26886 Federal Register / Vol. 60, No. 97 / Friday, May 19, 1995 / Notices

Texas, also has applied to acquire First

National Bank of Dayton, Dayton, Texas.

Board of Governors of the Federal Reserve

System, May 15, 1995.

Jennifer J. Johnson,

Deputy Secretary of the Board.

[FR Doc. 95–12349 Filed 5–18–95; 8:45 am]

BILLING CODE 6210–01–F

401(k)Plan and ESOP of United States

Trust Company of New York; Change

in Bank Control Notice

Acquisition of Shares of Banks or

Bank Holding Companies

The notificant listed below has

applied under the Change in Bank

Control Act (12 U.S.C. 1817(j)) and §

225.41 of the Board’s Regulation Y (12

CFR 225.41) to acquire a bank or bank

holding company. The factors that are

considered in acting on notices are set

forth in paragraph 7 of the Act (12

U.S.C. 1817(j)(7)).

The notice is available for immediate

inspection at the Federal Reserve Bank

indicated. Once the notice has been

accepted for processing, it will also be

available for inspection at the offices of

the Board of Governors. Interested

persons may express their views in

writing to the Reserve Bank indicated

for the notice or to the offices of the

Board of Governors. Comments must be

received not later than June 2, 1995.

A. Federal Reserve Bank of New

York (William L. Rutledge, Senior Vice

President) 33 Liberty Street, New York,

New York 10045:

1. 401(k)Plan and ESOP of United

States Trust Company of New York,

New York, New York; to acquire 24.9

percent of the voting shares of New

USTC Holdings Corporation, New York,

New York, and thereby indirectly

acquire New U.S. Trust Company of

New York, New York, New York; U.S.

Trust Company of California, Los

Angeles, California; U.S. Trust Company

of Texas, Dallas, Texas; and U.S. Trust

Company of Florida Savings Bank, Palm

Beach, Florida.

Board of Governors of the Federal Reserve

System, May 15, 1995.

Jennifer J. Johnson,

Deputy Secretary of the Board.

[FR Doc. 95–12350 Filed 5–18–95; 8:45 am]

BILLING CODE 6210–01–F

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Agency for Health Care Policy and

Research

Nominations of Clinical Practice

Guideline Topics

The Agency for Health Care Policy

and Research (AHCPR) is inviting

recommendations of health topics, with

supporting rationale, for consideration

by AHCPR in selecting topics for

development of clinical practice

guidelines. The process AHCPR

employs in establishing priorities and

selecting topics for guidelines, based on

statutory criteria, is described below.

Background

The Agency for Health Care Policy

and Research (AHCPR) is charged,

under Title IX of the Public Health

Service Act (PHS Act), with enhancing

the quality, appropriateness, and

effectiveness of health care services, and

access to such services. The AHCPR

accomplishes its goals through the

establishment of a broad base of

scientific research and through the

promotion of improvements in clinical

practice and in the organization,

financing, and delivery of health care

services. (42 U.S.C. 299–299c–6 and

1320b–12.)

As part of its charge, under section

912 of the PHS Act, the Administrator

of AHCPR arranges for the development,

periodic review, and updating of

clinically relevant guidelines that may

be used by physicians, other health care

practitioners, providers, educators, and

health care consumers to assist in

determining how diseases, disorders,

and other health conditions can most

effectively and appropriately be

prevented, diagnosed, treated, and

clinically managed. (See 42 U.S.C.

299b–1(a).)

The guidelines are required to:

1. Be based on the best available

research and professional judgment;

2. Be presented in formats appropriate

for use by physicians, other health care

practitioners, providers, medical

educators, medical review

organizations, and consumers;

3. Be presented in treatment-specific

or condition-specific forms appropriate

for use in clinical practice, educational

programs, and review of quality and

appropriateness of medical care;

4. Include information on the risks

and benefits of alternative strategies for

prevention, diagnosis, treatment, and

management of the particular health

condition(s); and

5. Include information on the costs of

alternative strategies for prevention,

diagnosis, treatment, and management

of the particular health condition(s),

where cost information is available and

reliable.

Section 914(a) of the PHS Act (42

U.S.C. 299b–3(a)) identifies factors to be

considered in establishing priorities for

guidelines, including the extent to

which the guidelines would:

1. Improve methods for disease

prevention;

2. Improve methods of diagnosis,

treatment, and clinical management for

the benefit of a significant number of

individuals;

3. Reduce clinically significant

variations among clinicians in the

particular services and procedures

utilized in making diagnoses and

providing treatments; and

4. Reduce clinically significant

variations in the outcomes of health care

services and procedures.

Section 914 also provides that the

methodology may include the

considerations under section 904 of the

PHS Act, relevant to establishing

priorities for technology assessments,

and other considerations determined by

the Administrator to be appropriate.

The criteria for determining priorities

for technology assessments include: The

prevalence of a particular health

condition; variations in current practice;

the economic burden posed by the

prevention, diagnosis, treatment, and

clinical management of a health

condition, including the impact on

publicly funded programs; aggregate

cost of the use of the technology(ies)

involved; the morbidity and mortality

associated with the health condition;

and the potential to improve health

outcomes or affect costs associated with

the prevention, diagnosis, or treatment

of the condition.

Consistent with several Title IX

provisions, such as sections 912(e) and

914(a)(2)(B) of the PHS Act, and with

section 1142 of the Social Security Act,

the Administrator assures that the needs

and priorities of the Medicare program

are reflected appropriately in the agenda

and priorities for development of

guidelines. In the future, the

Administrator will also give special

consideration to topics which are not

likely to be addressed by the private

sector, and to those which are likely to

be implemented by organized systems of

care.

In response to section 914(a)(2)(C),

which requires the Administrator to

publish a methodology for establishing

priorities for guideline topics and a

Federal Register notice of topics under

consideration annually, a notice was

published on September 1993, entitled

‘‘Criteria for Selection of Clinical