[Federal Register Volume 77, Number 225 (Wednesday, November 21, 2012)]
[Notices]
[Pages 69865-69866]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-28236]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
60-Day Proposed Information Collection; Request for Public
Comment: Indian Health Service Contract Health Services Report
AGENCY: Indian Health Service.
ACTION: Notice.
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SUMMARY: In compliance with Section 3506(c)(2)(A) of the Paperwork
Reduction Act of 1995 which requires 60 days for public comment on
proposed information collection projects, Indian Health Service (IHS)
is publishing for comment a summary of a proposed information
collection to be submitted to the Office of Management and Budget (OMB)
for review.
Proposed Collection: Title: 0917-0002, ``IHS Contract Health
Service Report.'' Type ofInformation Collection Request: Extension,
without change, of a currently approved information collection, 0917-
0002, ``IHS Contract Health Service Report.'' Form Number: IHS 843-1A.
The form can be found on the Public Use Forms Web page(s) at the IHS
Web site (http://www.ihs.gov/cio/puf/) and the Department of Health and
Human Services' Web site (http://www.hhs.gov/forms/publicuse.html).
Need and Use of Information Collection: The IHS Contract Health
Service (CHS) Program, located in the Office of Resource Access and
Partnerships, needs this information to certify that the health care
services requested and authorized by the IHS have been performed by the
CHS provider(s) to have providers validate services provided; to
process payments for health care services performed by such providers;
and to serve as a legal document for health and medical care authorized
by IHS and rendered by health care providers under contract with the
IHS. Affected Public: Patients, health and medical care providers or
Tribal Governments. Type of Respondents: Health and medical care
providers.
Burden Hours: The table below provides: Types of data collection
instruments, Estimated number of respondents, Number of responses per
respondent, Average burden hour per response, and Total annual burden
hours.
[[Page 69866]]
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Estimated Average burden
Data collection instrument(s) number of Responses per hour per Total annual
respondents respondent response * burden hours
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IHS 843-1A...................................... 7,977 52 3/60 20,740
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Total....................................... .............. .............. .............. 20,740
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* For ease of understanding, burden hours are also provided in actual minutes.
The total estimated burden for this collection is 20,740 hours.
There are no Capital Costs, Operating Costs, and/or Maintenance
Costs to report.
Request for Comments: Your written comments and/or suggestions are
invited on one or more of the following points: (a) Whether the
information collection activity is necessary to carry out an agency
function; (b) whether the IHS processes the information collected in a
useful and timely fashion; (c) the accuracy of the public burden
estimate (this is the amount of time needed for individual respondents
to provide the requested information); (d) whether the methodology and
assumptions used to determine the estimate are logical; (e) ways to
enhance the quality, utility, and clarity of the information being
collected; and (f) ways to minimize the public burden through the use
of automated, electronic, mechanical, or other technological collection
techniques or other forms of information technology.
Send Comments and Requests for Further Information: Send your
written comments and requests for more information on the proposed
collection or requests to obtain a copy of the data collection
instrument(s) and instructions to: Tamara Clay, IHS Reports Clearance
Officer, 801 Thompson Avenue, TMP, Suite 450, Rockville, MD 20852; call
non-toll free (301) 443-1611; send via facsimile to (301) 443-2316, or
send your email requests, comments, and return address to
[email protected].
Comment Due Date: Your comments regarding this information
collection are best assured of having their full effect if received
within 60-days of the date of this publication.
Dated: November 9, 2012.
Yvette Roubideaux,
Director, Indian Health Service.
[FR Doc. 2012-28236 Filed 11-20-12; 8:45 am]
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