[Federal Register Volume 76, Number 170 (Thursday, September 1, 2011)]
[Notices]
[Pages 54470-54472]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-22395]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[60Day-11-0891]
Proposed Data Collections Submitted for Public Comment and
Recommendations
In compliance with the requirement of Section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995 for opportunity for public comment on
proposed data collection projects, the Centers for Disease Control and
Prevention (CDC) will publish periodic summaries of proposed projects.
To request more information on the proposed projects or to obtain a
copy of the data collection plans and instruments, call 404-639-5960
and send comments to Daniel Holcomb, CDC Reports Clearance Officer,
1600 Clifton Road, MS-D74, Atlanta, GA 30333 or send an e-mail to
[email protected].
Comments are invited on: (a) Whether the proposed collection of
information is necessary for the proper performance of the functions of
the agency, including whether the information shall have practical
utility; (b) the accuracy of the agency's estimate of the burden of the
proposed collection of information; (c) ways to enhance the quality,
utility, and clarity of the information to be collected; and (d) ways
to minimize the burden of the collection of information on respondents,
including through the use of automated collection techniques or other
forms of information technology. Written comments should be received
within 60 days of this notice.
Proposed Project
World Trade Center Health Program Enrollment, Appeals &
Reimbursement--New--National Institute for Occupational Safety and
Health (NIOSH), Centers for Disease Control and Prevention (CDC).
Background and Brief Description
The James Zadroga 9/11 Health and Compensation Act of 2010 (Zadroga
Act), promulgated on December 22, 2010, establishes a Federal program
to support health monitoring and treatment for emergency responders;
recovery and cleanup workers; and residents, building occupants, and
area workers in New York City who were directly impacted and adversely
affected by the terrorist attacks of September 11, 2001. In order to
provide medical monitoring and treatment to eligible individuals, the
World Trade Center (WTC) Health Program will collect eligibility and
appeals data as well as information from medical and prescription
pharmaceutical providers.
All responders to the New York City attack who will be newly
seeking medical monitoring and treatment and survivors of the attack
who were not covered by the Medical Monitoring and Treatment Program
(MMTP) (for responders) or the Community Program (for survivors) prior
to January 2, 2011, may apply to obtain coverage under the new WTC
Health Program. In order to begin the determination eligibility
process, an enrollment form must be completed. After an eligibility
application is submitted to the Program, an unsuccessful applicant has
an opportunity to appeal the decision; enrolled participants have
further appeal rights. Health care and prescription pharmaceutical
providers will be required to submit medical determinations to the WTC
Program Administrator and request reimbursement.
Data are being collected in order to determine the eligibility of
applicants. If an applicant is denied enrollment based on the
information provided, the applicant will receive a letter that gives
the reason for the denial and the opportunity to appeal the decision.
Once someone is enrolled, he or she may request approval for
reimbursement of travel if the individual must travel more than 250
miles to receive healthcare services.
Healthcare providers and pharmacies will file claims electronically
or by paper form to be paid for their services.
There are three separate enrollment forms for each population of
responders (FDNY responders, general responders, and survivors). The
following information includes the definition of each population:
``FDNY responder'' is defined as a member of the Fire Department of New
York City (whether fire or emergency personnel, active, or retired) who
participated at least one day in the rescue and recovery effort at any
of the former World Trade Center sites. ``General Responder'' is a
worker or volunteer who provided Rescue, Recovery, Demolition, Debris,
Removal and related support services in the aftermath of the September
11, 2001 attacks on the World Trade Center but was not affiliated with
the Fire Department of New York. ``Survivor'' is a person who was
present in the disaster area in the aftermath of the September 11, 2001
attacks on the World Trade Center as a result of his or her work,
residence, or attendance at school, childcare, or adult daycare.
The eligibility application form will collect general contact
information as well as information regarding the WTC disaster area
experience. Some of the information provided will be shared with the
Federal Bureau of Investigation in order to screen an individual
against the terrorist watch list maintained by the Federal government.
This information will also be shared with the WTC Program Administrator
and will be kept in a secure manner.
WTC Health Program applicants and enrolled participants have
opportunities to appeal adverse decisions made by the WTC Program
Administrator. The first opportunity to appeal arises after a
determination that an applicant does not meet the eligibility
requirements. Once enrolled in the Program, participants will also have
the opportunity to appeal a decision not to certify a WTC-related
health condition or a determination that treatment will not be
authorized as medically necessary. In the notification letter
explaining the adverse determination, the applicant will be advised
that an appeal can be requested by submitting in writing his or her
name, contact information, and an explanation for the basis of the
appeal.
Certain enrolled participants may be reimbursed for necessary and
reasonable transportation and expenses incident to the securing of
medically necessary treatment through the nationwide network if the
care involves travel of more than 250 miles. Individuals requesting
reimbursement must fill out a 1-page written form requesting such
information as date of travel, distance, and total expense.
Pharmacies will transmit reimbursement claims to the WTC Health
Program. The following data
[[Page 54471]]
elements will be collected for pharmacy reimbursement: Pharmacy name,
pharmacy address, drug name, prescription number, patient name, patient
ID number, and cost. Pharmacies utilize Electronic Data Interchange
(EDI) processing at the point-of-sale to transmit claims to the World
Trade Center Health Program (WTC-HP). The EDI transmission conforms to
ANSI standards developed by the National Council for Prescription Drug
Programs. The information collection burden occurs as the WTC-HP member
information is copied from the membership card at the point-of-sale.
The EDI transmission occurs in real-time as the prescription
transaction is made.
The Zadroga Act of 2010 requires that all qualifying WTC-related
health conditions or health conditions medically associated with a WTC-
related health condition be certified by member to enable reimbursement
of treatment services for care rendered to that member for a given
qualifying condition(s). To meet the requirement for certification and
maintain continuity of care for an individual who had been enrolled in
the prior MMTP or Community Program, the WTC Health Program physician
shall attest that a prior determination was rendered in the previous
federally sponsored program. The attestation will include the
physician's name and signature, the name of the patient, and the name
of the health condition and its diagnostic (ICD-9) code.
An individual who is new to the WTC Health Program must have a
certified WTC-related health condition or health condition medically
associated with WTC-related health condition to receive reimbursement
for treatment and other services. If a new medical determination is
being made, the Program clinician must provide to the WTC Health
Program the patient's name and program identification number, the name
and diagnostic code of the health condition, and a brief narrative
explaining the key exposure findings. The narrative will include
information such as the time and duration of the individual's presence
in defined geographic areas (of exposure), whether the individual was
caught in the dust cloud on September 11, 2001, whether the individual
conducted strenuous activity while in the exposure zone(s), the
individual's symptom time course relative to September 11, 2001, and
the reasons a person might be more likely to get sick from given
exposures (family history or coexisting medical problems).
A Program physician will also submit a form to the WTC Health
Program when a member needs medical treatment for a condition that has
not yet been certified. In that case, the physician will request
authorization to treat the condition because of the urgency of the
medical scenario. The physician will sign a form attesting that a
determination was made, and indicate the patient's name and the name of
the health condition and its diagnostic code.
Physicians will be compensated through administrative expenses
invoiced by their respective Clinical Center of Excellence that is
under contract with the Federal government.
There are no costs to respondents other than their time.
Estimate of Annualized Burden Hours
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Number of Avg. burden
Type of respondents Form name Number of responses per per response Total burden
respondents respondent (in hrs) (in hrs)
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Responder (FDNY and General Eligibility and 290 1 10/60 48
Responder)/Survivor. Qualification
for the WTC
Health Program.
FDNY Responder................ World Trade 189 1 30/60 95
Center Health
Program FDNY
Responder
Eligibility
Application.
General Responder............. World Trade 2979 1 30/60 1490
Center Health
Program
Responder
Eligibility
Application
(Other than
FDNY).
WTC Survivor.................. World Trade 1560 1 15/60 390
Center Health
Program
Survivor
Eligibility
Application.
Responder (FDNY and General Denial Letter 47 1 30/60 24
Responder)/Survivor. and Appeal
Notification--E
ligibility.
Responder (FDNY and General Denial Letter 30 1 30/60 15
Responder)/Survivor. and Appeal
Notification--H
ealth
Conditions.
Responder (FDNY and General Denial Letter 588 1 30/60 294
Responder)/Survivor. and Appeal
Notification--T
reatment.
Responder (FDNY and General WTC Health 10 1 10/60 2
Responder)/Survivor. Program Medical
Travel Refund
Request.
Physician..................... WTC Health 2,300 14 1 32,200
Condition
Certification
Request.
Attestation for 2,300 14 5/60 2,683
previously-
enrolled.
Request for 6,000 1 30/60 3,000
treatment
pending
authorization.
Pharmacy...................... Outpatient 150 261 1/60 653
prescription
pharmaceuticals.
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[[Page 54472]]
Total..................... ................ .............. .............. .............. 40,894
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Dated:August 25, 2011.
Daniel Holcomb,
Reports Clearance Officer, Centers for Disease Control and Prevention.
[FR Doc. 2011-22395 Filed 8-31-11; 8:45 am]
BILLING CODE 4163-18-P