Federal Register / Vol. 70, No. 208 / Friday, October 28, 2005 / Notices 62121 

HL increases, so does the demand for 

accurate information about incidence, 

rate of screening, referral to care, and 

loss to follow-up. Given the lack of a 

standardized and readily accessible 

source of data, CDC’s Early Hearing 

Detection and Intervention (EHDI) 

program has developed a survey to be 

used annually for State and Territory 

EHDI Program Coordinators that utilizes 

uniform definitions to collect aggregate, 

standardized EHDI data from states and 

territories. This information is 

important for helping to ensure infants 

and children are receiving 

recommended screening and follow-up 

services, documenting the occurrence 

and etiology of differing degrees of HL 

among infants, and determining the 

overall impact of infant HL on future 

outcomes, such as cognitive 

development and family dynamics. 

These data will also assist state EHDI 

programs with quality improvement 

activities and provide information that 

will be helpful in assessing the impact 

of Federal initiatives. The public will be 

able to access this information via CDC’s 

EHDI Web site (http://www.cdc.gov/ 

ncbddd/ehdi/). There are no costs to 

respondents other than their time. 

ANNUALIZED BURDEN TABLE

Respondents Number of 

respondents 

Number of 

responses per 

respondent 

Average burden 

per response 

(in hrs.) 

Total burden 

hours 

State and territory EHDI program coordinators ............................... 53 1 4 212 

Total .......................................................................................... 212 

Dated: October 21, 2005. 

Betsey Dunaway, 

Acting Reports Clearance Officer, Centers for 

Disease Control and Prevention. 

[FR Doc. 05–21539 Filed 10–27–05; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[60Day–06–05CY] 

Proposed Data Collections Submitted 

for Public Comment and 

Recommendations 

In compliance with the requirement 

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

Paperwork Reduction Act of 1995 for 

opportunity for public comment on 

proposed data collection projects, the 

Centers for Disease Control and 

Prevention (CDC) will publish periodic 

summaries of proposed projects. To 

request more information on the 

proposed projects or to obtain a copy of 

the data collection plans and 

instruments, call 404–639–4766 and 

send comments to Seleda Perryman, 

CDC Assistant Reports Clearance 

Officer, 1600 Clifton Road, MS–D74, 

Atlanta, GA 30333 or send an e-mail to 

omb@cdc.gov. 

Comments are invited on: (a) Whether 

the proposed collection of information 

is necessary for the proper performance 

of the functions of the agency, including 

whether the information shall have 

practical utility; (b) the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information; (c) 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected; and (d) ways to minimize the 

burden of the collection of information 

on respondents, including through the 

use of automated collection techniques 

or other forms of information 

technology. Written comments should 

be received within 60 days of this 

notice. 

Proposed Project 

Survey of Illness and Injury Among 

Backcountry Users in Yellowstone 

National Park—New—Centers for 

Disease Control and Prevention (CDC), 

National Center for Infectious Diseases 

(NCID). 

There are limited data on the risk 

factors for illness and injury among 

persons who travel into backcountry 

areas of the United States. The 

backcountry encompasses primitive or 

wilderness areas that lack most facilities 

and services and that are reached 

primarily by hiking, boating, or 

horseback. In general, backcountry users 

must bring in their own supplies (such 

as shelter, food, water, or water 

treatment supplies). As many as 68% to 

82% of long-distance hikers and 

backpackers have reported experiencing 

illnesses or injuries during their time in 

the backcountry. For example, 4% to 

56% have reported gastrointestinal 

illnesses and 41% to 62% have reported 

musculoskeletal injuries. 

Such a high burden of illness and 

injury has significant medical and 

economic implications given the 

increasing popularity of backcountry 

use. In 1994–95, almost 8% of 

Americans age 16 years and older (about 

15 million persons) went backpacking 

in the previous 12 months, which 

involved camping for one or more 

nights along a trail and carrying food, 

shelter, and utensils with them. In the 

same period of time, about 14% (or 28 

million persons) camped in primitive 

settings that usually lacked restrooms, 

hookups, and most facilities and 

services. In fact, camping in 

backcountry areas increased by about 

72% from 1982–83 to 1994–95. While 

people can travel in the backcountry in 

many locations and on both private and 

public lands, many travelers hike, 

backpack, and camp in the backcountry 

in national parks. In 2003, there were 

over 266 million recreational visits to 

national parks with over 1.8 million 

overnight stays in the backcountry. 

Yellowstone National Park alone had 

almost 19,690 persons visit the 

backcountry in 2003, accounting for 

over 46,000 overnight stays. 

Because little is known about health 

outcomes for visitors who use the 

backcountry areas of our nation’s parks, 

advice to park managers and the public 

is currently general in nature, based 

only on standard disease prevention 

principles. Furthermore, some outdoor 

use groups have recently questioned 

some of this standard advice, such as 

the universal need for careful filtration 

and disinfection of backcountry 

drinking water. This study will 

investigate behavioral and 

environmental risk factors that may be 

associated with illness and injury 

among persons who require park 

permits to travel into backcountry areas 

in Yellowstone National Park during the 

backcountry season from May 1–Oct. 31, 

2006. The data collected will be used to 

provide an estimate of the burden of 

illness and injury among backcountry 

users and will also provide information 

about a variety of risk factors for illness 

and injury in the backcountry, including 

the risks associated with drinking 

untreated water from lakes and streams. 

With this information, the National Park 

Service (NPS) will be able to address 

62122 Federal Register / Vol. 70, No. 208 / Friday, October 28, 2005 / Notices 

many of the questions raised by outdoor 

users and public health officials, and 

improve and strengthen evidence-based 

NPS guidelines for backcountry health 

and sanitation practices. To gather this 

information, consent to contact after the 

conclusion of the backcountry trip will 

be obtained from an estimated 7,000 

backcountry users 18 years of age or 

older when they present to the 

Yellowstone National Park’s permit 

offices prior to entering the 

backcountry. A questionnaire (in either 

Internet-based or paper-based format) 

will then be offered to an estimated 

5,600 backcountry users who consent to 

be contacted. Participants will be asked 

about their health (before, during and 

after backcountry travel), water 

consumption, water preparation habits, 

food consumption, food preparation 

habits, sanitation practices, recreational 

water use, animal exposure, and 

demographics. 

This study is the beginning of what 

will be an ongoing effort to improve the 

scientific basis of NPS 

recommendations and policies related 

to protecting human health in the 

backcountry. This effort seeks to begin 

to identify disease transmission 

pathways and assess disease and injury 

risks associated with specific activities, 

choices, and behaviors of backcountry 

visitors, such as water purification, 

sanitation practices, and hygiene. 

Thoroughly understanding transmission 

pathways and the interactions of agent, 

environment, and host will enable the 

NPS to effectively and efficiently 

improve visitor protection efforts. 

There will be no cost to or 

remuneration of respondents other than 

their time. Their participation is 

voluntary and there will be no penalty 

for non-participation. 

Estimate of Annualized Burden Table 

Respondents Form name Number of 

respondents 

Number 

responses 

per respondent 

Hrs/response 

(in hours) 

Total response burden hours 

Backcountry Users of Yellowstone Park ... Consent to Further Contact ...................... 7000 1 2/60 233 

Web-Based Questionnaire ........................ 5600 1 15/60 1400 

Total ....................................................... .................... .................. .................. 1633 

Dated: October 21, 2005. 

Betsey Dunaway, 

Acting Reports Clearance Officer, Centers for 

Disease Control and Prevention. 

[FR Doc. 05–21540 Filed 10–27–05; 8:45 am] 

BILLING CODE 4163–18–P 1 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–R–0021, CMS–

838, CMS–10134, CMS–R–137, CMS–R–257, 

CMS–29/CMS–30, CMS–10150, CMS–381, 

CMS–10161, CMS–10162, and 10136] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

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 & Medicaid 

Services (CMS), 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 function; 

(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: Withholding 

Medicare Payments to Recover 

Medicaid Overpayments and 

Supporting Regulations in 42 CFR 

447.31; Use: Overpayments may occur 

in either the Medicare and Medicaid 

program, at times resulting in a situation 

where an institution or person that 

provides services owes a repayment to 

one program while still receiving 

reimbursement from the other. Certain 

Medicaid providers which are subject to 

offsets for the collection of Medicaid 

overpayments may terminate or 

substantially reduce their participation 

in Medicaid, leaving the State Medicaid 

Agency unable to recover the amounts 

due. These information collection 

requirements give CMS the authority to 

recover Medicaid overpayments by 

offsetting payments due to a provider 

under the program. Form Number: 

CMS–R–0021 (OMB #0938–0287); 

Frequency: Reporting—On occasion; 

Affected Public: State, Local or Tribal 

Government; Number of Respondents: 

54; Total Annual Responses: 27; Total 

Annual Hours: 81. 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicare Credit 

Balance Reporting Requirements and 

Supporting Regulations in 42 CFR 

405.371, 405.378, and 413.20; Form 

Number: CMS–838 (OMB #0938–0600); 

Use: Section 1815(a) of the Social 

Security Act authorizes the Secretary to 

request information from providers 

which is necessary to properly 

administer the Medicare program. 

Quarterly credit balance reporting is 

needed to monitor and control the 

identification and timely collection of 

improper payments. The reporting 

requirements provide CMS with the 

authority to impose sanctions such as 

the suspension of program payments in 

accordance with 42 CFR 413.20(e) and 

405.371 if providers do not report credit 

balances on a timely basis. Furthermore, 

once a credit balance has been 

identified on a CMS–838 form and 

demand for payment is made, CMS has 

the authority to charge interest if the 

amount is not repaid within 30 days in 

accordance with 42 CFR 405.378. The 

collection of credit balance information 

is needed to ensure that millions of 

dollars in improper program payments 

are collected. Approximately 48,300 

health care providers will be required to 

submit a quarterly credit balance report 

that identifies the amount of improper 

payments they received that are due to 

Medicare. The intermediaries will 

monitor the reports to ensure these 

funds are collected; Frequency: 

Quarterly; Affected Public: Not-forprofit institutions, Business or other forprofit; Number of Respondents: 48,300; 

Total Annual Responses: 193,200; Total 

Annual Hours: 579,600.