[Federal Register Volume 67, Number 110 (Friday, June 7, 2002)]
[Notices]
[Page 39404]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-14275]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[Document Identifier: CMS-10065]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare and 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 and Medicaid
Services (CMS) (formerly known as the Health Care Financing
Administration (HCFA)), 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 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: Making Good Choices Survey; Form No.: CMS-10065
(OMB 0938-NEW); Use This is a request for clearance for a
survey ``Making Good Choices about Medicare Health Plan Survey''. As
part of the continuous quality improvement effort for the National
Medicare Education Program (NMEP), this survey will be used to assess
the impact of new educational materials developed for individuals who
are turning 65 and entering the Medicare program. The measures and
educational materials are based on the Transtheoretical Model of Change
(TTM, the ``stage model''), which has been applied and proven effective
in facilitating behavior change in a wide range of health behaviors
including smoking cessation, exercise acquisition and mammography
screening. The materials are designed to increase new enrollees'
readiness to compare their health plan options and make an informed
choice. The use of an investigational design in the present study (one
group will receive the materials, another will not) will allow CMS to
determine whether the materials increase readiness to make an informed
choice, self-efficacy, knowledge about the Medicare program,
information seeking, and satisfaction with health plan choice. It will
assist CMS with its national educational campaign to inform
beneficiaries about their health plan choices.--; Frequency: Once with
follow-up; Affected Public: Individuals or Households; Number of
Respondents: 1350; Total Annual Responses: 1350; Total Annual Hours:
1013 hours.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS's
Web Site address at http://www.hcfa.gov/regs/prdact95.htm, or E-mail
your request, including your address, phone number, OMB number, and CMS
document identifier, 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 60 days of this notice directly to the CMS Paperwork Clearance
Officer designated at the following address: CMS, Office of Information
Services, Security and Standards Group, Division of CMS Enterprise
Standards, Attention: Melissa Musotto, Room N2-14-26, 7500 Security
Boulevard, Baltimore, Maryland 21244-1850.
Dated: May 29, 2002.
John P. Burke III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer, CMS
Office of Information Services, Security and Standards Group, Division
of CMS Enterprise Standards.
[FR Doc. 02-14275 Filed 6-6-02; 8:45 am]
BILLING CODE 4120-03-P