[Federal Register Volume 70, Number 28 (Friday, February 11, 2005)]
[Notices]
[Page 7277]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-2659]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10131]


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.
    Type of Information Collection Request: New Collection; Title of 
Information Collection: Evaluation of Medicare Disease Management 
Demonstrations; Form No.: CMS-10131 (OMB 0938-NEW); Use: CMS 
contracted with Mathematica Policy Research, Inc. for the evaluation of 
programs and disease management. The purpose of the patient survey is 
to assess the impact of disease management and prescription drug 
benefits (the latter in 3 of the sites) on patient's health and 
functioning status, care satisfaction, health behaviors and knowledge 
of condition. Data from the physician survey will be used to assess 
physician satisfaction with disease management services, their 
perceptions of the impact of disease management on patient outcomes, 
education, and service use, and on their own practice and office 
workload.; Frequency: On Occasion; Affected Public: Individuals or 
households, Business or other for-profit; Number of Respondents: 5000; 
Total Annual Responses: 2500; Total Annual Hours: 1625.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS Web 
site address at http://www.cms.hhs.gov/regulations/pra/, or E-mail your 
request, including your address, phone number, OMB number, and CMS 
document identifier, to P[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: OMB Human Resources and Housing Branch, 
Attention: Christopher Martin, New Executive Office Building, Room 
10235, Washington, DC 20503.

    Dated: February 3, 2005.
John P. Burke, III,
CMS Paperwork Reduction Act Reports Clearance Officer, Office of 
Strategic Operations and Regulatory Affairs, Regulations Development 
Group.
[FR Doc. 05-2659 Filed 2-10-05; 8:45 am]
BILLING CODE 4120-03-P