Agency Information Collection Activities: Proposed Collection; Comment Request, 13793-13794 [E7-5297]
Download as PDF
Federal Register / Vol. 72, No. 56 / Friday, March 23, 2007 / Notices
Dated: March 8, 2007.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E7–4901 Filed 3–22–07; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10095]
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: Detailed
Explanation of Non-Coverage and
Notice of Medicare Non-Coverage and
Supporting Regulations in 42 CFR
422.624 and 42 CFR 422.626; Use:
Providers will deliver a Notice of
Medicare Non-Coverage to enrollees at
least two days prior to the end of
covered services in skilled nursing
facilities, home health agencies, and
comprehensive outpatient rehabilitation
facilities. Enrollees will use this
information to determine whether they
wish to appeal the service termination
to the Quality Improvement
Organization (QIO) in their State. If the
enrollee decides to appeal, the Medicare
Health organization will send the QIO
and the enrollee a Detailed Explanation
of Non-Coverage detailing the rationale
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AGENCY:
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for the termination decision. Form
Number: CMS–10095 (OMB#: 0938–
0910); Frequency: Reporting: Yearly;
Affected Public: Business or other forprofit and Not-for-profit institutions;
Number of Respondents: 454; Total
Annual Responses: 47,558; Total
Annual Hours: 23,780.52.
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.
Written comments and
recommendations for the proposed
information collections must be mailed
or faxed within 30 days of this notice
directly to the OMB desk officer: OMB
Human Resources and Housing Branch,
Attention: Carolyn Lovett, New
Executive Office Building, Room 10235,
Washington, DC 20503, Fax Number:
(202) 395–6974.
Dated: March 16, 2007.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E7–5296 Filed 3–22–07; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10216, CMS–R–
0053, CMS–179, CMS–10137, CMS–10069
and CMS–R–246]
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;
AGENCY:
PO 00000
Frm 00059
Fmt 4703
Sfmt 4703
13793
(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 without change of a
currently approved collection; Title of
Information Collection: Alternative
Benefits State Plan Amendment Health
Opportunity Accounts (HOA)
Demonstration Program; Use: The DRA
provides States with numerous
flexibilities in operating their State
Medicaid programs. For example,
Section 6082 of the DRA allows up to
10 States to operate Medicaid
demonstrations to test alternative
systems for delivering their Medicaid
benefits. Under these demonstrations,
States would have the flexibility to
deliver their Medicaid benefits to
volunteer beneficiaries through a
program that is comprised of an HOA
and a High Deductible Health Plan
(HDHP). Under the DRA, States can
submit a State Plan Pre-print to CMS to
effectuate this change to their Medicaid
programs. CMS will provide a State
Medicaid Director letter providing
guidance on this provision and the
implementation of the DRA and the
associated State Plan Amendment
template for use by States to modify
their Medicaid State Plans if they
choose to implement this flexibility;
Form Number: CMS–10216 (OMB#:
0938–1007); Frequency: Reporting: Onetime; Affected Public: State, Local or
tribal Government; Number of
Respondents: 56; Total Annual
Responses: 10; Total Annual Hours: 10.
2. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Imposition of
Cost Sharing Charges Under Medicare
and Supporting Regulations Contained
in 42 CFR 447.53; Use: The purpose of
this collection is to ensure that States
impose nominal cost sharing charges
upon categorically and medically needy
individuals as allowed by law and
implementing regulations. States must
identify in their State plan the
following: (1) The service for which the
charge is made; (2) The amount of the
charge; (3) The basis for determining the
charge; (4) The method used to collect
the charge; (5) The basis for determining
whether an individual is unable to pay
the charge and the way in which the
individual will be identified to
providers; and, (6) The procedures for
implementing and enforcing the
exclusions from cost sharing; Form
E:\FR\FM\23MRN1.SGM
23MRN1
sroberts on PROD1PC70 with NOTICES
13794
Federal Register / Vol. 72, No. 56 / Friday, March 23, 2007 / Notices
Number: CMS–R–0053 (OMB#: 0938–
0429); Frequency: Reporting:
Occasionally; Affected Public: State,
Local or tribal Government; Number of
Respondents: 56; Total Annual
Responses: 2; Total Annual Hours: 20.
3. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Transmittal and
Notice of Approval of State Plan
Material and Supporting Regulations in
42 CFR 430.10–430.20 and 440.167;
Use: The CMS–179 is used by State
agencies to transmit State plan material
to the Centers for Medicare & Medicaid
Services (CMS) for approval prior to
amending their State plan. The State
plan is the method in which States
inform staff of State policies, standards,
procedures and instructions. The CMS–
179 is currently used by State agencies
administering the Medicaid program
and CMS regional offices (RO). State
agencies use the form to submit State
plan amendments (SPAs) (including
supporting documentation) to the CMS
RO for review and approval prior to
amending their plan in accordance with
42 CFR 430.10–430.20. The CMS–179
includes instructions for completing the
form. The inclusion of instructions is to
assist State agencies in completing the
form, thereby ensuring a more uniform
and timely plan amendment approval
process. The CMS–179 is the only
source available to State agencies for
submittal/approval of SPAs. This plan
amendment approval process is
necessary to ensure the State plan
continues to meet statutory and
regulatory requirements and thereby
ensure the State’s eligibility for Federal
financial participation. CMS will use
this information to track the estimated
Federal budget impact associated with
the SPAs. This information may result
in more accurate Federal Medicaid
expenditure estimates; Form Number:
CMS–179 (OMB#: 0938–0193);
Frequency: Reporting: Occasionally;
Affected Public: State, Local or tribal
Government; Number of Respondents:
56; Total Annual Responses: 10; Total
Annual Hours: 560.
4. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Application for
Prescription Drug Plans (PDP);
Application for Medicare Advantage
Prescription Drug (MA–PD);
Application for Cost Plans To Offer
Qualified Prescription Drug Coverage;
Application for Employer Group Waiver
Plans To Offer Prescription Drug
Coverage; Service Area Expansion
Application for Prescription Drug
Coverage; Use: Collection of this
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16:41 Mar 22, 2007
Jkt 211001
information is mandated in Part D of the
Medicare Prescription Drug,
Improvement, and Modernization Act of
2003. The application requirements are
codified in Subpart K of 42 CFR part
423. Coverage for the prescription drug
benefit is provided through prescription
drug plans (PDPs) that offer drug-only
coverage, or through Medicare
Advantage (MA) organizations that offer
integrated prescription drug and health
care coverage (MA–PD plans). PDPs
must offer a basic drug benefit.
Medicare Advantage Coordinated Care
Plans (MA–CCPs) must offer either a
basic benefit or may offer broader
coverage for no additional cost.
Medicare Advantage Private Fee for
Service Plans (MA–PFFS) may choose to
offer a Part D benefit. Cost Plans that are
regulated under Section 1876 of the
Social Security Act, and Employer
Group Plans may also provide a Part D
benefit. If any of the contracting
organizations meet basic requirements,
they may also offer supplemental
benefits through enhanced alternative
coverage for an additional premium.
The information will be collected
under the solicitation of proposals from
PDP, MA–PD, Cost Plan, and Employer
Group Waiver Plans applicants. The
collected information will be used by
CMS to: (1) Insure that applicants meet
CMS requirements, and (2) support the
determination of contract awards.
The major program change that has
occurred in Part D applications was that
CMS removed several attestations
related to Health Insurance Portability
and Accountability Act (HIPAA), bids
and privacy; Form Number: CMS–10137
(OMB#: 0938–0936); Frequency:
Reporting: Once; Affected Public:
Business or other for-profit and Not-forprofit institutions; Number of
Respondents: 857; Total Annual
Responses: 857; Total Annual Hours:
28,122.
5. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Medicare
Waiver Demonstration Application; Use:
The Medicare Waiver Demonstration
Application will be used to collect
standard information needed to
implement congressionally mandated
and administration high priority
demonstrations. The application will be
used to gather information about the
characteristics of the applicant’s
organization, benefits, and services they
propose to offer, success in operating
the model, and evidence that the model
is likely to be successful in the Medicare
program. The standard application will
be used for all waiver demonstrations
and will reduce the burden on
PO 00000
Frm 00060
Fmt 4703
Sfmt 4703
applicants, provide for consistent and
timely information collections across
demonstrations, and provide a userfriendly format for respondents; Form
Number: CMS–10069 (OMB#: 0938–
0880); Frequency: Reporting: Once;
Affected Public: Business or other forprofit and Not-for-profit institutions;
Number of Respondents: 75; Total
Annual Responses: 75; Total Annual
Hours: 6000.
6. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Medicare
CAHPS Survey; Use: The collection of
Consumer Assessment of Healthcare
Providers and Systems (CAHPS) Survey
measures is necessary to hold health
and prescription drug plans accountable
for the quality of care and services they
deliver. This requirement will allow
CMS to obtain information for the
proper oversight of the program. This
information is used to help beneficiaries
choose among plans, contribute to
improved quality of care through
identification of quality improvement
opportunities, and assist CMS in
carrying out its responsibilities; Form
Number: CMS–R–246 (OMB#: 0938–
0732); Frequency: Reporting: Yearly;
Affected Public: Individuals or
households; Number of Respondents:
660,000; Total Annual Responses:
660,000; Total Annual Hours: 217,800.
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.
To be assured consideration,
comments and recommendations for the
proposed information collections must
be received at the address below, no
later than 5 p.m. on May 22, 2007.
CMS, Office of Strategic Operations
and Regulatory Affairs, Division of
Regulations Development—A,
Attention: Melissa Musotto, Room C4–
26–05, 7500 Security Boulevard,
Baltimore, Maryland 21244–1850.
Dated: March 16, 2007.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E7–5297 Filed 3–22–07; 8:45 am]
BILLING CODE 4120–01–P
E:\FR\FM\23MRN1.SGM
23MRN1
Agencies
[Federal Register Volume 72, Number 56 (Friday, March 23, 2007)]
[Notices]
[Pages 13793-13794]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-5297]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10216, CMS-R-0053, CMS-179, CMS-10137, CMS-
10069 and CMS-R-246]
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 without change
of a currently approved collection; Title of Information Collection:
Alternative Benefits State Plan Amendment Health Opportunity Accounts
(HOA) Demonstration Program; Use: The DRA provides States with numerous
flexibilities in operating their State Medicaid programs. For example,
Section 6082 of the DRA allows up to 10 States to operate Medicaid
demonstrations to test alternative systems for delivering their
Medicaid benefits. Under these demonstrations, States would have the
flexibility to deliver their Medicaid benefits to volunteer
beneficiaries through a program that is comprised of an HOA and a High
Deductible Health Plan (HDHP). Under the DRA, States can submit a State
Plan Pre-print to CMS to effectuate this change to their Medicaid
programs. CMS will provide a State Medicaid Director letter providing
guidance on this provision and the implementation of the DRA and the
associated State Plan Amendment template for use by States to modify
their Medicaid State Plans if they choose to implement this
flexibility; Form Number: CMS-10216 (OMB: 0938-1007);
Frequency: Reporting: One-time; Affected Public: State, Local or tribal
Government; Number of Respondents: 56; Total Annual Responses: 10;
Total Annual Hours: 10.
2. Type of Information Collection Request: Extension without change
of a currently approved collection; Title of Information Collection:
Imposition of Cost Sharing Charges Under Medicare and Supporting
Regulations Contained in 42 CFR 447.53; Use: The purpose of this
collection is to ensure that States impose nominal cost sharing charges
upon categorically and medically needy individuals as allowed by law
and implementing regulations. States must identify in their State plan
the following: (1) The service for which the charge is made; (2) The
amount of the charge; (3) The basis for determining the charge; (4) The
method used to collect the charge; (5) The basis for determining
whether an individual is unable to pay the charge and the way in which
the individual will be identified to providers; and, (6) The procedures
for implementing and enforcing the exclusions from cost sharing; Form
[[Page 13794]]
Number: CMS-R-0053 (OMB: 0938-0429); Frequency: Reporting:
Occasionally; Affected Public: State, Local or tribal Government;
Number of Respondents: 56; Total Annual Responses: 2; Total Annual
Hours: 20.
3. Type of Information Collection Request: Extension without change
of a currently approved collection; Title of Information Collection:
Transmittal and Notice of Approval of State Plan Material and
Supporting Regulations in 42 CFR 430.10-430.20 and 440.167; Use: The
CMS-179 is used by State agencies to transmit State plan material to
the Centers for Medicare & Medicaid Services (CMS) for approval prior
to amending their State plan. The State plan is the method in which
States inform staff of State policies, standards, procedures and
instructions. The CMS-179 is currently used by State agencies
administering the Medicaid program and CMS regional offices (RO). State
agencies use the form to submit State plan amendments (SPAs) (including
supporting documentation) to the CMS RO for review and approval prior
to amending their plan in accordance with 42 CFR 430.10-430.20. The
CMS-179 includes instructions for completing the form. The inclusion of
instructions is to assist State agencies in completing the form,
thereby ensuring a more uniform and timely plan amendment approval
process. The CMS-179 is the only source available to State agencies for
submittal/approval of SPAs. This plan amendment approval process is
necessary to ensure the State plan continues to meet statutory and
regulatory requirements and thereby ensure the State's eligibility for
Federal financial participation. CMS will use this information to track
the estimated Federal budget impact associated with the SPAs. This
information may result in more accurate Federal Medicaid expenditure
estimates; Form Number: CMS-179 (OMB: 0938-0193); Frequency:
Reporting: Occasionally; Affected Public: State, Local or tribal
Government; Number of Respondents: 56; Total Annual Responses: 10;
Total Annual Hours: 560.
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Application for
Prescription Drug Plans (PDP); Application for Medicare Advantage
Prescription Drug (MA-PD); Application for Cost Plans To Offer
Qualified Prescription Drug Coverage; Application for Employer Group
Waiver Plans To Offer Prescription Drug Coverage; Service Area
Expansion Application for Prescription Drug Coverage; Use: Collection
of this information is mandated in Part D of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003. The application
requirements are codified in Subpart K of 42 CFR part 423. Coverage for
the prescription drug benefit is provided through prescription drug
plans (PDPs) that offer drug-only coverage, or through Medicare
Advantage (MA) organizations that offer integrated prescription drug
and health care coverage (MA-PD plans). PDPs must offer a basic drug
benefit. Medicare Advantage Coordinated Care Plans (MA-CCPs) must offer
either a basic benefit or may offer broader coverage for no additional
cost. Medicare Advantage Private Fee for Service Plans (MA-PFFS) may
choose to offer a Part D benefit. Cost Plans that are regulated under
Section 1876 of the Social Security Act, and Employer Group Plans may
also provide a Part D benefit. If any of the contracting organizations
meet basic requirements, they may also offer supplemental benefits
through enhanced alternative coverage for an additional premium.
The information will be collected under the solicitation of
proposals from PDP, MA-PD, Cost Plan, and Employer Group Waiver Plans
applicants. The collected information will be used by CMS to: (1)
Insure that applicants meet CMS requirements, and (2) support the
determination of contract awards.
The major program change that has occurred in Part D applications
was that CMS removed several attestations related to Health Insurance
Portability and Accountability Act (HIPAA), bids and privacy; Form
Number: CMS-10137 (OMB: 0938-0936); Frequency: Reporting:
Once; Affected Public: Business or other for-profit and Not-for-profit
institutions; Number of Respondents: 857; Total Annual Responses: 857;
Total Annual Hours: 28,122.
5. Type of Information Collection Request: Extension without change
of a currently approved collection; Title of Information Collection:
Medicare Waiver Demonstration Application; Use: The Medicare Waiver
Demonstration Application will be used to collect standard information
needed to implement congressionally mandated and administration high
priority demonstrations. The application will be used to gather
information about the characteristics of the applicant's organization,
benefits, and services they propose to offer, success in operating the
model, and evidence that the model is likely to be successful in the
Medicare program. The standard application will be used for all waiver
demonstrations and will reduce the burden on applicants, provide for
consistent and timely information collections across demonstrations,
and provide a user-friendly format for respondents; Form Number: CMS-
10069 (OMB: 0938-0880); Frequency: Reporting: Once; Affected
Public: Business or other for-profit and Not-for-profit institutions;
Number of Respondents: 75; Total Annual Responses: 75; Total Annual
Hours: 6000.
6. Type of Information Collection Request: Extension without change
of a currently approved collection; Title of Information Collection:
Medicare CAHPS Survey; Use: The collection of Consumer Assessment of
Healthcare Providers and Systems (CAHPS) Survey measures is necessary
to hold health and prescription drug plans accountable for the quality
of care and services they deliver. This requirement will allow CMS to
obtain information for the proper oversight of the program. This
information is used to help beneficiaries choose among plans,
contribute to improved quality of care through identification of
quality improvement opportunities, and assist CMS in carrying out its
responsibilities; Form Number: CMS-R-246 (OMB: 0938-0732);
Frequency: Reporting: Yearly; Affected Public: Individuals or
households; Number of Respondents: 660,000; Total Annual Responses:
660,000; Total Annual Hours: 217,800.
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 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 at the address below,
no later than 5 p.m. on May 22, 2007.
CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development--A, Attention: Melissa Musotto,
Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Dated: March 16, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. E7-5297 Filed 3-22-07; 8:45 am]
BILLING CODE 4120-01-P