Agency Information Collection Activities: Submission for OMB Review; Comment Request, 4583 [06-749]
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Federal Register / Vol. 71, No. 18 / Friday, January 27, 2006 / Notices
Association, New Lenox, Illinois (in
organization).
Board of Governors of the Federal Reserve
System, January 24, 2006.
Robert deV. Frierson,
Deputy Secretary of the Board.
[FR Doc. E6–1051 Filed 1–26–06; 8:45 am]
BILLING CODE 6210–01–S
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–855]
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
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: Revision of a currently
approved collection; Title of
Information Collection: Medicare
Enrollment Application; Form No.:
CMS–855 (OMB #0938–0685); Use: This
application is currently required of all
health care providers/suppliers who
wish to enroll in the Medicare program.
It is submitted when an applicant
chooses to enroll into the Medicare
program or when an enrolled provider
or supplier reports a change to their
Medicare information. The application
is used by a Medicare fee-for-service
contractor to collect data to assure the
applicant meets all Federal and State
requirements to provide health care
services to Medicare beneficiaries. This
application also allows a Medicare feefor-service contractor to ensure that the
rmajette on PROD1PC67 with NOTICES
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15:17 Jan 26, 2006
Jkt 208001
provider/supplier is not sanctioned
from the Medicare program, or debarred,
suspended or excluded from any other
Federal agency or program.; Frequency:
Reporting—Other—; Affected Public:
Business or other for-profit, Individuals
or Households, Not-for-profit
institutions; Number of Respondents:
400,000; Total Annual Responses:
400,000; Total Annual Hours: 1,200,000.
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/
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 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 February 27, 2006.
OMB Human Resources and Housing
Branch, Attention: Carolyn Lovett, CMS
Desk Officer, New Executive Office
Building, Room 10235, Washington, DC
20503.
Dated: January 20, 2006.
Michelle Shortt,
Acting Director, Regulations Development
Group, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 06–749 Filed 1–26–06; 8:45 am]
BILLING CODE 4120–01–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–1557, CMS–R–
0074, CMS–416, CMS–437A and 437B]
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
AGENCY:
PO 00000
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Fmt 4703
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4583
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: Survey Report
Form Clinical Laboratory Improvement
Amendments (CLIA) and supporting
regulations under 42 CFR 493.1–
493.2001; Form Number: CMS–1557
(OMB#: 0938–0544); Use: This form is
used by the State agency to determine
a laboratory’s compliance with CLIA.
This information is needed for a
laboratory’s CLIA certification and
recertification; Frequency:
Recordkeeping and Reporting—
Biennially; Affected Public: Business or
other for-profit, Not-for-profit
institutions, Federal, State, Local or
Tribal Government; Number of
Respondents: 25,000; Total Annual
Responses: 12,500; Total Annual Hours:
6,250.
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Income and
Eligibility Verification System Reporting
in Section 1137 of the Social Security
Act and Supporting Regulations in 42
CFR 431.17, 431.306, 435.910, 435.920,
435.940–435.960; Form Number: CMS–
R–0074 (OMB#: 0938–0467); Use: This
information is used to verify the income
and eligibility of Medicaid applicants
and recipients as required by Section
1137 of the Social Security Act; Affected
Public: Individuals or Households and
State, Local or Tribal Government;
Number of Respondents: 54; Total
Annual Responses: 54; Total Annual
Hours: 124,054.
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Annual Early
and Periodic Screening, Diagnostic and
Treatment Services (EPSDT)
Participation Report; Form No.: CMS–
416 (OMB #0938–0354); Use: States are
required to submit an annual report on
the provision of EPSDT services to CMS
pursuant to section 1902(1)(43)(D) of the
Social Security Act. These reports
provide CMS with data necessary to
assess the effectiveness of State EPSDT
programs, to determine a state’s results
in achieving its participation goal, and
to respond to inquiries; Frequency:
E:\FR\FM\27JAN1.SGM
27JAN1
]]>Agencies
[Federal Register Volume 71, Number 18 (Friday, January 27, 2006)]
[Notices]
[Page 4583]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 06-749]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-855]
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: Revision of a currently
approved collection; Title of Information Collection: Medicare
Enrollment Application; Form No.: CMS-855 (OMB 0938-0685);
Use: This application is currently required of all health care
providers/suppliers who wish to enroll in the Medicare program. It is
submitted when an applicant chooses to enroll into the Medicare program
or when an enrolled provider or supplier reports a change to their
Medicare information. The application is used by a Medicare fee-for-
service contractor to collect data to assure the applicant meets all
Federal and State requirements to provide health care services to
Medicare beneficiaries. This application also allows a Medicare fee-
for-service contractor to ensure that the provider/supplier is not
sanctioned from the Medicare program, or debarred, suspended or
excluded from any other Federal agency or program.; Frequency:
Reporting--Other--; Affected Public: Business or other for-profit,
Individuals or Households, Not-for-profit institutions; Number of
Respondents: 400,000; Total Annual Responses: 400,000; Total Annual
Hours: 1,200,000.
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/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 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 February 27,
2006.
OMB Human Resources and Housing Branch, Attention: Carolyn Lovett,
CMS Desk Officer, New Executive Office Building, Room 10235,
Washington, DC 20503.
Dated: January 20, 2006.
Michelle Shortt,
Acting Director, Regulations Development Group, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 06-749 Filed 1-26-06; 8:45 am]
BILLING CODE 4120-01-M
