Authorization of Emergency Use of an In Vitro Diagnostic for Detection of the Novel Avian Influenza A(H7N9) Virus; Availability, 38044-38052 [2013-15096]
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38044
Federal Register / Vol. 78, No. 122 / Tuesday, June 25, 2013 / Notices
accreditation program expires December
27, 2013.
mstockstill on DSK4VPTVN1PROD with NOTICES
II. Approval of Deeming Organizations
Section 1865(a)(2) of the Act and our
regulations at § 488.8(a) require that our
findings concerning review and
approval of a national accrediting
organization’s requirements consider,
among other factors, the applying
accrediting organization’s requirements
for accreditation; survey procedures;
resources for conducting required
surveys; capacity to furnish information
for use in enforcement activities;
monitoring procedures for provider
entities found not in compliance with
the conditions or requirements; and
ability to provide us with the necessary
data for validation.
Section 1865(a)(3)(A) of the Act
further requires that we publish, within
60 days of receipt of an organization’s
complete application, a notice
identifying the national accrediting
body making the request, describing the
nature of the request, and providing at
least a 30-day public comment period.
We have 210 days from the receipt of a
complete application to publish notice
of approval or denial of the application.
The purpose of this proposed notice
is to inform the public of AOA/HFAP’s
request for continued CMS approval of
its CAH accreditation program. This
notice also solicits public comment on
whether AOA/HFAP’s requirements
meet or exceed the Medicare conditions
of participation for CAHs.
III. Evaluation of Deeming Authority
Request
AOA/HFAP submitted all the
necessary materials to enable us to make
a determination concerning its request
for continued approval of its CAH
accreditation program. This application
was determined to be complete on May
31, 2013. Under section 1865(a)(2) of the
Act and our regulations at § 488.8
(Federal review of accrediting
organizations), our review and
evaluation of AOA/HFAP will be
conducted in accordance with, but not
necessarily limited to, the following
factors:
• The equivalency of AOA/HFAP’s
standards for CAHs as compared with
CMS’ CAH conditions of participation.
• AOA/HFAP’s survey process to
determine the following:
++ The composition of the survey
team, surveyor qualifications, and the
ability of the organization to provide
continuing surveyor training.
++ The comparability of AOA/
HFAP’s processes to those of state
agencies, including survey frequency,
and the ability to investigate and
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respond appropriately to complaints
against accredited facilities.
++ AOA/HFAP’s processes and
procedures for monitoring a CAH found
out of compliance with AOA/HFAP’s
program requirements. These
monitoring procedures are used only
when AOA/HFAP identifies
noncompliance. If noncompliance is
identified through validation reviews or
complaint surveys, the state survey
agency monitors corrections as specified
at § 488.7(d).
++ AOA/HFAP’s capacity to report
deficiencies to the surveyed facilities
and respond to the facility’s plan of
correction in a timely manner.
++ AOA/HFAP’s capacity to provide
us with electronic data and reports
necessary for effective validation and
assessment of the organization’s survey
process.
++ The adequacy of AOA/HFAP’s
staff and other resources, and its
financial viability.
++ AOA/HFAP’s capacity to
adequately fund required surveys.
++ AOA/HFAP’s policies with
respect to whether surveys are
announced or unannounced, to assure
that surveys are unannounced.
++ AOA/HFAP’s agreement to
provide CMS with a copy of the most
current accreditation survey together
with any other information related to
the survey as CMS may require
(including corrective action plans).
IV. Collection of Information
Requirements
This document does not impose
information collection and
recordkeeping requirements.
Consequently, it need not be reviewed
by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 35).
V. Response to Public Comments
Because of the large number of public
comments we normally receive on
Federal Register documents, we are not
able to acknowledge or respond to them
individually. We will consider all
comments we receive by the date and
time specified in the DATES section of
this preamble, and, when we proceed
with a subsequent document, we will
respond to the comments in the
preamble to that document.
Upon completion of our evaluation,
including evaluation of comments
received as a result of this notice, we
will publish a final notice in the Federal
Register announcing the result of our
evaluation.
Authority: (Catalog of Federal Domestic
Assistance Program No. 93.778, Medical
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Assistance Program; No. 93.773 Medicare—
Hospital Insurance Program; and No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
Dated: June 20, 2013.
Marilyn Tavenner,
Administrator, Centers for Medicare &
Medicaid Services.
[FR Doc. 2013–15175 Filed 6–24–13; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2013–N–0651]
Authorization of Emergency Use of an
In Vitro Diagnostic for Detection of the
Novel Avian Influenza A(H7N9) Virus;
Availability
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
The Food and Drug
Administration (FDA) is announcing the
issuance of an Emergency Use
Authorization (EUA) (the Authorization)
for an in vitro diagnostic device for
detection of the novel avian influenza
A(H7N9) virus. FDA is issuing this
Authorization under the Federal Food,
Drug, and Cosmetic (FD&C) Act, as
requested by the Centers for Disease
Control and Prevention (CDC). The
Authorization contains, among other
things, conditions on the emergency use
of the authorized in vitro diagnostic
device. The Authorization follows the
determination by the Secretary of Health
and Human Services (HHS) that there is
a significant potential for a public
health emergency that has a significant
potential to affect national security or
the health and security of U.S. citizens
living abroad that involves the novel
avian influenza A(H7N9) virus. On the
basis of such determination, the
Secretary also declared that
circumstances exist justifying the
authorization of emergency use of in
vitro diagnostics for detection of the
novel avian influenza A(H7N9) virus
subject to the terms of any authorization
issued under the FD&C Act. The
Authorization, which includes an
explanation of the reasons for issuance,
is reprinted in this document.
DATES: The Authorization is effective as
of April 22, 2013.
ADDRESSES: Submit written requests for
single copies of the EUA to the Office
of Counterterrorism and Emerging
Threats, Food and Drug Administration,
10903 New Hampshire Ave., Bldg. 32,
Rm. 4121, Silver Spring, MD 20993–
SUMMARY:
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Federal Register / Vol. 78, No. 122 / Tuesday, June 25, 2013 / Notices
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0002. Send one self-addressed adhesive
label to assist that office in processing
your request or include a fax number to
which the Authorization may be sent.
See the SUPPLEMENTARY INFORMATION
section for electronic access to the
Authorization.
FOR FURTHER INFORMATION CONTACT:
Luciana Borio, Assistant Commissioner
for Counterterrorism Policy, Office of
Counterterrorism and Emerging Threats,
Food and Drug Administration, 10903
New Hampshire Ave., Bldg. 32, Rm.
4118, Silver Spring, MD 20993–0002,
301–796–8510 (this is not a toll free
number).
SUPPLEMENTARY INFORMATION:
I. Background
Section 564 of the FD&C Act (21
U.S.C. 360bbb–3), as amended by the
Project BioShield Act of 2004 (Pub. L.
108–276) and the Pandemic and AllHazards Preparedness Reauthorization
Act of 2013 (Pub. L. 113–5), allows FDA
to strengthen the public health
protections against biological, chemical,
nuclear, and radiological agents. Among
other things, section 564 of the FD&C
Act allows FDA to authorize the use of
an unapproved medical product or an
unapproved use of an approved medical
product in certain situations. With this
EUA authority, FDA can help assure
that medical countermeasures may be
used in emergencies to diagnose, treat,
or prevent serious or life-threatening
diseases or conditions caused by
biological, chemical, nuclear, or
radiological agents when there are no
adequate, approved, and available
alternatives.
Section 564(b)(1) of the FD&C Act
provides that, before an EUA may be
issued, the Secretary of HHS must
declare that circumstances exist
justifying the authorization based on
one of the following grounds: (1) A
determination by the Secretary of
Homeland Security that there is a
domestic emergency, or a significant
potential for a domestic emergency,
involving a heightened risk of attack
with a biological, chemical, radiological,
or nuclear agent or agents; (2) a
determination by the Secretary of
Defense that there is a military
emergency, or a significant potential for
a military emergency, involving a
heightened risk to U.S. military forces of
attack with a biological, chemical,
radiological, or nuclear agent or agents;
(3) a determination by the Secretary of
HHS that there is a public health
emergency, or a significant potential for
a public health emergency, that affects,
or has a significant potential to affect,
national security or the health and
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security of U.S. citizens living abroad,
and that involves a biological, chemical,
radiological, or nuclear agent or agents,
or a disease or condition that may be
attributable to such agent or agents; 1 or
(4) the identification of a material threat
by the Secretary of Homeland Security
pursuant to section 319F–2 of the Public
Health Service (PHS) Act (42 U.S.C.
247d–6b) sufficient to affect national
security or the health and security of
U.S. citizens living abroad.
Once the Secretary has declared that
circumstances exist justifying an
authorization under section 564 of the
FD&C Act, FDA may authorize the
emergency use of a drug, device, or
biological product if the Agency
concludes that the statutory criteria are
satisfied. Under section 564(h)(1) of the
FD&C Act, FDA is required to publish,
in the Federal Register, a notice of each
authorization, and each termination or
revocation of an authorization, and an
explanation of the reasons for the
action. Section 564 of the FD&C Act
permits FDA to authorize the
introduction into interstate commerce of
a drug, device, or biological product
intended for use when the Secretary of
HHS has declared that circumstances
exist justifying the authorization of
emergency use. Products appropriate for
emergency use may include products
and uses that are not approved, cleared,
or licensed under sections 505, 510(k),
or 515 of the FD&C Act (21 U.S.C. 355,
360(k), and 360e) or section 351 of the
PHS Act (42 U.S.C. 262). FDA may issue
an EUA only if, after consultation with
the HHS Assistant Secretary for
Preparedness and Response, the
Director of the National Institutes of
Health, and the Director of CDC (to the
extent feasible and appropriate given
the applicable circumstances), FDA 2
concludes: (1) That an agent referred to
in a declaration of emergency or threat
can cause a serious or life-threatening
disease or condition; (2) that, based on
the totality of scientific evidence
available to FDA, including data from
adequate and well-controlled clinical
trials, if available, it is reasonable to
believe that: (A) The product may be
effective in diagnosing, treating, or
1 As amended by the Pandemic and All-Hazards
Preparedness Reauthorization Act of 2013 (Pub. L.
113–5), the Secretary of HHS may make a
determination of a public health emergency, or a
significant potential for a public health emergency,
under section 564 of the FD&C Act. The Secretary
is no longer required to make a determination of a
public health emergency under section 319 of the
PHS Act, 42 U.S.C. 247d, to support a
determination made under section 564 of the FD&C
Act.
2 The Secretary of HHS has delegated the
authority to issue an EUA under section 564 of the
FD&C Act to the Commissioner of Food and Drugs.
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preventing—(i) such disease or
condition; or (ii) a serious or lifethreatening disease or condition caused
by a product authorized under section
564, approved or cleared under the
FD&C Act, or licensed under section 351
of the PHS Act, for diagnosing, treating,
or preventing such a disease or
condition caused by such an agent; and
(B) the known and potential benefits of
the product, when used to diagnose,
prevent, or treat such disease or
condition, outweigh the known and
potential risks of the product, taking
into consideration the material threat
posed by the agent or agents identified
in a declaration under section
564(b)(1)(D) of the FD&C Act, if
applicable; (3) that there is no adequate,
approved, and available alternative to
the product for diagnosing, preventing,
or treating such disease or condition;
and (4) that such other criteria as the
Secretary of HHS may by regulation
prescribe are satisfied.
No other criteria of issuance have
been prescribed by regulation under
section 564(c)(4) of the FD&C Act.
Because the statute is self-executing,
regulations or guidance are not required
for FDA to implement the EUA
authority.
II. EUA Request for an In Vitro
Diagnostic for Detection of the Novel
Avian Influenza A(H7N9) Virus
On April 19, 2013, under section
564(b)(1)(C) of the FD&C Act (21 U.S.C.
360bbb–3(b)(1)(C)), the Secretary of
HHS determined that there is a
significant potential for a public health
emergency that has a significant
potential to affect national security or
the health and security of U.S. citizens
living abroad that involves the novel
avian influenza A(H7N9) virus. Also on
April 19, 2013, under section 564(b)(1)
of the FD&C Act, and on the basis of
such determination, the Secretary of
HHS declared that circumstances exist
justifying the authorization of
emergency use of in vitro diagnostics for
detection of the novel avian influenza
A(H7N9) virus, subject to the terms of
any authorization issued under section
564 of the FD&C Act. The Secretary also
specified that this declaration is a
declaration of an emergency with
respect to in vitro diagnostics as defined
under the Public Readiness and
Emergency Preparedness (PREP) Act
Declaration for Pandemic Influenza
Diagnostics, Personal Respiratory
Protection Devices, and Respiratory
Support Devices signed by then
Secretary Michael Leavitt on December
17, 2008 (73 FR 78362). Notice of the
determination and the declaration of the
Secretary were published in the Federal
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Register on April 30, 2013 (78 FR
25273). On April 19, 2013, CDC
requested, and on April 22, 2013, FDA
issued an EUA for the CDC Human
Influenza Virus Real-Time RT–PCR
Diagnostic Panel-Influenza A/H7
(Eurasian Lineage) Assay subject to the
terms of this authorization.
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III. Electronic Access
An electronic version of this
document and the full text of the
Authorization are available on the
Internet at https://www.regulations.gov.
IV. The Authorization
Having concluded that the criteria for
issuance of the Authorization under
section 564(c) of the FD&C Act are met,
FDA has authorized the emergency use
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of an in vitro diagnostic device for
detection of the novel avian influenza
A(H7N9) virus subject to the terms of
the Authorization. The Authorization in
its entirety (not including the
authorized versions of the fact sheets
and other written materials) follows and
provides an explanation of the reasons
for its issuance, as required by section
564(h)(1) of the FD&C Act:
BILLING CODE 4160–01–P
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Dated: June 19, 2013.
Leslie Kux,
Assistant Commissioner for Policy.
[FR Doc. 2013–15096 Filed 6–24–13; 8:45 am]
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38052
Agencies
[Federal Register Volume 78, Number 122 (Tuesday, June 25, 2013)]
[Notices]
[Pages 38044-38052]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-15096]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2013-N-0651]
Authorization of Emergency Use of an In Vitro Diagnostic for
Detection of the Novel Avian Influenza A(H7N9) Virus; Availability
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA) is announcing the
issuance of an Emergency Use Authorization (EUA) (the Authorization)
for an in vitro diagnostic device for detection of the novel avian
influenza A(H7N9) virus. FDA is issuing this Authorization under the
Federal Food, Drug, and Cosmetic (FD&C) Act, as requested by the
Centers for Disease Control and Prevention (CDC). The Authorization
contains, among other things, conditions on the emergency use of the
authorized in vitro diagnostic device. The Authorization follows the
determination by the Secretary of Health and Human Services (HHS) that
there is a significant potential for a public health emergency that has
a significant potential to affect national security or the health and
security of U.S. citizens living abroad that involves the novel avian
influenza A(H7N9) virus. On the basis of such determination, the
Secretary also declared that circumstances exist justifying the
authorization of emergency use of in vitro diagnostics for detection of
the novel avian influenza A(H7N9) virus subject to the terms of any
authorization issued under the FD&C Act. The Authorization, which
includes an explanation of the reasons for issuance, is reprinted in
this document.
DATES: The Authorization is effective as of April 22, 2013.
ADDRESSES: Submit written requests for single copies of the EUA to the
Office of Counterterrorism and Emerging Threats, Food and Drug
Administration, 10903 New Hampshire Ave., Bldg. 32, Rm. 4121, Silver
Spring, MD 20993-
[[Page 38045]]
0002. Send one self-addressed adhesive label to assist that office in
processing your request or include a fax number to which the
Authorization may be sent. See the SUPPLEMENTARY INFORMATION section
for electronic access to the Authorization.
FOR FURTHER INFORMATION CONTACT: Luciana Borio, Assistant Commissioner
for Counterterrorism Policy, Office of Counterterrorism and Emerging
Threats, Food and Drug Administration, 10903 New Hampshire Ave., Bldg.
32, Rm. 4118, Silver Spring, MD 20993-0002, 301-796-8510 (this is not a
toll free number).
SUPPLEMENTARY INFORMATION:
I. Background
Section 564 of the FD&C Act (21 U.S.C. 360bbb-3), as amended by the
Project BioShield Act of 2004 (Pub. L. 108-276) and the Pandemic and
All-Hazards Preparedness Reauthorization Act of 2013 (Pub. L. 113-5),
allows FDA to strengthen the public health protections against
biological, chemical, nuclear, and radiological agents. Among other
things, section 564 of the FD&C Act allows FDA to authorize the use of
an unapproved medical product or an unapproved use of an approved
medical product in certain situations. With this EUA authority, FDA can
help assure that medical countermeasures may be used in emergencies to
diagnose, treat, or prevent serious or life-threatening diseases or
conditions caused by biological, chemical, nuclear, or radiological
agents when there are no adequate, approved, and available
alternatives.
Section 564(b)(1) of the FD&C Act provides that, before an EUA may
be issued, the Secretary of HHS must declare that circumstances exist
justifying the authorization based on one of the following grounds: (1)
A determination by the Secretary of Homeland Security that there is a
domestic emergency, or a significant potential for a domestic
emergency, involving a heightened risk of attack with a biological,
chemical, radiological, or nuclear agent or agents; (2) a determination
by the Secretary of Defense that there is a military emergency, or a
significant potential for a military emergency, involving a heightened
risk to U.S. military forces of attack with a biological, chemical,
radiological, or nuclear agent or agents; (3) a determination by the
Secretary of HHS that there is a public health emergency, or a
significant potential for a public health emergency, that affects, or
has a significant potential to affect, national security or the health
and security of U.S. citizens living abroad, and that involves a
biological, chemical, radiological, or nuclear agent or agents, or a
disease or condition that may be attributable to such agent or agents;
\1\ or (4) the identification of a material threat by the Secretary of
Homeland Security pursuant to section 319F-2 of the Public Health
Service (PHS) Act (42 U.S.C. 247d-6b) sufficient to affect national
security or the health and security of U.S. citizens living abroad.
---------------------------------------------------------------------------
\1\ As amended by the Pandemic and All-Hazards Preparedness
Reauthorization Act of 2013 (Pub. L. 113-5), the Secretary of HHS
may make a determination of a public health emergency, or a
significant potential for a public health emergency, under section
564 of the FD&C Act. The Secretary is no longer required to make a
determination of a public health emergency under section 319 of the
PHS Act, 42 U.S.C. 247d, to support a determination made under
section 564 of the FD&C Act.
---------------------------------------------------------------------------
Once the Secretary has declared that circumstances exist justifying
an authorization under section 564 of the FD&C Act, FDA may authorize
the emergency use of a drug, device, or biological product if the
Agency concludes that the statutory criteria are satisfied. Under
section 564(h)(1) of the FD&C Act, FDA is required to publish, in the
Federal Register, a notice of each authorization, and each termination
or revocation of an authorization, and an explanation of the reasons
for the action. Section 564 of the FD&C Act permits FDA to authorize
the introduction into interstate commerce of a drug, device, or
biological product intended for use when the Secretary of HHS has
declared that circumstances exist justifying the authorization of
emergency use. Products appropriate for emergency use may include
products and uses that are not approved, cleared, or licensed under
sections 505, 510(k), or 515 of the FD&C Act (21 U.S.C. 355, 360(k),
and 360e) or section 351 of the PHS Act (42 U.S.C. 262). FDA may issue
an EUA only if, after consultation with the HHS Assistant Secretary for
Preparedness and Response, the Director of the National Institutes of
Health, and the Director of CDC (to the extent feasible and appropriate
given the applicable circumstances), FDA \2\ concludes: (1) That an
agent referred to in a declaration of emergency or threat can cause a
serious or life-threatening disease or condition; (2) that, based on
the totality of scientific evidence available to FDA, including data
from adequate and well-controlled clinical trials, if available, it is
reasonable to believe that: (A) The product may be effective in
diagnosing, treating, or preventing--(i) such disease or condition; or
(ii) a serious or life-threatening disease or condition caused by a
product authorized under section 564, approved or cleared under the
FD&C Act, or licensed under section 351 of the PHS Act, for diagnosing,
treating, or preventing such a disease or condition caused by such an
agent; and (B) the known and potential benefits of the product, when
used to diagnose, prevent, or treat such disease or condition, outweigh
the known and potential risks of the product, taking into consideration
the material threat posed by the agent or agents identified in a
declaration under section 564(b)(1)(D) of the FD&C Act, if applicable;
(3) that there is no adequate, approved, and available alternative to
the product for diagnosing, preventing, or treating such disease or
condition; and (4) that such other criteria as the Secretary of HHS may
by regulation prescribe are satisfied.
---------------------------------------------------------------------------
\2\ The Secretary of HHS has delegated the authority to issue an
EUA under section 564 of the FD&C Act to the Commissioner of Food
and Drugs.
---------------------------------------------------------------------------
No other criteria of issuance have been prescribed by regulation
under section 564(c)(4) of the FD&C Act. Because the statute is self-
executing, regulations or guidance are not required for FDA to
implement the EUA authority.
II. EUA Request for an In Vitro Diagnostic for Detection of the Novel
Avian Influenza A(H7N9) Virus
On April 19, 2013, under section 564(b)(1)(C) of the FD&C Act (21
U.S.C. 360bbb-3(b)(1)(C)), the Secretary of HHS determined that there
is a significant potential for a public health emergency that has a
significant potential to affect national security or the health and
security of U.S. citizens living abroad that involves the novel avian
influenza A(H7N9) virus. Also on April 19, 2013, under section
564(b)(1) of the FD&C Act, and on the basis of such determination, the
Secretary of HHS declared that circumstances exist justifying the
authorization of emergency use of in vitro diagnostics for detection of
the novel avian influenza A(H7N9) virus, subject to the terms of any
authorization issued under section 564 of the FD&C Act. The Secretary
also specified that this declaration is a declaration of an emergency
with respect to in vitro diagnostics as defined under the Public
Readiness and Emergency Preparedness (PREP) Act Declaration for
Pandemic Influenza Diagnostics, Personal Respiratory Protection
Devices, and Respiratory Support Devices signed by then Secretary
Michael Leavitt on December 17, 2008 (73 FR 78362). Notice of the
determination and the declaration of the Secretary were published in
the Federal
[[Page 38046]]
Register on April 30, 2013 (78 FR 25273). On April 19, 2013, CDC
requested, and on April 22, 2013, FDA issued an EUA for the CDC Human
Influenza Virus Real-Time RT-PCR Diagnostic Panel-Influenza A/H7
(Eurasian Lineage) Assay subject to the terms of this authorization.
III. Electronic Access
An electronic version of this document and the full text of the
Authorization are available on the Internet at https://www.regulations.gov.
IV. The Authorization
Having concluded that the criteria for issuance of the
Authorization under section 564(c) of the FD&C Act are met, FDA has
authorized the emergency use of an in vitro diagnostic device for
detection of the novel avian influenza A(H7N9) virus subject to the
terms of the Authorization. The Authorization in its entirety (not
including the authorized versions of the fact sheets and other written
materials) follows and provides an explanation of the reasons for its
issuance, as required by section 564(h)(1) of the FD&C Act:
BILLING CODE 4160-01-P
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Dated: June 19, 2013.
Leslie Kux,
Assistant Commissioner for Policy.
[FR Doc. 2013-15096 Filed 6-24-13; 8:45 am]
BILLING CODE 4160-01-C