Agency Information Collection Activities: Proposed Collection; Comment Request, 36613 [05-12492]
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Federal Register / Vol. 70, No. 121 / Friday, June 24, 2005 / Notices
other forms of information technology to
minimize the information collection
burden.
1. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare
Provider Cost Report Reimbursement
Questionnaire and Supporting
Regulations in 42 CFR 413.20, 413.24,
and 415.60; Form Nos.: CMS–339 (OMB
# 0938–0301); Use: The purpose of Form
CMS–339 is to assist the provider in
preparing an acceptable cost report and
to minimize subsequent contact
between the provider and its
intermediary. Form CMS–339 provides
the basic data necessary to support the
information in the cost report. This
includes information the provider uses
to develop the provider and professional
components of physician compensation
so that compensation can be properly
allocated between the Part A and the
Part B trust funds. CMS is currently
working on eliminating Form CMS–339
and including the applicable questions
on the individual cost report forms.
Because of the time required to include
the applicable questions in each of the
individual cost reports, CMS is revising
the currently approved information
collection; Frequency: Annually;
Affected Public: Business or other forprofit, not-for-profit institutions, State,
local or tribal governments; Number of
Respondents: 35,904; Total Annual
Responses: 35,904; Total Annual Hours:
618,210.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access CMS’ Web site
address at https://www.cms.hhs.gov/
regulations/pra/, or e-mail your request,
including your address, phone number,
OMB number, and CMS document
identifier, to Paperwork@cms.hhs.gov,
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 to the
address below: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: William N. Parham, III, PRA
Analyst, Room C5–13–27, 7500 Security
Boulevard, Baltimore, Maryland 21244–
1850.
Dated: June 3, 2005.
Jim L. Wickliffe,
CMS Reports Clearance Officer, Regulations
Development Group, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 05–12161 Filed 6–23–05; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10130]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
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) 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.
1. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Federal Funding
of Emergency Health Services (Section
1011): Provider Payment Determination
and Request for Section 1011 On-Call
Payments; Form No.: CMS–10130 (OMB
# 0938–0952); Use: Section 1011 of
MMA provides that the Secretary will
establish a process for eligible providers
to request payment. The Secretary must
directly pay hospitals, physicians, and
ambulance providers (including Indian
Health Service, Indian tribe and tribal
organizations) for their otherwise unreimbursed costs of providing services
required by Section 1867 of the Social
Security Act (EMTALA) and related
hospital inpatient, outpatient and
ambulance services. Payments may be
made only for services furnished to
certain individuals described in the
statute as: (1) Undocumented aliens; (2)
aliens who have been paroled into the
United States at a United States port of
entry for the purpose of receiving
eligible services; and (3) Mexican
citizens permitted to enter the United
States for not more than 72 hours under
the authority of a biometric machine
readable border crossing identification
card (also referred to as a ‘‘laser visa’’)
AGENCY:
PO 00000
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36613
issued in accordance with the
requirements of regulations prescribed
under a specific section of the
Immigration and Nationality Act.;
Affected Public: Business or other forprofit, Not-for-profit institutions, and
State, Local or Tribal Governments;
Number of Respondents: 7,503,000;
Total Annual Responses: 7,512,000;
Total Annual Hours: 634,000.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access CMS’’ Web site
address at https://www.cms.hhs.gov/
regulations/pra/, or E-mail your request,
including your address, phone number,
OMB number, and CMS document
identifier, to Paperwork@cms.hhs.gov,
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 to the
address below: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: William N. Parham, III, PRA
Analyst, Room C5–13–27, 7500 Security
Boulevard, Baltimore, Maryland 21244–
1850.
Dated: June 17, 2005.
Michelle Shortt,
Acting Director, Regulations Development
Group, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 05–12492 Filed 6–23–05; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–5022–N]
Medicare Program; Solicitation for
Applications for the Medical Adult DayCare Services Demonstration
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice for solicitation of
applications.
AGENCY:
SUMMARY: This notice informs interested
parties of an opportunity to apply for
participation in the Medical Adult DayCare Services Demonstration. This
demonstration tests an alternative
approach to service delivery by allowing
home health beneficiaries to receive a
portion of the medical services included
in their home health plan of care in a
medical adult day-care facility
(MADCF). The project will allow us to
test potential improvements in quality
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[Federal Register Volume 70, Number 121 (Friday, June 24, 2005)]
[Notices]
[Page 36613]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-12492]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10130]
Agency Information Collection Activities: Proposed Collection;
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) 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.
1. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Federal Funding
of Emergency Health Services (Section 1011): Provider Payment
Determination and Request for Section 1011 On-Call Payments; Form No.:
CMS-10130 (OMB 0938-0952); Use: Section 1011 of MMA provides
that the Secretary will establish a process for eligible providers to
request payment. The Secretary must directly pay hospitals, physicians,
and ambulance providers (including Indian Health Service, Indian tribe
and tribal organizations) for their otherwise un-reimbursed costs of
providing services required by Section 1867 of the Social Security Act
(EMTALA) and related hospital inpatient, outpatient and ambulance
services. Payments may be made only for services furnished to certain
individuals described in the statute as: (1) Undocumented aliens; (2)
aliens who have been paroled into the United States at a United States
port of entry for the purpose of receiving eligible services; and (3)
Mexican citizens permitted to enter the United States for not more than
72 hours under the authority of a biometric machine readable border
crossing identification card (also referred to as a ``laser visa'')
issued in accordance with the requirements of regulations prescribed
under a specific section of the Immigration and Nationality Act.;
Affected Public: Business or other for-profit, Not-for-profit
institutions, and State, Local or Tribal Governments; Number of
Respondents: 7,503,000; Total Annual Responses: 7,512,000; Total Annual
Hours: 634,000.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS''
Web site address at https://www.cms.hhs.gov/regulations/pra/, or E-mail
your request, including your address, phone number, OMB number, and CMS
document identifier, to Paperwork@cms.hhs.gov, 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 to the address
below: CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development, Attention: William N. Parham, III,
PRA Analyst, Room C5-13-27, 7500 Security Boulevard, Baltimore,
Maryland 21244-1850.
Dated: June 17, 2005.
Michelle Shortt,
Acting Director, Regulations Development Group, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 05-12492 Filed 6-23-05; 8:45 am]
BILLING CODE 4120-01-P
