[Federal Register Volume 66, Number 33 (Friday, February 16, 2001)]
[Notices]
[Pages 10702-10703]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-3973]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-10011]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Health Care Financing 
Administration (HCFA), Department of Health and Human Services, has 
submitted to the Office of Management and Budget (OMB) the following 
proposal for the collection of information. Interested persons are 
invited to send comments regarding the burden estimate or any

[[Page 10703]]

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.
    Type of Information Collection Request: New Collection;
    Title of Information Collection: Stages of Change Survey for 
Informed Choice in the Medicare Population;
    Form No.: HCFA-10011 (OMB# 0938-NEW)
    Use: This is a survey of Medicare beneficiaries in the first step 
in the application the Transtheoretical Model (the ``stage model'') to 
informed choice in the Medicare population. The Transtheoretical Model 
has been applied and proven effective in facilitating behavior change 
in a wide range of health behaviors including smoking cessation, 
mammography screening, and safe sex. This work will yield 
psychometrically sound and externally valid measures of beneficiaries' 
readiness to make informed choices about health plans, and provide 
information to HCFA to assist with its national educational campaign to 
inform beneficiaries about their choices. Stages of Change measures 
will be administered to 560 Medicare beneficiaries' readiness to make 
informed choices about health plans, and provide information to guide 
HCFA's National Medicare Education Program (NMEP).;
    Frequency: Other: One-time survey;
    Affected Public: Individuals or Households;
    Number of Respondents: 560;
    Total Annual Responses: 560;
    Total Annual Hours: 327.
    To obtain copies of the supporting statement for the proposed 
paperwork collections referenced above, access HCFA's Web Site Address 
at http://www.hcfa.gov/regs/prdact95.htm, or E-mail your request, 
including your address and phone number, to [email protected], or call 
the Reports Clearance Office on (410) 786-1326. Written comments and 
recommendations for the proposed information collections must be mailed 
within 30 days of this notice directly to the OMB Desk Officer 
designated at the following address: OMB Human Resources and Housing 
Branch, Attention: Allison Eydt, New Executive Office Building, Room 
10235, Washington, DC 20503.

    Dated: January 25, 2001.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA, Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 01-3973 Filed 2-15-01; 8:45 am]
BILLING CODE 4120-03-P