Agency Information Collection Activities: Submission for OMB Review; Comment Request, 7233-7234 [E9-3156]
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Federal Register / Vol. 74, No. 29 / Friday, February 13, 2009 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–R–285, CMS–
10170, CMS–R–0074, CMS–R–107, CMS–
2786U, CMS–416 and CMS–10265]
cprice-sewell on PRODPC61 with NOTICES
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
AGENCY: 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), 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: Request For
Retirement Benefit Information; Use:
Section 1818 of the Social Security Act
provides that former State and local
government employees who are age 65
or older, that have been entitled to
Premium Part A for at least 7 years, and
did not have the premium paid for by
a State or a political subdivision of a
State, may have the Part A premium
reduced to zero. This collection will
assist in determining whether
individuals currently paying a monthly
premium for Medicare Part A coverage
are eligible to have their premium
reduced to zero. Form Number: CMS–R–
285 (OMB# 0938–0769); Frequency:
Monthly; Affected Public: State, Local or
Tribal Governments; Number of
Respondents: 1,500; Total Annual
Responses: 1,500; Total Annual Hours:
375. (For policy questions regarding this
collection contact: Denise Cox at 410–
786–3195. For all other issues call 410–
786–1326.)
2. Type of Information Collection
Request: Revision of a currently
VerDate Nov<24>2008
15:38 Feb 12, 2009
Jkt 217001
approved collection; Title of
Information Collection: Retiree Drug
Subsidy (RDS) Payment Request and
Instructions; Use: Under section 1860D–
22 of the Social Security Act, plan
sponsors (e.g., employers, unions) who
offer prescription drug coverage meeting
specified criteria to their qualified
covered retirees are eligible to receive a
28% tax-free subsidy for allowable drug
costs. Plan sponsors must submit
required prescription drug cost data and
other information in order to receive the
subsidy. Form Number: CMS–10170
(OMB# 0938–0977); Frequency: Yearly;
Affected Public: Business or other forprofits, not-for-profit institutions, notfor-profit institutions and State, Local or
Tribal Governments; Number of
Respondents: 4,500; Total Annual
Responses: 4,500; Total Annual Hours:
679,500. (For policy questions regarding
this collection contact: David Mlawsky
at 410–786–6851. For all other issues
call 410–786–1326.)
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Income and
Eligibility Verification System; Use:
This collection is necessary to verify
income and eligibility requirements for
Medicaid beneficiaries, as required by
Section 1137 of the Social Security Act.
Form Number: CMS–R–74 (OMB#
0938–0467); Frequency: Monthly;
Affected Public: State, Local or Tribal
Governments; Number of Respondents:
54; Total Annual Responses: 54; Total
Annual Hours: 124,054. (For policy
questions regarding this collection
contact: Mel Schmerler at 410–786–
3414. For all other issues call 410–786–
1326.)
4. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: MedicaidDetermining Third Party Liability (TPL)
State Plan Preprint and Supporting
Regulations in 42 CFR 433.138; Use:
The information collected from
Medicaid applicants and beneficiaries
as well as from State and local agencies
is necessary to determine the legal
liability of third parties to pay for
medical services in lieu of Medicaid
payment. Form Number: CMS–R–107
(OMB# 0938–0502); Frequency: On
occasion; Affected Public: Individuals or
households and State, Local or Tribal
Government; Number of Respondents:
2,900,000; Total Annual Responses:
2,900,000; Total Annual Hours: 510,968.
(For policy questions regarding this
collection contact Gwendolyn Talvert at
410–786–5928. For all other issues call
410–786–1326.)
PO 00000
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Fmt 4703
Sfmt 4703
7233
5. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Fire Safety
Survey Reports; Use: The Life Safety
Code (LSC) is a compilation of fire
safety requirements for new and existing
buildings and is updated and published
every 3 years by the National Fire
Protection Association (NFPA), a
private, non-profit organization
dedicated to reducing loss of life due to
fire. The Medicare regulations have
historically incorporated by reference
these requirements along with
Secretarial waiver authority. The
statutory basis for incorporating NFPA’s
LSC for our providers is under the
Secretary’s general rulemaking authority
at Sections 1102 and 1871 of the Social
Security Act. These forms are used by
the State Agencies to record data
collected to determine compliance with
standards specified in 416.44(b) for
ambulatory surgical centers (ASCs), and
494.60(e) for End-Stage Renal Disease
(ESRD) facilities. The Medicare Health
Insurance Program is authorized by
Title XVIII of the Social Security Act.
The CMS–2786U form is being revised
to include ESRD information. Form
Number: 2786U (OMB# 0938–0242);
Frequency: Weekly; Affected Public:
Individuals or households and State,
Local or Tribal Government; Number of
Respondents: 54; Total Annual
Responses: 2,442; Total Annual Hours:
4,884. (For policy questions regarding
this collection contact JoAnn Perry at
410–786–3336. For all other issues call
410–786–1326.)
6. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Annual Early
and Periodic Screening, Diagnostic and
Treatment (EPSDT) Report; Use: States
are required to submit an annual report
on the provision of EPSDT services
pursuant to section 1902(a)(43)(D) of the
Social Security Act. These reports
provide CMS with data necessary to
assess the effectiveness of State EPSDT
programs, to determine a State’s results
in achieving its participation goal and to
respond to inquiries. This collection is
being submitted as a revision based on
minor changes made to the form and
instructions. CMS has added three
additional lines of data to the form
(lines 12d, 12e and 12f). This
information is currently being collected;
however, CMS expanded the lines to
obtain a better understanding for the
utilization of dental services. CMS
believes there will be no additional
burden for the changes made to the
form. The changes were necessary to
E:\FR\FM\13FEN1.SGM
13FEN1
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7234
Federal Register / Vol. 74, No. 29 / Friday, February 13, 2009 / Notices
accommodate a need for more specific
dental data and to preliminary notify
States of a change in CPT codes. A
clarification was also made to line 14 of
the instructions. Form Number: CMS–
416 (OMB# 0938–0354); Frequency:
Yearly; Affected Public: State, Local or
Tribal Governments; Number of
Respondents: 56; Total Annual
Responses: 56; Total Annual Hours:
1,568. (For policy questions regarding
this collection contact Cindy Ruff at
410–786–5916. For all other issues call
410–786–1326.)
7. Type of Information Collection
Request: New collection; Title of
Information Collection: Mandatory
Insurer Reporting Requirements of
Section 111 of the Medicare, Medicaid
and SCHIP Act of 2007 (MMSEA) (Pub.
L.110–173); Use: Section 111 of the
Medicare, Medicaid and SCHIP
Extension Act of 2007 (Pub. L. 110–173)
amends the Medicare Secondary Payer
(MSP) provisions of the Social Security
Act (42 U.S.C. 1395y(b)) to provide for
mandatory reporting by group health
plan arrangements and by liability
insurance (including self-insurance), nofault insurance, and workers’
compensation laws and plans. The law
provides that, not withstanding any
other provision of law, the Secretary of
Health and Human Services may
implement this provision by program
instruction or otherwise. The Secretary
has elected not to implement the
provision through rulemaking and will
implement by publishing instructions
on a publicly available Web site and
submitting an information collection
request to OMB for review and approval
of the associated information collection
requirements.
Effective January 1, 2009, as required
by the MMSEA, an entity serving as an
insurer or third party administrator for
a group health plan and, in the case of
a group health plan that is self-insured
and self-administered, a plan
administrator or fiduciary must: (1)
Secure from the plan sponsor and plan
participants such information as the
Secretary may specify to identify
situations where the group health plan
is a primary plan to Medicare; and (2)
report such information to the Secretary
in the form and manner (including
frequency) specified by the Secretary.
Effective July 1, 2009, as required by
the MMSEA, ‘‘applicable plans,’’ must:
(1) Determine whether a claimant is
entitled to Medicare benefits; and, if so,
(2) report the identity of such claimant
and provide such other information as
the Secretary may require to properly
coordinate Medicare benefits with
respect to such insurance arrangements
in the form and manner (including
VerDate Nov<24>2008
15:38 Feb 12, 2009
Jkt 217001
frequency) as the Secretary may specify
after the claim is resolved through a
settlement, judgment, award or other
payment (regardless of whether or not
there is a determination or admission of
liability). Applicable plan refers to the
following laws, plans or other
arrangements, including the fiduciary or
administrator for such law, plan or
arrangement: (1) Liability insurance
(including self-insurance); (2) No-fault
insurance; and (3) Workers’
compensation laws or plans.
As indicated, the Secretary has
elected to implement this provision by
publishing instructions at a Web site
established for such purpose. The Web
site is (https://www.cms.hhs.gov/
MandatoryInsRep/). CMS shall use this
Web site to publish preliminary
guidance as well as the final
instructions. The Web site also advises
interested parties how to comment on
the preliminary guidance. Form
Number: CMS–10265 (OMB# 0938–
New); Frequency: Yearly; Affected
Public: Business or other for-profits, notfor-profit institutions and State, Local or
Tribal Governments; Number of
Respondents: 290,404; Total Annual
Responses: 6,920,504; Total Annual
Hours: 2,120,478. (For policy questions
regarding this collection contact John
Albert at 410–786–7457. For all other
issues call 410–786–1326.)
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 by the OMB desk officer at
the address below, no later than 5 p.m.
on March 16, 2009: OMB, Office of
Information and Regulatory Affairs,
Attention: CMS Desk Officer, New
Executive Office Building, Room 10235,
Washington, DC 20503, Fax Number:
(202) 395–6974.
Dated: February 6, 2009.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E9–3156 Filed 2–12–09; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–3210–N2]
Medicare Program; Medicare Evidence
Development & Coverage Advisory
Committee; Cancellation of the March
18, 2009 Meeting and Announcement
of the June 17, 2009 Meeting
AGENCY: Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice of meeting.
SUMMARY: This notice announces the
cancellation of the March 18, 2009
public meeting of the Medicare
Evidence Development & Coverage
Advisory Committee (MEDCAC)
(‘‘Committee’’) that was published in
the January 16, 2009 Federal Register
(74 FR 3051 through 3053). This notice
also announces a public meeting on
Wednesday, June 17, 2009. The
Committee generally provides advice
and recommendations concerning the
adequacy of scientific evidence needed
to determine whether certain medical
items and services can be covered under
the Medicare statute. This meeting will
focus on the use of Bayesian statistics to
interpret evidence in making coverage
decisions. The meeting will introduce
Bayesian concepts, contrast Bayesian
approaches with frequentist approaches,
and provide some examples of using
Bayesian techniques for meta-analyses.
This meeting is open to the public in
accordance with the Federal Advisory
Committee Act (5 U.S.C. App. 2, section
10(a)).
DATES: Meeting date: The public
meeting will be held on Wednesday,
June 17, 2009 from 7:30 a.m. until 4:30
p.m., eastern daylight time (e.d.t.).
Deadline for Submission of Written
Comments: Written comments must be
received at the address specified in the
ADDRESSES section of this notice by 5
p.m., e.d.t. on May 18, 2009. Once
submitted, all comments are final.
Deadlines for Speaker Registration
and Presentation Materials: The
deadline to register to be a speaker and
to submit Powerpoint presentation
materials and writings that will be used
in support of an oral presentation is
Monday, May 18, 2009, at 5 p.m., e.d.t.
Speakers may register by phone or via
e-mail by contacting the person listed in
the FOR FURTHER INFORMATION CONTACT
section of this notice. Presentation
materials must be received at the
address specified in the ADDRESSES
section of this notice.
E:\FR\FM\13FEN1.SGM
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]]>Agencies
[Federal Register Volume 74, Number 29 (Friday, February 13, 2009)]
[Notices]
[Pages 7233-7234]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-3156]
[[Page 7233]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-R-285, CMS-10170, CMS-R-0074, CMS-R-107, CMS-
2786U, CMS-416 and CMS-10265]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: 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), 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: Request For
Retirement Benefit Information; Use: Section 1818 of the Social
Security Act provides that former State and local government employees
who are age 65 or older, that have been entitled to Premium Part A for
at least 7 years, and did not have the premium paid for by a State or a
political subdivision of a State, may have the Part A premium reduced
to zero. This collection will assist in determining whether individuals
currently paying a monthly premium for Medicare Part A coverage are
eligible to have their premium reduced to zero. Form Number: CMS-R-285
(OMB 0938-0769); Frequency: Monthly; Affected Public: State,
Local or Tribal Governments; Number of Respondents: 1,500; Total Annual
Responses: 1,500; Total Annual Hours: 375. (For policy questions
regarding this collection contact: Denise Cox at 410-786-3195. For all
other issues call 410-786-1326.)
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Retiree Drug
Subsidy (RDS) Payment Request and Instructions; Use: Under section
1860D-22 of the Social Security Act, plan sponsors (e.g., employers,
unions) who offer prescription drug coverage meeting specified criteria
to their qualified covered retirees are eligible to receive a 28% tax-
free subsidy for allowable drug costs. Plan sponsors must submit
required prescription drug cost data and other information in order to
receive the subsidy. Form Number: CMS-10170 (OMB 0938-0977);
Frequency: Yearly; Affected Public: Business or other for-profits, not-
for-profit institutions, not-for-profit institutions and State, Local
or Tribal Governments; Number of Respondents: 4,500; Total Annual
Responses: 4,500; Total Annual Hours: 679,500. (For policy questions
regarding this collection contact: David Mlawsky at 410-786-6851. For
all other issues call 410-786-1326.)
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Income and
Eligibility Verification System; Use: This collection is necessary to
verify income and eligibility requirements for Medicaid beneficiaries,
as required by Section 1137 of the Social Security Act. Form Number:
CMS-R-74 (OMB 0938-0467); Frequency: Monthly; Affected Public:
State, Local or Tribal Governments; Number of Respondents: 54; Total
Annual Responses: 54; Total Annual Hours: 124,054. (For policy
questions regarding this collection contact: Mel Schmerler at 410-786-
3414. For all other issues call 410-786-1326.)
4. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicaid-
Determining Third Party Liability (TPL) State Plan Preprint and
Supporting Regulations in 42 CFR 433.138; Use: The information
collected from Medicaid applicants and beneficiaries as well as from
State and local agencies is necessary to determine the legal liability
of third parties to pay for medical services in lieu of Medicaid
payment. Form Number: CMS-R-107 (OMB 0938-0502); Frequency: On
occasion; Affected Public: Individuals or households and State, Local
or Tribal Government; Number of Respondents: 2,900,000; Total Annual
Responses: 2,900,000; Total Annual Hours: 510,968. (For policy
questions regarding this collection contact Gwendolyn Talvert at 410-
786-5928. For all other issues call 410-786-1326.)
5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Fire Safety
Survey Reports; Use: The Life Safety Code (LSC) is a compilation of
fire safety requirements for new and existing buildings and is updated
and published every 3 years by the National Fire Protection Association
(NFPA), a private, non-profit organization dedicated to reducing loss
of life due to fire. The Medicare regulations have historically
incorporated by reference these requirements along with Secretarial
waiver authority. The statutory basis for incorporating NFPA's LSC for
our providers is under the Secretary's general rulemaking authority at
Sections 1102 and 1871 of the Social Security Act. These forms are used
by the State Agencies to record data collected to determine compliance
with standards specified in 416.44(b) for ambulatory surgical centers
(ASCs), and 494.60(e) for End-Stage Renal Disease (ESRD) facilities.
The Medicare Health Insurance Program is authorized by Title XVIII of
the Social Security Act. The CMS-2786U form is being revised to include
ESRD information. Form Number: 2786U (OMB 0938-0242);
Frequency: Weekly; Affected Public: Individuals or households and
State, Local or Tribal Government; Number of Respondents: 54; Total
Annual Responses: 2,442; Total Annual Hours: 4,884. (For policy
questions regarding this collection contact JoAnn Perry at 410-786-
3336. For all other issues call 410-786-1326.)
6. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Annual Early and
Periodic Screening, Diagnostic and Treatment (EPSDT) Report; Use:
States are required to submit an annual report on the provision of
EPSDT services pursuant to section 1902(a)(43)(D) of the Social
Security Act. These reports provide CMS with data necessary to assess
the effectiveness of State EPSDT programs, to determine a State's
results in achieving its participation goal and to respond to
inquiries. This collection is being submitted as a revision based on
minor changes made to the form and instructions. CMS has added three
additional lines of data to the form (lines 12d, 12e and 12f). This
information is currently being collected; however, CMS expanded the
lines to obtain a better understanding for the utilization of dental
services. CMS believes there will be no additional burden for the
changes made to the form. The changes were necessary to
[[Page 7234]]
accommodate a need for more specific dental data and to preliminary
notify States of a change in CPT codes. A clarification was also made
to line 14 of the instructions. Form Number: CMS-416 (OMB
0938-0354); Frequency: Yearly; Affected Public: State, Local or Tribal
Governments; Number of Respondents: 56; Total Annual Responses: 56;
Total Annual Hours: 1,568. (For policy questions regarding this
collection contact Cindy Ruff at 410-786-5916. For all other issues
call 410-786-1326.)
7. Type of Information Collection Request: New collection; Title of
Information Collection: Mandatory Insurer Reporting Requirements of
Section 111 of the Medicare, Medicaid and SCHIP Act of 2007 (MMSEA)
(Pub. L.110-173); Use: Section 111 of the Medicare, Medicaid and SCHIP
Extension Act of 2007 (Pub. L. 110-173) amends the Medicare Secondary
Payer (MSP) provisions of the Social Security Act (42 U.S.C. 1395y(b))
to provide for mandatory reporting by group health plan arrangements
and by liability insurance (including self-insurance), no-fault
insurance, and workers' compensation laws and plans. The law provides
that, not withstanding any other provision of law, the Secretary of
Health and Human Services may implement this provision by program
instruction or otherwise. The Secretary has elected not to implement
the provision through rulemaking and will implement by publishing
instructions on a publicly available Web site and submitting an
information collection request to OMB for review and approval of the
associated information collection requirements.
Effective January 1, 2009, as required by the MMSEA, an entity
serving as an insurer or third party administrator for a group health
plan and, in the case of a group health plan that is self-insured and
self-administered, a plan administrator or fiduciary must: (1) Secure
from the plan sponsor and plan participants such information as the
Secretary may specify to identify situations where the group health
plan is a primary plan to Medicare; and (2) report such information to
the Secretary in the form and manner (including frequency) specified by
the Secretary.
Effective July 1, 2009, as required by the MMSEA, ``applicable
plans,'' must: (1) Determine whether a claimant is entitled to Medicare
benefits; and, if so, (2) report the identity of such claimant and
provide such other information as the Secretary may require to properly
coordinate Medicare benefits with respect to such insurance
arrangements in the form and manner (including frequency) as the
Secretary may specify after the claim is resolved through a settlement,
judgment, award or other payment (regardless of whether or not there is
a determination or admission of liability). Applicable plan refers to
the following laws, plans or other arrangements, including the
fiduciary or administrator for such law, plan or arrangement: (1)
Liability insurance (including self-insurance); (2) No-fault insurance;
and (3) Workers' compensation laws or plans.
As indicated, the Secretary has elected to implement this provision
by publishing instructions at a Web site established for such purpose.
The Web site is (https://www.cms.hhs.gov/MandatoryInsRep/). CMS shall
use this Web site to publish preliminary guidance as well as the final
instructions. The Web site also advises interested parties how to
comment on the preliminary guidance. Form Number: CMS-10265
(OMB 0938-New); Frequency: Yearly; Affected Public: Business
or other for-profits, not-for-profit institutions and State, Local or
Tribal Governments; Number of Respondents: 290,404; Total Annual
Responses: 6,920,504; Total Annual Hours: 2,120,478. (For policy
questions regarding this collection contact John Albert at 410-786-
7457. For all other issues call 410-786-1326.)
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 March 16, 2009:
OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk
Officer, New Executive Office Building, Room 10235, Washington, DC
20503, Fax Number: (202) 395-6974.
Dated: February 6, 2009.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. E9-3156 Filed 2-12-09; 8:45 am]
BILLING CODE 4120-01-P
