Submission for OMB Review; Comment Request, 34594-34595 [2018-15537]
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consumers who work to assist Medicare
providers with quality improvement
throughout the spectrum of care and to
review quality concerns for the
protection of beneficiaries and the
Medicare Trust Fund. This program is a
key component of the U.S. Department
of Health and Human Services’ (HHS)
National Quality Strategy and the CMS
Quality Strategy. The work is aligned
with the current HHS and CMS
administration priorities to empower
patients and doctors to make decisions
about their health care; usher in a new
era of state flexibility and local
leadership; support innovative
approaches to improve quality,
accessibility, and affordability; and
improve the CMS customer experience.
In the current SOW, 14 QIN–QIOs
coordinate the work in 53 U.S. states
and territories.
CMS evaluates the quality and
effectiveness of the QIO program as
authorized in Part B of Title XI of the
Social Security Act. CMS created the
Independent Evaluation Center (IEC) to
provide CMS and its stakeholders with
an independent and objective program
evaluation of the 11th SOW.
For the program to improve
medication safety and prevent adverse
drug events (ADEs), QIN–QIOs provide
technical assistance to providers,
practitioners, organizations offering
Medicare Advantage plans under
Medicare Part C, and prescription drug
sponsors offering drug plans under Part
D. ADEs are defined as ‘‘injury resulting
from medical intervention related to a
drug,’’ and cause the majority of
preventable deaths in hospitals. ADEs
escalate healthcare costs and utilization,
increasing admission and readmission
rates, emergency department (ED) visits,
and physician visits. ADEs are
particularly problematic for older adults
who have multiple chronic conditions
and interact with many care settings.
Opioid misuse and overdose is a
significant cause of ADEs and was
declared a public health emergency by
the White House in 2017. In 2016, over
14 million Medicare Part D beneficiaries
received opioid prescriptions, and many
of these beneficiaries received extreme
amounts of the drugs. The Medicare
population has one of the highest and
fastest-growing rates of diagnosed
opioid use disorder.
As part of the HHS Opioid Initiative
launched in March 2015, CMS
developed a multipronged approach to
combat misuse and promote programs
that support treatment and recovery
support services for clinicians,
beneficiaries, and families. CMS also
worked with HHS and other health
agencies to develop a National Action
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Plan for Adverse Drug Prevention
(2014). In addition to opioids, the
Action Plan focused on ADEs caused by
other high-risk medication (HRM)
groups: Anticoagulants and diabetic
medications. Given the burden of ADEs
caused by these three classes of drugs,
focusing prevention efforts in these
areas could have a significant impact on
reducing harm and improving
population health among Medicare
beneficiaries.
The QIO program provides technical
assistance to reduce ADEs in
beneficiaries resulting from
polypharmacy, specifically those who
use three or more medications including
a prescription in a HRM) drug groups.
In the 11th SOW, specific interventions
include training providers through
Learning Action Networks; developing
collaborations among local providers
across care settings; providing materials
and information resources; and helping
providers collect data to monitor
prescribing practices.
To evaluate the effectiveness of this
program, we will use a mixed method
evaluation combining secondary data
analysis of Medicare claims with a
community provider survey. We plan to
conduct an online survey of 1,200
community-based pharmacists,
physicians, and nursing home
administrators or directors of nursing in
nursing homes. These participants were
selected based on their role in
prescribing HRM and treating ADEs.
The proposed survey assesses the
extent to which the National Action
Plan for Adverse Drug Prevention
strategies have been used, the level of
engagement with the QIO, and other
influences that can help explain
progress towards the goals of the QIN–
QIO SOW. The questions used for these
constructs related to program and nonprogram influences have been adopted
from previously used and/or validated
instruments, including the IEC Nursing
Home Survey that was approved under
OMB control number 0938–1330.
The survey will also provide
estimates of the attribution of the QIN–
QIO program for improving ADE
prevention, and reported impact of the
QIN–QIO program from the perspective
of healthcare providers. The perceived
influence on quality improvement
efforts will be quantified and, along
with econometric modeling methods,
will be used to assess program
attribution. Estimating attribution is a
contract requirement for the IEC and
helps provide evidence of impact of the
QIN–QIO program. Since current
analytical methods do not adequately
address the overlap of quality
improvement initiatives targeting
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medication safety and ADE prevention,
the IEC developed an innovative
approach, combining survey input with
modeling, to estimate the relative
importance of the QIN–QIO program.
The concept is supported at the highest
level of administration for Quality
Improvement at CMS and has been
presented at national conferences and to
CMS/CCSQ leadership. The survey data
is an essential component of this
analytic method.
The information collected through the
survey will complement the existing
data by helping identify factors
associated with ADE outcomes of
interest from existing data sets such as
Medicare claims. For example, claims
data can provide information on
whether the number of prescriptions for
opioids has decreased, but not what has
helped to facilitate the decrease. Form
Number: CMS–10675 (OMB control
number: 0938–NEW); Frequency:
Annually; Affected Public: Private
sector (Business or other for-profits);
Number of Respondents: 1,200; Total
Annual Responses: 1,200; Total Annual
Hours: 300. (For policy questions
regarding this collection contact Nancy
Sonnenfeld at 410–786–1294.)
Dated: July 16, 2018.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2018–15466 Filed 7–19–18; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Submission for OMB Review;
Comment Request
Title: ORR–6, ORR Requirements for
Refugee Cash Assistance; and Refugee
Medical Assistance (45 CFR part 400).
OMB No.: 0970–0036.
Description: As required by section
412(e) of the Immigration and
Nationality Act, the Administration for
Children and Families (ACF), Office of
Refugee Resettlement (ORR), is
requesting the information from Form
ORR–6 to determine the effectiveness of
the State cash and medical assistance,
and social services programs. State-byState Refugee Cash Assistance (RCA)
and Refugee Medical Assistance (RMA)
utilization rates derived from Form
ORR–6 are calculated for use in
formulating program initiatives,
priorities, standards, budget requests,
and assistance policies. ORR regulations
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Federal Register / Vol. 83, No. 140 / Friday, July 20, 2018 / Notices
require that State Refugee Resettlement
and Wilson-Fish agencies, and local and
Tribal governments complete Form
ORR–6 in order to participate in the
above-mentioned programs.
Respondents: State governments,
Replacement Designees, and Wilson/
Fish Alternative Projects.
ANNUAL BURDEN ESTIMATES
Instrument
Number of
respondents
Number of
responses
per
respondent
Average
burden hours
per response
Total burden
hours
ORR–6 Performance Report ...........................................................................
57
2
8
912
Estimated Total Annual Burden
Hours: 912.
Copies of the proposed collection may
be obtained by writing to the
Administration for Children and
Families, Office of Planning, Research
and Evaluation, 330 C Street SW,
Washington, DC 20201. Attention
Reports Clearance Officer. All requests
should be identified by the title of the
information collection. Email address:
infocollection@acf.hhs.gov.
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, Email: OIRA_
SUBMISSION@OMB.EOP.GOV, Attn:
Desk Officer for the Administration for
Children and Families.
Robert Sargis,
Reports Clearance Officer.
[FR Doc. 2018–15537 Filed 7–19–18; 8:45 am]
BILLING CODE 4184–45–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2009–D–0052]
Documenting Electronic Data Files and
Statistical Analysis Programs; Draft
Guidance for Industry; Availability;
Extension of Comment Period
AGENCY:
Food and Drug Administration,
daltland on DSKBBV9HB2PROD with NOTICES
HHS.
Notice of availability; extension
of comment period.
ACTION:
The Food and Drug
Administration (FDA or Agency) is
extending the comment period for the
notice of availability that published in
the Federal Register on May 21, 2018.
SUMMARY:
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In that document, FDA requested
comments on the draft revised guidance
for industry (GFI) #197 entitled
‘‘Documenting Electronic Data Files and
Statistical Analysis Programs.’’ The
Agency is taking this action in response
to a request for an extension to allow
interested persons additional time to
submit comments.
FDA is extending the comment
period on the document published May
21, 2018 (83 FR 23468). Submit either
electronic or written comments on the
draft revised guidance by October 18,
2018, to ensure that the Agency
considers your comment on this draft
guidance before it begins work on the
final version of the guidance.
DATES:
You may submit comments
on any guidance at any time as follows:
ADDRESSES:
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal:
https://www.regulations.gov. Follow the
instructions for submitting comments.
Comments submitted electronically,
including attachments, to https://
www.regulations.gov will be posted to
the docket unchanged. Because your
comment will be made public, you are
solely responsible for ensuring that your
comment does not include any
confidential information that you or a
third party may not wish to be posted,
such as medical information, your or
anyone else’s Social Security number, or
confidential business information, such
as a manufacturing process. Please note
that if you include your name, contact
information, or other information that
identifies you in the body of your
comments, that information will be
posted on https://www.regulations.gov.
• If you want to submit a comment
with confidential information that you
do not wish to be made available to the
public, submit the comment as a
written/paper submission and in the
manner detailed (see ‘‘Written/Paper
Submissions’’ and ‘‘Instructions’’).
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Written/Paper Submissions
Submit written/paper submissions as
follows:
• Mail/Hand delivery/Courier (for
written/paper submissions): Dockets
Management Staff (HFA–305), Food and
Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
• For written/paper comments
submitted to the Dockets Management
Staff, FDA will post your comment, as
well as any attachments, except for
information submitted, marked and
identified, as confidential, if submitted
as detailed in ‘‘Instructions.’’
Instructions: All submissions received
must include the Docket No. FDA–
2009–D–0052 for ‘‘Documenting
Electronic Data Files and Statistical
Analysis Programs.’’ Received
comments will be placed in the docket
and, except for those submitted as
‘‘Confidential Submissions,’’ publicly
viewable at https://www.regulations.gov
or at the Dockets Management Staff
between 9 a.m. and 4 p.m., Monday
through Friday.
• Confidential Submissions—To
submit a comment with confidential
information that you do not wish to be
made publicly available, submit your
comments only as a written/paper
submission. You should submit two
copies total. One copy will include the
information you claim to be confidential
with a heading or cover note that states
‘‘THIS DOCUMENT CONTAINS
CONFIDENTIAL INFORMATION.’’ The
Agency will review this copy, including
the claimed confidential information, in
its consideration of comments. The
second copy, which will have the
claimed confidential information
redacted/blacked out, will be available
for public viewing and posted on
https://www.regulations.gov. Submit
both copies to the Dockets Management
Staff. If you do not wish your name and
contact information to be made publicly
available, you can provide this
information on the cover sheet and not
in the body of your comments and you
must identify this information as
‘‘confidential.’’ Any information marked
as ‘‘confidential’’ will not be disclosed
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Agencies
[Federal Register Volume 83, Number 140 (Friday, July 20, 2018)]
[Notices]
[Pages 34594-34595]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-15537]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
Submission for OMB Review; Comment Request
Title: ORR-6, ORR Requirements for Refugee Cash Assistance; and
Refugee Medical Assistance (45 CFR part 400).
OMB No.: 0970-0036.
Description: As required by section 412(e) of the Immigration and
Nationality Act, the Administration for Children and Families (ACF),
Office of Refugee Resettlement (ORR), is requesting the information
from Form ORR-6 to determine the effectiveness of the State cash and
medical assistance, and social services programs. State-by-State
Refugee Cash Assistance (RCA) and Refugee Medical Assistance (RMA)
utilization rates derived from Form ORR-6 are calculated for use in
formulating program initiatives, priorities, standards, budget
requests, and assistance policies. ORR regulations
[[Page 34595]]
require that State Refugee Resettlement and Wilson-Fish agencies, and
local and Tribal governments complete Form ORR-6 in order to
participate in the above-mentioned programs.
Respondents: State governments, Replacement Designees, and Wilson/
Fish Alternative Projects.
Annual Burden Estimates
----------------------------------------------------------------------------------------------------------------
Number of Average burden
Instrument Number of responses per hours per Total burden
respondents respondent response hours
----------------------------------------------------------------------------------------------------------------
ORR-6 Performance Report.................... 57 2 8 912
----------------------------------------------------------------------------------------------------------------
Estimated Total Annual Burden Hours: 912.
Copies of the proposed collection may be obtained by writing to the
Administration for Children and Families, Office of Planning, Research
and Evaluation, 330 C Street SW, Washington, DC 20201. Attention
Reports Clearance Officer. All requests should be identified by the
title of the information collection. Email address:
[email protected].
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, Email:
[email protected], Attn: Desk Officer for the Administration
for Children and Families.
Robert Sargis,
Reports Clearance Officer.
[FR Doc. 2018-15537 Filed 7-19-18; 8:45 am]
BILLING CODE 4184-45-P