Agency Information Collection Activities: Submission for OMB Review; Comment Request, 54750 [05-18508]

Agencies

• Centers for Medicare & Medicaid Services
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 70, Number 179 (Friday, September 16, 2005)]
[Notices]
[Page 54750]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-18508]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-1856/1893, CMS-R-254, CMS-10160, CMS-10154]


Agency Information Collection Activities: Submission for OMB 
Review; 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), 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 function; (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: Request for 
Certification in the Medicare and/or Medicaid Program to Provide 
Outpatient Physical Therapy (OPT) and/or Speech Pathology Services, OPT 
Speech Pathology Survey Report and Supporting Regulations in 42 CFR 
485.701-485.729.; Form No.: CMS-1856, CMS-1893 (OMB  0938-
0065); Use: The Medicare Program requires OPT providers to meet certain 
health and safety requirements. The request for certification form is 
used by State agency surveyors to determine if minimum Medicare 
eligibility requirements are met. The survey report form records the 
result of the on-site survey; Frequency: On occasion and Other--every 6 
years; Affected Public: Business or other for-profit; Number of 
Respondents: 2,968; Total Annual Responses: 495; Total Annual Hours: 
866.
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: National Medicare 
Education Program (NMEP); Form No.: CMS-R-254 (OMB  0938-
0738); Use: The NMEP was developed to inform people with Medicare, 
their family members, and other interested parties about their Medicare 
options. The Medicare Modernization Act of 2003 expanded the program to 
include among other things, a new Prescription Drug Benefit; therefore, 
this package has been revised to include this information. The NMEP 
employs numerous communication channels to educate people with Medicare 
and help them make more informed decisions concerning the Medicare 
program benefits; health plan choices; supplemental health insurance; 
rights, responsibilities, and protections; and preventive health 
services. As part of the NMEP, CMS must provide information to this 
population about the Medicare program and their Health Plan options, as 
well as information about the new prescription drug coverage to help 
them choose the option that is right for them. This survey seeks to 
assess the awareness, knowledge, understanding and experiences of 
people with Medicare regarding the Medicare program overall and these 
new initiatives; Frequency: On occasion; Affected Public: Individuals 
or Households; Number of Respondents: 5,700; Total Annual Responses: 
5,700; Total Annual Hours: 1,425.
    3. Type of Information Collection Request: New collection; Title of 
Information Collection: The Consumer Assessment of Health Behaviors 
Survey; Form No.: CMS-10160 (OMB  0938-NEW); Use: New focus on 
personalizing messages by relating health care choices with individual 
beliefs may help guide these educational efforts. The intent of this 
survey is to understand the role personal responsibility plays when 
people with Medicare make health care decisions; Affected Public: 
Individuals or households; Number of Respondents: 1580; Total Annual 
Responses: 1580; Total Annual Hours: 395.
    4. Type of Information Collection Request: New collection; Title of 
Information Collection: Physician Assessment of Hospital Quality 
Reports; Form No.: CMS-10154 (OMB  0938-NEW); Use: This 
assessment will monitor the attitudes and behaviors of physicians as 
they relate to the concerns of their patients who have been exposed to 
hospital quality-of-care reports at CMS's Web Site; Affected Public: 
Individuals or households; Number of Respondents: 1730; Total Annual 
Responses: 1730; Total Annual Hours: 346.
    To obtain copies of the supporting statement and any related forms 
for these 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.
    To be assured consideration, comments and recommendations for the 
proposed information collections must be received by the OMB Desk 
Officer at the address below, no later than 5 p.m. on October 17, 2005.

OMB Human Resources and Housing Branch, Attention: Christopher Martin, 
New Executive Office Building, Room 10235, Washington, DC 20503.

    Dated: September 8, 2005.
Michelle Short,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 05-18508 Filed 9-15-05; 8:45 am]
BILLING CODE 4120-01-P