Agency Information Collection Activities: Submission for OMB Review; Comment Request, 9560-9561 [06-1769]
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9560
Federal Register / Vol. 71, No. 37 / Friday, February 24, 2006 / Notices
1. Type of Information Collection
Request: New Collection; Title of
Information Collection: Model
Creditable Coverage Disclosure Notices;
Use: Section 1860D–1 of the MMA
requires entities that offer prescription
drug benefits under any of the types of
coverage described in 42 CFR 423.56(b)
to provide a disclosure of creditable
coverage status to all Medicare Part D
eligible individuals covered under the
entity’s plan. These disclosure notices
must be provided to Part D eligible
individuals, at a minimum, at the
following times: (1) Prior to an
individual’s initial enrollment period
for Part D, (2) prior to the effective date
of enrollment in the entity’s coverage,
and upon any change in creditable
status; (3) prior to the commencement of
the Part D Annual Coordinated Election
Period (ACEP) which begins on
November 15 of each year, and (4) upon
request by the individual. Disclosure of
whether prescription drug coverage is
creditable provides Medicare eligible
individuals with important information
relating to their Medicare Part D
enrollment.
Form Number: CMS–10182 (OMB#:
0938–New);
Frequency: Recordkeeping, Third
party disclosure and Reporting: On
occasion, Annually, and Other-As
requested;
Affected Public: Individuals or
Households, Business or other for-profit,
Not-for-profit institutions and Federal,
State, Local or Tribal Government;
Number of Respondents: 450,160;
Total Annual Responses: 1,225,173;
Total Annual Hours: 522,204.
CMS is requesting OMB review and
approval of these collections by March
29, 2006, with a 180-day approval
period. Written comments and
recommendations will be considered
from the public if received by the
individuals designated below by March
17, 2006.
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/
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.
Interested persons are invited to send
comments regarding the burden or any
other aspect of these collections of
information requirements. However, as
noted above, comments on these
information collection and
recordkeeping requirements must be
VerDate Aug<31>2005
18:03 Feb 23, 2006
Jkt 208001
mailed to the designees referenced
below by March 17, 2006:
Centers for Medicare and Medicaid
Services, Office of Strategic
Operations and Regulatory Affairs,
Room C4–26–05, 7500 Security
Boulevard, Baltimore, MD 21244–
1850, Attn: Bonnie L Harkless,
and,
OMB Human Resources and Housing
Branch, Attention: Carolyn Lovett,
New Executive Office Building, Room
10235, Washington, DC 20503.
Dated: February 15, 2006.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 06–1768 Filed 2–23–06; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–1500 (12–90),
CMS–1490U, CMS–1490S, CMS–1500 (08–
05)]
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: Extension of a currently
approved collection; Title of
Information Collection: Health
Insurance Common Claims Form and
Supporting Regulations at 42 CFR part
424, subpart C; Form Number: CMS–
AGENCY:
PO 00000
Frm 00048
Fmt 4703
Sfmt 4703
1500 (12–90), CMS–1490–U, CMS–
1490–S (OMB#: 0938–0008); Use: The
Form CMS–1500 answers the needs of
many health insurers. It is the basic
form prescribed by CMS for the
Medicare program and is only accepted
from physicians and suppliers that are
excluded from the mandatory electronic
claims submission requirements set
forth in the Administrative
Simplification Compliance Act (ASCA)
Public Law 107–105 and the
implementing regulation at 42 CFR
424.32. The Medicaid State Agencies,
CHAMPUS/TriCare, Office of Workers’
Compensation Programs (OWCP), U.S.
Railroad Retirement Board (RRB), Blue
Cross/Blue Shield Plans, the Federal
Employees Health Benefit Plan, and
several private health plans also use it;
it is the de facto standard ‘‘professional’’
claim form. CMS is seeking re-approval
of the CMS–1500 (12/90), CMS–1490–U,
and the CMS–1490–S forms.; Frequency:
Reporting—On occasion; Affected
Public: State, Local, or Tribal
Government, Business or other-forprofit, Not-for-profit institutions;
Number of Respondents: 902,378; Total
Annual Responses: 957,204,707; Total
Annual Hours: 46,383,364.
2. Type of Information Collection
Request: New collection; Title of
Information Collection: Health
Insurance Common Claims Form and
Supporting Regulations at 42 CFR part
424, subpart C; Form Number: CMS–
1500 (08–05), CMS–1490–S (OMB#:
0938–NEW); Use: CMS is
simultaneously seeking approval for
form CMS–1500 (08–05) and the CMS–
1500 (12–90). A concurrent approval for
the two forms is needed to allow the
industry to prepare for the conversion,
i.e. computer system conversions and
mass printing of the form CMS–1500
(08–05). The CMS–1500 (08–05) will be
accepted beginning in October, 2006. Its
use will be mandatory in 2007. In 2007,
the CMS–1500 (12–90) and the
corresponding OMB control number
will be discontinued. The Form CMS–
1500 answers the needs of many health
insurers. It is the basic form prescribed
by CMS for the Medicare program and
is only accepted from physicians and
suppliers that are excluded from the
mandatory electronic claims submission
requirements set forth in the
Administrative Simplification
Compliance Act (ASCA) Public Law
107–105 and the implementing
regulation at 42 CFR 424.32. The
Medicaid State Agencies, CHAMPUS/
TriCare, Office of Workers’
Compensation Programs (OWCP), U.S.
Railroad Retirement Board (RRB), Blue
Cross/Blue Shield Plans, the Federal
E:\FR\FM\24FEN1.SGM
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Federal Register / Vol. 71, No. 37 / Friday, February 24, 2006 / Notices
Employees Health Benefit Plan, and
several private health plans also use it;
it is the de facto standard ‘‘professional’’
claim form.; Frequency: Reporting—On
occasion; Affected Public: State, Local,
or Tribal Government, Business or
other-for-profit, Not-for-profit
institutions; Number of Respondents:
902,378; Total Annual Responses:
957,204,707; Total Annual Hours:
46,383,364.
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 March 27, 2006. OMB Human
Resources and Housing Branch,
Attention: Carolyn Lovett, CMS Desk
Officer, New Executive Office Building,
Room 10235, Washington, DC 20503.
Dated: February 16, 2006.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 06–1769 Filed 2–23–06; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–4115–N]
Medicare Program; Request for
Nominations for the Advisory Panel on
Medicare Education
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
wwhite on PROD1PC65 with NOTICES
AGENCY:
SUMMARY: This notice requests
nominations for individuals to serve on
the Advisory Panel on Medicare
Education (the Panel). The Panel
advises and makes recommendations to
the Secretary of Health and Human
Services (HHS) (the Secretary) and the
Administrator of the Centers for
Medicare & Medicaid Services (CMS) on
opportunities for CMS to optimize the
effectiveness of the National Medicare
Education Program and other CMS
VerDate Aug<31>2005
18:03 Feb 23, 2006
Jkt 208001
programs that help Medicare
beneficiaries understand the range of
health plan options available under the
Medicare program.
DATES: Effective Date: Nominations will
be considered if we receive them at the
appropriate address, provided in the
ADDRESSES section of this notice, no
later than 5 p.m., e.s.t. on Friday, March
17, 2006.
ADDRESSES: Mail or deliver nominations
to the following address: Lynne G.
Johnson, Center for Beneficiary Choices,
Centers for Medicare & Medicaid
Services, 7500 Security Boulevard, Mail
stop S1–20–21, Baltimore, MD 21244–
1850.
FOR FURTHER INFORMATION CONTACT:
Lynne G. Johnson, Health Insurance
Specialist, Division of Partnership
Development, Center for Beneficiary
Choices, Centers for Medicare &
Medicaid Services, 7500 Security
Boulevard, Mail stop S1–20–21,
Baltimore, MD 21244–1850, (410) 786–
0090. Please refer to the CMS Advisory
Committees Information Line (1–877–
449–5659 toll free)/(410–786–9379
local) or the Internet (https://
www.cms.hhs.gov/FACA/04_APME.asp)
for additional information and updates
on committee activities, or contact Ms.
Johnson via e-mail at
lynne.johnson@cms.hhs.gov. Press
inquiries are handled through the CMS
Press Office at (202) 690–6145.
SUPPLEMENTARY INFORMATION: Section
222 of the Public Health Service Act (42
U.S.C. 217a), as amended, grants to the
Secretary the authority to establish an
advisory council or committee for the
purpose of advising him in connection
with any of his functions. Under the
Federal Advisory Committee Act
(FACA) (Pub. L. 92–463), the Secretary
signed the charter establishing the Panel
on January 21, 1999 (64 FR 7899) and
approved the renewal of the charter on
January 14, 2005 (70 FR 4129). The
Panel advises HHS and CMS on
opportunities to enhance the
effectiveness of consumer education
materials serving the Medicare program.
The goals of the Panel are to provide
advice on the following:
• Developing and implementing a
national Medicare education program
that describes the options for selecting
health plans and prescription drug
benefits under Medicare.
• Enhancing the Federal
Government’s effectiveness in informing
the Medicare consumer, including the
appropriate use of public-private
partnerships.
• Expanding outreach to vulnerable
and underserved communities,
including racial and ethnic minorities,
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Fmt 4703
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9561
in the context of a national Medicare
education program.
• Assembling an information base of
best practices for helping consumers
evaluate health plan options and
building a community infrastructure for
information, counseling, and assistance.
The Panel shall consist of a maximum
of 20 members. The Chair shall either be
appointed from among the 20 members,
or a Federal official will be designated
to serve as the Chair. The charter
specifies that meetings shall be held
approximately four times per year.
Members will be expected to attend all
meetings. The members and the Chair
shall be selected from representatives of
the general public and authorities
knowledgeable in the fields of:
• Senior citizen advocacy.
• Outreach to minority communities.
• Health communications.
• Managing a prescription drug
benefit.
• Disease-related health advocacy.
• Disability policy and access.
• Health economics research.
• Health insurers and plans.
• Providers and clinicians.
• Matters of labor and retirement.
This notice is an invitation to
interested organizations or individuals
to submit their nominations for
membership on the Panel. The
Secretary, or his designee, will appoint
new members to the Panel from among
those candidates determined to have the
expertise required to meet specific
agency needs, and in a manner to ensure
an appropriate balance of membership.
Current members whose terms expire in
2006 may be considered for
reappointment, if renominated, subject
to committee service guidelines.
Each nomination must state that the
nominee has expressed a willingness to
serve as a Panel member and must be
accompanied by a resume and a brief
biographical summary of the nominee’s
experience. In order to permit an
evaluation of possible sources of
conflict of interest, potential candidates
will be asked to provide detailed
information concerning such matters as
financial holdings, consultancies, and
research grants or contracts. Selfnominations will also be accepted.
Authority: (Section 222 of the Public
Health Service Act (42 U.S.C. 217(a)); Pub. L.
92–463 (5 U.S.C. App. 2); and, 41 CFR
section 102–3.5 through 102–3.175).
(Catalog of Federal Domestic Assistance
Program No. 93.774, Medicare—
Supplementary Medical Insurance Program.)
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]]>Agencies
[Federal Register Volume 71, Number 37 (Friday, February 24, 2006)]
[Notices]
[Pages 9560-9561]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 06-1769]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-1500 (12-90), CMS-1490U, CMS-1490S, CMS-1500
(08-05)]
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: Health Insurance
Common Claims Form and Supporting Regulations at 42 CFR part 424,
subpart C; Form Number: CMS-1500 (12-90), CMS-1490-U, CMS-1490-S
(OMB: 0938-0008); Use: The Form CMS-1500 answers the needs of
many health insurers. It is the basic form prescribed by CMS for the
Medicare program and is only accepted from physicians and suppliers
that are excluded from the mandatory electronic claims submission
requirements set forth in the Administrative Simplification Compliance
Act (ASCA) Public Law 107-105 and the implementing regulation at 42 CFR
424.32. The Medicaid State Agencies, CHAMPUS/TriCare, Office of
Workers' Compensation Programs (OWCP), U.S. Railroad Retirement Board
(RRB), Blue Cross/Blue Shield Plans, the Federal Employees Health
Benefit Plan, and several private health plans also use it; it is the
de facto standard ``professional'' claim form. CMS is seeking re-
approval of the CMS-1500 (12/90), CMS-1490-U, and the CMS-1490-S
forms.; Frequency: Reporting--On occasion; Affected Public: State,
Local, or Tribal Government, Business or other-for-profit, Not-for-
profit institutions; Number of Respondents: 902,378; Total Annual
Responses: 957,204,707; Total Annual Hours: 46,383,364.
2. Type of Information Collection Request: New collection; Title of
Information Collection: Health Insurance Common Claims Form and
Supporting Regulations at 42 CFR part 424, subpart C; Form Number: CMS-
1500 (08-05), CMS-1490-S (OMB: 0938-NEW); Use: CMS is
simultaneously seeking approval for form CMS-1500 (08-05) and the CMS-
1500 (12-90). A concurrent approval for the two forms is needed to
allow the industry to prepare for the conversion, i.e. computer system
conversions and mass printing of the form CMS-1500 (08-05). The CMS-
1500 (08-05) will be accepted beginning in October, 2006. Its use will
be mandatory in 2007. In 2007, the CMS-1500 (12-90) and the
corresponding OMB control number will be discontinued. The Form CMS-
1500 answers the needs of many health insurers. It is the basic form
prescribed by CMS for the Medicare program and is only accepted from
physicians and suppliers that are excluded from the mandatory
electronic claims submission requirements set forth in the
Administrative Simplification Compliance Act (ASCA) Public Law 107-105
and the implementing regulation at 42 CFR 424.32. The Medicaid State
Agencies, CHAMPUS/TriCare, Office of Workers' Compensation Programs
(OWCP), U.S. Railroad Retirement Board (RRB), Blue Cross/Blue Shield
Plans, the Federal
[[Page 9561]]
Employees Health Benefit Plan, and several private health plans also
use it; it is the de facto standard ``professional'' claim form.;
Frequency: Reporting--On occasion; Affected Public: State, Local, or
Tribal Government, Business or other-for-profit, Not-for-profit
institutions; Number of Respondents: 902,378; Total Annual Responses:
957,204,707; Total Annual Hours: 46,383,364.
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 March 27, 2006.
OMB Human Resources and Housing Branch, Attention: Carolyn Lovett, CMS
Desk Officer, New Executive Office Building, Room 10235, Washington, DC
20503.
Dated: February 16, 2006.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 06-1769 Filed 2-23-06; 8:45 am]
BILLING CODE 4120-01-P
