83_FR_48614 83 FR 48428 - Agency Forms Undergoing Paperwork Reduction Act Review

83 FR 48428 - Agency Forms Undergoing Paperwork Reduction Act Review

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

Federal Register Volume 83, Issue 186 (September 25, 2018)

Page Range48428-48430
FR Document2018-20807

Federal Register, Volume 83 Issue 186 (Tuesday, September 25, 2018)
[Federal Register Volume 83, Number 186 (Tuesday, September 25, 2018)]
[Notices]
[Pages 48428-48430]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-20807]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-18-0891]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Centers 
for Disease Control and Prevention (CDC) has submitted the information 
collection request titled World Trade Center Health Program Enrollment, 
Treatment, Appeals & Reimbursement to the Office of Management and 
Budget (OMB) for review and approval. CDC previously published a 
``Proposed Data Collection Submitted for Public Comment and 
Recommendations'' notice on May 11, 2018, to obtain comments from the 
public and affected agencies. CDC did not receive comments related to 
the previous notice. This notice serves to allow an additional 30 days 
for public and affected agency comments.
    CDC will accept all comments for this proposed information 
collection project. The Office of Management and Budget is particularly 
interested in comments that:
    (a) Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    (b) Evaluate the accuracy of the agencies estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    (c) Enhance the quality, utility, and clarity of the information to 
be collected;
    (d) Minimize the burden of the collection of information on those 
who are to respond, including, through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submission of responses; and
    (e) Assess information collection costs.
    To request additional information on the proposed project or to 
obtain a copy of the information collection plan and instruments, call 
(404) 639-7570 or send an email to omb@cdc.gov. Direct written comments 
and/or suggestions regarding the items contained in this notice to the 
Attention: CDC Desk Officer, Office of Management and Budget, 725 17th 
Street NW, Washington, DC 20503 or by fax to (202) 395-5806. Provide 
written comments within 30 days of notice publication.

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 
(NIOSH), 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 individuals affected by the terrorist 
attacks on September 11, 2001. Eligible individuals include 
firefighters and related personnel, law enforcement officers, and 
rescue, recovery, and cleanup workers who responded to the 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 information collection 
previously approved under the World Trade Center Health Program 
Petition for the Addition of a New WTC-Related Health Condition for 
Coverage under the World Trade Center (WTC) Health Program (OMB No. 
0920-0929, expiration date 7/31/2018), which has been discontinued. The 
revision of OMB No. 0920-0891 will provide a comprehensive summary of 
information collection needed to administer the World Trade Center 
Health Program.
    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

[[Page 48429]]

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. 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 2 hours (rounded).
    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 will 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 one hour per 
respondent. The annual burden estimate for decertification appeals is 8 
hours.
    We further estimate that Program members request certification for 
20,000 health conditions each year. Of those 20,000, we estimate that 
one percent (200) of certification requests are denied by the WTC 
Health Program. We also 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 
one hour. The burden estimate for certification denial appeals is 90 
hours.
    In addition, 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 one 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 revision request also includes the addition of 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 will to take no longer than 0.25 hours to complete. 
The burden estimate for the HIPAA Release form is 8 hours.
    The total estimated annualized burden hours are 14,063, an increase 
of 469 hours from the previously approved estimate of 13,594 hours. The 
revised estimate includes forms that have not been modified; changes 
due to the appeals processes authorized by 42 CFR 88.21 and 42 CFR 
88.23; inclusion of the new HIPPA Release Form; incorporation of a form 
previously approved under OMB No. 0920-0929; and miscellaneous actions. 
The revision request provides a detailed summary of each change and its 
impact on the burden estimate.

                                        Background and Brief Description
----------------------------------------------------------------------------------------------------------------
                                                                                     Number of    Average burden
         Type of respondent                   Form name              Number of     responses per   per response
                                                                    respondents     respondent      (in hours)
----------------------------------------------------------------------------------------------------------------
FDNY Responder.....................  World Trade Center Health                45               1           30/60
                                      Program FDNY Responder
                                      Eligibility Application.
General Responder..................  World Trade Center Health             2,475               1           30/60
                                      Program Responder
                                      Eligibility Application
                                      (Other than FDNY).
Pentagon/Shanksville Responder.....  World Trade Center Health               630               1           30/60
                                      Program Pentagon/
                                      Shanksville Responder.
WTC Survivor.......................  World Trade Center Health             1,350               1           30/60
                                      Program Survivor
                                      Eligibility Application
                                      (all languages).
General responder..................  Clinic Selection Postcard             2,475               1           15/60
                                      for new general responders
                                      in NY/NJ to select a
                                      clinic.
Program Medical Provider...........  Physician Request for                20,000               1           30/60
                                      Certification (WTC-3).
Responder (FDNY and General          Denial Letter and Appeal                 45               1           30/60
 Responder)/Survivor.                 Notification--Enrollment.
Responder (FDNY and General          Disenrollment Letter and                  3               1           30/60
 Responder)/Survivor.                 Appeal Notification--
                                      Enrollment.

[[Page 48430]]

 
Responder (FDNY and General          Decertification Letter and                5               1             1.5
 Responder)/Survivor.                 Appeal Notification--
                                      Health Condition.
Responder (FDNY and General          Denial Letter and Appeal                 60               1             1.5
 Responder)/Survivor.                 Notification--Health
                                      Condition Certification.
Responder (FDNY and General          Denial Letter and Appeal                 26               1             1.5
 Responder)/Survivor.                 Notification--Treatment
                                      Authorization.
Responder (FDNY and General          WTC Health Program Medical               10               1           10/60
 Responder)/Survivor.                 Travel Refund Request.
Program Members....................  Designated Representative                30               1           15/60
                                      Form.
Program Member.....................  HIPAA Release Form to allow              30               1           15/60
                                      the sharing of member
                                      information with a third
                                      party.
Pharmacy...........................  Outpatient prescription                 150             261            1/60
                                      pharmaceuticals.
Program Medical Provider...........  Reimbursement Denial Letter             600               1           30/60
                                      and Appeal Notification--
                                      Providers.
Responder/Survivor/Advocate          Petition for the addition                60               1               1
 (physician).                         of health conditions.
----------------------------------------------------------------------------------------------------------------


Jeffrey M. Zirger,
Acting 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. 2018-20807 Filed 9-24-18; 8:45 am]
 BILLING CODE 4163-18-P



                                               48428                     Federal Register / Vol. 83, No. 186 / Tuesday, September 25, 2018 / Notices

                                               threats, both domestically and                            Dated: August 17, 2018.                             instruments, call (404) 639–7570 or
                                               internationally to its components,                      Alex M. Azar II,                                      send an email to omb@cdc.gov. Direct
                                               which are as follows:                                   Secretary.                                            written comments and/or suggestions
                                               Æ Center for Global Health (CBB)                        [FR Doc. 2018–20835 Filed 9–24–18; 8:45 am]           regarding the items contained in this
                                               Æ Center for Preparedness and Response                  BILLING CODE 4160–18–P
                                                                                                                                                             notice to the Attention: CDC Desk
                                                 (CBC)                                                                                                       Officer, Office of Management and
                                               Æ Center for State, Tribal, Local and                                                                         Budget, 725 17th Street NW,
                                                 Territorial Support (CBD)                             DEPARTMENT OF HEALTH AND                              Washington, DC 20503 or by fax to (202)
                                               Æ Office of Minority Health and Health                  HUMAN SERVICES                                        395–5806. Provide written comments
                                                 Equity (CBE)                                                                                                within 30 days of notice publication.
                                                 • Deputy Director for Public Health                   Centers for Disease Control and
                                                                                                                                                             Proposed Project
                                               Science and Surveillance (CP): The                      Prevention
                                                                                                                                                               World Trade Center Health Program
                                               Deputy Director for Public Health                       [30Day–18–0891]                                       Enrollment, Treatment, Appeals &
                                               Science and Surveillance leads,
                                                                                                                                                             Reimbursement (OMB Control No.
                                               promotes, and facilitates science,                      Agency Forms Undergoing Paperwork
                                                                                                                                                             0920–0891, Expires 09/30/2018)—
                                               surveillance, standards and policies to                 Reduction Act Review
                                                                                                                                                             Revision—National Institute for
                                               reduce the burden of diseases in the
                                                                                                          In accordance with the Paperwork                   Occupational Safety and Health
                                               United States and globally to its                                                                             (NIOSH), Centers for Disease Control
                                                                                                       Reduction Act of 1995, the Centers for
                                               components, which are as follows:                                                                             and Prevention (CDC).
                                                                                                       Disease Control and Prevention (CDC)
                                               Æ National Center for Health Statistics                 has submitted the information
                                                 (CPC)                                                                                                       Background and Brief Description
                                                                                                       collection request titled World Trade
                                               Æ Center for Surveillance,                              Center Health Program Enrollment,                        NIOSH seeks to request OMB
                                                 Epidemiology, and Laboratory                          Treatment, Appeals & Reimbursement to                 approval to revise the currently
                                                 Services (CPN)                                        the Office of Management and Budget                   approved information collection
                                               Æ Office of Science (CPP)                               (OMB) for review and approval. CDC                    activities that support the World Trade
                                               Æ Office of Laboratory Science and                      previously published a ‘‘Proposed Data                Center (WTC) Health Program. The
                                                 Safety (CPQ)                                          Collection Submitted for Public                       James Zadroga 9/11 Health and
                                                 • Deputy Director for Non-Infectious                  Comment and Recommendations’’                         Compensation Act of 2010 (Pub. L. 111–
                                               Diseases (CU): The Deputy Director for                  notice on May 11, 2018, to obtain                     347, as amended by Pub. L. 114–113)
                                               Non-Infectious Diseases reduces the                     comments from the public and affected                 created the WTC Health Program to
                                               burden of non-infectious diseases,                      agencies. CDC did not receive comments                provide medical monitoring and
                                               injuries, birth defects, disabilities and               related to the previous notice. This                  treatment benefits to eligible individuals
                                               environmental health hazards to its                     notice serves to allow an additional 30               affected by the terrorist attacks on
                                               components, which are as follows:                       days for public and affected agency                   September 11, 2001. Eligible individuals
                                               Æ National Center on Birth Defects and                  comments.                                             include firefighters and related
                                                 Developmental Disabilities (CUB)                         CDC will accept all comments for this              personnel, law enforcement officers,
                                               Æ National Center for Chronic Disease                   proposed information collection project.              and rescue, recovery, and cleanup
                                                 Prevention and Health Promotion                       The Office of Management and Budget                   workers who responded to the attacks in
                                                 (CUC)                                                 is particularly interested in comments                New York City, at the Pentagon, and in
                                               Æ National Center for Environmental                     that:                                                 Shanksville, Pennsylvania (responders),
                                                 Health/Agency for Toxic Substances                       (a) Evaluate whether the proposed                  and to eligible persons who were
                                                 and Disease Registry (CUG)                            collection of information is necessary                present in the dust or dust cloud on
                                               Æ National Center for Injury Prevention                 for the proper performance of the                     September 11, 2001, or who worked,
                                                 and Control (CUH)                                     functions of the agency, including                    resided, or attended school, childcare,
                                                 • Deputy Director for Infectious                      whether the information will have                     or adult daycare in the New York City
                                               Diseases (CV): Deputy Director for                      practical utility;                                    disaster area (survivors).
                                               Infectious Diseases leads, promotes, and                   (b) Evaluate the accuracy of the                      This request also seeks to incorporate
                                               facilitates science, programs, and                      agencies estimate of the burden of the                information collection previously
                                               policies to reduce the burden of                        proposed collection of information,                   approved under the World Trade Center
                                               infectious disease in the United States                 including the validity of the                         Health Program Petition for the
                                               and globally and its components, which                  methodology and assumptions used;                     Addition of a New WTC-Related Health
                                               are as follows:                                            (c) Enhance the quality, utility, and              Condition for Coverage under the World
                                                                                                       clarity of the information to be                      Trade Center (WTC) Health Program
                                               Æ National Center for Immunization and
                                                                                                       collected;                                            (OMB No. 0920–0929, expiration date 7/
                                                 Respiratory Diseases (CVG)
                                                                                                          (d) Minimize the burden of the                     31/2018), which has been discontinued.
                                               Æ National Center for Emerging and
                                                                                                       collection of information on those who                The revision of OMB No. 0920–0891
                                                 Zoonotic Infectious Diseases (CVL)
                                                                                                       are to respond, including, through the                will provide a comprehensive summary
                                               Æ National Center for HIV/AIDS, Viral
                                                                                                       use of appropriate automated,                         of information collection needed to
                                                 Hepatitis, STD and TB Prevention
                                                                                                       electronic, mechanical, or other                      administer the World Trade Center
                                                 IV. Delegations of Authority: All                     technological collection techniques or                Health Program.
                                               delegations and redelegations of                        other forms of information technology,                   Since its inception in 2011, the WTC
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                                               authority made to officials and                         e.g., permitting electronic submission of             Health Program has been approved to
                                               employees of affected organizational                    responses; and                                        collect information from applicants and
                                               components will continue in them or                        (e) Assess information collection                  Program members (enrolled WTC
                                               their successors pending further                        costs.                                                responders and survivors) concerning
                                               redelegation, provided they are                            To request additional information on               eligibility and enrollment, appointment
                                               consistent with this reorganization.                    the proposed project or to obtain a copy              of a designated representative, medical
                                                  Authority: 44 U.S.C. 3101.                           of the information collection plan and                care, travel reimbursement, and appeal


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                                                                              Federal Register / Vol. 83, No. 186 / Tuesday, September 25, 2018 / Notices                                               48429

                                               of adverse Program decisions. The WTC                         decertification decisions. The                       Health Program decision to deny
                                               Health Program is also currently                              information collection will also be                  reimbursement to a Program medical
                                               approved to collect information from                          expanded to allow Program members to                 provider for treatment determined not to
                                               Program medical providers, including                          provide additional information and/or                be medically necessary. Accordingly,
                                               health condition certification requests                       an oral statement. Of the estimated                  the Program proposes the addition of
                                               and pharmaceutical claims. The WTC                            51,472 Program members who have at                   information collected in the appeal
                                               Health Program has determined that                            least one health condition certification,            request. We estimate that of the nearly
                                               some existing forms need to be updated,                       we estimate that 0.02 percent (10) will              52,000 Program providers, we estimate
                                               and new information collections related                       be decertified, and 50 percent (5) of                that 1.15 percent (600) annually will be
                                               to a recent rulemaking should be added.                       those will appeal a decertification. We              denied reimbursement for treatment
                                                  Changes to WTC Health Program                              estimate that the appeal request letter              found to be not medically necessary or
                                               regulations in 42 CFR part 88 will                            will take no more than 0.5 hours per                 in accordance with treatment protocols,
                                               require the extension of existing                             respondent. Providing additional                     and will appeal the decision. We
                                               information collections. Specifically, 42                     information and/or an oral statement                 estimate that the appeal letter will take
                                               CFR 88.13 establishes procedures for the                      will take no more than one hour per                  no more than 0.5 hours to compile. The
                                               appeal of Program decisions to disenroll                      respondent. The annual burden estimate               burden estimate for treatment
                                               Program members and deny enrollment                           for decertification appeals is 8 hours.
                                               to applicants. Appeals of enrollment                             We further estimate that Program                  reimbursement denial appeals is 300
                                               denial decisions, which include the                           members request certification for 20,000             hours.
                                               submission of appeal request letters, are                     health conditions each year. Of those                   The revision request also includes the
                                               currently approved; the Program                               20,000, we estimate that one percent                 addition of a new form to allow
                                               proposes to extend this information                           (200) of certification requests are denied           applicants and Program members to
                                               collection to account for the burden of                       by the WTC Health Program. We also                   grant permission to share information
                                               requests for appeal of disenrollment                          expect that 30 percent of denied                     with a third person about an
                                               decisions. Of the over 70,000 Program                         certifications, or 60 individuals, will be           individual’s application or case. We
                                               members, we expect that 0.014 percent                         appealed. We estimate that the appeals               estimate that 30 applicants and
                                               (10) will be subsequently disenrolled                         letter takes no more than 30 minutes                 members will submit a Health Insurance
                                               from the Program. Of those, we expect                         and providing additional information                 Portability and Accountability Act
                                               that 30 percent (3) will appeal the                           and/or an oral statement will take no                (HIPAA) Release Form annually. The
                                               disenrollment decisions. We estimate                          more than one hour. The burden                       form will to take no longer than 0.25
                                               that the disenrollment appeal requests                        estimate for certification denial appeals            hours to complete. The burden estimate
                                               will take no more than 0.5 hours per                          is 90 hours.                                         for the HIPAA Release form is 8 hours.
                                               respondent. The annual burden estimate                           In addition, of the projected 51,472
                                               is 2 hours (rounded).                                         Program members who receive medical                     The total estimated annualized
                                                  Section 42 CFR 88.21 establishes                           care, we estimate that 0.05 percent (26)             burden hours are 14,063, an increase of
                                               procedures for the appeal of WTC                              will appeal a determination by the WTC               469 hours from the previously approved
                                               Health Program decisions to decertify a                       Health Program that the treatment being              estimate of 13,594 hours. The revised
                                               WTC-related health condition, deny                            sought is not medically necessary. We                estimate includes forms that have not
                                               certification, and deny treatment                             estimate that the appeals letter will take           been modified; changes due to the
                                               authorization. Appeals of health                              no more than 30 minutes and providing                appeals processes authorized by 42 CFR
                                               condition certification denials and                           additional information and/or an oral                88.21 and 42 CFR 88.23; inclusion of the
                                               treatment authorization denials, which                        statement will take no more than one                 new HIPPA Release Form; incorporation
                                               include the submission of appeal                              hour. The burden estimate for treatment              of a form previously approved under
                                               request letters, are currently approved;                      authorization denial appeals is 39                   OMB No. 0920–0929; and miscellaneous
                                               the Program proposes to extend this                           hours.                                               actions. The revision request provides a
                                               information collection to account for the                        Finally, 42 CFR 88.23 establishes                 detailed summary of each change and
                                               burden of requests for appeal of                              procedures for the appeal of a WTC                   its impact on the burden estimate.

                                                                                                             BACKGROUND AND BRIEF DESCRIPTION
                                                                                                                                                                                                      Average
                                                                                                                                                                                      Number of
                                                                                                                                                                  Number of                         burden per
                                                           Type of respondent                                             Form name                                                 responses per
                                                                                                                                                                 respondents                         response
                                                                                                                                                                                      respondent     (in hours)

                                               FDNY Responder ...............................       World Trade Center Health Program FDNY Re-                               45                 1          30/60
                                                                                                      sponder Eligibility Application.
                                               General Responder ............................       World Trade Center Health Program Responder Eli-                       2,475                1          30/60
                                                                                                      gibility Application (Other than FDNY).
                                               Pentagon/Shanksville Responder ......                World Trade Center Health Program Pentagon/                             630                 1          30/60
                                                                                                      Shanksville Responder.
                                               WTC Survivor .....................................   World Trade Center Health Program Survivor Eligi-                      1,350                1          30/60
                                                                                                      bility Application (all languages).
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                                               General responder .............................      Clinic Selection Postcard for new general respond-                     2,475                1          15/60
                                                                                                      ers in NY/NJ to select a clinic.
                                               Program Medical Provider ..................          Physician Request for Certification (WTC–3) .............          20,000                   1          30/60
                                               Responder (FDNY and General Re-                      Denial Letter and Appeal Notification—Enrollment ....                  45                   1          30/60
                                                 sponder)/Survivor.
                                               Responder (FDNY and General Re-                      Disenrollment Letter and Appeal Notification—Enroll-                       3                1          30/60
                                                 sponder)/Survivor.                                   ment.



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                                               48430                           Federal Register / Vol. 83, No. 186 / Tuesday, September 25, 2018 / Notices

                                                                                                       BACKGROUND AND BRIEF DESCRIPTION—Continued
                                                                                                                                                                                                           Average
                                                                                                                                                                                           Number of
                                                                                                                                                                        Number of                        burden per
                                                           Type of respondent                                                 Form name                                                  responses per
                                                                                                                                                                       respondents                        response
                                                                                                                                                                                           respondent     (in hours)

                                               Responder (FDNY and General Re-                        Decertification Letter and Appeal Notification—                                5               1            1.5
                                                 sponder)/Survivor.                                     Health Condition.
                                               Responder (FDNY and General Re-                        Denial Letter and Appeal Notification—Health Condi-                        60                  1            1.5
                                                 sponder)/Survivor.                                     tion Certification.
                                               Responder (FDNY and General Re-                        Denial Letter and Appeal Notification—Treatment                            26                  1            1.5
                                                 sponder)/Survivor.                                     Authorization.
                                               Responder (FDNY and General Re-                        WTC Health Program Medical Travel Refund Re-                               10                  1          10/60
                                                 sponder)/Survivor.                                     quest.
                                               Program Members ..............................         Designated Representative Form ...............................             30                  1          15/60
                                               Program Member ...............................         HIPAA Release Form to allow the sharing of mem-                            30                  1          15/60
                                                                                                        ber information with a third party.
                                               Pharmacy ...........................................   Outpatient prescription pharmaceuticals ....................             150                261            1/60
                                               Program Medical Provider ..................            Reimbursement Denial Letter and Appeal Notifica-                         600                  1           30/60
                                                                                                        tion—Providers.
                                               Responder/Survivor/Advocate (physi-                    Petition for the addition of health conditions ..............              60                  1                 1
                                                 cian).



                                               Jeffrey M. Zirger,                                               ADDRESSES:   You may submit comments                    manner detailed (see ‘‘Written/Paper
                                               Acting Chief, Information Collection Review                      as follows. Please note that late,                      Submissions’’ and ‘‘Instructions’’).
                                               Office, Office of Scientific Integrity, Office                   untimely filed comments will not be
                                               of the Associate Director for Science, Office                                                                            Written/Paper Submissions
                                                                                                                considered. Electronic comments must
                                               of the Director, Centers for Disease Control                     be submitted on or before November 26,                     Submit written/paper submissions as
                                               and Prevention.                                                  2018. The https://www.regulations.gov                   follows:
                                               [FR Doc. 2018–20807 Filed 9–24–18; 8:45 am]                      electronic filing system will accept                       • Mail/Hand Delivery/Courier (for
                                               BILLING CODE 4163–18–P                                           comments until 11:59 p.m. Eastern Time                  written/paper submissions): Dockets
                                                                                                                at the end of November 26, 2018.                        Management Staff (HFA–305), Food and
                                                                                                                Comments received by mail/hand                          Drug Administration, 5630 Fishers
                                               DEPARTMENT OF HEALTH AND                                         delivery/courier (for written/paper                     Lane, Rm. 1061, Rockville, MD 20852.
                                               HUMAN SERVICES                                                   submissions) will be considered timely                     • For written/paper comments
                                                                                                                if they are postmarked or the delivery                  submitted to the Dockets Management
                                               Food and Drug Administration                                                                                             Staff, FDA will post your comment, as
                                                                                                                service acceptance receipt is on or
                                               [Docket No. FDA–2018–N–3404]                                                                                             well as any attachments, except for
                                                                                                                before that date.
                                                                                                                                                                        information submitted, marked and
                                               Agency Information Collection                                    Electronic Submissions                                  identified, as confidential, if submitted
                                               Activities; Proposed Collection;                                                                                         as detailed in ‘‘Instructions.’’
                                                                                                                  Submit electronic comments in the                        Instructions: All submissions received
                                               Comment Request; Generic Drug User                               following way:
                                               Fee Cover Sheet                                                                                                          must include the Docket No. FDA–
                                                                                                                  • Federal eRulemaking Portal:                         2018–N–3404 for ‘‘Agency Information
                                               AGENCY:      Food and Drug Administration,                       https://www.regulations.gov. Follow the                 Collection Activities; Proposed
                                               HHS.                                                             instructions for submitting comments.                   Collection; Comment Request; Generic
                                               ACTION:     Notice.                                              Comments submitted electronically,                      Drug User Fee Cover Sheet.’’ Received
                                                                                                                including attachments, to https://                      comments, those filed in a timely
                                               SUMMARY:   The Food and Drug                                     www.regulations.gov will be posted to                   manner (see ADDRESSES), will be placed
                                               Administration (FDA or Agency) is                                the docket unchanged. Because your                      in the docket and, except for those
                                               announcing an opportunity for public                             comment will be made public, you are                    submitted as ‘‘Confidential
                                               comment on the proposed collection of                            solely responsible for ensuring that your               Submissions,’’ publicly viewable at
                                               certain information by the Agency.                               comment does not include any                            https://www.regulations.gov or at the
                                               Under the Paperwork Reduction Act of                             confidential information that you or a                  Dockets Management Staff between 9
                                               1995 (PRA), Federal Agencies are                                 third party may not wish to be posted,                  a.m. and 4 p.m., Monday through
                                               required to publish notice in the                                such as medical information, your or                    Friday.
                                               Federal Register concerning each                                 anyone else’s Social Security number, or                   • Confidential Submissions—To
                                               proposed collection of information,                              confidential business information, such                 submit a comment with confidential
                                               including each proposed extension of an                          as a manufacturing process. Please note                 information that you do not wish to be
                                               existing collection of information, and                          that if you include your name, contact                  made publicly available, submit your
                                               to allow 60 days for public comment in                           information, or other information that                  comments only as a written/paper
                                               response to the notice. This notice                              identifies you in the body of your                      submission. You should submit two
daltland on DSKBBV9HB2PROD with NOTICES




                                               solicits comments on collection of                               comments, that information will be                      copies total. One copy will include the
                                               information using Form FDA 3794,                                 posted on https://www.regulations.gov.                  information you claim to be confidential
                                               entitled ‘‘Generic Drug User Fee Cover                             • If you want to submit a comment                     with a heading or cover note that states
                                               Sheet.’’                                                         with confidential information that you                  ‘‘THIS DOCUMENT CONTAINS
                                               DATES: Submit either electronic or                               do not wish to be made available to the                 CONFIDENTIAL INFORMATION.’’ The
                                               written comments on the collection of                            public, submit the comment as a                         Agency will review this copy, including
                                               information by November 26, 2018.                                written/paper submission and in the                     the claimed confidential information, in


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Document Created: 2018-09-25 00:21:57
Document Modified: 2018-09-25 00:21:57
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
FR Citation83 FR 48428 

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