Agency Information Collection Activities: Submission for OMB Review; Comment Request, 77400-77401 [05-24567]

Download as PDF wwhite on PROD1PC61 with NOTICES 77400 Federal Register / Vol. 70, No. 250 / Friday, December 30, 2005 / Notices Educational materials for worker safety and training on the safe handling of titanium dioxide; (10) Data pertaining to the feasibility of establishing particle size-specific RELs for titanium dioxide. NIOSH will use this information to assess the scientific basis for the draft worker health recommendations contained in the draft Current Intelligence Bulletin and determine the need for revision to those draft recommendations for reducing occupational exposure to titanium dioxide. Status: The forum will include scientists and representatives from various government agencies, industry, labor, and other stakeholders, and is open to the public, limited only by the space available. The meeting room accommodates 80 people. Due to limited space, notification of intent to attend the meeting must be made to Diane Miller no later than February 14, 2006. Ms. Miller can be reached by telephone at 513/533–8450 or by e-mail at niocindocket@cdc.gov. Requests to attend the meeting will be accommodated on a first-come basis. Non-U.S. Citizens: Because of CDC Security Regulations, any non-U.S. citizen wishing to attend this meeting must provide the following information in writing to Diane Miller at the address below no later than February 14, 2006: (1) Visitor’s full name; (2) Gender; (3) Date of Birth; (4) Place of birth (city, province, state, country); (5) Citizenship; (6) Passport number; (7) Date of passport issue; (8) Date of passport expiration; (9) Type of Visa; (10) Visitor’s organization; (11) Organization address; (12) Organization telephone number; (13) Visitor’s position/title within the organization. This information will be transmitted to the CDC Security Office for approval. Visitors will be notified as soon as approval has been obtained. A copy of the draft Current Intelligence Bulletin Evaluation of Health Hazard and Recommendations for Occupational Exposure to Titanium Dioxide can be obtained from the Internet at http://www.cdc.gov/niosh/ docs/preprint/tio2 or a hard copy may be requested from the Docket Officer, Diane Miller (contact information below). Addresses: Comments should be submitted to the NIOSH Docket Office, ATTN: Diane Miller, Robert A. Taft Laboratories, 4676 Columbia Parkway, M/S C–34, Cincinnati, Ohio 45226, telephone 513/533–8450, fax 513/533– 8285. Comments may also be submitted directly through the Web site (http:// www.cdc.gov/niosh/docs/preprint/tio2) VerDate Aug<31>2005 18:16 Dec 29, 2005 Jkt 208001 or by e-mail to niocindocket@cdc.gov. Email attachments should be formatted in Microsoft Word. Comments should be submitted to NIOSH no later than March 31, 2006, and should reference docket number NIOSH–033 in the subject heading. Oral comments made at the public meeting must also be submitted to the docket in writing in order to be considered by the Agency. All information received in response to this notice will be available for public examination and copying at the NIOSH Docket Office, Room 111, 4676 Columbia Parkway, Cincinnati, Ohio 45226. Contact Persons For Technical Information: Christine Sofge 513/533– 8439 or Faye Rice 513/533–8335, M/S C–15, Robert A. Taft Laboratories, 4676 Columbia Parkway, Cincinnati, Ohio 45226. The Director, Management Analysis and Services Office, has been delegated the authority to sign Federal Register notices pertaining to announcements of meetings and other committee management activities for both CDC and the Agency for Toxic Substances and Disease Registry. Dated: December 22, 2005. Diane Allen, Acting Director, Management Analysis and Services Office, Centers for Disease Control and Prevention. [FR Doc. E5–8100 Filed 12–29–05; 8:45 am] BILLING CODE 4163–18–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifier: CMS–10157, CMS– 10172, CMS–R–0107 and CMS–R–285] Agency Information Collection Activities: Submission for OMB Review; 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), 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 AGENCY: PO 00000 Frm 00029 Fmt 4703 Sfmt 4703 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: CMS Real-time Eligibility Agreement and Access Request; Form Number: CMS–10157 (OMB#: 0938–0960); Use: Federal law requires that CMS take precautions to minimize the security risk to Federal information systems. Accordingly, CMS is requiring that trading partners who wish to conduct the eligibility transaction on a real-time basis to access Medicare beneficiary information provide certain assurances as a condition of receiving access to the Medicare database for the purpose of conducting eligibility verification. Health care providers, clearinghouses, and health plans that wish access to the Medicare database are required to complete this form. The information will be used to assure that those entities that access the Medicare database are aware of applicable provisions and penalties; Frequency: Recordkeeping and Reporting—One time; Affected Public: Business or other for-profit, Notfor-profit institutions; Number of Respondents: 122,000; Total Annual Responses: 122,000; Total Annual Hours: 45,000. 2. Type of Information Collection Request: New Collection; Title of Information Collection: Medicare Health Support Program Medical Records Abstraction; Form Number: CMS–10172 (OMB#: 0938–New); Use: The Medicare Health Support Program (MHS) is authorized under Section 721 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). There are eight Medicare Health Support Organizations (MHSOs) that have signed cooperative agreements with the Centers for Medicare & Medicaid Services (CMS) to provide care support services to targeted Medicare fee-for-service (FFS) beneficiaries. The purposes of the MHS program are to improve the quality of healthcare provided to Medicare FFS beneficiaries with congestive heart failure and/or diabetes and to reduce the healthcare treatment cost to Medicare. MHS performance measures provide CMS with information to monitor the program operations and identify positive or negative program effects, provide MHSOs with feedback, and E:\FR\FM\30DEN1.SGM 30DEN1 wwhite on PROD1PC61 with NOTICES Federal Register / Vol. 70, No. 250 / Friday, December 30, 2005 / Notices serve as the basis for MHS performance guarantees. To meet these requirements, CMS has developed a performance monitoring system for MHS. This system includes measures of clinical performance that require the collection of clinical data from the medical records of a sample of Medicare beneficiaries. Medical record abstraction will be performed in two phases: The first, a pilot test, will take place after approximately six months of program operations, and the second, the full study. CMS will obtain active informed consent from the affected beneficiaries prior to reviewing medical records; Frequency: Reporting—Other: Only Once; Affected Public: Individuals or Households and Business or other forprofit; Number of Respondents: 26,643; Total Annual Responses: 26,643; Total Annual Hours: 12,416. 3. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Medicare— Determining Third Party Liability (TPL) State Plan Preprint and Supporting Regulations in 42 CFR 433.138; Form Number: CMS–R–0107 (OMB#: 0938– 0502); Use: Medicaid beneficiaries frequently have third party resources which are legally obligated to pay medical claims before Medicaid pays. Section 42 CFR 433.138 requires State Medicaid agencies to take specific steps to identify third party resources and determine their legal liability to pay for services under the plan. The collection of TPL information results in significant program savings to the extent that liable third parties can be identified and payments can be made for services that would otherwise be paid for by the Medicaid program. The State Medicaid agencies are the primary users of the collected data. Whenever States identify third party resources, pertinent information is entered into the State’s Medicaid Management Information System (MMIS). This enables the State to advise the provider to bill the third party and to seek reimbursement in situations where Medicaid TPL claims have been paid; Frequency: Recordkeeping—On occasion; Affected Public: Individuals or Households and Federal, State, Local and Tribal Government; Number of Respondents: 2,700,000; Total Annual Responses: 2,700,000; Total Annual Hours: 472,259. 4. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Request for Retirement Benefit Information (BBA ’97); Form Number: CMS–R–285 (OMB#: 0938–0769); Use: The Request for Retirement Benefit Information form VerDate Aug<31>2005 18:16 Dec 29, 2005 Jkt 208001 is used to obtain retirement benefit information from beneficiaries that purchase Medicare Part A coverage. The Social Security Administration (SSA) will use this information to determine if a beneficiary meets the requirements to qualify for a Medicare Part A premium reduction; Frequency: Reporting—On occasion; Affected Public: State, Local or Tribal Government; Number of Respondents: 1500; Total Annual Responses: 1500; Total Annual Hours: 375. To obtain copies of the supporting statement and any related forms for these paperwork collections referenced above, access CMS Web site address at http://www.cms.hhs.gov/ PaperworkReductionActof1995, or email your request, including your address, phone number, OMB number, and CMS document identifier, to Paperwork@cms.hhs.gov, or call the Reports Clearance Office at (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 January 30, 2006. OMB Human Resources and Housing Branch, Attention: Carolyn Lovett, CMS Desk Officer, New Executive Office Building, Room 10235, Washington, DC 20503. Dated: December 21, 2005. Michelle Shortt, Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 05–24567 Filed 12–29–05; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. 2005N–0216] Agency Information Collection Activities; Announcement of Office of Management and Budget Approval; Medical Devices; Humanitarian Use Devices AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing that a collection of information entitled ‘‘Medical Devices; Humanitarian Use Devices’’ has been approved by the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995. PO 00000 Frm 00030 Fmt 4703 Sfmt 4703 77401 FOR FURTHER INFORMATION CONTACT: Jonna Capezzuto, Office of Management Programs (HFA–250), Food and Drug Administration, 5600 Fishers Lane, Rockville, MD 20857, 301–827–4659. SUPPLEMENTARY INFORMATION: In the Federal Register of October 24, 2005 (70 FR 61455), the agency announced that the proposed information collection had been submitted to OMB for review and clearance under 44 U.S.C. 3507. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. OMB has now approved the information collection and has assigned OMB control number 0910–0332. The approval expires on December 31, 2008. A copy of the supporting statement for this information collection is available on the Internet at http://www.fda.gov/ ohrms/dockets. Dated: December 22, 2005. Jeffrey Shuren, Assistant Commissioner for Policy. [FR Doc. E5–8110 Filed 12–29–05; 8:45 am] BILLING CODE 4160–01–S DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. 2005D–0195] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Mammography Quality Standards Act Final Regulations; Modifications and Additions to Policy Guidance Help System #9 AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing that a proposed collection of information has been submitted to the Office of Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995. DATES: Fax written comments on the collection of information by January 30, 2006. ADDRESSES: The Office of Management and Budget (OMB) is still experiencing significant delays in the regular mail, including first class and express mail, and messenger deliveries are not being accepted. To ensure that comments on the information collection are received, OMB recommends that comments be faxed to the Office of Information and Regulatory Affairs, OMB, Attn: Fumie E:\FR\FM\30DEN1.SGM 30DEN1

Agencies

[Federal Register Volume 70, Number 250 (Friday, December 30, 2005)]
[Notices]
[Pages 77400-77401]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-24567]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10157, CMS-10172, CMS-R-0107 and CMS-R-285]


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: CMS Real-time 
Eligibility Agreement and Access Request; Form Number: CMS-10157 
(OMB: 0938-0960); Use: Federal law requires that CMS take 
precautions to minimize the security risk to Federal information 
systems. Accordingly, CMS is requiring that trading partners who wish 
to conduct the eligibility transaction on a real-time basis to access 
Medicare beneficiary information provide certain assurances as a 
condition of receiving access to the Medicare database for the purpose 
of conducting eligibility verification. Health care providers, 
clearinghouses, and health plans that wish access to the Medicare 
database are required to complete this form. The information will be 
used to assure that those entities that access the Medicare database 
are aware of applicable provisions and penalties; Frequency: 
Recordkeeping and Reporting--One time; Affected Public: Business or 
other for-profit, Not-for-profit institutions; Number of Respondents: 
122,000; Total Annual Responses: 122,000; Total Annual Hours: 45,000.
    2. Type of Information Collection Request: New Collection; Title of 
Information Collection: Medicare Health Support Program Medical Records 
Abstraction; Form Number: CMS-10172 (OMB: 0938-New); Use: The 
Medicare Health Support Program (MHS) is authorized under Section 721 
of the Medicare Prescription Drug, Improvement, and Modernization Act 
of 2003 (MMA). There are eight Medicare Health Support Organizations 
(MHSOs) that have signed cooperative agreements with the Centers for 
Medicare & Medicaid Services (CMS) to provide care support services to 
targeted Medicare fee-for-service (FFS) beneficiaries. The purposes of 
the MHS program are to improve the quality of healthcare provided to 
Medicare FFS beneficiaries with congestive heart failure and/or 
diabetes and to reduce the healthcare treatment cost to Medicare. MHS 
performance measures provide CMS with information to monitor the 
program operations and identify positive or negative program effects, 
provide MHSOs with feedback, and

[[Page 77401]]

serve as the basis for MHS performance guarantees. To meet these 
requirements, CMS has developed a performance monitoring system for 
MHS. This system includes measures of clinical performance that require 
the collection of clinical data from the medical records of a sample of 
Medicare beneficiaries. Medical record abstraction will be performed in 
two phases: The first, a pilot test, will take place after 
approximately six months of program operations, and the second, the 
full study. CMS will obtain active informed consent from the affected 
beneficiaries prior to reviewing medical records; Frequency: 
Reporting--Other: Only Once; Affected Public: Individuals or Households 
and Business or other for-profit; Number of Respondents: 26,643; Total 
Annual Responses: 26,643; Total Annual Hours: 12,416.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare--
Determining Third Party Liability (TPL) State Plan Preprint and 
Supporting Regulations in 42 CFR 433.138; Form Number: CMS-R-0107 
(OMB: 0938-0502); Use: Medicaid beneficiaries frequently have 
third party resources which are legally obligated to pay medical claims 
before Medicaid pays. Section 42 CFR 433.138 requires State Medicaid 
agencies to take specific steps to identify third party resources and 
determine their legal liability to pay for services under the plan. The 
collection of TPL information results in significant program savings to 
the extent that liable third parties can be identified and payments can 
be made for services that would otherwise be paid for by the Medicaid 
program. The State Medicaid agencies are the primary users of the 
collected data. Whenever States identify third party resources, 
pertinent information is entered into the State's Medicaid Management 
Information System (MMIS). This enables the State to advise the 
provider to bill the third party and to seek reimbursement in 
situations where Medicaid TPL claims have been paid; Frequency: 
Recordkeeping--On occasion; Affected Public: Individuals or Households 
and Federal, State, Local and Tribal Government; Number of Respondents: 
2,700,000; Total Annual Responses: 2,700,000; Total Annual Hours: 
472,259.
    4. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Request for 
Retirement Benefit Information (BBA '97); Form Number: CMS-R-285 
(OMB: 0938-0769); Use: The Request for Retirement Benefit 
Information form is used to obtain retirement benefit information from 
beneficiaries that purchase Medicare Part A coverage. The Social 
Security Administration (SSA) will use this information to determine if 
a beneficiary meets the requirements to qualify for a Medicare Part A 
premium reduction; Frequency: Reporting--On occasion; Affected Public: 
State, Local or Tribal Government; Number of Respondents: 1500; Total 
Annual Responses: 1500; Total Annual Hours: 375.
    To obtain copies of the supporting statement and any related forms 
for these paperwork collections referenced above, access CMS Web site 
address at http://www.cms.hhs.gov/PaperworkReductionActof1995, 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 at (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 January 30, 2006.

OMB Human Resources and Housing Branch, Attention: Carolyn Lovett, CMS 
Desk Officer, New Executive Office Building, Room 10235, Washington, DC 
20503.

    Dated: December 21, 2005.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 05-24567 Filed 12-29-05; 8:45 am]
BILLING CODE 4120-01-P