[Federal Register Volume 85, Number 83 (Wednesday, April 29, 2020)]
[Notices]
[Pages 23836-23837]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-09039]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Document Identifier OS-0990-New]


Agency Emergency Information Collection Clearance Request for 
Public Comment

AGENCY: Office of the Secretary, HHS.

ACTION: Notice.

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    In compliance with the requirement of the Paperwork Reduction Act 
of 1995, the Office of the Secretary (OS), Department of Health and 
Human Services, is publishing the following summary of a proposed 
information collection request 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 
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.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, email your 
request, including your address, phone number, OMB number, and OS 
document identifier, to [email protected], or call the Reports 
Clearance Office on (202) 795-7714. Written comments and 
recommendations for the proposed information collections must be 
directed to the OS Paperwork Clearance Officer at the above email 
address within 7-days.
    Proposed Project: COVID-19 by PCR Requisition Form.
    OMB No. 0990-NEW.

Emergency Information Collection Clearance Request

    Office: HHS, Office of the Assistant Secretary for Health, Office 
of the Surgeon General.
    Abstract: The COVID-19 by PCR Requisition Form will be used to 
collect information from individuals who are participating in the 
federally supported, state managed, locally executed CBTS program to 
obtain COVID-19 laboratory testing. The COVID-19 by PCR Requisition 
Form will be used by approximately 200,000 individuals. The Lab 
Requisition form includes the ordering physician information, the 
laboratory account information, the date of collection, the time of 
collection; the

[[Page 23837]]

individual's last name, first name, date of birth, gender, language, 
race, ethnicity, address, phone number, insurance carrier name, and 
whether the individual has provided informed consent and received a 
copy of the privacy notice. The information from the Lab Requisition 
form is shared with the ordering provider, the contracted laboratory 
companies, the cognizant state health department, and the contracted 
call center. Aggregate data is shared with HHS and FEMA.

                                        Estimated Annualized Burden Table
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                                                                  Number of     Average  burden
             Type of respondent                  Number of      responses per      hours per       Total burden
                                                respondents       respondent        response          hours
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Individuals receiving COVID-19 testing......         200,000                1               .1           20,000
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Sherrette A. Funn,
Office of the Secretary, Paperwork Reduction Act Reports Clearance 
Officer.
[FR Doc. 2020-09039 Filed 4-28-20; 8:45 am]
BILLING CODE 4150-36-P