45012 Federal Register / Vol. 73, No. 149 / Friday, August 1, 2008 / Notices 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondent Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Hospital Chief Medical Officer ........................ Hospital Induction (NHAMCS–101) ............... 470 1 55/60 

Ancillary Service Executive ............................. Ambulatory Unit Induction (NHAMCS–101/U) 845 2 1 

Physician/Registered Nurse/Medical Record 

Clerk.

ED Patient Record form NHAMCS–100 (ED)] 220 100 7/60 

Medical Record Clerk ..................................... Pulling and re-filing Patient Records ............. 393 132 1/60 

Physician/Registered Nurse/Medical Record 

Clerk.

OPD Patient Record form [NHAMCS–100 

(OPD)].

125 200 6/60 

Physician/Phys. Asst./Nurse Practitioner/ 

Nurse Midwife.

Cervical Cancer Screening Supplement 

(CCSS) (NHAMCS–906).

250 1 15/60 

Physician/Registered Nurse/Medical Record 

Clerk.

ASC Patient Record form NHAMCS–100 

(ASC).

107 100 6/60 

Dated: July 24, 2008. 

Maryam I. Daneshvar, 

Acting Reports Clearance Officer, Centers for 

Disease Control and Prevention. 

[FR Doc. E8–17603 Filed 7–31–08; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[30Day–08–0212] 

Agency Forms Undergoing Paperwork 

Reduction Act Review 

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) 639–5960 or send an email to omb@cdc.gov. Send written 

comments to CDC Desk Officer, Office of 

Management and Budget, Washington, 

DC or by fax to (202) 395–6974. Written 

comments should be received within 30 

days of this notice. 

Proposed Project 

National Hospital Discharge Survey—

Revision—The National Hospital 

Discharge Survey (NHDS) (OMB# 0920–

0212), National Center for Health 

Statistics (NCHS), Centers for Disease 

Control and Prevention (CDC). 

Background and Brief Description 

Section 306 of the Public Health 

Service (PHS) Act (42 U.S.C. 242k), as 

amended, authorizes that the Secretary 

of Health and Human Services (DHHS), 

acting through NCHS, shall collect 

statistics on the extent and nature of 

illness and disability of the population 

of the United States. This three-year 

clearance request includes the data 

collection in 2008 and 2009 using the 

current NHDS design; a pretest of a new 

design; and data collection for 2010 and 

2011 of the survey using the new 

design. 

Current NHDS 

The National Hospital Discharge 

Survey (NHDS) has been conducted 

continuously by the National Center for 

Health Statistics, CDC, since 1965. It is 

the principal source of data on inpatient 

utilization of short-stay, non-Federal 

hospitals and is the principal annual 

source of nationally representative 

estimates on the characteristics of 

discharges, the lengths of stay, 

diagnoses, surgical and non-surgical 

procedures, and the patterns of use of 

care in hospitals in various regions of 

the country. It is the benchmark against 

which special programmatic data 

sources are measured. The data items 

collected are the basic core of the 

variables contained in the Uniform 

Hospital Discharge Data Set (UHDDS) in 

addition to several variables (admission 

source and type, admitting diagnosis 

and present on admission indicators) 

which are identical to those needed for 

billing of inpatient services for Medicare 

patients. In the current survey, data are 

obtained in one of three ways: 

Abstracted by hospital staff; abstracted 

by Bureau of the Census Staff under an 

interagency agreement; and provided in 

electronic format. Due to budgetary 

constraints, the number of hospitals and 

the number of discharges for the 2008 

and 2009 NHDS data collections will 

decrease by approximately 50% from 

previous years. 

Redesigned NHDS 

Although the current NHDS is still 

fulfilling its intended functions, it is 

based on concepts from the health care 

delivery system, as well as the hospital 

and patient universes, of previous 

decades. It has become clear that a 

redesign of the NHDS that provides 

greater depth of information is 

necessary. 

In 2008, a sample of 30 hospitals will 

be selected for a pretest. These hospitals 

will not be a probability sample, but 

instead will be intentionally selected to 

include hospitals of differing size, 

location and other characteristics 

related to their service and patient 

clientele. 

In 2010, a redesigned NHDS will be 

implemented and will consist of a 

completely new sample of 

approximately 240 hospitals. The 

redesigned NHDS will use a modified 

two stage design. The first stage 

sampling will be hospitals. The second 

stage of sampling will be discharges. A 

stratified, random sample of 120 

discharges is targeted within each 

hospital. In the redesigned survey all 

data will be abstracted by trained health 

care staff under contract. All data will 

be obtained from hospital records and 

charts and computer systems. 

The current data items will be 

collected with significant additional 

details. Patient level data items to be 

collected include personal identifiers 

such as social security number (last 4 

digits), name and medical record 

number; clinical laboratory results such 

as hematocrit and white blood cell 

count; and financial billing and record 

data. The survey includes detailed 

questions for three modules: Acute 

myocardial infarction; infectious 

disease; and end of life issues. Facility 

level data items include demographic 

information, clinical capabilities, and 

financial information. 

Users of NHDS data include, but are 

not limited to the CDC; the 

Congressional Research Office; the 

Office of the Assistant Secretary for 

Planning and Evaluation (ASPE); 

American Health Care Association, 

Centers for Medicare and Medicaid 

mstockstill on PROD1PC66 with NOTICES

Federal Register / Vol. 73, No. 149 / Friday, August 1, 2008 / Notices 45013 

Services (CMS), and Bureau of the 

Census. Data collected through the 

NHDS are essential for evaluating health 

status of the population, for the 

planning of programs and policy to 

elevate the health status of the Nation, 

for studying morbidity trends, and for 

research activities in the health field. 

NHDS data have been used extensively 

in the development and monitoring of 

goals for the Year 2000 and 2010 

Healthy People Objectives. In addition, 

NHDS data provide annual updates for 

numerous tables in the Congressionallymandated NCHS report, Health, United 

States. Other users of these data include 

universities, research organizations, 

foundations, and a variety of users in 

the print media. There is no cost to 

respondents other than their time to 

participate. The total estimated 

annualized burden hours are 5,591. 

TABLE 1—ESTIMATED ANNUALIZED BURDEN HOURS

Type of data collection Number of 

respondents 

Number of 

responses 

per 

respondent 

Average 

burden per 

response 

(in hours) 

Current NHDS Primary Procedure Hospitals Sample Listing Sheet ........................................... 13 12 25/60 

Current NHDS Primary Procedure Hospitals Medical Abstract Form ......................................... 13 250 5/60 

Current NHDS Primary Procedure Hospitals Transmittal Notice ................................................ 13 12 1/60 

Current NHDS Alternate Procedure Hospitals locating medical records .................................... 41 250 1/60 

Current NHDS In-House Tape or Printout Hospital—computer programming and submission 29 12 13/60 

Current NHDS Hospital Interview Questionnaire ........................................................................ 10 1 2 

Redesigned pretest Survey presentation to hospital .................................................................. 10 1 1 

Redesigned pretest Facility questionnaire .................................................................................. 10 1 4 

Redesigned pretest Sample discharges within hospital, obtain UB–04 & payment data ........... 10 10 14/60 

Redesigned pretest Verify sampling & reabstract medical records ............................................ 2 10 14/60 

Redesign pretest Debrief hospital staff ....................................................................................... 10 1 1 

Redesigned 2010–2011 Survey presentation to hospital ........................................................... 80 1 1 

Redesigned 2010–2011 Facility questionnaire ........................................................................... 80 1 4 

Redesigned 2010–2011 Sample discharges within hospital, obtain UB–04 & payment data .... 160 120 14/60 

Redesigned 2010–2011 Verify sampling & re-abstract medical records .................................... 3 25 14/60 

Dated: July 24, 2008. 

Maryam I. Daneshvar, 

Acting Reports Clearance Officer, Centers for 

Disease Control and Prevention. 

[FR Doc. E8–17605 Filed 7–31–08; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10265] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services. 

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) 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: Mandatory 

Insurer Reporting Requirements of 

Section 111 of the Medicare, Medicaid 

and SCHIP Act of 2007 (MMSEA) (Pub. 

L. 110–173); Use: Section 111 of the 

Medicare, Medicaid and SCHIP 

Extension Act of 2007 (Pub. L. 110–173) 

amends the Medicare Secondary Payer 

(MSP) provisions of the Social Security 

Act (42 U.S.C. 1395y(b)) to provide for 

mandatory reporting by group health 

plan arrangements and by liability 

insurance (including self-insurance), nofault insurance, and workers’

compensation laws and plans. The law 

provides that, not withstanding any 

other provision of law, the Secretary of 

Health and Human Services may 

implement this provision by program 

instruction or otherwise. The Secretary 

has elected not to implement the 

provision through rulemaking and will 

implement by publishing instructions 

on a publicly available Web site and 

submitting an information collection 

request to OMB for review and approval 

of the associated information collection 

requirements. 

Effective January 1, 2009, as required 

by the MMSEA, an entity serving as an 

insurer or third party administrator for 

a group health plan and, in the case of 

a group health plan that is self-insured 

and self-administered, a plan 

administrator or fiduciary must: (1) 

Secure from the plan sponsor and plan 

participants such information as the 

Secretary may specify to identify 

situations where the group health plan 

is a primary plan to Medicare; and (2) 

report such information to the Secretary 

in the form and manner (including 

frequency) specified by the Secretary. 

Effective July 1, 2009, as required by 

the MMSEA, ‘‘applicable plans,’’ must: 

(1) Determine whether a claimant is 

entitled to Medicare benefits; and, if so, 

(2) report the identity of such claimant 

and provide such other information as 

the Secretary may require to properly 

coordinate Medicare benefits with 

respect to such insurance arrangements 

in the form and manner (including 

frequency) as the Secretary may specify 

after the claim is resolved through a 

settlement, judgment, award or other 

payment (regardless of whether or not 

there is a determination or admission of 

liability). Applicable plan refers to the 

following laws, plans or other 

arrangements, including the fiduciary or 

administrator for such law, plan or 

arrangement: (1) Liability insurance 

(including self-insurance); (2) No-fault 

mstockstill on PROD1PC66 with NOTICES