61256 Federal Register / Vol. 69, No. 199 / Friday, October 15, 2004 / Notices 

Survey/questionnaire—children with special health care needs Number of

respondents 

Number of

responses per 

respondent 

Average

burden per

response 

Developmental work for future module: 

Screener ............................................................................................................................... 10,000 1 5/60 

Survey ................................................................................................................................... 2,000 1 30/60 

SLAITS website—button or permanent website submission link: 

Survey ................................................................................................................................... 100 1 3/60 

2007 Burden Estimates

Screener ............................................................................................................................... 589,847 1 5/60

Survey ................................................................................................................................... 102,000 1 25/60 

Developmental work for future modules: 

Screener ............................................................................................................................... 10,000 1 5/60 

Survey ................................................................................................................................... 2,000 1 30/60 

SLAITS website—button or permanent website submission link: 

Survey ................................................................................................................................... 100 1 3/60 

Dated: October 8, 2004. 

Alvin Hall, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention.

[FR Doc. 04–23150 Filed 10–14–04; 8:45 am] 

BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[30Day–04II] 

Proposed Data Collections Submitted 

for Public Comment and 

Recommendations 

The Centers for Disease Control and 

Prevention (CDC) publishes a list of 

information collection requests under 

review by the Office of Management and 

Budget (OMB) in compliance with the 

Paperwork Reduction Act (44 U.S.C. 

Chapter 35). To request a copy of these 

requests, call the CDC Reports Clearance 

Officer at (404) 498–1210 or send an email to omb@cdc.gov. Send written 

comments to CDC Desk Officer, Human 

Resources and Housing Branch, New 

Executive Office Building, Room 10235, 

Washington, DC 20503 or by fax to (202) 

395–6974. Written comments should be 

received within 30 days of this notice. 

Proposed Project 

Evaluation of State Nutrition and 

Physical Activity Programs to Prevent 

Obesity and Other Chronic Diseases—

New—National Center for Chronic 

Disease Prevention and Health 

Promotion (NCCDHP), Centers for 

Disease Control and Prevention (CDC). 

The ‘‘State Nutrition and Physical 

Activity Programs to Prevent Obesity 

and Other Chronic Diseases’’ project 

was established by CDC to prevent and 

control obesity and other chronic 

diseases by supporting States in the 

development and implementation of 

nutrition and physical activity 

interventions, particularly through 

population-based strategies such as 

policy-level changes, environmental 

supports and the social marketing 

process. The goal of the programs in this 

project is to attain population-based 

behavior change such as increased 

physical activity and better dietary 

habits; this will likely lead to a 

reduction in the prevalence of obesity, 

and ultimately to a reduction in the 

prevalence of obesity-related chronic 

diseases. 

The evaluation questions for ‘‘State 

Nutrition and Physical Activity 

Programs to Prevent Obesity and Other 

Chronic Diseases’’ have been designed 

to focus on three primary areas: (1) CDC 

training and technical assistance; (2) 

State plan development; and (3) State 

interventions. Within each of these 

primary evaluation areas, the program 

has identified specific evaluation 

questions that have been chosen for 

study. The evaluation questions will be 

asked of the funded states via a Webbased data collection system supported 

by an electronic database. This 

evaluation will take place every six 

months during the funding cycle. The 

proposed project will be conducted over 

a three-year period. There is no cost to 

the respondents. The total burden hours 

are 480.

Respondents Number of

respondents 

Number

responses per

respondent 

Average burden

per response

(in hrs.) 

Funded State Programs .................................................................................................. 20 2 12 

Federal Register / Vol. 69, No. 199 / Friday, October 15, 2004 / Notices 61257

Dated: October 8, 2004. 

Alvin Hall, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention.

[FR Doc. 04–23151 Filed 10–14–04; 8:45 am] 

BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare and Medicaid 

Services 

[Document Identifier: CMS–10109 and CMS–

10114] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request

AGENCY: Centers for Medicare and 

Medicaid Services, HHS. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Centers for Medicare and Medicaid 

Services (CMS) (formerly known as the 

Health Care Financing Administration 

(HCFA), Department of Health and 

Human Services, is publishing the 

following summary of proposed 

collections for public comment. 

Interested persons are invited to send 

comments regarding this burden 

estimate or any other aspect of this 

collection of information, including any 

of the following subjects: (1) The 

necessity and utility of the proposed 

information collection for the proper 

performance of the agency’s functions; 

(2) the accuracy of the estimated 

burden; (3) ways to enhance the quality, 

utility, and clarity of the information to 

be collected; and (4) the use of 

automated collection techniques or 

other forms of information technology to 

minimize the information collection 

burden. 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection:. Hospital 

Reporting Initiative—Hospital Quality 

Measures; Use: The purpose is to collect 

data to produce valid, reliable, 

comparable and salient quality 

measures to provide a potent stimulus 

for clinicians and providers to improve 

the quality of care they provide. This 

reporting initiative in which hospitals 

may participate is a significant step 

toward a more informed public and a 

means to sustain health care quality 

improvement. The data is currently 

being collected from hospitals by CMS. 

The hospitals submitting data have 

volunteered to participate in public 

reporting. This effort places no 

additional data collection requirements 

or burdens on hospitals. Section 501(b) 

of the MMA offers monetary incentives 

for hospitals participating in reporting; 

Form Number: CMS–10109 (OMB#: 

0938–0918); Frequency: Quarterly; 

Affected Public: Business or other forprofit and Not-for-profit institutions; 

Number of Respondents: 4,000; Total 

Annual Responses: 16,000; Total 

Annual Hours: 238,000. 

2. Type of Information Collection 

Request: New collection; Title of 

Information Collection: National 

Provider Identifier (NPI) Application 

and Update Form and Supporting 

Regulation in 45 CFR 142.408, 162.406, 

and 162.408; Form No.: CMS–10114 

(OMB# 0938-NEW); Use: The form will 

be used by health care providers to 

apply for NPIs and to update the 

information collected from them 

whenever it changes.; Frequency: On 

occasion and/or one-time; Affected 

Public: Business or other for-profit, Notfor-profit institutions and Federal 

Government; Number of Respondents:

1,193,945; Total Annual Responses:

1,193,945; Total Annual Hours: 448,128. 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS Web Site 

address at http://www.cms.hhs.gov/

regulations/pra/, or E-mail your request, 

including your address, phone number, 

OMB number, and CMS document 

identifier, to Paperwork@hcfa.gov, or 

call the Reports Clearance Office on 

(410) 786–1326. Written comments and 

recommendations for the proposed 

information collections must be mailed 

within 30 days of this notice directly to 

the OMB desk officer: 

OMB Human Resources and Housing 

Branch, Attention: Christopher Martin, 

New Executive Office Building, Room 

10235, Washington, DC 20503.

Dated: October 7, 2004. 

John P. Burke, III, 

Paperwork Reduction Act Team Leader, CMS 

Reports Clearance Officer, Office of Strategic 

Operations and Regulatory Affairs, Division 

of Regulations Development and Issuances.

[FR Doc. 04–23122 Filed 10–14–04; 8:45 am] 

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare and Medicaid 

Services 

[Document Identifier: CMS–10128, CMS–

10112 and CMS–10068] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request

AGENCY: Centers for Medicare and 

Medicaid Services. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Centers for Medicare and Medicaid 

Services (CMS) (formerly known as the 

Health Care Financing Administration 

(HCFA)), Department of Health and 

Human Services, is publishing the 

following summary of proposed 

collections for public comment. 

Interested persons are invited to send 

comments regarding this burden 

estimate or any other aspect of this 

collection of information, including any 

of the following subjects: (1) The 

necessity and utility of the proposed 

information collection for the proper 

performance of the agency’s functions; 

(2) the accuracy of the estimated 

burden; (3) ways to enhance the quality, 

utility, and clarity of the information to 

be collected; and (4) the use of 

automated collection techniques or 

other forms of information technology to 

minimize the information collection 

burden. 

1. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Public 

Reporting on Quality Outcomes 

National Survey of Hospital Executives 

(‘‘PRO QUO’’); Use: CMS seeks to 

survey hospitals quality improvement 

executives in spring 2005 to assess 

awareness of CMS Hospital Quality 

Initiatives and related publicity, and to 

assess impact of these initiatives on 

hospitals and their quality improvement 

programs. Findings will be used to 

enhance CMS programs to assist 

hospitals in quality improvement. Form 

Number: CMS–10128 (OMB#: 0938–

NEW); Frequency: Once; Affected 

Public: Not-for-profit institutions and 

business or other for-profit; Number of 

Respondents: 1,600; Total Annual 

Responses: 1,600; Total Annual Hours:

792. 

2. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Phone Surveys 

of Product/Service for Medicare 

Payment Validation and Supporting 

Regulations in 42 CFR 405.502; Form 

No.: CMS–10112 (OMB# 0938–NEW);