[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]


-----------------------------------------------------------------------

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.

-----------------------------------------------------------------------

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]]



----------------------------------------------------------------------------------------------------------------
                                                     Estimated                    Average burden
          Data collection instrument(s)              number of     Responses per     hour per      Total annual
                                                    respondents     respondent      response *     burden hours
----------------------------------------------------------------------------------------------------------------
IHS 843-1A......................................           7,977              52            3/60          20,740
                                                 ---------------------------------------------------------------
    Total.......................................  ..............  ..............  ..............          20,740
----------------------------------------------------------------------------------------------------------------
* 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]
BILLING CODE 4165-16-P