Agency Information Collection Activities: Submission for OMB Review; Comment Request, 63485 [2010-25932]
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Federal Register / Vol. 75, No. 199 / Friday, October 15, 2010 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–1561, CMS–R–
308, CMS–10335 and CMS–R–53]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Centers for Medicare &
Medicaid Services, HHS.
In compliance with the requirement
of section 3506I(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: Health
Insurance Benefit Agreement; Use:
Applicants to the Medicare program are
required to agree to provide services in
accordance with Federal requirements.
The CMS–1561 is 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.
Form Number: CMS–1561 (OMB#:
0938–0832); Frequency: Yearly; Affected
Public: Private Sector: Business or other
for-profits and Not-for-profit
institutions; Number of Respondents:
3,000; Total Annual Responses: 3,000;
Total Annual Hours: 500. (For policy
questions regarding this collection
contact JoAnn Perry at 410–786–3336.
For all other issues call
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Children’s
Health Insurance Program; Use: States
are required to submit title XXI plans
and amendments for approval by the
mstockstill on DSKH9S0YB1PROD with NOTICES
AGENCY:
VerDate Mar<15>2010
16:01 Oct 14, 2010
Jkt 223001
Secretary pursuant to section 2102 of
the Social Security Act in order to
receive funds for initiating and
expanding health insurance coverage for
uninsured children. States are also
required to submit State expenditure
and statistical reports, annual reports
and State evaluations to the Secretary as
outlined in title XXI of the Social
Security Act. Form Number: CMS–R–
308 (OMB#: 0938–0841); Frequency:
Yearly, Quarterly, Once and/or
Occasionally; Affected Public: State,
Local, or Tribal Governments; Number
of Respondents: 56; Total Annual
Responses: 1,114,124 Total Annual
Hours: 864,973. (For policy questions
regarding this collection contact Nancy
Goetschius at 410–786–0707. For all
other issues call 410–786–1326.) 410–
786–1326.)
3. Type of Information Collection
Request: New collection; Title of
Information Collection: Current State
Practices Related to Payments to
Providers for Health Care- Acquired
Conditions; Use: The Patient Protection
and Affordable Care Act of 2010
(Affordable Care Act), enacted March
23, 2010 includes provisions prohibiting
Federal Financial Participation to States
for payments for health care-acquired
conditions (HCACs). Section 2702(a)
specifically requires that the Secretary
identify current State practices that
prohibit payment for HCACs and
incorporate those practices or elements
of those practices which she determines
appropriate for application to the
Medicaid program. In accordance with
section 2702(a) of the Affordable Care
Act, CMS is issuing this survey to States
to obtain information on current State
Medicaid practices for prohibiting
payments for HCACs. Form Number:
CMS–10335 (OMB#: 0938–New);
Frequency: Once; Affected Public: State,
Local, or Tribal Governments; Number
of Respondents: 50 Total Annual
Responses: 50; Total Annual Hours: 50
(For policy questions regarding this
collection contact Venesa Day at 410–
786–8281. For all other issues call 410–
786–1326.)
4. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Imposition of
Cost Sharing Charges under Medicaid
and Supporting Regulations in 42 CFR
447.53; Use: The purpose of this
collection is to ensure that States
impose normal cost sharing charges
upon categorically and medically needy
individuals as allowed by law and
implementing regulations. States must
identify in their State plan the service
for which the charge is made, the
amount of the charge, the basis for
PO 00000
Frm 00053
Fmt 4703
Sfmt 4703
63485
determining the charge, the basis for
determining whether an individual is
unable to pay the charge and the way in
which the individual will be identified
to providers, and the procedures for
implementing and enforcing the
exclusions from cost sharing. Form
Number: CMS–R–53 (OMB#: 0938–
0429); Frequency: Occasionally;
Affected Public: State, Local, or Tribal
Governments; Number of Respondents:
56; Total Annual Responses: 2; Total
Annual Hours: 20. (For policy questions
regarding this collection contact Barbara
Washington at 410–786–9964. 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 November 15, 2010.
OMB, Office of Information and
Regulatory Affairs, Attention: CMS Desk
Officer, Fax Number: (202) 395–6974, Email: OIRA_submission@omb.eop.gov.
Dated: October 8, 2010.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2010–25932 Filed 10–14–10; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[30Day–11–0728]
Agency Forms Undergoing Paperwork
Reduction Act Review
The Centers for Disease Control and
Prevention (CDC) publishes a list of
information collection requests under
review by the Office of Management and
Budget (OMB) in compliance with the
Paperwork Reduction Act (44 U.S.C.
chapter 35). To request a copy of these
requests, call the CDC Reports Clearance
Officer at (404) 639–5960 or send an email to omb@cdc.gov. Send written
comments to CDC Desk Officer, Office of
Management and Budget, Washington,
E:\FR\FM\15OCN1.SGM
15OCN1
]]>Agencies
[Federal Register Volume 75, Number 199 (Friday, October 15, 2010)]
[Notices]
[Page 63485]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-25932]
[[Page 63485]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-1561, CMS-R-308, CMS-10335 and CMS-R-53]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
In compliance with the requirement of section 3506I(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: Health Insurance
Benefit Agreement; Use: Applicants to the Medicare program are required
to agree to provide services in accordance with Federal requirements.
The CMS-1561 is 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. Form
Number: CMS-1561 (OMB: 0938-0832); Frequency: Yearly; Affected
Public: Private Sector: Business or other for-profits and Not-for-
profit institutions; Number of Respondents: 3,000; Total Annual
Responses: 3,000; Total Annual Hours: 500. (For policy questions
regarding this collection contact JoAnn Perry at 410-786-3336. For all
other issues call
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Children's Health
Insurance Program; Use: States are required to submit title XXI plans
and amendments for approval by the Secretary pursuant to section 2102
of the Social Security Act in order to receive funds for initiating and
expanding health insurance coverage for uninsured children. States are
also required to submit State expenditure and statistical reports,
annual reports and State evaluations to the Secretary as outlined in
title XXI of the Social Security Act. Form Number: CMS-R-308
(OMB: 0938-0841); Frequency: Yearly, Quarterly, Once and/or
Occasionally; Affected Public: State, Local, or Tribal Governments;
Number of Respondents: 56; Total Annual Responses: 1,114,124 Total
Annual Hours: 864,973. (For policy questions regarding this collection
contact Nancy Goetschius at 410-786-0707. For all other issues call
410-786-1326.) 410-786-1326.)
3. Type of Information Collection Request: New collection; Title of
Information Collection: Current State Practices Related to Payments to
Providers for Health Care- Acquired Conditions; Use: The Patient
Protection and Affordable Care Act of 2010 (Affordable Care Act),
enacted March 23, 2010 includes provisions prohibiting Federal
Financial Participation to States for payments for health care-acquired
conditions (HCACs). Section 2702(a) specifically requires that the
Secretary identify current State practices that prohibit payment for
HCACs and incorporate those practices or elements of those practices
which she determines appropriate for application to the Medicaid
program. In accordance with section 2702(a) of the Affordable Care Act,
CMS is issuing this survey to States to obtain information on current
State Medicaid practices for prohibiting payments for HCACs. Form
Number: CMS-10335 (OMB: 0938-New); Frequency: Once; Affected
Public: State, Local, or Tribal Governments; Number of Respondents: 50
Total Annual Responses: 50; Total Annual Hours: 50 (For policy
questions regarding this collection contact Venesa Day at 410-786-8281.
For all other issues call 410-786-1326.)
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Imposition of
Cost Sharing Charges under Medicaid and Supporting Regulations in 42
CFR 447.53; Use: The purpose of this collection is to ensure that
States impose normal cost sharing charges upon categorically and
medically needy individuals as allowed by law and implementing
regulations. States must identify in their State plan the service for
which the charge is made, the amount of the charge, the basis for
determining the charge, the basis for determining whether an individual
is unable to pay the charge and the way in which the individual will be
identified to providers, and the procedures for implementing and
enforcing the exclusions from cost sharing. Form Number: CMS-R-53
(OMB: 0938-0429); Frequency: Occasionally; Affected Public:
State, Local, or Tribal Governments; Number of Respondents: 56; Total
Annual Responses: 2; Total Annual Hours: 20. (For policy questions
regarding this collection contact Barbara Washington at 410-786-9964.
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 November 15,
2010.
OMB, Office of Information and Regulatory Affairs, Attention: CMS
Desk Officer, Fax Number: (202) 395-6974, E-mail: OIRA_submission@omb.eop.gov.
Dated: October 8, 2010.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 2010-25932 Filed 10-14-10; 8:45 am]
BILLING CODE 4120-01-P
