7398 Federal Register / Vol. 86, No. 17 / Thursday, January 28, 2021 / Notices 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[60Day–21–0234; Docket No. CDC–2020– 

0125] 

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 the opportunity to comment on 

a proposed and/or continuing 

information collection, as required by 

the Paperwork Reduction Act of 1995. 

This notice invites comment on a 

proposed information collection project 

titled the National Ambulatory Medical 

Care Survey (NAMCS). The goal of the 

project is to assess the health of the 

population through patient use of 

physician offices, community health 

centers (CHCs), and to monitor the 

characteristics of physician practices. 

DATES: CDC must receive written 

comments on or before March 29, 2021. 

ADDRESSES: You may submit comments, 

identified by Docket No. CDC–2020– 

0125 by any of the following methods: 

• Federal eRulemaking Portal: 

Regulations.gov. Follow the instructions 

for submitting comments. 

• Mail: Jeffrey M. Zirger, 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. CDC will post, without 

change, all relevant comments to 

Regulations.gov. 

Please note: Submit all comments 

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 Jeffrey M. Zirger, 

Information Collection Review Office, 

Centers for Disease Control and 

Prevention, 1600 Clifton Road NE, MS– 

D74, Atlanta, Georgia 30329; phone: 

404–639–7570; Email: omb@cdc.gov. 

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 the OMB for approval. To 

comply with this requirement, we are 

publishing this notice of a proposed 

data collection as described below. 

The OMB is particularly interested in 

comments that will help: 

1. 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; 

2. Evaluate the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information, 

including the validity of the 

methodology and assumptions used; 

3. Enhance the quality, utility, and 

clarity of the information to be 

collected; and 

4. 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 submissions 

of responses. 

5. Assess information collection costs. 

Proposed Project 

National Ambulatory Medical Care 

Survey (NAMCS) (OMB Control No. 

0920–0234, Exp. 05/31/2022)— 

Revision—National Center for Health 

Statistics (NCHS), Centers for Disease 

Control and Prevention (CDC). 

Background and Brief Description 

The National Ambulatory Medical 

Care Survey (NAMCS) was conducted 

intermittently from 1973 through 1985, 

and annually since 1989. The survey is 

conducted under authority of Section 

306 of the Public Health Service Act (42 

U.S.C. 242k). 

NAMCS is part of the ambulatory care 

component of the National Health Care 

Surveys (NHCS), a family of providerbased surveys that capture health care 

utilization from a variety of settings, 

including hospital in-patient and longterm care facilities. NCHS surveys of 

health care providers include NAMCS, 

the National Hospital Ambulatory 

Medical Care Survey (NHAMCS) (OMB 

Control No. 0920–0278, Exp. 09/30/ 

2023), the National Hospital Care 

Survey (OMB Control No. 0920–0212, 

Exp. 03/31/2022), and National Postacute and Long-term Care Study (OMB 

Control No. 0920–0943, Exp. 09/30/ 

2023). 

An overarching purpose of NAMCS is 

to meet the needs and demands for 

statistical information about the 

provision of ambulatory medical care 

services in the United States; this fulfills 

one of NCHS missions, to monitor the 

nation’s health. In addition, NAMCS 

provides ambulatory medical care data 

to study: (1) The performance of the 

U.S. health care system, (2) care for the 

rapidly aging population, (3) changes in 

services such as health insurance 

coverage change, (4) the introduction of 

new medical technologies, and (5) the 

use of electronic health records (EHRs). 

Ongoing societal changes have led to 

considerable diversification in the 

organization, financing, and 

technological delivery of ambulatory 

medical care. This diversification is 

evidenced by the proliferation of 

insurance and benefit alternatives for 

individuals, the development of new 

forms of physician group practices and 

practice arrangements (such as officebased practices owned by hospitals), 

and growth in the number of alternative 

sites of care. 

Ambulatory services are rendered in a 

wide variety of settings, including 

physician offices and hospital 

outpatient and emergency departments. 

Since more than 65% of ambulatory 

medical care visits occur in physician 

offices, NAMCS provides data on the 

majority of ambulatory medical care 

services. 

In addition to health care provided in 

physician offices and outpatient and 

emergency departments, community 

health centers (CHCs) play an important 

role in the health care community by 

providing care to people who might not 

be able to afford it, otherwise. CHCs are 

local, non-profit, community-owned 

health care settings, which serve 

approximately 28 million individuals 

throughout the United States. 

This revision seeks approval to adjust 

the CHC sample size. In 2021, the 

sample size will be reduced to 50 CHCs, 

and in 2022 allocated funds will cover 

a sample size of 110 CHCs. In 2023 the 

sample size will increase to 115 CHCs. 

There will be no modification to the 

office-based physician sample. In the 

2021 survey year we will include the 

supplemental sample of physicians from 

Federal Register / Vol. 86, No. 17 / Thursday, January 28, 2021 / Notices 7399 

which visit data are collected through 

submission of EHRs with the approved 

2019 sample size, and for subsequent 

survey years when deemed necessary. 

The annualized 2021–2023 NAMCS 

sample size is projected to be 6,000 

office-based physicians and 92 CHCs. 

Questions on the traditional office-base 

physician survey will be modified for 

clarification and to keep current with 

medical practice and terminology. In 

2020 we are also seeking to include the 

potential for experiments involving 

physician incentives for some officebased physicians. In 2021, data 

collection for CHCs will transition from 

manual abstraction to be sent through 

EHRs. A set-up fee will be allotted to 

sampled CHCs to offset the cost of this 

new data collection method. With this 

transition, a new CHC facility interview 

will be implemented and personally 

identifiable information (PII) will be 

collected from both the CHCs, and 

physicians who submit EHR data. For 

both the traditional office-based 

physicians and CHCs, we will continue 

COVID–19 questions in 2021 and for 

subsequent data years where 

information is pertinent. We will also 

begin to conduct methodological work 

to improve upon the survey. Estimated 

annualized burden is 9,272 hours. 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondents Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hrs.) 

Total burden 

(in hrs.) 

Office-based Physicians or Staff (Abstraction) ... Physician Induction Interview (2020) .................. 500 1 30/60 250 

Pulling, re-filing medical record forms (FR abstracts) (2020).500 30 1/60 250 

CHC Executive/Medical Directors ....................... CHC Facility Induction Interview (2020) ............. 17 1 30/60 9 

CHC Providers ..................................................... Provider Induction Interview (2020) .................... 52 1 30/60 26 

CHC Provider Staff .............................................. Pulling, re-filing medical record forms (FR abstracts).52 30 1/60 26 

Office-based Physicians (Abstraction) and CHC 

Providers.

Reinterview Study (2020) ................................... 33 1 15/60 8 

Office-based Physicians or Staff (Abstraction) ... Physician Induction Interview (2021–2023) ........ 3,000 1 30/60 1,500 

Pulling, re-filing medical record forms (FR abstracts) (2021–2023).3,000 30 1/60 1,500 

Office-based Physician Staff (EHR Submission) Physician Facility Interview (PFI) (2021–2023) .. 3,000 1 45/60 2,250 

Pulling, re-filing medical record forms (EHR 

Onboarding) (2021–2023).

3,000 1 60/60 3,000 

CHC Staff ............................................................ CHC Facility Interview (2021–2023) ................... 92 1 15/60 23 

Prepare and transmit EHR for Visit Data (quarterly) (2021–2023).92 4 60/60 368 

Office-based Physicians (Abstraction) ................ Reinterview Study (2021–2023) ......................... 250 1 15/60 63 

Total .............................................................. ............................................................................. ........................ ........................ .................... 9,272 

Jeffrey M. Zirger, 

Lead, Information Collection Review Office, 

Office of Scientific Integrity, Office of Science, 

Centers for Disease Control and Prevention. 

[FR Doc. 2021–01691 Filed 1–27–21; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[30Day–21–20PM] 

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 Oral Health 

Basic Screening Survey for Children 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 July 2, 2020 to obtain 

comments from the public and affected 

agencies. CDC received three 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. 

Comments and recommendations for the 

proposed information collection should 

be sent within 30 days of publication of 

this notice to www.reginfo.gov/public/ 

do/PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. 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 

Oral Health Basic Screening Survey 

for Children—Existing Collection in use 

without an OMB Control Number— 

National Center for Chronic Disease 

Prevention and Health Promotion 

(NCCDPHP), Centers for Disease Control 

and Prevention (CDC).