Agency Information Collection Activities; Proposed Collection: Comment Request, 27241-27242 [2013-11090]

Download as PDF 27241 Federal Register / Vol. 78, No. 90 / Thursday, May 9, 2013 / Notices estimated to take approximately up to 1 hour and 15 minutes each. The Patient Survey builds on previous periodic Patient User-Visit Surveys, which were conducted to learn about the process and outcomes of care in CHCs, MHCs, HCHs, and PHPCs. The original questionnaires were derived from the National Health Interview Survey (NHIS) and the National Ambulatory Medical Care Survey (NAMCS) conducted by the National Center for Health Statistics (NCHS). Conformance with the NHIS and NAMCS allowed comparisons between these NCHS surveys and the previous User-Visit Surveys. The new Patient Survey was developed using a questionnaire methodology similar to that used in the past, and will also potentially allow some time-trend 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 ICR are summarized in the table below. The annual estimate of burden is as follows: comparisons for HCs with the previous User-Visit survey data, including monitoring of processes and outcomes over time. In addition, this wave of the survey will be conducted in languages not used in previous surveys (English and Spanish only), and will include patients from the fastest growing U.S. population segment, Asian Americans and Pacific Islanders. Languages that will be used in the proposed survey include Chinese (Mandarin and Cantonese), Korean, Vietnamese, Spanish, and English. With the exception of Spanish speakers, other racial and ethnic subgroups were not able to participate in previous surveys in their own languages. Burden Statement: Burden in this context means the time expended by persons to generate, maintain, retain, Responses per respondent Number of respondents Form name Total responses Average burden per response (in hours) Total burden hours Grantee/Site Recruitment .................................................. Patient Recruitment (At clinic) ........................................... Patient Survey (Administered at clinic) .............................. Patient Recruitment (Through local advertisements/flyers/ word-of-mouth) ............................................................... Patient Survey (Administered following local advertising) 2 21 15 3 1 1 6 21 15 3.0 0.17 1.25 18.00 3.57 18.75 71 54 1 1 71 54 0.08 1.25 5.68 67.50 Total Pretest ............................................................... 69 ........................ ........................ .......................... 113.50 Submit your comments to the desk officer for HRSA, either by email to OIRA_submission@omb.eop.gov or by fax to 202–395–5806. Please direct all correspondence to the ‘‘attention of the desk officer for HRSA.’’ Deadline: Comments on this ICR should be received within 30 days of this notice. ADDRESSES: Dated: May 3, 2013. Bahar Niakan, Director, Division of Policy and Information Coordination. [FR Doc. 2013–11088 Filed 5–8–13; 8:45 am] BILLING CODE 4165–15–P DEPARTMENT OF HEALTH AND HUMAN SERVICES mstockstill on DSK4VPTVN1PROD with NOTICES Health Resources and Services Administration 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 SUMMARY: VerDate Mar<15>2010 17:18 May 08, 2013 Jkt 229001 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 Information Collection 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: Countermeasures Injury Compensation Program (OMB No. 0915–0334)— Revision Abstract: This is a revision to the request for OMB approval of the PO 00000 Frm 00064 Fmt 4703 Sfmt 4703 information collection requirements for the Countermeasures Injury Compensation Program (CICP or Program). The CICP, within the Health Resources and Services Administration (HRSA), administers the compensation program specified by the Public Readiness and Emergency Preparedness Act (PREP Act). The CICP provides compensation to eligible individuals (requesters) who suffer serious injuries directly caused by a covered countermeasure administered or used pursuant to a PREP Act Declaration, or to their estates and/or survivors. A declaration is issued by the Secretary of the Department of Health and Humans Services (Secretary). The purpose of a declaration is to identify a disease, health condition, or a threat to health that is currently, or may in the future constitute, a public health emergency. In addition, the Secretary, through a declaration, may recommend and encourage the development, manufacturing, distribution, dispensing, and administration or use of one or more covered countermeasures to treat, prevent, or diagnose the disease, condition, or threat specified in the declaration. To determine whether a requester is eligible for Program benefits (compensation) for the injury, the CICP E:\FR\FM\09MYN1.SGM 09MYN1 27242 Federal Register / Vol. 78, No. 90 / Thursday, May 9, 2013 / Notices must review the Request for Benefits Package, which includes the Request for Benefits Form and Authorization for Use or Disclosure of Health Information Form(s), as well as the injured countermeasure recipient’s medical records and supporting documentation. A requester who is an injured countermeasure recipient may be eligible to receive benefits for unreimbursed medical expenses and/or lost employment income. The estate of a deceased countermeasure recipient may also be eligible to receive medical benefits and/or benefits for lost employment income accrued prior to the injured countermeasure recipient’s death. If death was the result of the administration or use of the countermeasure, certain survivor(s) of deceased eligible countermeasure recipients may be eligible to receive a death benefit, but not unreimbursed medical expenses or lost employment income benefits (42 CFR § 110.33). The death benefit is calculated using either the ‘‘standard calculation’’ or the ‘‘alternative calculation.’’ The ‘‘standard calculation’’ is based on the death benefit available under the Public Safety Officers’ Benefits (PSOB) Program (42 CFR § 110.82(b)). The ‘‘alternative calculation’’ is based on the deceased countermeasure recipient’s income and is only available to the recipient’s dependent(s) who is (are) younger than age 18. Approval is requested for the required continued information collection via the Request for Benefits Package, which has been updated to include all categories of potentially eligible requesters, including adult children, so that the CICP may continue to accept and process requests for benefits. The Request for Benefits Form and Instructions have been revised to remove the request for a social security number, update the CICP Web site address, and add a new category of eligible requesters, adult children. This new category was added because the CICP is generally required to use the same categories of survivors in order of priority for benefits as established and defined by the PSOB Program (42 CFR § 110.11(b)). This new category of survivors was added under the PSOB Program. Approval is requested for new mechanisms of medical documentation and supporting documentation collection. During the eligibility review, the CICP would like to provide requesters with the opportunity to supplement their case files with additional medical records and supporting documentation before a final Program decision is made. The CICP would ask requesters to complete and sign a form indicating whether they intend to submit additional documentation prior to the final determination of their case. Number of respondents Form name Request for Benefits Form and Supporting Documentation ............................................................ Authorization for Use or Disclosure of Health Information Form ................................................... Additional Documentation and Certification ........... Benefits Package and Supporting Documentation Number of responses per respondent Approval is requested for a benefits documentation package the CICP plans to send to requesters who may be eligible for compensation, which includes certification forms and instructions outlining the documentation needed to determine the types and amounts of benefits. This documentation is required under 42 CFR § 110.61–110.63 of the CICP’s implementing regulations to enable the Program to determine the types and amounts of benefits the requester may be eligible to receive. 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: Average burden per response (in hours) Total responses 100 1 100 100 30 30 1 1 1 100 30 30 2 *.75 .125 200 22.5 3.75 260 Total ................................................................ 11 Total burden hours 1,100 4 260 13.875 1,326.25 *45 min. 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. mstockstill on DSK4VPTVN1PROD with NOTICES ADDRESSES: Dated: May 3, 2013. Bahar Niakan, Director, Division of Policy and Information Coordination. [FR Doc. 2013–11090 Filed 5–8–13; 8:45 am] 17:18 May 08, 2013 Office of Inspector General [Docket Number: OIG–1300–N] Updated Special Advisory Bulletin on the Effect of Exclusion From Participation in Federal Health Care Programs Office of Inspector General (OIG), HHS. AGENCY: ACTION: BILLING CODE 4165–15–P VerDate Mar<15>2010 DEPARTMENT OF HEALTH AND HUMAN SERVICES Jkt 229001 PO 00000 Notice. Frm 00065 Fmt 4703 Sfmt 4703 This notice announces the release of an updated Special Advisory Bulletin on the effect of exclusion from participation in Federal health care programs by OIG. The updated Special Advisory Bulletin describes the scope and effect of the legal prohibition on payment by Federal health care programs for items or services furnished (1) by an excluded person or (2) at the medical direction or on the prescription of an excluded person. For purposes of OIG exclusion, payment by a Federal health care program includes amounts based on a cost report, fee schedule, SUMMARY: E:\FR\FM\09MYN1.SGM 09MYN1

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[Federal Register Volume 78, Number 90 (Thursday, May 9, 2013)]
[Notices]
[Pages 27241-27242]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-11090]


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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 Information Collection 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: Countermeasures Injury 
Compensation Program (OMB No. 0915-0334)--Revision

    Abstract: This is a revision to the request for OMB approval of the 
information collection requirements for the Countermeasures Injury 
Compensation Program (CICP or Program). The CICP, within the Health 
Resources and Services Administration (HRSA), administers the 
compensation program specified by the Public Readiness and Emergency 
Preparedness Act (PREP Act). The CICP provides compensation to eligible 
individuals (requesters) who suffer serious injuries directly caused by 
a covered countermeasure administered or used pursuant to a PREP Act 
Declaration, or to their estates and/or survivors. A declaration is 
issued by the Secretary of the Department of Health and Humans Services 
(Secretary). The purpose of a declaration is to identify a disease, 
health condition, or a threat to health that is currently, or may in 
the future constitute, a public health emergency. In addition, the 
Secretary, through a declaration, may recommend and encourage the 
development, manufacturing, distribution, dispensing, and 
administration or use of one or more covered countermeasures to treat, 
prevent, or diagnose the disease, condition, or threat specified in the 
declaration.
    To determine whether a requester is eligible for Program benefits 
(compensation) for the injury, the CICP

[[Page 27242]]

must review the Request for Benefits Package, which includes the 
Request for Benefits Form and Authorization for Use or Disclosure of 
Health Information Form(s), as well as the injured countermeasure 
recipient's medical records and supporting documentation.
    A requester who is an injured countermeasure recipient may be 
eligible to receive benefits for unreimbursed medical expenses and/or 
lost employment income. The estate of a deceased countermeasure 
recipient may also be eligible to receive medical benefits and/or 
benefits for lost employment income accrued prior to the injured 
countermeasure recipient's death. If death was the result of the 
administration or use of the countermeasure, certain survivor(s) of 
deceased eligible countermeasure recipients may be eligible to receive 
a death benefit, but not unreimbursed medical expenses or lost 
employment income benefits (42 CFR Sec.  110.33). The death benefit is 
calculated using either the ``standard calculation'' or the 
``alternative calculation.'' The ``standard calculation'' is based on 
the death benefit available under the Public Safety Officers' Benefits 
(PSOB) Program (42 CFR Sec.  110.82(b)). The ``alternative 
calculation'' is based on the deceased countermeasure recipient's 
income and is only available to the recipient's dependent(s) who is 
(are) younger than age 18.
    Approval is requested for the required continued information 
collection via the Request for Benefits Package, which has been updated 
to include all categories of potentially eligible requesters, including 
adult children, so that the CICP may continue to accept and process 
requests for benefits. The Request for Benefits Form and Instructions 
have been revised to remove the request for a social security number, 
update the CICP Web site address, and add a new category of eligible 
requesters, adult children. This new category was added because the 
CICP is generally required to use the same categories of survivors in 
order of priority for benefits as established and defined by the PSOB 
Program (42 CFR Sec.  110.11(b)). This new category of survivors was 
added under the PSOB Program.
    Approval is requested for new mechanisms of medical documentation 
and supporting documentation collection. During the eligibility review, 
the CICP would like to provide requesters with the opportunity to 
supplement their case files with additional medical records and 
supporting documentation before a final Program decision is made. The 
CICP would ask requesters to complete and sign a form indicating 
whether they intend to submit additional documentation prior to the 
final determination of their case.
    Approval is requested for a benefits documentation package the CICP 
plans to send to requesters who may be eligible for compensation, which 
includes certification forms and instructions outlining the 
documentation needed to determine the types and amounts of benefits. 
This documentation is required under 42 CFR Sec.  110.61-110.63 of the 
CICP's implementing regulations to enable the Program to determine the 
types and amounts of benefits the requester may be eligible to receive.
    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 responses   per  response     Total burden
                                                                      respondents       respondent                        (in hours)          hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
Request for Benefits Form and Supporting Documentation............              100                1              100           11              1,100
Authorization for Use or Disclosure of Health Information Form....              100                1              100            2                200
Additional Documentation and Certification........................               30                1               30            *.75              22.5
Benefits Package and Supporting Documentation.....................               30                1               30             .125              3.75
                                                                   -------------------------------------------------------------------------------------
    Total.........................................................              260                4              260           13.875          1,326.25
--------------------------------------------------------------------------------------------------------------------------------------------------------
*45 min.


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.

    Dated: May 3, 2013.
Bahar Niakan,
Director, Division of Policy and Information Coordination.
[FR Doc. 2013-11090 Filed 5-8-13; 8:45 am]
BILLING CODE 4165-15-P