34016 Federal Register / Vol. 74, No. 133 / Tuesday, July 14, 2009 / Notices 

FEDERAL RESERVE SYSTEM 

Sunshine Act; Notice of Meeting 

TIME AND DATE: 11:30 a.m., Monday, 

July 20, 2009. 

PLACE: Marriner S. Eccles Federal 

Reserve Board Building, 20th and C 

Streets, NW., Washington, DC 20551. 

STATUS: Closed. 

MATTERS TO BE CONSIDERED: 

1. Personnel actions (appointments, 

promotions, assignments, 

reassignments, and salary actions) 

involving individual Federal Reserve 

System employees. 

2. Any items carried forward from a 

previously announced meeting. 

FOR MORE INFORMATION PLEASE CONTACT: 

Michelle Smith, Director, or Dave 

Skidmore, Assistant to the Board, Office 

of Board Members at 202–452–2955. 

SUPPLEMENTARY INFORMATION: You may 

call 202–452–3206 beginning at 

approximately 5 p.m. two business days 

before the meeting for a recorded 

announcement of bank and bank 

holding company applications 

scheduled for the meeting; or you may 

contact the Board’s Web site at http:// 

www.federalreserve.gov for an electronic 

announcement that not only lists 

applications, but also indicates 

procedural and other information about 

the meeting. 

Dated: July 10, 2009. 

Robert deV. Frierson, 

Deputy Secretary of the Board. 

[FR Doc. E9–16843 Filed 7–10–09; 4:15 pm] 

BILLING CODE 6210–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

that the Office of Management and 

Budget (OMB) approve the proposed 

information collection project: ‘‘Medical 

Expenditure Panel Survey (MEPS) 

Household Component and the MEPS 

Medical Provider Component through 

2012.’’ In accordance with the 

Paperwork Reduction Act of 1995, 

Public Law 104–13 (44 U.S.C. 

3506(c)(2)(A)), AHRQ invites the public 

to comment on this proposed 

information collection. 

This proposed information collection 

was previously published in the Federal 

Register on May 6th 2009 and allowed 

60 days for public comment. No 

comments were received. The purpose 

of this notice is to allow an additional 

30 days for public comment. 

DATES: Comments on this notice must be 

received by August 13, 2009. 

ADDRESSES: Written comments should 

be submitted to: AHRQ’s OMB Desk 

Officer by fax at (202) 395–6974 

(attention: AHRQ’s desk officer) or by email at OIRAsubmission@omb.eop.gov 

(attention: AHRQ’s desk officer). 

Copies of the proposed collection 

plans, data collection instruments, and 

specific details on the estimated burden 

can be obtained from the AHRQ Reports 

Clearance Officer. 

FOR FURTHER INFORMATION CONTACT: 

Doris Lefkowitz, AHRQ Reports 

Clearance Officer, (301) 427–1477, or by 

e-mail at doris.lefkowitz@ahrq.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

‘‘Medical Expenditure Panel Survey 

(MEPS) Household Component and the 

MEPS Medical Provider Component 

through 2012’’ 

AHRQ seeks to renew the Medical 

Expenditure Panel Survey Household 

Component (MEPS–HC) and the MEPS 

Medical Provider Component (MEPS– 

MPC) through the year 2012. For over 

thirty years, the results of the MEPS and 

its predecessor surveys (the 1977 

National Medical Care Expenditure 

Survey, the 1980 National Medical Care 

Utilization and Expenditure Survey and 

the 1987 National Medical Expenditure 

Survey) have been used by OMB, DHHS, 

Congress and a wide number of health 

services researchers to analyze health 

care use, expenses and health policy. 

AHRQ is authorized to conduct the 

MEPS pursuant to 42 U.S.C. 299b–2. 

Major changes continue to take place 

in the health care delivery system. The 

MEPS is needed to provide information 

about the current state of the health care 

system as well as to track changes over 

time. The current MEPS design, unlike 

the previous periodic surveys, permits 

annual estimates of use of health care 

and expenditures and sources of 

payment for that health care. It also 

permits tracking individual change in 

employment, income, health insurance 

and health status over two years. The 

use of the National Health Interview 

Survey (NHIS) as a sampling frame 

expands the surveys’ analytic capacity 

by providing another data point for 

comparisons over time. 

The MEPS–HC and MEPS–MPC are 

two of three components of the MEPS: 

b MEPS–HC is a sample of 

households participating in the National 

Health Interview Survey (NHIS) in the 

prior calendar year and are interviewed 

5 times over a 2 and 1/2 year period. 

These 5 interviews yield two years of 

information on use of and expenditures 

for health care, sources of payment for 

that health care, insurance status, 

employment, health status and health 

care quality. 

b MEPS–MPC collects information 

from medical and financial records 

maintained by hospitals, physicians, 

pharmacies, health care institutions, 

and home health agencies named as 

sources of care by household 

respondents. 

b Insurance Component (MEPS–IC): 

The MEPS–IC collects information on 

establishment characteristics, insurance 

offerings and premiums from 

employers. The MEPS–IC is conducted 

by the Census Bureau for AHRQ and is 

cleared separately. 

This request is for the MEPS–HC and 

MEPS–MPC only. 

Method of Collection 

The MEPS is designed to meet the 

need for information to estimate health 

expenses, insurance coverage, access, 

use and quality. Households selected for 

participation in the MEPS are 

interviewed five times in person. These 

rounds of interviewing are spaced about 

5 months apart. The interview will take 

place with a family respondent who will 

report for him/herself and for other 

family members. 

After a preliminary mail contact 

containing an advance letter, 

households will be mailed MEPS record 

keeping materials (a calendar) and a 

DVD and brochure. After the advance 

contact, households will be contacted 

for the first of five in-person interviews. 

The interviews are conducted as a 

computer assisted personal interview 

(CAPI). The CAPT instrument is 

organized as a core instrument that will 

repeat unchanged in each of the rounds. 

Additional sections are asked only once 

a year and provide greater depth. 

Dependent interviewing methods in 

which respondents are asked to confirm 

or revise data provided in earlier 

interviews will be used to update 

information such as employment and 

health insurance data after the round in 

which such data are usually collected. 

The main data collection modules for 

the MEPS–HC are as follows: 

Household Component Core 

Instrument. The core instrument 

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Federal Register / Vol. 74, No. 133 / Tuesday, July 14, 2009 / Notices 34017 

collects data about persons in sample 

households. Topical areas asked in each 

round of interviewing include condition 

enumeration, health status, health care 

utilization including prescribed 

medicines, expense and payment, 

employment, and health insurance. 

Other topical areas that are asked only 

once a year include access to care, 

priority conditions, income, assets, 

satisfaction with health plans and 

providers, children’s health, adult 

preventive care. While many of the 

questions are asked about the entire 

reporting unit (RU), which is typically 

a family, only one person normally 

provides this information. 

Adult Self-Administered 

Questionnaire. A brief self-administered 

questionnaire (SAQ), administered once 

a year in rounds 2 and 4, will be used 

to collect self-reported (rather than 

through household proxy) information 

on health status, health opinions and 

satisfaction with health care for adults 

18 and older. 

Diabetes Care SAQ. A brief self 

administered questionnaire on the 

quality of diabetes care is administered 

once a year in rounds 3 and 5 to persons 

identified as having diabetes. 

Permission forms for the MEPS–MPC. 

As in previous panels of the MEPS, we 

will ask respondents for permission to 

obtain supplemental information from 

their medical providers (hospitals, 

physicians, health care institutions, 

home health agencies and pharmacies). 

MEPS–MPC Instruments 

The main objective of the MEPS–MPC 

is a collection of data from medical 

providers that will serve as an 

imputation source of medical 

expenditure and source of payment data 

reported by household respondents. 

This data will supplement, replace and 

verify information provided by 

household respondents about the 

charges, payments, and sources of 

payment associated with specific health 

care encounters. The questionnaires 

used in the MEPS–MPC vary according 

to type of provider. The data collection 

instruments are as follows: 

Home Care for Health Care Providers 

Questionnaire. This questionnaire is 

used to collect data from home health 

care agencies which provide medical 

care services to household respondents. 

Information collected includes type of 

personnel providing care, hours or visits 

provided per month, and the charges 

and payments for services received. 

Home Care Provider Questionnaire for 

Non-Health Care Providers. This is used 

to collect information about services 

provided in the home by non-health 

care workers to household respondents 

because of a medical condition; for 

example, cleaning or yard work, 

transportation, shopping, or child care. 

Office-based Providers Questionnaire. 

This questionnaire is for the officebased physician sample, including 

doctors of medicine (MDs) and 

osteopathy (DOs), as well as providers 

practicing under the direction or 

supervision of an MD or DO (e.g., 

physician assistants and nurse 

practitioners working in clinics). 

Providers of care in private offices as 

well as staff model HMOs are included. 

Separately Billing Doctors 

Questionnaire. Information from 

physicians identified by hospitals as 

providing care to sampled persons 

during the course of inpatient, 

outpatient department or emergency 

room care, but who bill separately from 

the hospital, is collected in this 

questionnaire. 

Hospitals Questionnaire. This 

questionnaire is used to collect 

information about hospital events, 

including inpatient stays, outpatient 

department, and emergency room visits. 

Hospital data are collected not only 

from the billing department, but from 

medical records and administrative 

records departments as well. Medical 

records departments are contacted to 

determine the names of all the doctors 

who treated the patient during a stay or 

visit. In many cases, the hospital 

administrative office also has to be 

contacted to determine whether the 

doctors identified by medical records 

billed separately from the hospital itself. 

Institutions Questionnaire. This 

questionnaire is used to collect data 

from health care institutions providing 

care to sampled persons and includes 

nursing homes, assisted living facilities, 

rehabilitation facilities, as well as any 

other health care facilities providing 

health care to a sampled person. 

Pharmacies Questionnaire. This 

questionnaire requests the prescription 

name, NDC code, date prescription was 

filled, payments by source, prescription 

strength, form and quantity, and person 

for whom the prescription was filled. 

Most pharmacies have the requested 

information available in electronic 

format and respond by providing a 

computer generated printout of the 

patient’s prescription information. If the 

computerized form is unavailable, the 

pharmacy can report their data to a 

telephone interviewer. 

Estimated Annual Respondent Burden 

Exhibit I shows the estimated 

annualized burden hours for the 

respondents time to participate in the 

MEPS–HC and MEPS–MPC. The MEPS– 

HC Core Interview will be completed by 

15,000 ‘‘family level’’ respondents, also 

referred to as RU respondents. Since the 

MEPS–HC consists of 5 rounds of 

interviewing covering a full two years of 

data, the annual average number of 

responses per respondent is 2.5 

responses per year. The MEPS–HC core 

requires an average response time of 1 

and 2 hours to administer. The Adult 

SAQ will be completed once a year by 

each person in the RU that is 18 years 

old and older, an estimated 21,000 

persons. The Adult SAQ requires an 

average of 7 minutes to complete. The 

Diabetes care SAQ will be completed 

once a year by each person in the RU 

identified as having diabetes, an 

estimated 1,800 persons and takes about 

3 minutes to complete. Permission 

forms for the MEPS–MPC will be 

completed once for each medical 

provider seen by any RU member. Each 

of the 15,000 RUs in the MEPS–HC will 

complete an average of 5.2 forms, which 

require about 3 minutes each to 

complete. The total annual burden 

hours for the MEPS–HC is estimated to 

be 62,690 hours. 

The MEPS–MPC uses 7 different 

questionnaires; 6 for medical providers 

and 1 for pharmacies. Each 

questionnaire is relatively short and 

requires 3 to 5 minutes to complete. 

The total annual burden hours for the 

MEPS–MPC is estimated to be 20,077 

hours. The total annual burden hours 

for the MEPS–HC and MPC is estimated 

to be 82,767 hours. 

Exhibit 2 shows the estimated annual 

cost burden associated with the 

respondents’ time to participate in this 

information collection. The annual cost 

burden for the MEPS–HC is estimated to 

be $1,226,216; the annual cost burden 

for the MEPS–MPC is estimated to be 

$285,965. 

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34018 Federal Register / Vol. 74, No. 133 / Tuesday, July 14, 2009 / Notices 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Form name Number of 

respondents 

Number of 

responses per 

respondent 

Hours per 

response 

Total burden 

hours 

MEPS–HC 

MEPS–HC Core Interview ............................................................................... 15,000 2.5 1.5 56,250 

Adult SAQ ........................................................................................................ 21,000 1 7/60 2,450 

Diabetes care SAQ .......................................................................................... 1,800 1 3/60 90 

Permission forms for the MEPS–MPC ............................................................ 15,000 5.2 3/60 3,900 

Subtotal for the MEPS–HC ....................................................................... 52,800 na na 62,690 

MEPS–MPC 

Home care for health care providers questionnaire ........................................ 441 6.5 5/60 239 

Home care for non-health care providers questionnaire ................................. 23 6.6 5/60 13 

Office-based providers questionnaire .............................................................. 13,665 5.8 5/60 6,605 

Separately billing doctors questionnaire .......................................................... 12,450 2 3/60 1,245 

Hospitals questionnaire ................................................................................... 5,402 6.5 5/60 2,926 

Institutions (non-hospital) questionnaire .......................................................... 72 1.5 5/60 9 

Pharmacies questionnaire ............................................................................... 7,760 23.3 3/60 9,040 

Subtotal for the MEPS–MPC .................................................................... 39,813 na na 20,077 

Grand Total ....................................................................................... 92,613 na na 82,767 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Form name Number of 

respondents 

Total burden 

hours 

Average 

hourly 

wage rate* 

Total cost 

burden 

MEPS–IIC 

MEPS–HC Core Interview ............................................................................... 15,000 56,250 $19.56 $1,100,250 

Adult SAQ ........................................................................................................ 21,000 2,450 19.56 47,922 

Diabetes care SAQ .......................................................................................... 1,800 90 19.56 1,760

Permission forms for the MEPS–MPC ............................................................ 15,000 3,900 19.56 76,284 

Subtotal for the MEPS–HC ....................................................................... 52,800 62,690 na 1,226,216 

MEPS–MPC 

Home care for health care providers questionnaire ........................................ 441 239 14.24 3,403 

Home care for non-health care providers questionnaire ................................. 23 13 19.56 254 

Office-based providers questionnaire .............................................................. 13,665 6,605 14.24 94,055 

Separately billing doctors questionnaire .......................................................... 12,450 1,245 14.24 17,729 

Hospitals questionnaire ................................................................................... 5,402 2,926 14.24 41,666 

Institutions (non-hospital) questionnaire .......................................................... 72 9 14.24 128 

Pharmacies questionnaire ............................................................................... 7,760 9,040 14.24 128,730 

Subtotal for the MEPS–MPC .................................................................... 39,813 20,077 na 285,965 

Grand Total ....................................................................................... 92,613 82,767 na 1,512,181 

* Based upon the mean of the average wages for Healthcare Support Workers, All Other (319099) and All Occupations (00–0000), Occupational Employment Statistics, May 2007 National Occupational Employment and Wage Estimates United States, U.S. Department of Labor, Bureau of Labor Statistics. http://www.bls.gov/oes/current/oes_nat.htm#b29–0000. 

Estimated Annual Costs to the Federal 

Government 

Exhibit 3 shows the total and 

annualized cost of this information 

collection. The cost associated with the 

design and data collection of the MEPS– 

HC and MEPS–MPC is estimated to be 

$47.6 million in each of the next three 

fiscal years. 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST

Cost component Total cost 

(millions) 

Annualized cost 

(millions) 

Sampling Activities ....................................................................................................................................... $2.79 $0.93 

Interviewer Recruitment and Training ......................................................................................................... 8.52 2.84 

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Federal Register / Vol. 74, No. 133 / Tuesday, July 14, 2009 / Notices 34019 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST—Continued 

Cost component Total cost 

(millions) 

Annualized cost 

(millions) 

Data Collection Activities ............................................................................................................................. 86.7 28.9 

Data Processing .......................................................................................................................................... 21.39 7.13 

Production of Public Use Data Files ........................................................................................................... 19.53 6.51 

Project Management .................................................................................................................................... 3.93 1.31 

Total ...................................................................................................................................................... 142.8 47.6 

Request for Comments 

In accordance with the above-cited 

Paperwork Reduction Act legislation, 

comments on AHRQ’s information 

collection are requested with regard to 

any of the following: (a) Whether the 

proposed collection of information is 

necessary for the proper performance of 

AHRQ health care research and health 

care information dissemination 

functions, including whether the 

information will have practical utility; 

(b) the accuracy of AHRQ’s estimate of 

burden (including hours and costs) of 

the proposed collection(s) 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 upon the 

respondents, including the use of 

automated collection techniques or 

other forms of information technology. 

Comments submitted in response to 

this notice will be summarized and 

included in the Agency’s subsequent 

request for OMB approval of the 

proposed information collection. All 

comments will become a matter of 

public record. 

Dated: July 1, 2009. 

Carolyn M. Clancy, 

Director. 

[FR Doc. E9–16567 Filed 7–13–09; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

that the Office of Management and 

Budget (OMB) approve the proposed 

information collection under the 

project: ‘‘Evaluation of AHRQ’s Effective 

Health Care Program.’’ In accordance 

with the Paperwork Reduction Act of 

1995, Public Law 104–13 (44 U.S.C. 

3506(c)(2)(A)), AHRQ invites the public 

to comment on this proposed 

information collection. 

This proposed information collection 

was previously published in the Federal 

Register on April 24th, 2009 and 

allowed 60 days for public comment. No 

comments were received. The purpose 

of this notice is to allow an additional 

30 days for public comment. 

DATES: Comments on this notice must be 

received by August 13, 2009. 

ADDRESSES: Written comments should 

be submitted to: AHRQs OMB Desk 

Officer by fax at (202) 395–6974 

(attention: AHRQ’s desk officer) or by email at OIRA_submission@omb.eop.gov 

(attention: AHRQ’s desk officer). 

Copies of the proposed collection 

plans, data collection instruments, and 

specific details on the estimated burden 

can be obtained from the AHRQ Reports 

Clearance Officer. 

FOR FURTHER INFORMATION CONTACT: 

Doris Lefkowitz, AHRQ Reports 

Clearance Officer, (301) 427–1477, or by 

e-mail at doris.lefkowitz@ahrq.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

’’Evaluation of AHRQ’s Effective Health 

Care Program’’ 

AHRQ proposes to perform an 

evaluation of the Effective Health Care 

(EHC) programs’ governance structure, 

methods for engaging stakeholders and 

approaches to setting national research 

priorities. Pursuant to Section 1013 of 

the Medicare Prescription Drug, 

Improvement, and Modernization Act of 

2003, Public Law 108–173, the EHC 

program was established by AHRQ to 

conduct research, demonstrations, and 

evaluations designed to improve the 

quality, effectiveness, and efficiency of 

Medicare, Medicaid, and the State 

Children’s Health Insurance Program. 

The EHC program was designed to 

provide effectiveness and comparative 

effectiveness evidence of medical 

treatments, therapeutics, devices and 

drugs to assist policymakers, health care 

providers, clinicians, consumers, and 

other stakeholders in making informed 

decisions. The EHC program has offered 

a platform for combining explicit 

reviews of scientific evidence on the 

clinical effectiveness of pharmaceuticals 

and other health care interventions, as 

well as the translation and 

dissemination of scientific findings into 

meaningfui messages for a wide variety 

of audiences. It serves as an interface 

between the clinical research entities 

and health policy making entities. This 

program also provides a critical step in 

AHRQ’s mission to support informed 

decision making. In addition to its 

program staff, the EHC program relies 

on four centers to generate and 

disseminate evidence: The Evidencebased Practice Centers (EPCs), the 

Developing Evidence to Inform 

Decisions about Effectiveness (DEcIDE) 

Network Centers, the John M. Eisenberg 

Clinical Decisions and Communications 

Science Center, and the Centers for 

Education & Research on Therapeutics 

(CERTs). Since the process of 

developing and disseminating this 

evidence is a complex undertaking, 

AHRQ has contracted with IMPAQ 

International, LLC and Abt Associates, 

Inc. (henceforth referred to as the 

‘‘IMPAQ team’’) to perform this 

evaluation. 

Information will be collected to 

identify strengths and weaknesses in the 

current EHC program’s governance 

structure, methods for engaging 

stakeholders, and approaches to setting 

priorities for the research conducted by 

the EHC program. The second phase of 

the evaluation will be to contrast the 

EHC program with international 

programs of similar purpose. To 

implement this evaluation, the IMPAQ 

team will conduct the following 

information collections: 

(1) Key informant interviews about 

the governance structure of the EHC 

program; 

(2) An online survey of EHC center 

staff and EHC program users and 

stakeholders; 

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