81_FR_73313 81 FR 73108 - Proposed Data Collection Submitted for Public Comment and Recommendations

81 FR 73108 - Proposed Data Collection Submitted for Public Comment and Recommendations

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention

Federal Register Volume 81, Issue 205 (October 24, 2016)

Page Range73108-73110
FR Document2016-25579

The Centers for Disease Control and Prevention (CDC), as part of its continuing effort to reduce public burden and maximize the utility of government information, invites the general public and other Federal agencies to take this opportunity to comment on proposed and/or continuing information collections, as required by the Paperwork Reduction Act of 1995. This notice invites comment on a proposed revision to the ``World Trade Center Health Program Enrollment, Treatment, Appeals & Reimbursement'' information collection approved under OMB Control Number 0920-0891, which allows the collection of information from Program members and affiliated medical providers for the purpose of determining eligibility and providing treatment services in accordance with the James Zadroga 9/11 Health and Compensation Act of 2010.

Federal Register, Volume 81 Issue 205 (Monday, October 24, 2016) 
[Federal Register Volume 81, Number 205 (Monday, October 24, 2016)]
[Notices]
[Pages 73108-73110]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-25579]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-17-0891; Docket No. CDC-2016-0099]


Proposed Data Collection Submitted for Public Comment and 
Recommendations

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice with comment period.

-----------------------------------------------------------------------

SUMMARY: The Centers for Disease Control and Prevention (CDC), as part 
of its continuing effort to reduce public burden and maximize the 
utility of government information, invites the general public and other 
Federal agencies to take this opportunity to comment on proposed and/or 
continuing information collections, as required by the Paperwork 
Reduction Act of 1995. This notice invites comment on a proposed 
revision to the ``World Trade Center Health Program Enrollment, 
Treatment, Appeals & Reimbursement'' information collection approved 
under OMB Control Number 0920-0891, which allows the collection of 
information from Program members and affiliated medical providers for 
the purpose of determining eligibility and providing treatment services 
in accordance with the James Zadroga 9/11 Health and Compensation Act 
of 2010.

DATES: Written comments must be received on or before December 23, 
2016.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2016-
0099 by any of the following methods:
     Federal eRulemaking Portal: Regulations.gov. Follow the 
instructions for submitting comments.
     Mail: Leroy A. Richardson, Information Collection Review 
Office, Centers for Disease Control and Prevention, 1600 Clifton Road 
NE., MS-D74, Atlanta, Georgia 30329.
    Instructions: All submissions received must include the agency name 
and Docket Number. All relevant comments received will be posted 
without change to Regulations.gov, including any personal information 
provided. For access to the docket to read background documents or 
comments received, go to Regulations.gov.
    Please note: All public comment should be submitted through the 
Federal eRulemaking portal (regulations.gov) or by U.S. mail to the 
address listed above.

FOR FURTHER INFORMATION CONTACT: To request more information on the 
proposed project or to obtain a copy of the information collection plan 
and instruments, contact the Information Collection Review Office, 
Centers for Disease Control and Prevention, 1600 Clifton Road NE., MS-
D74, Atlanta, Georgia 30329; phone: 404-639-7570; Email: [email protected].

SUPPLEMENTARY INFORMATION: 
    Under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501-
3520), Federal agencies must obtain approval from the Office of 
Management and Budget (OMB) for each collection of information they 
conduct or sponsor. In addition, the PRA also requires Federal agencies 
to provide a 60-day notice in the Federal Register concerning each 
proposed collection of information, including each new proposed 
collection, each proposed extension of existing collection of 
information, and each reinstatement of previously approved information 
collection before submitting the collection to OMB for approval. To 
comply with this requirement, we are publishing this notice of proposed 
revisions to an existing data collection as described below.
    Comments are invited on: (a) Whether the proposed revisions to an 
existing 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 revised collection of 
information; (c) ways to enhance the quality, utility, and clarity of 
the information to be collected; (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; and (e) estimates of capital or start-up costs and costs of 
operation, maintenance, and purchase of services to provide 
information. Burden means the total time, effort, or financial 
resources expended by persons to generate, maintain, retain, disclose 
or provide information to or for a Federal agency. 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.

Proposed Project

    World Trade Center Health Program Enrollment, Treatment, Appeals & 
Reimbursement (OMB Control No. 0920-0891, Expires 09/30/2018)--
Revision--National Institute for Occupational Safety and Health, 
Centers for Disease Control and Prevention (CDC).

Background and Brief Description

    NIOSH seeks to request OMB approval to revise the currently 
approved information collection activities that support the World Trade 
Center (WTC) Health Program. The James Zadroga 9/11 Health and 
Compensation Act of 2010 (Pub. L. 111-347, as amended by Pub. L. 114-
113) created the WTC Health Program to provide medical monitoring and 
treatment benefits to eligible firefighters and related personnel, law 
enforcement officers, and rescue, recovery, and cleanup workers who 
responded to the September 11, 2001, terrorist attacks in New York 
City, at the Pentagon, and in Shanksville, Pennsylvania (responders), 
and to eligible persons who were present in the dust or dust cloud on 
September 11, 2001, or who worked, resided, or attended school, 
childcare, or adult daycare in the New York City disaster area 
(survivors).
    This request also seeks to incorporate the World Trade Center 
Health Program Petition for the addition of a New WTC-Related Health 
Condition for Coverage

[[Page 73109]]

under the WTC Health Program package (0920-0929) into the existing 
approval, World Trade Center Health Program Enrollment, Appeals, 
Reimbursement, & Petitions (OMB Control No. 0920-0891). Upon approval, 
OMB Control number 0920-0929 will be discontinued.
    Since its inception in 2011, the WTC Health Program has been 
approved to collect information from applicants and Program members 
(enrolled WTC responders and survivors) concerning eligibility and 
enrollment, appointment of a designated representative, medical care, 
travel reimbursement, and appeal of adverse Program decisions. The WTC 
Health Program is also currently approved to collect information from 
Program medical providers, including health condition certification 
requests and pharmaceutical claims. Currently-approved total estimated 
burden is 13,594 hours annually. See OMB Control No. 0920-0891, exp. 
September 30, 2018.
    The WTC Health Program has determined that some existing forms need 
to be updated, and new information collections related to a recent 
rulemaking should be added.
    Changes to WTC Health Program regulations in 42 CFR part 88 will 
require the extension of existing information collections. 
Specifically, 42 CFR 88.13 establishes procedures for the appeal of 
Program decisions to disenroll Program members and deny enrollment to 
applicants. Appeals of enrollment denial decisions, which include the 
submission of appeal request letters, are currently approved; the 
Program proposes to extend this information collection to account for 
the burden of requests for appeal of disenrollment decisions. Of the 
over 70,000 Program members, we expect that 0.014 percent (10) will be 
subsequently disenrolled from the Program. Of those, we expect that 30 
percent (3) will appeal the disenrollment decisions. We estimate that 
the disenrollment appeal requests will take no more than 0.5 hours per 
respondent. The annual burden estimate is 1.5 hours.
    Section 42 CFR 88.21 establishes procedures for the appeal of WTC 
Health Program decisions to decertify a WTC-related health condition, 
deny certification, and deny treatment authorization. Appeals of health 
condition certification denials and treatment authorization denials, 
which include the submission of appeal request letters, are currently 
approved; the Program proposes to extend this information collection to 
account for the burden of requests for appeal of decertification 
decisions. The information collection would also be expanded to allow 
Program members to provide additional information and/or an oral 
statement. Of the estimated 51,472 Program members who have at least 
one health condition certification, we estimate that 0.02 percent (10) 
will be decertified, and 50 percent (5) of those will appeal a 
decertification. We estimate that the appeal request letter will take 
no more than 0.5 hours per respondent. Providing additional information 
and/or an oral statement will take no more than 1 hour per respondent. 
The annual burden estimate for decertification appeals is 7.5 hours. We 
estimate that Program members request certification for 20,000 health 
conditions each year. Of those 20,000, we estimate that 1 percent (200) 
of certification requests are denied by the WTC Health Program. We 
further expect that 30 percent of denied certifications, or 60 
individuals, will be appealed. We estimate that the appeals letter 
takes no more than 30 minutes and providing additional information and/
or an oral statement will take no more than 1 hour. The burden estimate 
for certification denial appeals is 90 hours. Finally, of the projected 
51,472 Program members who receive medical care, we estimate that 0.05 
percent (26) will appeal a determination by the WTC Health Program that 
the treatment being sought is not medically necessary. We estimate that 
the appeals letter will take no more than 30 minutes and providing 
additional information and/or an oral statement will take no more than 
1 hour. The burden estimate for treatment authorization denial appeals 
is 39 hours.
    Finally, 42 CFR 88.23 establishes procedures for the appeal of a 
WTC Health Program decision to deny reimbursement to a Program medical 
provider for treatment determined not to be medically necessary. 
Accordingly, the Program proposes the addition of information collected 
in the appeal request. We estimate that of the nearly 52,000 Program 
providers, we estimate that 1.15 percent (600) annually will be denied 
reimbursement for treatment found to be not medically necessary or in 
accordance with treatment protocols, and will appeal the decision. We 
estimate that the appeal letter will take no more than 0.5 hours to 
compile. The burden estimate for treatment reimbursement denial appeals 
is 300 hours.
    The Program also finds it necessary to add a new form to allow 
applicants and Program members to grant permission to share information 
with a third person about an individual's application or case. We 
estimate that 30 applicants and members will submit a Health Insurance 
Portability and Accountability Act (HIPAA) Release Form annually. The 
form is expected to take no longer than 0.25 hours to complete. The 
burden estimate for the HIPAA Release form is 7.5 hours.
    In addition to describing those burden estimates revised by this 
action, the estimated annualized burden hours for those collection 
instruments not subject to revision in this action are included in the 
table below.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of    Average burden
      Type of respondent            Form name        Number of     responses per   per response    Total burden
                                                    respondents     respondent      (in hours)         hours
----------------------------------------------------------------------------------------------------------------
FDNY Responder................  World Trade                   45               1           30/60              23
                                 Center Health
                                 Program FDNY
                                 Responder
                                 Eligibility
                                 Application.
General Responder.............  World Trade                2,475               1           30/60           1,238
                                 Center Health
                                 Program
                                 Responder
                                 Eligibility
                                 Application
                                 (Other than
                                 FDNY).
Pentagon/Shanksville Responder  World Trade                  630               1           30/60             315
                                 Center Health
                                 Program
                                 Pentagon/
                                 Shanksville
                                 Responder.
WTC Survivor..................  World Trade                1,350               1           30/60             675
                                 Center Health
                                 Program
                                 Survivor
                                 Eligibility
                                 Application
                                 (all languages).

[[Page 73110]]

 
General responder.............  Postcard for new           2,475               1           15/60             619
                                 general
                                 responders in
                                 NY/NJ to select
                                 a clinic.
Program Medical Provider......  Physician                 20,000               1           30/60          10,000
                                 Request for
                                 Certification.
Responder (FDNY and General     Denial Letter                 45               1           30/60              23
 Responder)/Survivor.            and Appeal
                                 Notification--E
                                 nrollment.
Responder (FDNY and General     Disenrollment                  3               1           30/60             1.5
 Responder)/Survivor.            Letter and
                                 Appeal
                                 Notification.
Responder (FDNY and General     Denial Letter                 60               1           90/60              90
 Responder)/Survivor.            and Appeal
                                 Notification--H
                                 ealth Condition
                                 Certification.
Responder (FDNY and General     Decertification                5               1           90/60             7.5
 Responder)/Survivor.            Letter and
                                 Appeal
                                 Notification.
Responder (FDNY and General     Denial Letter                 26               1           90/60              39
 Responder)/Survivor.            and Appeal
                                 Notification--T
                                 reatment
                                 Authorization.
Responder (FDNY and General     WTC Health                    10               1           10/60               2
 Responder)/Survivor.            Program Medical
                                 Travel Refund
                                 Request.
Designated Rep Form...........  Form to                       10               1           15/60               3
                                 designate a
                                 representative.
HIPAA Release.................  Form to share                 10               1           15/60               3
                                 member
                                 information.
Pharmacy......................  Outpatient                   150             261            1/60             653
                                 prescription
                                 pharmaceuticals.
Program Medical Provider......  Reimbursement                600               1           30/60             300
                                 Denial Letter
                                 and Appeal
                                 Notification.
Responder/Survivor/Advocate     Petition for the              60               1           60/60              60
 (physician).                    addition of
                                 health
                                 conditions.
                                                 ---------------------------------------------------------------
    Total.....................  ................  ..............  ..............  ..............          14,052
----------------------------------------------------------------------------------------------------------------


Leroy A. Richardson,
Chief, Information Collection Review Office, Office of Scientific 
Integrity, Office of the Associate Director for Science, Office of the 
Director, Centers for Disease Control and Prevention.
[FR Doc. 2016-25579 Filed 10-21-16; 8:45 am]
 BILLING CODE P

73108 Federal Register / Vol. 81, No. 205 / Monday, October 24, 2016 / Notices 4. Quarterly Reports DATES: Written comments must be proposed revised collection of (d) Budget Review received on or before December 23, information; (c) ways to enhance the (e) Audit Status 2016. quality, utility, and clarity of the 5. Internal Audit ADDRESSES: You may submit comments, information to be collected; (d) ways to (f) Internal Audit Charter identified by Docket No. CDC–2016– minimize the burden of the collection of (g) Lockbox Operations Audit Report 0099 by any of the following methods: information on respondents, including 6. Mid-Year Financial Audit • Federal eRulemaking Portal: through the use of automated collection 7. Office of Resource Management Regulations.gov. Follow the instructions techniques or other forms of information Annual Report for submitting comments. technology; and (e) estimates of capital • Mail: Leroy A. Richardson, or start-up costs and costs of operation, Closed Session maintenance, and purchase of services Information Collection Review Office, Information covered under 5 U.S.C. Centers for Disease Control and to provide information. Burden means 552b(c)(4) and (c)(9)(B). Prevention, 1600 Clifton Road NE., MS– the total time, effort, or financial D74, Atlanta, Georgia 30329. resources expended by persons to Adjourn Instructions: All submissions received generate, maintain, retain, disclose or CONTACT PERSON FOR MORE INFORMATION: must include the agency name and provide information to or for a Federal Kimberly Weaver, Director, Office of Docket Number. All relevant comments agency. This includes the time needed External Affairs, (202) 942–1640. received will be posted without change to review instructions; to develop, to Regulations.gov, including any acquire, install and utilize technology Dated: October 20, 2016. personal information provided. For and systems for the purpose of Megan Grumbine, collecting, validating and verifying General Counsel, Federal Retirement Thrift access to the docket to read background documents or comments received, go to information, processing and Investment Board. maintaining information, and disclosing [FR Doc. 2016–25761 Filed 10–20–16; 4:15 pm] Regulations.gov. Please note: All public comment and providing information; to train BILLING CODE 6760–01–P should be submitted through the personnel and to be able to respond to Federal eRulemaking portal a collection of information, to search (regulations.gov) or by U.S. mail to the data sources, to complete and review address listed above. the collection of information; and to DEPARTMENT OF HEALTH AND transmit or otherwise disclose the HUMAN SERVICES FOR FURTHER INFORMATION CONTACT: To information. request more information on the Centers for Disease Control and proposed project or to obtain a copy of Proposed Project Prevention the information collection plan and World Trade Center Health Program instruments, contact the Information Enrollment, Treatment, Appeals & [60Day–17–0891; Docket No. CDC–2016– Collection Review Office, Centers for 0099] Reimbursement (OMB Control No. Disease Control and Prevention, 1600 0920–0891, Expires 09/30/2018)— Clifton Road NE., MS–D74, Atlanta, Revision—National Institute for Proposed Data Collection Submitted Georgia 30329; phone: 404–639–7570; Occupational Safety and Health, Centers for Public Comment and Email: omb@cdc.gov. for Disease Control and Prevention Recommendations SUPPLEMENTARY INFORMATION: (CDC). AGENCY: Centers for Disease Control and Under the Paperwork Reduction Act Prevention (CDC), Department of Health of 1995 (PRA) (44 U.S.C. 3501–3520), Background and Brief Description and Human Services (HHS). Federal agencies must obtain approval NIOSH seeks to request OMB ACTION: Notice with comment period. from the Office of Management and approval to revise the currently Budget (OMB) for each collection of approved information collection SUMMARY: The Centers for Disease information they conduct or sponsor. In activities that support the World Trade Control and Prevention (CDC), as part of addition, the PRA also requires Federal Center (WTC) Health Program. The its continuing effort to reduce public agencies to provide a 60-day notice in James Zadroga 9/11 Health and burden and maximize the utility of the Federal Register concerning each Compensation Act of 2010 (Pub. L. 111– government information, invites the proposed collection of information, 347, as amended by Pub. L. 114–113) general public and other Federal including each new proposed created the WTC Health Program to agencies to take this opportunity to collection, each proposed extension of provide medical monitoring and comment on proposed and/or existing collection of information, and treatment benefits to eligible firefighters continuing information collections, as each reinstatement of previously and related personnel, law enforcement required by the Paperwork Reduction approved information collection before officers, and rescue, recovery, and Act of 1995. This notice invites submitting the collection to OMB for cleanup workers who responded to the comment on a proposed revision to the approval. To comply with this September 11, 2001, terrorist attacks in ‘‘World Trade Center Health Program requirement, we are publishing this New York City, at the Pentagon, and in Enrollment, Treatment, Appeals & notice of proposed revisions to an Shanksville, Pennsylvania (responders), Reimbursement’’ information collection existing data collection as described and to eligible persons who were approved under OMB Control Number below. present in the dust or dust cloud on 0920–0891, which allows the collection Comments are invited on: (a) Whether sradovich on DSK3GMQ082PROD with NOTICES September 11, 2001, or who worked, of information from Program members the proposed revisions to an existing resided, or attended school, childcare, and affiliated medical providers for the collection of information is necessary or adult daycare in the New York City purpose of determining eligibility and for the proper performance of the disaster area (survivors). providing treatment services in functions of the agency, including This request also seeks to incorporate accordance with the James Zadroga 9/ whether the information shall have the World Trade Center Health Program 11 Health and Compensation Act of practical utility; (b) the accuracy of the Petition for the addition of a New WTC- 2010. agency’s estimate of the burden of the Related Health Condition for Coverage VerDate Sep<11>2014 17:42 Oct 21, 2016 Jkt 241001 PO 00000 Frm 00053 Fmt 4703 Sfmt 4703 E:\FR\FM\24OCN1.SGM 24OCN1

Federal Register / Vol. 81, No. 205 / Monday, October 24, 2016 / Notices 73109 under the WTC Health Program package that the disenrollment appeal requests that 0.05 percent (26) will appeal a (0920–0929) into the existing approval, will take no more than 0.5 hours per determination by the WTC Health World Trade Center Health Program respondent. The annual burden estimate Program that the treatment being sought Enrollment, Appeals, Reimbursement, & is 1.5 hours. is not medically necessary. We estimate Petitions (OMB Control No. 0920–0891). Section 42 CFR 88.21 establishes that the appeals letter will take no more Upon approval, OMB Control number procedures for the appeal of WTC than 30 minutes and providing 0920–0929 will be discontinued. Health Program decisions to decertify a additional information and/or an oral Since its inception in 2011, the WTC WTC-related health condition, deny statement will take no more than 1 hour. Health Program has been approved to certification, and deny treatment The burden estimate for treatment collect information from applicants and authorization. Appeals of health authorization denial appeals is 39 Program members (enrolled WTC condition certification denials and hours. responders and survivors) concerning treatment authorization denials, which Finally, 42 CFR 88.23 establishes eligibility and enrollment, appointment include the submission of appeal procedures for the appeal of a WTC of a designated representative, medical request letters, are currently approved; Health Program decision to deny care, travel reimbursement, and appeal the Program proposes to extend this reimbursement to a Program medical of adverse Program decisions. The WTC information collection to account for the provider for treatment determined not to Health Program is also currently burden of requests for appeal of be medically necessary. Accordingly, approved to collect information from decertification decisions. The the Program proposes the addition of Program medical providers, including information collection would also be information collected in the appeal health condition certification requests expanded to allow Program members to request. We estimate that of the nearly and pharmaceutical claims. Currently- provide additional information and/or 52,000 Program providers, we estimate approved total estimated burden is an oral statement. Of the estimated that 1.15 percent (600) annually will be 13,594 hours annually. See OMB 51,472 Program members who have at denied reimbursement for treatment Control No. 0920–0891, exp. September least one health condition certification, found to be not medically necessary or 30, 2018. we estimate that 0.02 percent (10) will in accordance with treatment protocols, The WTC Health Program has be decertified, and 50 percent (5) of and will appeal the decision. We determined that some existing forms those will appeal a decertification. We estimate that the appeal letter will take need to be updated, and new estimate that the appeal request letter no more than 0.5 hours to compile. The information collections related to a will take no more than 0.5 hours per burden estimate for treatment recent rulemaking should be added. respondent. Providing additional reimbursement denial appeals is 300 Changes to WTC Health Program information and/or an oral statement hours. regulations in 42 CFR part 88 will will take no more than 1 hour per The Program also finds it necessary to require the extension of existing respondent. The annual burden estimate add a new form to allow applicants and information collections. Specifically, 42 for decertification appeals is 7.5 hours. Program members to grant permission to CFR 88.13 establishes procedures for the We estimate that Program members share information with a third person appeal of Program decisions to disenroll request certification for 20,000 health about an individual’s application or Program members and deny enrollment conditions each year. Of those 20,000, case. We estimate that 30 applicants and to applicants. Appeals of enrollment we estimate that 1 percent (200) of members will submit a Health Insurance denial decisions, which include the certification requests are denied by the Portability and Accountability Act submission of appeal request letters, are WTC Health Program. We further expect (HIPAA) Release Form annually. The currently approved; the Program that 30 percent of denied certifications, form is expected to take no longer than proposes to extend this information or 60 individuals, will be appealed. We 0.25 hours to complete. The burden collection to account for the burden of estimate that the appeals letter takes no estimate for the HIPAA Release form is requests for appeal of disenrollment more than 30 minutes and providing 7.5 hours. decisions. Of the over 70,000 Program additional information and/or an oral In addition to describing those burden members, we expect that 0.014 percent statement will take no more than 1 hour. estimates revised by this action, the (10) will be subsequently disenrolled The burden estimate for certification estimated annualized burden hours for from the Program. Of those, we expect denial appeals is 90 hours. Finally, of those collection instruments not subject that 30 percent (3) will appeal the the projected 51,472 Program members to revision in this action are included in disenrollment decisions. We estimate who receive medical care, we estimate the table below. ESTIMATED ANNUALIZED BURDEN HOURS Number of Average Type of Number of responses burden per Total burden Form name respondent respondents per response hours respondent (in hours) FDNY Responder .............................. World Trade Center Health Program 45 1 30/60 23 FDNY Responder Eligibility Appli- cation. General Responder ........................... World Trade Center Health Program 2,475 1 30/60 1,238 sradovich on DSK3GMQ082PROD with NOTICES Responder Eligibility Application (Other than FDNY). Pentagon/Shanksville Responder ..... World Trade Center Health Program 630 1 30/60 315 Pentagon/Shanksville Responder. WTC Survivor .................................... World Trade Center Health Program 1,350 1 30/60 675 Survivor Eligibility Application (all languages). VerDate Sep<11>2014 17:42 Oct 21, 2016 Jkt 241001 PO 00000 Frm 00054 Fmt 4703 Sfmt 4703 E:\FR\FM\24OCN1.SGM 24OCN1

73110 Federal Register / Vol. 81, No. 205 / Monday, October 24, 2016 / Notices ESTIMATED ANNUALIZED BURDEN HOURS—Continued Number of Average Type of Number of responses burden per Total burden Form name respondent respondents per response hours respondent (in hours) General responder ............................ Postcard for new general respond- 2,475 1 15/60 619 ers in NY/NJ to select a clinic. Program Medical Provider ................ Physician Request for Certification .. 20,000 1 30/60 10,000 Responder (FDNY and General Re- Denial Letter and Appeal Notifica- 45 1 30/60 23 sponder)/Survivor. tion—Enrollment. Responder (FDNY and General Re- Disenrollment Letter and Appeal No- 3 1 30/60 1.5 sponder)/Survivor. tification. Responder (FDNY and General Re- Denial Letter and Appeal Notifica- 60 1 90/60 90 sponder)/Survivor. tion—Health Condition Certifi- cation. Responder (FDNY and General Re- Decertification Letter and Appeal 5 1 90/60 7.5 sponder)/Survivor. Notification. Responder (FDNY and General Re- Denial Letter and Appeal Notifica- 26 1 90/60 39 sponder)/Survivor. tion—Treatment Authorization. Responder (FDNY and General Re- WTC Health Program Medical Trav- 10 1 10/60 2 sponder)/Survivor. el Refund Request. Designated Rep Form ....................... Form to designate a representative 10 1 15/60 3 HIPAA Release ................................. Form to share member information 10 1 15/60 3 Pharmacy .......................................... Outpatient prescription pharma- 150 261 1/60 653 ceuticals. Program Medical Provider ................ Reimbursement Denial Letter and 600 1 30/60 300 Appeal Notification. Responder/Survivor/Advocate (physi- Petition for the addition of health 60 1 60/60 60 cian). conditions. Total ........................................... ........................................................... ........................ ........................ ........................ 14,052 Leroy A. Richardson, Act of 1995. This notice invites to Regulations.gov, including any Chief, Information Collection Review Office, comment on the proposed information personal information provided. For Office of Scientific Integrity, Office of the collection project entitled ‘‘Assessment access to the docket to read background Associate Director for Science, Office of the of Targeted Training and Technical documents or comments received, go to Director, Centers for Disease Control and Assistance (TTA) Efforts on the Regulations.gov. Prevention. Implementation of Comprehensive Please note: All public comment [FR Doc. 2016–25579 Filed 10–21–16; 8:45 am] Cancer Control’’. CDC is requesting to should be submitted through the BILLING CODE P collect information about TTA offered Federal eRulemaking portal under two different cooperative (Regulations.gov) or by U.S. mail to the agreements using case studies, a web- address listed above. DEPARTMENT OF HEALTH AND based survey, and in-depth interviews FOR FURTHER INFORMATION CONTACT: To HUMAN SERVICES in order to document how TTA was request more information on the Centers for Disease Control and provided and identify elements of TTA proposed project or to obtain a copy of Prevention administered across both cooperative the information collection plan and agreements that could inform the instruments, contact the Information [60Day–17–17AW; Docket No. CDC–2016– development of a viable TTA model for Collection Review Office, Centers for 0101] enhancing future tobacco and cancer Disease Control and Prevention, 1600 prevention and control efforts. Clifton Road NE., MS–D74, Atlanta, Proposed Data Collection Submitted DATES: Written comments must be Georgia 30329; phone: 404–639–7570; for Public Comment and received on or before December 23, Email: omb@cdc.gov. Recommendations 2016. SUPPLEMENTARY INFORMATION: Under the AGENCY: Centers for Disease Control and ADDRESSES: You may submit comments, Paperwork Reduction Act of 1995 (PRA) Prevention (CDC), Department of Health identified by Docket No. CDC–2016– (44 U.S.C. 3501–3520), Federal agencies and Human Services (HHS). 0101 by any of the following methods: must obtain approval from the Office of ACTION: Notice with comment period. • Federal eRulemaking Portal: Management and Budget (OMB) for each Regulations.gov. Follow the instructions collection of information they conduct SUMMARY: The Centers for Disease for submitting comments. or sponsor. In addition, the PRA also Control and Prevention (CDC), as part of • Mail: Leroy A. Richardson, requires Federal agencies to provide a its continuing efforts to reduce public 60-day notice in the Federal Register sradovich on DSK3GMQ082PROD with NOTICES Information Collection Review Office, burden and maximize the utility of Centers for Disease Control and concerning each proposed collection of government information, invites the Prevention, 1600 Clifton Road, NE., information, including each new general public and other Federal MS–D74, Atlanta, Georgia 30329. proposed collection, each proposed agencies to take this opportunity to Instructions: All submissions received extension of existing collection of comment on proposed and/or must include the agency name and information, and each reinstatement of continuing information collections, as Docket Number. All relevant comments previously approved information required by the Paperwork Reduction received will be posted without change collection before submitting the VerDate Sep<11>2014 17:42 Oct 21, 2016 Jkt 241001 PO 00000 Frm 00055 Fmt 4703 Sfmt 4703 E:\FR\FM\24OCN1.SGM 24OCN1


Document Created: 2016-10-21 23:46:22
Document Modified: 2016-10-21 23:46:22
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice with comment period.
DatesWritten comments must be received on or before December 23, 2016.
ContactTo request more information on the proposed project or to obtain a copy of the information collection plan and instruments, contact the Information Collection Review Office, Centers for Disease Control and Prevention, 1600 Clifton Road NE., MS- D74, Atlanta, Georgia 30329; phone: 404-639-7570; Email: [email protected]
FR Citation81 FR 73108 
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