advisory Committee (RAC) will discuss
Biosafety measures for research with highly
pathogenic avian influenza H5N1 strains that
have the potential to be transmissible
through respiratory droplets and related data
management activities. Please check the
meeting agenda at OBA Meetings Page
(available at the following URL: https://
oba.od.nih.gov/rdna_rac/rac_meetings.html)
for more information.
Place: National Institutes of Health,
Building 45, Lower Level, Conference Room
C1–C2, 45 Center Drive, Rockville, MD
20892.
Contact Person: Chezelle George, Office of
Biotechnology Activities, Office of Science
Policy/OD, National Institutes of Health,
6705 Rockledge Drive, Room 750, Bethesda,
MD 20892, 301–496–9838,
georgec@od.nih.gov.
Information is also available on the
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the meeting will be posted when available.
OMB’s ‘‘Mandatory Information
Requirements for Federal Assistance Program
Announcements’’ (45 FR 39592, June 11,
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[Federal Register Volume 78, Number 5 (Tuesday, January 8, 2013)]
[Notices]
[Pages 1214-1216]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-00031]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Proposed Collection:
Comment Request
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In compliance with the requirement for opportunity for public
comment on proposed data collection projects (section 3506(c)(2)(A) of
Title 44, United States Code, as amended by the Paperwork Reduction Act
of 1995, Pub. L. 104-13), the Health Resources and Services
Administration (HRSA) publishes periodic summaries of proposed projects
being developed for submission to the Office of Management and Budget
(OMB) under the Paperwork Reduction Act of 1995. To request more
information on the proposed project or to obtain a copy of the data
collection plans and draft instruments, email paperwork@hrsa.gov or
call the HRSA Reports Clearance Officer at (301) 443-1984.
HRSA especially requests comments on: (1) The necessity and utility
of the proposed information collection for the proper performance of
the agency's functions, (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.
Information Collection Request Title: National Practitioner Data Bank
for Adverse Information on Physicians and Other Health Care
Practitioners--45 CFR Part 60 Regulations and Forms OMB No. 0915-0126--
Revision
Abstract: This is a request for a revision of OMB approval of the
information collections contained in regulations found at 45 CFR Part
60 governing the National Practitioner Data Bank (NPDB) and the forms
to be used in registering with, reporting information to, and
requesting information from the NPDB. Section 6403 of the Patient
Protection and Affordable Care Act of 2010 (Affordable Care Act) Public
Law 111-148 requires the transfer of all data in the Healthcare
Integrity and Protection Data Bank (HIPDB) to the NPDB. Data collection
will not change; however, the merger will consolidate forms from OMB
No. 0915-0239 for HIPDB under OMB No. 0915-0126 for NPDB.
Responsibility for NPDB implementation and operation resides in the
Bureau of Health Professions, Health Resources and Services
Administration (HRSA), Department of Health and Human Services (HHS).
Operation of the HIPDB was delegated by the HHS Office of the Inspector
General to HRSA. This rule
[[Page 1215]]
eliminates duplicative data reporting and access requirements between
the HIPDB [established through the Health Insurance Portability and
Accountability Act of 1996 (HIPPA) under Section 1128(b)(5) of the
Social Security Act (42 U.S.C. 1320a-7e)] and the NPDB [established
through the Health Care Quality Improvement Act of 1986 under Title IV
(42 U.S.C. 11101 et seq.) and expanded by Section 1921 of the Social
Security Act (42 U.S.C. 1396r-2)]. Information previously collected and
disclosed through the HIPDB will be collected and disclosed through the
NPDB. Section 6403 of the Affordable Care Act consolidates the
collection and disclosure of information from both data banks under
Title 45 part 60 of the Code of Federal Regulations (CFR). The
Department of Health and Human Services (HHS) will subsequently remove
Title 45 part 61, which implemented the HIPDB.
The intent of NPDB is to improve the quality of health care by
encouraging hospitals, state licensing boards, professional societies,
and other entities providing health care services, to identify and
discipline those who engage in unprofessional behavior; and to restrict
the ability of incompetent health care practitioners, providers, or
suppliers to move from state to state without disclosure of previous
damaging or incompetent performance. It also serves as a fraud and
abuse clearinghouse for the reporting and disclosing of certain final
adverse actions (excluding settlements in which no findings of
liability have been made) taken against health care practitioners,
providers, or suppliers by health plans, federal agencies, and state
agencies.
The NPDB acts primarily as a flagging system; its principal purpose
is to facilitate comprehensive review of practitioners' professional
credentials and background. Information is collected from, and
disseminated to, eligible entities (entities that are entitled to query
and/or report to the NPDB under the three aforementioned statutory
authorities) on the following: (1) Medical malpractice payments, (2)
licensure actions taken by Boards of Medical Examiners, (3) state
licensure and certification actions, (4) federal licensure and
certification actions, (5) negative actions or findings taken by peer
review organizations or private accreditation entities, (6) adverse
actions taken against clinical privileges, (7) federal or state
criminal convictions related to the delivery of a health care item or
service, (8) civil judgments related to the delivery of a health care
item or service, (9) exclusions from participation in federal or state
health care programs, and (10) other adjudicated actions or decisions.
It is intended that NPDB information should be considered with other
relevant information in evaluating credentials of health care
practitioners, providers, and suppliers.
The reporting forms and the request for information forms (query
forms) are accessed, completed, and submitted to the NPDB
electronically through the NPDB Web site at https://www.npdb-hipdb.hrsa.gov/. All reporting and querying is performed through this
secure Web site.
Burden Statement: Burden in this context means the time expended by
persons to generate, maintain, retain, disclose, or provide the
information requested. This includes the time needed to review
instructions, to develop, acquire, install and utilize technology and
systems for the purpose of collecting, validating and verifying
information, processing and maintaining information, and disclosing and
providing information, to train personnel and to be able to respond to
a collection of information, to search data sources, to complete and
review the collection of information, and to transmit or otherwise
disclose the information. The total annual burden hours estimated for
this Information Collection Request are summarized in the table below.
The annual estimate of burden is as follows:
----------------------------------------------------------------------------------------------------------------
Number of Average burden
Form name Number of responses per Total per response Total burden
respondents respondent responses (in hours) hours
----------------------------------------------------------------------------------------------------------------
Entity Registration (initial)... 856 1 856 1 856
Entity Registration (renewal)... 12,748 1 12,748 1 12,748
Individual Subject Query........ 4,460,926 1 4,460,926 0.1 446,093
Individual Self Query........... 64,187 1 64,187 0.4 25,675
Title IV Clinical Privileges 862 1 862 0.75 647
Action.........................
Professional Society Membership 67 1 67 0.75 50
Action.........................
State Licensure Action.......... 62,178 1 62,178 0.75 46,634
DEA/Federal Licensure Action.... 497 1 497 0.75 373
Exclusion/Debarment............. 16,243 1 16,243 0.75 12,182
Government and Administrative 2,592 1 2,592 0.75 1,944
Action.........................
Health Plan Action.............. 515 1 515 0.75 386
Civil Judgment.................. 10 1 10 0.75 8
Criminal Conviction............. 1,253 1 1,253 0.75 940
Medical Malpractice Payment..... 13,326 1 13,326 0.75 9,995
Private Accreditation Entity and 10 1 10 0.75 8
Peer Review Organization.......
Authorized Agent Designation 2055 1 2055 0.25 514
Form (Add & Edit)..............
Account Discrepancy Report...... 20 1 20 0.25 5
Report Review Request Form...... 83 1 83 .25 21
Electronic Transfer Funds 276 1 276 0.25 69
Authorization..................
Subject Statement and Dispute 100 1 100 1 100
Initiation Form (Individual &
Organization)..................
-------------------------------------------------------------------------------
TOTAL....................... 4,641,704 .............. 4,641,704 .............. 561,395
----------------------------------------------------------------------------------------------------------------
ADDRESSES: Submit your comments to paperwork@hrsa.gov or mail the HRSA
Reports Clearance Officer, Room 10-29, Parklawn Building, 5600 Fishers
Lane, Rockville, MD 20857.
Deadline: Comments on this Information Collection Request must be
received within 60 days of this notice.
[[Page 1216]]
Dated: December 21, 2012.
Bahar Niakan,
Director, Division of Policy and Information Coordination.
[FR Doc. 2013-00031 Filed 1-7-13; 8:45 am]
BILLING CODE 4165-15-P
