Agency Information Collection Activities: Submission for OMB Review; Comment Request, 28056-28057 [E7-9473]
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28056
Federal Register / Vol. 72, No. 96 / Friday, May 18, 2007 / Notices
we attempted to obtain a balance
between availability of data needed to
assess the impact of the intervention,
and the generalizability of the setting of
care. In revisions made to the protocol
we have focused on developing an
intervention that could be conducted in
a community pharmacy, and as such
may be generalizable to community
pharmacies.
Dated: May 10, 2007.
Carolyn M. Clancy,
Director.
[FR Doc. 07–2481 Filed 5–17–07; 8:45 am]
BILLING CODE 4160–90–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10233, CMS–
10234 and CMS–10236]
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;
(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: New collection; Title of
Information Collection: Regional
Preferred Provider Organization (RPPO)
Reconciliation Cost Report; Form
Number: CMS–10233 (OMB#: 0938–
New); Use: The Medicare Prescription
Drug, Improvement, and Modernization
Act of 2003 (MMA), Title II, Subtitle C
(Offering of Medicare Advantage
Regional Plans; Medicare Advantage
Competition) provided for the
establishment of Medicare Advantage
Regional Plans. Subsequently, the
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AGENCY:
VerDate Aug<31>2005
17:06 May 17, 2007
Jkt 211001
Regional Preferred Provider
Organization (RPPO) program was
developed and began contracting with
Managed Care Organizations (MCOs)
and enrolling beneficiaries for the 2006
contract year. Section 1858 of the Social
Security Act provides for risk sharing
with RPPOs to be in place for contract
years 2006 and 2007. The Code of
Federal Regulations at 42 CFR 422.458
provides specific direction with respect
to how the Centers for Medicare and
Medicaid Services (CMS) will share risk
with the RPPOs. The regulations require
CMS to collect Allowable Cost data, and
to compare this data to Target Amounts.
If the comparison demonstrates that
there were either savings or losses in the
contract year, the regulations provide
specific risk corridors to be used in
determining the Risk Sharing
Reconciliation amount due to either the
plan or CMS. The Risk Sharing
Reconciliation cost report will be used
to collect the information necessary to
accurately reconcile the payments made
to RPPOs for the 2006 and 2007 contract
years. Frequency: Reporting—Annually;
Affected Public: Business or other forprofit and Not-for-profit institutions;
Number of Respondents: 14; Total
Annual Responses: 14; Total Annual
Hours: 1,120.
2. Type of Information Collection
Request: New collection; Title of
Information Collection: State Plan Preprint implementing Section 6087 of the
Deficit Reduction Act: Optional SelfDirection Personal Assistance Services
(PAS) Program (Cash and Counseling);
Form Number: CMS–10234 (OMB#:
0938–New); Use: Information submitted
via the State Plan Amendment (SPA)
pre-print will be used by the Centers for
Medicare & Medicaid Services (CMS)
Central and Regional Offices to analyze
a State’s proposal to implement Section
6087 of the Deficit Reduction Act
(DRA). State Medicaid Agencies will
complete the SPA pre-print, and submit
it to CMS for a comprehensive analysis.
The pre-print contains assurances,
check-off items, and areas for States to
describe policies and procedures for
subjects such as quality assurance, risk
management, and voluntary and
involuntary disenrollment; Frequency:
Reporting—Once; Affected Public: State,
Local, or Tribal Government; Number of
Respondents: 56; Total Annual
Responses: 30; Total Annual Hours: 600.
3. Type of Information Collection
Request: New collection; Title of
Information Collection: Disclosure of
Financial Relationships Report
(‘‘DFRR’’); Form Number: CMS–10236
(OMB#: 0938–New); Use: Section
1877(f) of the Social Security Act
requires that each entity providing
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Sfmt 4703
covered items or services for which
payment may be made shall provide the
Secretary with information concerning
the entity’s ownership, investment, and
compensation arrangements, in such
form, manner, and at such times as the
Secretary shall specify. DFRR is a new
collection instrument that will be used
by CMS to obtain information necessary
to analyze each hospital’s compliance
with Section 1877 of the Social Security
Act (‘‘the physician self-referral law’’),
and implementing regulations (42 Code
of Federal Regulations, Subpart J).
Frequency: Reporting—Once; Affected
Public: Business or other for-profit and
Not-for-profit institutions; Number of
Respondents: 500; Total Annual
Responses: 500; Total Annual Hours:
2,000.
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 July 17, 2007.
CMS, Office of Strategic Operations
and Regulatory Affairs, Division of
Regulations Development—B, Attention:
William N. Parham, III, Room C4–26–
05, 7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: May 11, 2007.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E7–9472 Filed 5–17–07; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–265–94 and
CMS–460]
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
AGENCY:
E:\FR\FM\18MYN1.SGM
18MYN1
pwalker on PROD1PC71 with NOTICES
Federal Register / Vol. 72, No. 96 / Friday, May 18, 2007 / Notices
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: Independent
Renal Dialysis Facility Cost Report and
supporting regulations 42 CFR 413.20
and 42 CFR 413.24; Form No.: CMS–
265–94 (OMB# 0938–0236); Use:
Providers of services participating in the
Medicare program are required under
sections 1815(a), 1833(e), 1861(v)(1)(A)
and 1881(b)(2)(B) of the Social Security
Act to submit annual information to
achieve reimbursement for health care
services rendered to Medicare
beneficiaries. The Form CMS 265–94
cost report is needed to determine the
amount of reasonable cost due to the
providers for furnishing medical
services to Medicare beneficiaries.
The data collected will be used for the
following additional purposes: (a)
Determination of reimbursement rates
for renal dialysis treatments, selfdialysis training, and other reasonable
and medically necessary services
rendered in connection with these
treatments; (b) justification of requests
for adjustments or exceptions in the
reimbursements rates; and, (c)
accumulation of data for overall
evaluation. Worksheet B, Worksheet C
and Worksheet D have been modified to
implement provisions of the Medicare
Prescription Drug Improvement and
Modernization Act of 2003. On
Worksheet B, the allocation of
Administrative and General cost to
Separately Billable Drugs was
eliminated. On Worksheet C, two
columns were sub-divided to identify
services before, on or after 4/1/2005. A
line was added to Worksheet D to report
bad debts for dual eligible beneficiaries.
None of these changes request new
information; rather, the changes require
reporting of data in greater detail than
was previously reported. Frequency:
VerDate Aug<31>2005
17:06 May 17, 2007
Jkt 211001
Reporting—Annually; Affected Public:
Business or other for-profit, Not-forprofit institutions; Number of
Respondents: 4,885; Total Annual
Responses: 4,885; Total Annual Hours:
957,460.
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Medicare
Participating Physician or Supplier
Agreement; Form No.: CMS–460 (OMB#
0938–0373); Use: The CMS–460 is the
agreement a physician, supplier or their
authorized official signs to participate in
Medicare Part B. By signing the
agreement to participate in Medicare,
the physician, supplier or their
authorized official agrees to accept the
Medicare-determined payment for
Medicare covered services as payment
in full and to charge the Medicare Part
B beneficiary no more than the
applicable deductible or coinsurance for
the covered services. For purposes of
this explanation, the term a supplier
means any person or entity that may bill
Medicare for Part B services (e.g. DME
supplier, nurse practitioner, supplier of
diagnostic tests) except a Medicare
provider of services (e.g. hospital),
which must participate to be paid by
Medicare for covered care.
There are additional benefits
associated with payment for services
paid under the Medicare fee schedule.
Payments made under the Medicare fee
schedule for physician services to
participating physicians and suppliers
are based on 100 percent of the
Medicare fee schedule amount, while
the Medicare fee schedule payment for
physician services by nonparticipating
physicians and suppliers is based on 95
percent of the fee schedule amount.
Physicians and suppliers who do not
participate in Medicare are subject to
limits on their actual charges for
unassigned claims for physician
services. These limits, known as
limiting charges, cannot exceed 115
percent of the non-participant fee
schedule, which is set at 95 percent of
the full fee schedule amount. In
addition, if a physician or supplier does
not accept assignment on a claim for
Medicare payment, the physician or
supplier must collect payment from the
beneficiary. If the physician or supplier
accepts assignment on the claim,
Medicare pays its share of the payment
directly to the physician or supplier,
resulting in faster and more certain
payment. Frequency: Reporting, Other—
when starting a new business; Affected
Public: Business or other for-profit;
Number of Respondents: 6000; Total
Annual Responses: 6000; Total Annual
Hours: 1500.
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28057
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: May 10, 2007.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E7–9473 Filed 5–17–07; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Submission for OMB Review;
Comment Request
Title: Income Withholding for
Support (IWO) (Formerly: Order to
Withhold Income for Child Support and
Notice of an Order to Withhold Income
for Child Support).
OMB No.: 0970–0154.
Description: Pub. L. 104–193, The
Personal Responsibility and Work
Opportunity Reconciliation Act
(PRWORA) of 1996, Section 324,
requires the Federal Office of Child
Support Enforcement (OCSE) to develop
a standardized form to collect child
support payments from an obligor’s
employer. The form, which promotes
standardization and is used for title IV–
D and non-IV–D cases that require
income withholding, expires 5/31/2007,
and the Administration for Children and
Families is taking this opportunity to
revise the form and its instructions.
Overall, the language and format of
the form have been edited, modified,
and made easier to read and
comprehend. The two-page form
provides a detailed legal description of
the established order, support amounts,
and remittance information an employer
E:\FR\FM\18MYN1.SGM
18MYN1
Agencies
[Federal Register Volume 72, Number 96 (Friday, May 18, 2007)]
[Notices]
[Pages 28056-28057]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-9473]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-265-94 and CMS-460]
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
[[Page 28057]]
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: Independent Renal
Dialysis Facility Cost Report and supporting regulations 42 CFR 413.20
and 42 CFR 413.24; Form No.: CMS-265-94 (OMB 0938-0236); Use:
Providers of services participating in the Medicare program are
required under sections 1815(a), 1833(e), 1861(v)(1)(A) and
1881(b)(2)(B) of the Social Security Act to submit annual information
to achieve reimbursement for health care services rendered to Medicare
beneficiaries. The Form CMS 265-94 cost report is needed to determine
the amount of reasonable cost due to the providers for furnishing
medical services to Medicare beneficiaries.
The data collected will be used for the following additional
purposes: (a) Determination of reimbursement rates for renal dialysis
treatments, self-dialysis training, and other reasonable and medically
necessary services rendered in connection with these treatments; (b)
justification of requests for adjustments or exceptions in the
reimbursements rates; and, (c) accumulation of data for overall
evaluation. Worksheet B, Worksheet C and Worksheet D have been modified
to implement provisions of the Medicare Prescription Drug Improvement
and Modernization Act of 2003. On Worksheet B, the allocation of
Administrative and General cost to Separately Billable Drugs was
eliminated. On Worksheet C, two columns were sub-divided to identify
services before, on or after 4/1/2005. A line was added to Worksheet D
to report bad debts for dual eligible beneficiaries. None of these
changes request new information; rather, the changes require reporting
of data in greater detail than was previously reported. Frequency:
Reporting--Annually; Affected Public: Business or other for-profit,
Not-for-profit institutions; Number of Respondents: 4,885; Total Annual
Responses: 4,885; Total Annual Hours: 957,460.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare
Participating Physician or Supplier Agreement; Form No.: CMS-460
(OMB 0938-0373); Use: The CMS-460 is the agreement a
physician, supplier or their authorized official signs to participate
in Medicare Part B. By signing the agreement to participate in
Medicare, the physician, supplier or their authorized official agrees
to accept the Medicare-determined payment for Medicare covered services
as payment in full and to charge the Medicare Part B beneficiary no
more than the applicable deductible or coinsurance for the covered
services. For purposes of this explanation, the term a supplier means
any person or entity that may bill Medicare for Part B services (e.g.
DME supplier, nurse practitioner, supplier of diagnostic tests) except
a Medicare provider of services (e.g. hospital), which must participate
to be paid by Medicare for covered care.
There are additional benefits associated with payment for services
paid under the Medicare fee schedule. Payments made under the Medicare
fee schedule for physician services to participating physicians and
suppliers are based on 100 percent of the Medicare fee schedule amount,
while the Medicare fee schedule payment for physician services by
nonparticipating physicians and suppliers is based on 95 percent of the
fee schedule amount. Physicians and suppliers who do not participate in
Medicare are subject to limits on their actual charges for unassigned
claims for physician services. These limits, known as limiting charges,
cannot exceed 115 percent of the non-participant fee schedule, which is
set at 95 percent of the full fee schedule amount. In addition, if a
physician or supplier does not accept assignment on a claim for
Medicare payment, the physician or supplier must collect payment from
the beneficiary. If the physician or supplier accepts assignment on the
claim, Medicare pays its share of the payment directly to the physician
or supplier, resulting in faster and more certain payment. Frequency:
Reporting, Other--when starting a new business; Affected Public:
Business or other for-profit; Number of Respondents: 6000; Total Annual
Responses: 6000; Total Annual Hours: 1500.
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.
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: May 10, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. E7-9473 Filed 5-17-07; 8:45 am]
BILLING CODE 4120-01-P