Agency Information Collection Activities: Proposed Collection; Comment Request, 18658 [E7-7004]
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18658
Federal Register / Vol. 72, No. 71 / Friday, April 13, 2007 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Office of the Secretary
[Document Identifier: OS–4040–0005] [30Day Notice]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Office of the Secretary, HHS.
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Office of the Secretary (OS), Department
of Health and Human Services, is
publishing the following summary of a
proposed collection 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.
Type of Information Collection
Request: Revision.
Title of Information Collection: SF–
424 Individual.
Form/OMB No.: OS–4040–0005.
Use: The SF–424 (individual) is a
simplified, alternative government-wide
data set and application cover page for
use by Federal grant-making agencies
that award grants to individuals. The
form will include one change to one
field—the Social Security Number
(SSN). The SSN field will remain
optional. The SSN field will be changed
to pre-populate the first five digits with
‘‘000–00–’’ The applicant will only
enter the last four digits of the SSN.
This change ensures the entire SSN will
not be collected or stored. This change
will not increase the collection burden
to the applicant.
Frequency: Recordkeeping on
Occasion.
Affected Public: Individuals or
Households.
Annual Number of Respondents:
5827.
Total Annual Responses: 6949.
Average Burden per Response: 25
minutes.
Total Annual Hours: 2895.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
pwalker on PROD1PC71 with NOTICES
AGENCY:
VerDate Aug<31>2005
17:52 Apr 12, 2007
Jkt 211001
referenced above, e-mail your request,
including your address, phone number,
OMB number, and OS document
identifier, to
Sherette.funncoleman@hhs.gov , or call
the Reports Clearance Office on (202)
690–6162. Written comments and
recommendations for the proposed
information collections must be
received within 30 days of this notice
directly to the Desk Officer at the
address below:
OMB Desk Officer: John Kraemer,
OMB Human Resources and Housing
Branch, Attention: (OMB #4040–0005),
New Executive Office Building, Room
10235, Washington, DC 20503.
Dated: April 5, 2007.
Mary Oliver-Anderson,
Paperwork Reduction Act Reports Clearance
Officer, Office of the Secretary.
[FR Doc. E7–7004 Filed 4–12–07; 8:45 am]
BILLING CODE 4150–17–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10227, CMS–
1561 and 1561A, CMS–2728, CMS–10221,
CMS–R–290, and CMS–R–26]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services.
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: Existing collection in use
without an OMB Control Number; Title
of Information Collection: PACE State
Plan Amendment Pre-print; Form
Number: CMS–10227 (OMB#: 0938–
AGENCY:
PO 00000
Frm 00039
Fmt 4703
Sfmt 4703
New); Use: The Balanced Budget Act of
1997 created section 1934 of the Social
Security Act that established the
Program for the All-Inclusive Care for
the Elderly (PACE). The legislation
established the PACE program as a
Medicaid State plan option serving the
frail and elderly in the home and
community. In accordance with the rule
published in the November 24, 1999
Federal Register (64 FR 66271), if a
State elects to offer PACE as an optional
Medicaid benefit, it must complete a
State Plan Amendment described as
Enclosures #3, 4, 5, 6 and 7. In State
Medicaid Director letters dated March
23, 1998 and November 9, 2000, CMS
advised States that it had provided a
suggested pre-print and supplemental
pages for a State to express its intention
to elect PACE as an option to its State
plans. As pre-print packet Enclosures
#3–7 were suggested and not required,
CMS did not believe at the time that a
suggested form required clearance from
OMB. The PACE regulation 42 CFR part
460 was first published in the Federal
Register as an interim final rule on
November 24, 1999. The final PACE rule
was published on December 8, 2006.
CMS is seeking OMB approval to use
Enclosures #3, 4, 5, 6 and 7. The
information is used by CMS to affirm
that the State elects to offer PACE an
optional State plan service and the
specifications of eligibility, payment
and enrollment for the program;
Frequency: Reporting—Once; Affected
Public: State, Local or Tribal
Governments; Number of Respondents:
56; Total Annual Responses: 56 possible
responses but we have only received 20
thus far; Total Annual Hours: 1,120.
2. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Health
Insurance Benefit Agreement and
Supporting Regulations at 42 CFR 489;
Form Numbers: CMS–1561 and 1561A
(OMB#: 0938–0832); Use: Applicants to
the Medicare program are required to
agree to provide services in accordance
with Federal requirements. The CMS–
1561 and 1561A are essential for CMS
to ensure that applicants are in
compliance with the requirements.
Applicants will be required to sign the
completed form and provide operational
information to CMS to assure that they
continue to meet the requirements after
approval; Frequency: Reporting—Other:
all new applicants must complete;
Affected Public: State, Local or Tribal
Governments, Business or Other for
profit and Not-for-profit institutions;
Number of Respondents: 3300; Total
E:\FR\FM\13APN1.SGM
13APN1
]]>Agencies
[Federal Register Volume 72, Number 71 (Friday, April 13, 2007)]
[Notices]
[Page 18658]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-7004]
[[Page 18658]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary
[Document Identifier: OS-4040-0005] [30-Day Notice]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Office of the Secretary, HHS.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Office of the Secretary (OS),
Department of Health and Human Services, is publishing the following
summary of a proposed collection 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.
Type of Information Collection Request: Revision.
Title of Information Collection: SF-424 Individual.
Form/OMB No.: OS-4040-0005.
Use: The SF-424 (individual) is a simplified, alternative
government-wide data set and application cover page for use by Federal
grant-making agencies that award grants to individuals. The form will
include one change to one field--the Social Security Number (SSN). The
SSN field will remain optional. The SSN field will be changed to pre-
populate the first five digits with ``000-00-'' The applicant will only
enter the last four digits of the SSN. This change ensures the entire
SSN will not be collected or stored. This change will not increase the
collection burden to the applicant.
Frequency: Recordkeeping on Occasion.
Affected Public: Individuals or Households.
Annual Number of Respondents: 5827.
Total Annual Responses: 6949.
Average Burden per Response: 25 minutes.
Total Annual Hours: 2895.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, e-mail your
request, including your address, phone number, OMB number, and OS
document identifier, to Sherette.funncoleman@hhs.gov , or call the
Reports Clearance Office on (202) 690-6162. Written comments and
recommendations for the proposed information collections must be
received within 30 days of this notice directly to the Desk Officer at
the address below:
OMB Desk Officer: John Kraemer, OMB Human Resources and Housing
Branch, Attention: (OMB 4040-0005), New Executive Office
Building, Room 10235, Washington, DC 20503.
Dated: April 5, 2007.
Mary Oliver-Anderson,
Paperwork Reduction Act Reports Clearance Officer, Office of the
Secretary.
[FR Doc. E7-7004 Filed 4-12-07; 8:45 am]
BILLING CODE 4150-17-P
