Agency Information Collection Activities: Proposed Collection; Comment Request, 30030-30031 [2010-12624]
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30030
Federal Register / Vol. 75, No. 103 / Friday, May 28, 2010 / Notices
bank holding companies may be
obtained from the National Information
Center website at www.ffiec.gov/nic/.
Unless otherwise noted, comments
regarding the applications must be
received at the Reserve Bank indicated
or the offices of the Board of Governors
not later than June 15, 2010.
A. Federal Reserve Bank of Chicago
(Colette A. Fried, Assistant Vice
President) 230 South LaSalle Street,
Chicago, Illinois 60690–1414:
1. NC Bancorp, Inc., Chicago, Illinois;
to continue to engage de novo in
making, acquiring, brokering or
servicing loans or other extensions of
credit, pursuant to section 225.28(b)(1)
of Regulation Y.
B. Federal Reserve Bank of San
Francisco (Kenneth Binning, Vice
President, Applications and
Enforcement) 101 Market Street, San
Francisco, California 94105–1579:
1. Mission Community Bancorp, San
Luis Obispo, California; Carpenter Fund
Manager GP, LLC; Carpenter Fund
Management, LLC; Carpenter
Community Bancfund, L.P.; Carpenter
Community Bancfund–A, L.P.;
Carpenter Community Bancfund–CA,
L.P.; CCFW, Inc.; and SCJ, Inc., all of
Irvine, California; to acquire Mission
Asset Management, Inc., San Luis
Obispo, California, and thereby egnage
in extending credit and servicing loans,
pursuant to section 225.28(b)(1) of
Regulation Y.
Board of Governors of the Federal Reserve
System, May 25, 2010.
Robert deV. Frierson,
Deputy Secretary of the Board.
[FR Doc. 2010–12913 Filed 5–27–10; 8:45 am]
BILLING CODE 6210–01–S
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10314, CMS–
264–94, CMS–1728–94, CMS–10240 and
CMS–P–0015A]
jlentini on DSKJ8SOYB1PROD with NOTICES
Agency Information Collection
Activities: Proposed Collection;
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) is publishing the
following summary of proposed
collections for public comment.
Interested persons are invited to send
VerDate Mar<15>2010
17:43 May 27, 2010
Jkt 220001
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: Medicare
Savings Program Protection from
Medicaid Estate Recovery—State Plan
Pre-print under Title XIX. Form No:
CMS–10314 (OMB# 0938–New); Use:
Section 115 of the Medicare
Improvements for Patients and
Providers Act (MIPPA)—2008, provides
new protections from Medicaid estate
recovery for limited categories of dual
eligibles age 55 and over. To offer these
protections, States have to amend their
Medicaid State plans to reflect these
new limits on estate recovery. To reduce
paperwork burden and expedite this
process, CMS is providing States with a
pre-printed document (i.e., a State plan
preprint) which neither needs nor
requires any insertion of language or
even completion of a check-off box. As
Section 115 simply mandates
compliance (there is no option not to
comply), States only need return the
preprint page (as prepared by CMS) to
CMS, as a requested amendment to their
State Plan. This is a one-time only
submission, with little burden
imposition and complete electronic
routing to and from States. Frequency:
Reporting—Once; Affected Public: State,
Local or Tribal Governments; Number of
Respondents: 51; Total Annual
Responses: 51; Total Annual Hours:
102. (For policy questions regarding this
collection contact Nancy Dieter at 410–
786–7219. For all other issues call 410–
786–1326.)
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Independent
Renal Dialysis Facility Cost Report; Use:
The Independent Renal Dialysis Facility
Cost Report, is filed annually by
providers participating in the Medicare
program to identify the specific items of
cost and statistics of facility operation
that independent renal dialysis facilities
are required to report. Form Number:
CMS–265–94 (OMB#: 0938–0236);
Frequency: Yearly; Affected Public:
Business or other for-profits and Not-
PO 00000
Frm 00064
Fmt 4703
Sfmt 4703
for-profit institutions; Number of
Respondents: 5,508; Total Annual
Responses: 5,508; Total Annual Hours:
275,400. (For policy questions regarding
this collection contact Gail Duncan at
410–786–7278. For all other issues call
410–786–1326.)
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Home Health
Agency Cost Report; Use: These cost
report forms are filed annually by
freestanding providers participating in
the Medicare program to effect year end
cost settlement for providing services to
Medicare beneficiaries. The data
submitted on the cost reports supports
management of Federal programs.
Providers receiving Medicare
reimbursement must provide adequate
cost data based on financial and
statistical records which can be verified
by qualified auditors. The data from
these cost reporting forms will be used
for the purpose of evaluating current
levels of Medicare reimbursement. Form
Number: CMS–1728–94 (OMB#: 0938–
0022); Frequency: Yearly; Affected
Public: Business or other for-profits and
Not-for-profit institutions; Number of
Respondents: 7,479; Total Annual
Responses: 7,479; Total Annual Hours:
1,690,254. (For policy questions
regarding this collection contact Angela
Havrilla at 410–786–4516. For all other
issues call 410–786–1326.)
4. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Data Collection
for the Nursing Home Value-Based
Purchasing (NHVBP) Demonstration;
Use: The goal of the NHVBP
Demonstration is to use financial
incentives to improve the quality of care
in nursing homes. The main purpose of
the NHVBP data collection effort is to
gather information that will enable CMS
to determine which nursing homes will
be eligible to receive incentive
payments under the NHVBP
Demonstration. Information will be
collected from nursing homes
participating in the demonstration on an
ongoing basis. CMS will collect payrollbased staffing, agency staffing and
resident census information to help
assess the quality of care in
participating nursing homes. CMS will
determine which homes qualify for an
incentive payment based on their
relative performance in terms of quality.
Form Number: CMS–10240 (OMB#:
0938–1039); Frequency: Quarterly;
Affected Public: Business or other forprofits and Not-for-profit institutions;
Number of Respondents: 178; Total
Annual Responses: 712; Total Annual
E:\FR\FM\28MYN1.SGM
28MYN1
30031
Federal Register / Vol. 75, No. 103 / Friday, May 28, 2010 / Notices
Hours: 5,530. (For policy questions
regarding this collection contact Ron
Lambert at 410–786–6624. For all other
issues call 410–786–1326.)
5. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare
Current Beneficiary Survey; Use: The
Medicare Current Beneficiary Survey
(MCBS) serves to measure what impact
the changes have on the program and its
beneficiaries. The MCBS is a
comprehensive data collection effort
that fills an information gap in the
Centers for Medicare and Medicaid
Services, and is depended on to help
manage the program. Being able to
examine various characteristics and to
chart evolving trends offers policy
makers a reliable tool for making
informed decisions. The MCBS is used
to identify potential new policy
direction or modifications to the
Medicare program and once those
program enhancements are
implemented, monitor the impact of
those changes. The central goals of the
MCBS are to determine medical care
expenditures and sources of payment
for all services, including copayments,
deductibles, and non-covered services;
to ascertain all types of health insurance
coverage and relate coverage to actual
payments; and to trace processes over
time, such as changes in health status,
spending down to Medicaid eligibility,
and the impacts of program changes.
Form Number: CMS–P–0015A (OMB#:
0938–0568); Frequency: Yearly; Affected
Public: Business or other for-profits and
Not-for-profit institutions; Number of
Respondents: 16,217; Total Annual
Responses: 48,650; Total Annual Hours:
57,062. (For policy questions regarding
this collection contact William Long at
410–786–7927. 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
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.
In commenting on the proposed
information collections please reference
the document identifier or OMB control
number. To be assured consideration,
comments and recommendations must
be submitted in one of the following
ways by July 27, 2010:
1. Electronically. You may submit
your comments electronically to https://
www.regulations.gov. Follow the
instructions for ‘‘Comment or
Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) accepting comments.
2. By regular mail. You may mail
written comments to the following
address: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: Document Identifier/OMB
Control Number, Room C4–26–05, 7500
Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: May 21, 2010.
Martique Jones,
Director, Regulations Development DivisionB, Office of Strategic Operations and
Regulatory Affairs.
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Proposed Information Collection
Activity; Comment Request
Proposed Projects
Title: Child Care and Development
Block Grant Reporting Requirements—
ACF–700.
OMB No.: 0980–0241.
Description: The Child Care and
Development Fund (CCDF) report
requests annual Tribal aggregate
information on services provided
through the CCDF, which is required by
the CCDF Final Rule (45 FR parts 98 and
99). Tribal Lead Agencies (TLAs) are
required to submit annual aggregate data
appropriate to Tribal programs on
children and families receiving CCDFfunded child care services. The CCDF
statute and regulations also require
TLAs to submit a supplemental
narrative as part of the ACF–700 report.
This narrative describes child care
activities and actions in the TLA’s
service area. Information from the ACF–
700 and supplemental narrative report
will be included in the Secretary’s
Report to Congress, as appropriate, and
will be shared with all TLAs to inform
them of CCDF-funded activities in other
Tribal programs.
Respondents: Tribal Governments.
[FR Doc. 2010–12624 Filed 5–27–10; 8:45 am]
BILLING CODE 4120–01–P
ANNUAL BURDEN ESTIMATES
Number of
respondents
Instrument
jlentini on DSKJ8SOYB1PROD with NOTICES
ACF–700 Report ..............................................................................................
Estimated Total Annual Burden
Hours: 9,880.
In compliance with the requirements
of Section 506(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 and
VerDate Mar<15>2010
17:43 May 27, 2010
Jkt 220001
260
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
PO 00000
Frm 00065
Fmt 4703
Sfmt 4703
Number of
responses
per respondent
1
Average
burden hours
per response
38
Total burden
hours
9,880
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
E:\FR\FM\28MYN1.SGM
28MYN1
]]>Agencies
[Federal Register Volume 75, Number 103 (Friday, May 28, 2010)]
[Notices]
[Pages 30030-30031]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-12624]
=======================================================================
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10314, CMS-264-94, CMS-1728-94, CMS-10240 and
CMS-P-0015A]
Agency Information Collection Activities: Proposed Collection;
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) 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: Medicare Savings Program Protection from
Medicaid Estate Recovery--State Plan Pre-print under Title XIX. Form
No: CMS-10314 (OMB 0938-New); Use: Section 115 of the Medicare
Improvements for Patients and Providers Act (MIPPA)--2008, provides new
protections from Medicaid estate recovery for limited categories of
dual eligibles age 55 and over. To offer these protections, States have
to amend their Medicaid State plans to reflect these new limits on
estate recovery. To reduce paperwork burden and expedite this process,
CMS is providing States with a pre-printed document (i.e., a State plan
preprint) which neither needs nor requires any insertion of language or
even completion of a check-off box. As Section 115 simply mandates
compliance (there is no option not to comply), States only need return
the preprint page (as prepared by CMS) to CMS, as a requested amendment
to their State Plan. This is a one-time only submission, with little
burden imposition and complete electronic routing to and from States.
Frequency: Reporting--Once; Affected Public: State, Local or Tribal
Governments; Number of Respondents: 51; Total Annual Responses: 51;
Total Annual Hours: 102. (For policy questions regarding this
collection contact Nancy Dieter at 410-786-7219. For all other issues
call 410-786-1326.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Independent Renal
Dialysis Facility Cost Report; Use: The Independent Renal Dialysis
Facility Cost Report, is filed annually by providers participating in
the Medicare program to identify the specific items of cost and
statistics of facility operation that independent renal dialysis
facilities are required to report. Form Number: CMS-265-94
(OMB: 0938-0236); Frequency: Yearly; Affected Public: Business
or other for-profits and Not-for-profit institutions; Number of
Respondents: 5,508; Total Annual Responses: 5,508; Total Annual Hours:
275,400. (For policy questions regarding this collection contact Gail
Duncan at 410-786-7278. For all other issues call 410-786-1326.)
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Home Health
Agency Cost Report; Use: These cost report forms are filed annually by
freestanding providers participating in the Medicare program to effect
year end cost settlement for providing services to Medicare
beneficiaries. The data submitted on the cost reports supports
management of Federal programs. Providers receiving Medicare
reimbursement must provide adequate cost data based on financial and
statistical records which can be verified by qualified auditors. The
data from these cost reporting forms will be used for the purpose of
evaluating current levels of Medicare reimbursement. Form Number: CMS-
1728-94 (OMB: 0938-0022); Frequency: Yearly; Affected Public:
Business or other for-profits and Not-for-profit institutions; Number
of Respondents: 7,479; Total Annual Responses: 7,479; Total Annual
Hours: 1,690,254. (For policy questions regarding this collection
contact Angela Havrilla at 410-786-4516. For all other issues call 410-
786-1326.)
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Data Collection
for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration; Use:
The goal of the NHVBP Demonstration is to use financial incentives to
improve the quality of care in nursing homes. The main purpose of the
NHVBP data collection effort is to gather information that will enable
CMS to determine which nursing homes will be eligible to receive
incentive payments under the NHVBP Demonstration. Information will be
collected from nursing homes participating in the demonstration on an
ongoing basis. CMS will collect payroll-based staffing, agency staffing
and resident census information to help assess the quality of care in
participating nursing homes. CMS will determine which homes qualify for
an incentive payment based on their relative performance in terms of
quality. Form Number: CMS-10240 (OMB: 0938-1039); Frequency:
Quarterly; Affected Public: Business or other for-profits and Not-for-
profit institutions; Number of Respondents: 178; Total Annual
Responses: 712; Total Annual
[[Page 30031]]
Hours: 5,530. (For policy questions regarding this collection contact
Ron Lambert at 410-786-6624. For all other issues call 410-786-1326.)
5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare Current
Beneficiary Survey; Use: The Medicare Current Beneficiary Survey (MCBS)
serves to measure what impact the changes have on the program and its
beneficiaries. The MCBS is a comprehensive data collection effort that
fills an information gap in the Centers for Medicare and Medicaid
Services, and is depended on to help manage the program. Being able to
examine various characteristics and to chart evolving trends offers
policy makers a reliable tool for making informed decisions. The MCBS
is used to identify potential new policy direction or modifications to
the Medicare program and once those program enhancements are
implemented, monitor the impact of those changes. The central goals of
the MCBS are to determine medical care expenditures and sources of
payment for all services, including copayments, deductibles, and non-
covered services; to ascertain all types of health insurance coverage
and relate coverage to actual payments; and to trace processes over
time, such as changes in health status, spending down to Medicaid
eligibility, and the impacts of program changes. Form Number: CMS-P-
0015A (OMB: 0938-0568); Frequency: Yearly; Affected Public:
Business or other for-profits and Not-for-profit institutions; Number
of Respondents: 16,217; Total Annual Responses: 48,650; Total Annual
Hours: 57,062. (For policy questions regarding this collection contact
William Long at 410-786-7927. 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 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.
In commenting on the proposed information collections please
reference the document identifier or OMB control number. To be assured
consideration, comments and recommendations must be submitted in one of
the following ways by July 27, 2010:
1. Electronically. You may submit your comments electronically to
https://www.regulations.gov. Follow the instructions for ``Comment or
Submission'' or ``More Search Options'' to find the information
collection document(s) accepting comments.
2. By regular mail. You may mail written comments to the following
address: CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development, Attention: Document Identifier/OMB
Control Number, Room C4-26-05, 7500 Security Boulevard, Baltimore,
Maryland 21244-1850.
Dated: May 21, 2010.
Martique Jones,
Director, Regulations Development Division-B, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2010-12624 Filed 5-27-10; 8:45 am]
BILLING CODE 4120-01-P
