Agency Information Collection Activities: Proposed Collection; Comment Request, 19776-19777 [2011-8462]
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19776
Federal Register / Vol. 76, No. 68 / Friday, April 8, 2011 / Notices
Clinical and Operational Performance
(DCOP) within the Medicare Drug
Benefit Group. Form Number: CMS–
10185 (OMB#: 0938–0992); Frequency:
Yearly, Quarterly, Semi-Annually;
Affected Public: Private Sector, business
or other for-profit; Number of
Respondents: 2993; Total Annual
Responses: 48,490; Total Annual Hours:
128,754. (For policy questions regarding
this collection contact LaToyia Grant at
410–786–5434. For all other issues call
410–786–1326.)
2. Type of Information Collection
Request: Revision of currently approved
collection; Title of Information
Collection: Part C Medicare Advantage
(MA) Reporting Requirements and
Supporting Regulations; Use: CMS has
authority to establish reporting
requirements for Medicare Advantage
Organizations (MAO’s) as described in
42 CFR 422.516(a). Each MAO must
have an effective procedure to develop,
compile, evaluate, and report to CMS, to
its enrollees, and to the general public,
at the times and in the manner that CMS
requires, and while safeguarding the
confidentiality of the doctor-patient
relationship, statistics and other
information with respect to the cost of
its operations, patterns of service
utilization, availability, accessibility,
and acceptability of its services,
developments in the health status of its
enrollees, and other matters that CMS
may require. Data collected via
Medicare Part C Reporting
Requirements will be an integral
resource for oversight, monitoring,
compliance and auditing activities
necessary to ensure quality provision of
the benefits provided by MA plans to
enrollees. Form Number: CMS–10261
(OMB# 0938–1054); Frequency: Yearly,
Quarterly; Affected Public: Business or
other for-profits; Number of
Respondents: 588; Total Annual
Responses: 1158; Total Annual Hours:
245,528. (For policy questions regarding
this collection contact Terry Leid at
410–786–8973. For all other issues call
410–786–1326.)
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: CMS Survey
Tool for https://www.cms.gov and
https://www.medicare.gov; Use: The
purpose of this submission is to
continue to collect information from
Internet users as they exit from the Web
sites Medicare.gov and CMS.gov. To
ensure that we gather information about
user reactions to the Web sites, we have
developed a survey tool that users can
complete when they exit either site or
by accessing a link on the bottom bar on
the page. The responses on this survey
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tool will help CMS to make appropriate
changes to the Web sites in the future.
The survey tool contains questions
about the information that visitors are
seeking from the sites, the degree to
which either site was useful to them, the
improvements that they would like to
see in the sites, and their general
comments. Form Number: CMS–R–268
(OMB# 0938–0756); Frequency: Yearly;
Affected Public: Individuals and
households, Private sector—Business or
other for-profit; Number of
Respondents: 7,000; Total Annual
Responses: 9,100; Total Annual Hours:
1,167. (For policy questions regarding
this collection contact Matthew Aiken at
410–786–1029. 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 May 9, 2011: OMB, Office of
Information and Regulatory Affairs,
Attention: CMS Desk Officer. Fax
Number: (202) 395–6974. E-mail:
OIRA_submission@omb.eop.gov.
Dated: April 1, 2011.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2011–8464 Filed 4–7–11; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10252, CMS–
1856 and CMS–1893]
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
AGENCY:
PO 00000
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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: Revision of a currently
approved collection; Title of
Information Collection: Certificate of
Destruction for Data Acquired from the
Centers for Medicare and Medicaid
Services; Use: The Certificate of
Destruction is used by recipients of
CMS data to certify that they have
destroyed the data they have received
through a CMS Data Use Agreement
(DUA). The DUA requires the
destruction of the data at the completion
of the project/expiration of the DUA.
The DUA addresses the conditions
under which CMS will disclose and the
User will maintain CMS data that are
protected by the Privacy Act of 1974,
§ 552a and the Health Insurance
Portability Accountability Act of 1996.
CMS has developed policies and
procedures for such disclosures that are
based on the Privacy Act and the Health
Insurance Portability Act (HIPAA). The
Certificate of Destruction is required to
close out the DUA and to ensure the
data are destroyed and not used for
another purpose. Form Number: CMS–
10252 (OMB# 0938–1046); Frequency:
On occasion; Affected Public: Business
or other for-profit; Number of
Respondents: 500; Total Annual
Responses: 500; Total Annual Hours:
84. (For policy questions regarding this
collection, contact Sharon Kavanagh at
(410) 786–5441. For all other issues call
(410) 786–1326.)
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: (CMS–1856)
Request for Certification in the Medicare
and/or Medicaid Program to Provide
Outpatient Physical Therapy and/or
Speech Pathology Services, and (CMS–
1893) Outpatient Physical Therapy—
Speech Pathology Survey Report; Use:
CMS–1856 is used as an application to
be completed by providers of outpatient
physical therapy and/or speech-
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srobinson on DSKHWCL6B1PROD with NOTICES
Federal Register / Vol. 76, No. 68 / Friday, April 8, 2011 / Notices
language pathology services requesting
participation in Medicare/Medicaid
programs. This form initiates the
process for obtaining a decision as to
whether the conditions of participation
are met as a provider of outpatient
physical therapy and/or speechlanguage pathology services. It is used
by the State agencies to enter new
provider into the ASPEN (Automated
Survey Process Environment). CMS–
1893 is used by the State survey agency
to record data collected during an onsite survey of a provider of outpatient
physical therapy and/or speechlanguage pathology services, to
determine compliance with the
applicable conditions of participation,
and to report this information to the
Federal Government. The form is
primarily a coding worksheet designed
to facilitate data reduction and retrieval
into the ASPEN system. The
information needed to make
certification decisions is available to
CMS only through the use of
information abstracted from the form;
Form Numbers: CMS–1856 and CMS–
1893 (OMB#: 0938–0065); Frequency:
Annually, occasionally; Affected Public:
Private Sector; Business or other forprofit and not-for-profit institutions;
Number of Respondents: 2,968; Total
Annual Responses: 495; Total Annual
Hours: 866. (For policy questions
regarding this collection contact Georgia
Johnson at 410–786–6859. 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 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 at 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 June 7, 2011.
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,
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Attention: Document Identifier/OMB
Control Number, Room C4–26–05, 7500
Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: April 1, 2011.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2011–8462 Filed 4–7–11; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10382]
Emergency Clearance: Public
Information Collection Requirements
Submitted to the Office of Management
and Budget (OMB)
Center for Medicare and
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 and 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 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.
We are, however, requesting an
emergency review of the information
collection referenced below. In
compliance with the requirement of
section 3506(c)(2)(A) of the Paperwork
Reduction Act of 1995, we have
submitted to the Office of Management
and Budget (OMB) the following
requirements for emergency review. We
are requesting an emergency review
because the collection of this
information is needed before the
expiration of the normal time limits
under OMB’s regulations at 5 CFR
1320.13. This is necessary to ensure
compliance with an initiative of the
Administration. We cannot reasonably
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19777
comply with the normal clearance
procedures due to an unexpected event
as stated in 5 CFR 1320.13(a)(2)(iii). The
use of the normal clearance procedures
would cause a statutory deadline to be
missed.
1. Type of Information Collection
Request: New collection; Title of
Information Collection: Medicaid
Emergency Psychiatric Demonstration
Use: Section 2707 of the Patient
Protection and Affordable Care Act was
enacted to implement a demonstration
to study the effects of allowing
Medicaid payment for the inpatient
stabilization of a more serious mental
health related problem. That is, to
provide payment for inpatient
stabilization for psychiatric patients
aged 21 to 64 who express suicidal or
homicidal gestures and are considered a
danger to themselves or others.
By allowing coverage for inpatient
admission for emergency psychiatric
treatment otherwise prohibited by the
Medicaid institutions for mental
diseases exclusion, the Demonstration
may improve access to appropriate
psychiatric care, improve quality of care
for Medicaid patients, and encourage
greater availability of inpatient
psychiatric beds, thereby reducing the
necessity of psychiatric boarding.
As a condition for receiving payment
under this Demonstration, a State shall
be responsible for collecting and
reporting information to the Centers for
Medicare & Medicaid Services (CMS)
about the conduct of the Demonstration
in the State for the purposes of
providing Federal oversight and the
evaluation of the Demonstration and
required to cooperate with the CMS
evaluation team. CMS is also required to
submit to Congress, a recommendation
as to whether the Demonstration project
should be continued after December 31,
2013, and expanded on a national basis.
The statute requires that a State
seeking to participate in this
Demonstration project shall submit an
application that includes such
information, provisions, and assurances
necessary to assess the State’s ability to
conduct the Demonstration as compared
with other State applicants. The State
Medical Director will submit the
Demonstration application proposal.
Form Number: CMS–10382 (OMB#:
0938–New); Frequency: Once; Affected
Public: Individuals or Households;
Number of Respondents: 44; Total
Annual Responses: 54; Total Annual
Hours: 2,106. (For policy questions
regarding this collection contact Diana
Ayres 410–786–7203. For all other
issues call 410–786–1326.)
CMS is requesting OMB review and
approval of this collection by May 9,
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]]>Agencies
[Federal Register Volume 76, Number 68 (Friday, April 8, 2011)]
[Notices]
[Pages 19776-19777]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-8462]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10252, CMS-1856 and CMS-1893]
Agency Information Collection Activities: Proposed Collection;
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) 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: Revision of a currently
approved collection; Title of Information Collection: Certificate of
Destruction for Data Acquired from the Centers for Medicare and
Medicaid Services; Use: The Certificate of Destruction is used by
recipients of CMS data to certify that they have destroyed the data
they have received through a CMS Data Use Agreement (DUA). The DUA
requires the destruction of the data at the completion of the project/
expiration of the DUA. The DUA addresses the conditions under which CMS
will disclose and the User will maintain CMS data that are protected by
the Privacy Act of 1974, Sec. 552a and the Health Insurance
Portability Accountability Act of 1996. CMS has developed policies and
procedures for such disclosures that are based on the Privacy Act and
the Health Insurance Portability Act (HIPAA). The Certificate of
Destruction is required to close out the DUA and to ensure the data are
destroyed and not used for another purpose. Form Number: CMS-10252
(OMB 0938-1046); Frequency: On occasion; Affected Public:
Business or other for-profit; Number of Respondents: 500; Total Annual
Responses: 500; Total Annual Hours: 84. (For policy questions regarding
this collection, contact Sharon Kavanagh at (410) 786-5441. For all
other issues call (410) 786-1326.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: (CMS-1856)
Request for Certification in the Medicare and/or Medicaid Program to
Provide Outpatient Physical Therapy and/or Speech Pathology Services,
and (CMS-1893) Outpatient Physical Therapy--Speech Pathology Survey
Report; Use: CMS-1856 is used as an application to be completed by
providers of outpatient physical therapy and/or speech-
[[Page 19777]]
language pathology services requesting participation in Medicare/
Medicaid programs. This form initiates the process for obtaining a
decision as to whether the conditions of participation are met as a
provider of outpatient physical therapy and/or speech-language
pathology services. It is used by the State agencies to enter new
provider into the ASPEN (Automated Survey Process Environment). CMS-
1893 is used by the State survey agency to record data collected during
an on-site survey of a provider of outpatient physical therapy and/or
speech-language pathology services, to determine compliance with the
applicable conditions of participation, and to report this information
to the Federal Government. The form is primarily a coding worksheet
designed to facilitate data reduction and retrieval into the ASPEN
system. The information needed to make certification decisions is
available to CMS only through the use of information abstracted from
the form; Form Numbers: CMS-1856 and CMS-1893 (OMB: 0938-
0065); Frequency: Annually, occasionally; Affected Public: Private
Sector; Business or other for-profit and not-for-profit institutions;
Number of Respondents: 2,968; Total Annual Responses: 495; Total Annual
Hours: 866. (For policy questions regarding this collection contact
Georgia Johnson at 410-786-6859. 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 at 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 June 7, 2011.
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: April 1, 2011.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 2011-8462 Filed 4-7-11; 8:45 am]
BILLING CODE 4120-01-P
