Agency Information Collection Activities: Submission for OMB Review; Comment Request, 69218-69219 [E7-23746]
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69218
Federal Register / Vol. 72, No. 235 / Friday, December 7, 2007 / Notices
Board of Governors of the Federal Reserve
System, December 4, 2007.
Margaret McCloskey Shanks,
Associate Secretary of the Board.
[FR Doc.E7–23787 Filed 12–6–07; 8:45 am]
BILLING CODE 6210–01–S
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10232, CMS–
10120, CMS–10241, CMS–370, 377 and 378]
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: New Collection; Title of
Information Collection: State Plan Preprint for Integrated Medicare and
Medicaid Programs; Use: Information
submitted via the State Plan
Amendment (SPA) pre-print will be
used by CMS Central and Regional
Offices to analyze a State’s proposal to
implement integrated Medicare and
Medicaid programs. The pre-print is an
optional document for use by States to
highlight the arrangements between a
State and Medicare Advantage Special
Needs Plans that are also providing
Medicaid services. State Medicaid
Agencies will complete the SPA preprint and submit it to CMS for a
comprehensive analysis. The pre-print
provides the opportunity for States to
confirm that their integrated care model
complies with both federal statutory and
pwalker on PROD1PC71 with NOTICES
AGENCY:
VerDate Aug<31>2005
16:30 Dec 06, 2007
Jkt 214001
regulatory requirements. The pre-print
contains assurances, check-off items,
and areas for States to describe policies
and procedures for subjects such as
enrollment, marketing and quality
assurance. Form Numbers: CMS–10251
(OMB#: 0938–NEW); Frequency:
Reporting—Once; Affected Public: State,
Local, or Tribal Governments; Number
of Respondents: 56; Total Annual
Responses: 30; Total Annual Hours:
600.
2. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: 1932 State Plan
Amendment Template, State Plan
Requirements and Supporting
Regulations in 42 CFR 438.50; Form
No.: CMS–10120 (OMB#: 0938–0933);
Use: The State Medicaid Agencies will
complete the template. CMS will review
the information to determine if the State
has met all the requirements under
Section 1932(l)(1)(A) of the Social
Security Act and 42 CFR 438.50. Once
all requirements are met, the State will
be allowed to enroll Medicaid
beneficiaries on a mandatory basis into
managed care entities without section
1115 or 1915(b) waiver authority;
Frequency: On occasion; Affected
Public: State, local, or tribal
government; Number of Respondents:
56; Total Annual Responses: 10; Total
Annual Hours: 100.
3. Type of Information Collection
Request: New Collection; Title of
Information Collection: Annual State
Report and Annual State Performance
Rankings; Use: The Deficit Reduction
Act of 2005 (DRA) requires CMS to
contract with a vendor to conduct a
monthly national survey of retail
prescription drug prices and to report
the prices to the States. These national
average prices will be used as a
benchmark by the States for the
management of their prescription drug
programs. The law also requires that
States report their drug utilization rates
for non-innovator multiple source
drugs, their payment rates under their
State plan, and their dispensing fees. A
template will be used to facilitate data
collection. The States’ rankings are to be
presented to the Congress and the
States. Form Number: CMS–10241
(OMB#: 0938–NEW); Frequency:
Reporting—Yearly; Affected Public:
States, Local or Tribal Governments;
Number of Respondents: 51; Total
Annual Responses: 51; Total Annual
Hours: 765.
4. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Health
Insurance Benefit Agreement,
PO 00000
Frm 00038
Fmt 4703
Sfmt 4703
Ambulatory Surgical Centers (ASC)
Request for Certification in the Medicare
Program, ASC Survey Report Form and
ASC Conditions of Coverage; Use: The
Health Insurance Benefit Agreement is
utilized for the purpose of establishing
for payment under Title XVIII of the
Social Security Act. The ASC Request
for Certification form is utilized as an
application for facilities wishing to
participate in the Medicare program as
an ASC. This form initiates the process
of obtaining a decision as to whether the
conditions for coverage are met. It also
promotes data retrieval from the Online
Data Input Edit (ODIE system, a
subsystem of the Online Survey
Certification and Report (OSCAR)
system by CMS Regional Offices (ROs).
The ASC Report Form is an instrument
used by the State survey agency to
record data collection in order to
determine supplier compliance with
individual conditions for coverage and
report it to the Federal Government. The
form is primarily a coding worksheet
designed to facilitate data reduction and
retrieval into the ODIE/OSCAR system
at the CMS ROs. This form includes
basic information on compliance (i.e.,
met, not met and explanatory
statements) and does not require any
descriptive information regarding the
survey activity itself. Form Numbers:
CMS–370, 377, 378 (OMB#: 0938–0266);
Frequency: Reporting—Occasionally
(initially and then every 3 years);
Affected Public: States, Local or Tribal
Governments; Number of Respondents:
5123; Total Annual Responses: 1707;
Total Annual Hours: 2,787.
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 by the OMB desk officer at
the address below, no later than 5 p.m.
on January 7, 2008.
OMB Human Resources and Housing
Branch, Attention: Katherine Astrich,
New Executive Office Building, Room
10235, Washington, DC 20503, Fax
Number: (202) 395–6974.
E:\FR\FM\07DEN1.SGM
07DEN1
69219
Federal Register / Vol. 72, No. 235 / Friday, December 7, 2007 / Notices
Dated: November 30, 2007.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
[FR Doc. E7–23746 Filed 12–6–07; 8:45 am]
Proposed Information Collection
Activity; Comment Request
BILLING CODE 4120–01–P
Administration for Children and
Families
Proposed Projects:
Title: Voluntary Establishment of
Paternity.
OMB No.: 0970–0175.
Description: Section 466(a)(5)(C) of
the Social Security Act requires States
to pass laws ensuring a simple civil
process for voluntarily acknowledging
paternity under which the State must
provide that the mother and putative
father must be given notice, orally and
in writing, of the benefits and legal
responsibilities and consequences of
acknowledging paternity. The
information is to be used by hospitals,
birth record agencies, and other entities
participating in the voluntary paternity
establishment program.
Respondents: State and Tribal IV–D
agencies.
ANNUAL BURDEN ESTIMATES
Instrument
Number of
respondents
Number of
responses per
respondent
Average
burden hours
per response
Total burden
hours
None ................................................................................................................
1,025,521
Variable
.166
170,236
Estimated Total Annual Burden
Hours: 170,236.
In compliance with the requirements
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Administration for Children and
Families is soliciting public comment
on the specific aspects of the
information collection described above.
Copies of the proposed collection of
information can be obtained and
comments may be forwarded by writing
to the Administration for Children nd
Families, Office of Administration,
Office of Information Services, 370
L’Enfant Promenade, SW., Washington,
DC 20447, Attn: ACF Reports Clearance
Officer. E-mail address:
infocollection@acf.hhs.gov. All requests
should be identified by the title of the
information collection.
The Department specifically requests
comments on: (a) Whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden of the
proposed collection of information; (c)
the quality, utility, and clarity of the
information to be collected; and (d)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques or
other forms of information technology.
Consideration will be given to
comments and suggestions submitted
within 60 days of this publication.
Dated: November 30, 2007.
Robert Sargis,
Reports Clearance Officer.
[FR Doc. 07–5964 Filed 12–6–07; 8:45 am]
BILLING CODE 4184–01–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Title: Head Start Program Information
Report.
OMB No.: 0980–0017.
Description: The Office of Head Start
within the Administration for Children
and Families, United States Department
of Health and Human Services, is
proposing to renew authority to collect
information using the Head Start
Program Information Report (PIR). The
PIR provides information about Head
Start and Early Head Start services
received by the children and families
enrolled in Head Start programs. The
information collected in the PIR is used
to inform the public about these
programs and to make periodic reports
to Congress about the status of children
in Head Start programs as required by
the Head Start Act.
Respondents: Head Start and Early
Head Start program grant recipients.
Proposed Information Collection
Activity; Comment Request
Proposed Projects:
ANNUAL BURDEN ESTIMATES
Number of
respondents
Number of
responses per
respondent
Average
burden hours
per response
Total burden
hours
Head Start Program Information Report ..........................................................
pwalker on PROD1PC71 with NOTICES
Instrument
2,690
1
4
10,760
Estimated Total Annual Burden
Hours: 10,760.
In compliance with the requirements
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Administration for Children and
Families is soliciting public comment
VerDate Aug<31>2005
16:30 Dec 06, 2007
Jkt 214001
on the specific aspects of the
information collection described above.
Copies of the proposed collection of
information can be obtained and
comments may be forwarded by writing
to the Administration for Children and
Families, Office of Information Services,
PO 00000
Frm 00039
Fmt 4703
Sfmt 4703
370 L’Enfant Promenade, SW.,
Washington, DC 20447, Attn: ACF
Reports Clearance Officer. All requests
should be identified by the title of the
information collection.
The Department specifically requests
comments on: (a) Whether the proposed
E:\FR\FM\07DEN1.SGM
07DEN1
]]>Agencies
[Federal Register Volume 72, Number 235 (Friday, December 7, 2007)]
[Notices]
[Pages 69218-69219]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-23746]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10232, CMS-10120, CMS-10241, CMS-370, 377 and
378]
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: New Collection; Title of
Information Collection: State Plan Pre-print for Integrated Medicare
and Medicaid Programs; Use: Information submitted via the State Plan
Amendment (SPA) pre-print will be used by CMS Central and Regional
Offices to analyze a State's proposal to implement integrated Medicare
and Medicaid programs. The pre-print is an optional document for use by
States to highlight the arrangements between a State and Medicare
Advantage Special Needs Plans that are also providing Medicaid
services. State Medicaid Agencies will complete the SPA pre-print and
submit it to CMS for a comprehensive analysis. The pre-print provides
the opportunity for States to confirm that their integrated care model
complies with both federal statutory and regulatory requirements. The
pre-print contains assurances, check-off items, and areas for States to
describe policies and procedures for subjects such as enrollment,
marketing and quality assurance. Form Numbers: CMS-10251 (OMB:
0938-NEW); Frequency: Reporting--Once; Affected Public: State, Local,
or Tribal Governments; Number of Respondents: 56; Total Annual
Responses: 30; Total Annual Hours: 600.
2. Type of Information Collection Request: Extension without change
of a currently approved collection; Title of Information Collection:
1932 State Plan Amendment Template, State Plan Requirements and
Supporting Regulations in 42 CFR 438.50; Form No.: CMS-10120
(OMB: 0938-0933); Use: The State Medicaid Agencies will
complete the template. CMS will review the information to determine if
the State has met all the requirements under Section 1932(l)(1)(A) of
the Social Security Act and 42 CFR 438.50. Once all requirements are
met, the State will be allowed to enroll Medicaid beneficiaries on a
mandatory basis into managed care entities without section 1115 or
1915(b) waiver authority; Frequency: On occasion; Affected Public:
State, local, or tribal government; Number of Respondents: 56; Total
Annual Responses: 10; Total Annual Hours: 100.
3. Type of Information Collection Request: New Collection; Title of
Information Collection: Annual State Report and Annual State
Performance Rankings; Use: The Deficit Reduction Act of 2005 (DRA)
requires CMS to contract with a vendor to conduct a monthly national
survey of retail prescription drug prices and to report the prices to
the States. These national average prices will be used as a benchmark
by the States for the management of their prescription drug programs.
The law also requires that States report their drug utilization rates
for non-innovator multiple source drugs, their payment rates under
their State plan, and their dispensing fees. A template will be used to
facilitate data collection. The States' rankings are to be presented to
the Congress and the States. Form Number: CMS-10241 (OMB:
0938-NEW); Frequency: Reporting--Yearly; Affected Public: States, Local
or Tribal Governments; Number of Respondents: 51; Total Annual
Responses: 51; Total Annual Hours: 765.
4. Type of Information Collection Request: Extension without change
of a currently approved collection; Title of Information Collection:
Health Insurance Benefit Agreement, Ambulatory Surgical Centers (ASC)
Request for Certification in the Medicare Program, ASC Survey Report
Form and ASC Conditions of Coverage; Use: The Health Insurance Benefit
Agreement is utilized for the purpose of establishing for payment under
Title XVIII of the Social Security Act. The ASC Request for
Certification form is utilized as an application for facilities wishing
to participate in the Medicare program as an ASC. This form initiates
the process of obtaining a decision as to whether the conditions for
coverage are met. It also promotes data retrieval from the Online Data
Input Edit (ODIE system, a subsystem of the Online Survey Certification
and Report (OSCAR) system by CMS Regional Offices (ROs). The ASC Report
Form is an instrument used by the State survey agency to record data
collection in order to determine supplier compliance with individual
conditions for coverage and report it to the Federal Government. The
form is primarily a coding worksheet designed to facilitate data
reduction and retrieval into the ODIE/OSCAR system at the CMS ROs. This
form includes basic information on compliance (i.e., met, not met and
explanatory statements) and does not require any descriptive
information regarding the survey activity itself. Form Numbers: CMS-
370, 377, 378 (OMB: 0938-0266); Frequency: Reporting--
Occasionally (initially and then every 3 years); Affected Public:
States, Local or Tribal Governments; Number of Respondents: 5123; Total
Annual Responses: 1707; Total Annual Hours: 2,787.
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 by the OMB desk
officer at the address below, no later than 5 p.m. on January 7, 2008.
OMB Human Resources and Housing Branch, Attention: Katherine
Astrich, New Executive Office Building, Room 10235, Washington, DC
20503, Fax Number: (202) 395-6974.
[[Page 69219]]
Dated: November 30, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. E7-23746 Filed 12-6-07; 8:45 am]
BILLING CODE 4120-01-P
