Federal Register / Vol. 69, No. 219 / Monday, November 15, 2004 / Notices 65601

implications of various financing 

models. 

7. What privacy and security 

considerations, including compliance 

with relevant rules of the Health 

Insurance Portability and 

Accountability Act of 1996 (HIPAA), are 

implicated by the NHIN, and how could 

they be addressed? 

8. How could the framework for a 

NHIN address public policy objectives 

for broad participation, responsiveness, 

open and non-proprietary interoperable 

infrastructure? 

Management and Operational 

Considerations 

9. How could private sector 

competition be appropriately addressed 

and/or encouraged in the construction 

and implementation of a NHIN? 

10. How could the NHIN be 

established to maintain a health 

information infrastructure that: 

a. Evolves appropriately from private 

investment; 

b. Is non-proprietary and available in 

the public domain; 

c. Achieves country-wide 

interoperability; and 

d. Fosters market innovation. 

11. How could a NHIN be established 

so that it will be utilized in the delivery 

of care by healthcare providers, 

regardless of their size and location, and 

also achieve enough national coverage 

to ensure that lower income rural and 

urban areas could be sufficiently 

served? 

12. How could community and 

regional health information exchange 

projects be affected by the development 

and implementation of a NHIN? What 

issues might arise and how could they 

be addressed? 

13. What effect could the 

implementation and broad adoption of a 

NHIN have on the health information 

technology market at large? Could the 

ensuing market opportunities be 

significant enough to merit the 

investment in a NHIN by the industry? 

To what entities could the benefits of 

these market opportunities accrue, and 

what implication (if any) does that have 

for the level of investment and/or role 

required from those beneficiaries in the 

establishment and perpetuation of a 

NHIN? 

Standards and Policies To Achieve 

Interoperability 

(Question 4b above asks how 

standards and policy setting for a NHIN 

could be considered and achieved. The 

questions below focus more specifically 

on standards and policy requirements.) 

14. What kinds of entity or entities 

could be needed to develop and diffuse 

interoperability standards and policies? 

What could be the characteristics of 

these entities? Do they exist today? 

15. How should the development and 

diffusion of technically sound, fully 

informed interoperability standards and 

policies be established and managed for 

a NHIN, initially and on an ongoing 

basis, that effectively address privacy 

and security issues and fully comply 

with HIPAA? How can these standards 

be protected from proprietary bias so 

that no vendors or organizations have 

undue influence or advantage? 

Examples of such standards and policies 

include: secure connectivity, mobile 

authentication, patient identification 

management and information exchange. 

16. How could the efforts to develop 

and diffuse interoperability standards 

and policy relate to existing Standards 

Development Organizations (SDOs) to 

ensure maximum coordination and 

participation? 

17. What type of management and 

business rules could be required to 

promote and produce widespread 

adoption of interoperability standards 

and the diffusion of such standards into 

practice? 

18. What roles and relationships 

should the federal government take in 

relation to how interoperability 

standards and policies are developed, 

and what roles and relationships should 

it refrain from taking? 

Financial and/or Regulatory Incentives 

and Legal Considerations 

19. Are financial incentives required 

to drive the development of a 

marketplace for interoperable health 

information, so that relevant private 

industry companies will participate in 

the development of a broadly available, 

open and interoperable NHIN? If so, 

what types of incentives could gain the 

maximum benefit for the least 

investment? What restrictions or 

limitation should these incentives carry 

to ensure that the public interest is 

advanced? 

20.What kind of incentives should be 

available to regional stakeholders (e.g., 

health care providers, physicians, 

employers that purchase health 

insurance, payers) to use a health 

information exchange architecture based 

on a NHIN? 

21. Are there statutory or regulatory 

requirements or prohibitions that might 

be perceived as barriers to the formation 

and operation of a NHIN, or to support 

it with critical functions? 

22. How could proposed 

organizational mechanisms or 

approaches address statutory and 

regulatory requirements (e.g., data 

privacy and security, antitrust 

constraints and tax issues)? 

Other 

23. Describe the major design 

principles/elements of a potential 

technical architecture for a NHIN. This 

description should be suitable for public 

discussion. 

24. How could success be measured 

in achieving an interoperable health 

information infrastructure for the public 

sector, private sector and health care 

community or region?

Dated: November 9, 2004. 

David J. Brailer, 

National Coordinator, Office of the National 

Coordinator for Health Information 

Technology.

[FR Doc. 04–25382 Filed 11–10–04; 11:30 

am] 

BILLING CODE 4150–24–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration on Aging 

Agency Information Collection 

Activities; Proposed Collection; 

Comment Request; Senior Medicare 

Patrol Program Outcome Measurement

AGENCY: Administration on Aging, HHS.

ACTION: Notice.

SUMMARY: The Administration on Aging 

(AoA) is announcing an opportunity for 

public comment on the proposed 

collection of certain information by the 

agency. Under the Paperwork Reduction 

Act of 1995 (the PRA), Federal agencies 

are required to publish notice in the 

Federal Register concerning each 

proposed collection of information, 

including each proposed extension of an 

existing collection of information, and 

to allow 60 days for public comment in 

response to the notice. This notice 

solicits comments on the information 

collection requirements relating to 

Senior Medicare Patrol (SMP) program 

outcome measurement.

DATES: Submit written or electronic 

comments on the collection of 

information by January 14, 2005.

ADDRESSES: Submit electronic 

comments on the collection of 

information to: Barbara.dieker@aoa.gov.

Submit written comments on the 

collection of information to Barbara 

Dieker, Administration on Aging, 

Washington, DC 20201 or by fax at (202) 

357–3558.

FOR FURTHER INFORMATION CONTACT:

Barbara Dieker at (202) 357–0139 or 

Barbara.dieker@aoa.gov.

65602 Federal Register / Vol. 69, No. 219 / Monday, November 15, 2004 / Notices 

SUPPLEMENTARY INFORMATION: Under the 

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. 

‘‘Collection of information’’ is defined 

in 44 U.S.C. 3502(3) and 5 CFR 

1320.3(c) and includes agency request 

or requirements that members of the 

public submit reports, keep records, or 

provide information to a third party. 

Section 3506(c)(2)(A) of the PRA (44 

U.S.C. 3506(c)(2)(A)) requires Federal 

agencies to provide a 60-day notice in 

the Federal Register concerning each 

proposed collection of information, 

including each proposed extension of an 

existing collection of information, 

before submitting the collection to OMB 

for approval. To comply with this 

requirement, AoA is publishing notice 

of the proposed collection of 

information set forth in this document. 

With respect to the following collection 

of information, AoA invites comments 

on: (1) Whether the proposed collection 

of information is necessary for the 

proper performance of AoA’s functions, 

including whether the information will 

have practical utility; (2) the accuracy of 

AoA’s estimate of the burden of the 

proposed collection of information, 

including the validity of the 

methodology and assumptions used; (3) 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected; and (4) ways to minimize the 

burden of the collection of information 

on respondents, including through the 

use of automated collection techniques 

when appropriate, and other forms of 

information technology. AoA estimates 

the burden of this collection of 

information as follows: 

Frequency: Annually. 

Respondents: Medicare beneficiaries 

after SMP education/training on fraud 

prevention; administered by staff or 

senior volunteers in 57 SMP projects 

nationwide. 

Estimated number of responses:

21,000. 

Total Estimated Burden Hours: 2,300.

Josefina G. Carbonell, 

Assistant Secretary for Aging.

[FR Doc. 04–25241 Filed 11–12–04; 8:45 am] 

BILLING CODE 4154–01–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare and Medicaid 

Services 

[Document Identifier: CMS–R–185, CMS 

10131, CMS–10054 and CMS–R–50] 

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: Extension of a currently 

approved collection; Title of 

Information Collection: Granting and 

Withdrawal of Deeming Authority to 

Private Nonprofit Accreditation 

Organizations and of State Exemption 

Under State Laboratory Programs and 

Supporting Regulations in 42 CFR 

493.551–493.557; Use: The information 

required is necessary to determine 

whether a private accreditation 

organization’s or State licensure 

program’s standards and accreditation/

licensure process is equal to or more 

stringent than those of CLIA. Form 

Number: CMS–R–185 (OMB#: 0938–

0686); Frequency: Initial application 

and as needed; Affected Public: Not-forprofit institutions, Business or other forprofit and State, Local, or Tribal 

Government; Number of Respondents: 8; 

Total Annual Responses: 76; Total 

Annual Hours: 768. 

2. Type of Information Collection 

Request: New Collection; Title of 

Information Collection: Evaluation of 

Medicare Disease Management 

Demonstrations; Form No.: CMS–10131 

(OMB# 0938–NEW); Use: CMS 

contracted with Mathematic Policy 

Research, Inc. (MPR) for the evaluation 

of disease management programs. The 

purpose of the patient survey is to 

assess the impact of disease 

management and prescription drug 

benefits on patient health, functioning 

status, care satisfaction, health 

behaviors and knowledge of condition. 

Data from the physician survey will be 

used to assess physician satisfaction 

with disease management services, 

physician perceptions of the impact of 

disease management on patient 

outcomes, education and service use, 

and the impact of disease management 

programs on physician practices and 

office workload.; Frequency: On 

Occasion; Affected Public: Individuals 

or households, Business or other forprofit; Number of Respondents: 5000; 

Total Annual Responses: 2500; Total 

Annual Hours: 1625. 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Recognition of 

Payment for New Technology Services 

for Ambulatory Payment Classifications 

(APCs) under the Outpatient 

Prospective Payment System and 

Supporting Regulations in 42 CFR, 

413.65 and 419.42; Form No.: CMS–

10054 (OMB# 0938–0860); Use:

Information is necessary to determine 

services eligible for payment in new 

technology ambulatory payment 

classifications (APCs) in the outpatient 

prospective payment system; Frequency:

On Occasion; Affected Public: Business 

or other for-profit; Number of 

Respondents: 15; Total Annual 

Responses: 15; Total Annual Hours:

180. 

4. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medical Records 

Review under PPS and Supporting 

Regulations in 42 CFR, Sections 412.40–

412.52; Form No.: CMS–R–50 (OMB# 

0938–0359); Use: The Quality 

Improvement Organizations (QIOs) are 

authorized to conduct medical review 

activities under the Prospective 

Payment System (PPS) . In order to 

conduct these review activites, the 

agency depends upon hospitals to make 

available specific records regarding care 

provided to Medicare beneficiaries. The 

Clinical Data Abstraction Centers 

(CDACs) obtain copies of medical 

records from which they abstract data to 

analyze patterns of care and outcomes 

for heart failure/myocardial infarction, 

pneumonia, diabetes and surgical 

infection.; Frequency: Other: when 

records are reviewed; Affected Public: