Agency Information Collection Activities: Submission for OMB Review; Comment Request, 35444-35445 [2011-15057]
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Federal Register / Vol. 76, No. 117 / Friday, June 17, 2011 / Notices
Mary Forbes,
Paperwork Reduction Act Clearance Officer,
Office of the Secretary.
[FR Doc. 2011–15079 Filed 6–16–11; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
[Document Identifier OS–0990–New; 60-Day
Notice]
Agency Information Collection
Request. 60-Day Public Comment
Request
Office of the Secretary, HHS.
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Office of the Secretary (OS), Department
of Health and Human Services, is
publishing the following summary of a
proposed information collection request
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
AGENCY:
women and girls through sex/genderspecific approaches. To that end, OWH
has established public/private
partnerships to address critical women’s
health issues nationwide including
cooperative agreements awarded to
eight community-based organizations in
2009 to design and implement
innovative and gender responsive HIV
prevention programs to meet the unique
risks and needs of women within their
communities who have currently
incarcerated or recently released male
partners (‘‘women partners’’). The
information presented in this evaluation
study is needed to determine the
overarching outcomes of the set of the
eight programs. The three-year study
will include quantitative data collected
at three time points, intervention
baseline, post-intervention, and 30 day
follow-up. The study will also include
qualitative data collected through focus
groups facilitated with program
participants at each of the eight program
sites, as well as interviews with one to
two key intervention staff at each of the
program sites.
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.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, e-mail your request,
including your address, phone number,
OMB number, and OS document
identifier, to
Sherette.funncoleman@hhs.gov, or call
the Reports Clearance Office on (202)
690–6162. Written comments and
recommendations for the proposed
information collections must be directed
to the OS Paperwork Clearance Officer
at the above e-mail address within 60days.
Proposed Project: HIV/AIDS Prevention
and Support Service for Women
Partners of Incarcerated/Recently
Released Men—OMB No. 0990–NewOffice of Women’s Health
Abstract: The mission of the Office on
Women’s Health (OWH) is to provide
leadership to promote health equity for
ESTIMATED ANNUALIZED BURDEN TABLE
Type of respondent
Baseline Survey ................................
Post Intervention Survey ...................
30 day Follow-up Survey ..................
Focus Group .....................................
Staff Interview ...................................
Average burden (in hours)
per response
320
288
256
64
8
1
1
1
1
1
15/60
15/60
15/60
1.0
1.0
80
72
64
64
8
........................
........................
........................
288
Program Participant .........................
Program Participant .........................
Program Participant .........................
Program Participant .........................
Intervention Staff ..............................
Total ...........................................
...........................................................
Mary Forbes,
Paperwork Reduction Act Clearance Officer
Office of the Secretary.
[FR Doc. 2011–15077 Filed 6–16–11; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
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Number of
responses per
respondent
Number of
respondents
Forms
[Document Identifier CMS–1856 and CMS–
1893]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Centers for Medicare &
Medicaid Services, HHS.
AGENCY:
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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
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Total burden
hours
minimize the information collection
burden.
1. 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 speechlanguage pathology services requesting
participation in the Medicare and
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
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Federal Register / Vol. 76, No. 117 / Friday, June 17, 2011 / Notices
emcdonald on DSK2BSOYB1PROD with NOTICES
speech-language pathology services. It is
used by the State agencies to enter new
provider into the Automated Survey
Process Environment (ASPEN). 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
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 July 18, 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: June 14, 2011.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2011–15057 Filed 6–16–11; 8:45 am]
BILLING CODE 4120–01–P
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier CMS–10334 and CMS–
10373]
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
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: Application for
Coverage in the Pre-Existing Condition
Insurance Plan; Use: The Department of
Health and Human Services (HHS)
Centers for Medicare & Medicaid
Services, Center for Consumer
Information and Insurance Oversight is
requesting clearance by the Office of
Management and Budget for
modifications to this previously
approved collection package. These
changes are being requested to (1)
provide a mechanism for a PCIP
enrollee who has moved from a stateadministered PCIP to quickly and
efficiently enroll into the federallyadministered PCIP (2) provide a
mechanism for a PCIP applicant to
identify a third party entity will pay
their premium to ensure appropriate
premium billing (3) provide a
mechanism whereby a licensed
insurance agent or broker may identify
their referral of an applicant (4) request
employer information to expand ways to
identify and prevent instances of insurer
dumping and (5) make clarifications to
existing application language. Form
Number: CMS–10334 (OCN: 0938–1095)
AGENCY:
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35445
Frequency: Once; Affected Public:
Individuals or households; Number of
Respondents: 83,333; Number of
Responses: 83,333; Total Annual Hours:
179,499. (For policy questions regarding
this collection, contact Laura Dash at
410–786–8623. For all other issues call
(410) 786–1326.)
2. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medical Loss
Ratio Quarterly Reporting; Use: Under
Section 2718 of the Affordable Care Act
and implementing regulations at 45 CFR
Part 158 (75 FR 74865, December 1,
2010) as modified by technical
corrections on December 30, 2010 (75
FR 82277), a health insurance issuer
(issuer) offering group or individual
health insurance coverage must submit
a report to the Secretary concerning the
amount the issuer spends each year on
claims, quality improvement expenses,
non-claims costs, Federal and State
taxes and licensing or regulatory fees,
and the amount of earned premium. An
issuer must provide an annual rebate to
enrollees if the amount it spends on
certain costs compared to its premium
revenue (excluding Federal and States
taxes and licensing or regulatory fees)
does not meet a certain ratio, referred to
as the medical loss ratio (MLR). An
interim final rule (IFR) implementing
the MLR was published on December 1,
2010 (75 FR 74865) and modified by
technical corrections on December 30,
2010 (75 FR 82277), which added Part
158 to Title 45 of the Code of Federal
Regulations. The IFR is effective January
1, 2011. Issuers are required to submit
annual MLR reporting data for each
large group market, small group market,
and individual market within each State
in which the issuer conducts business.
For policies that have a total annual
limit of $250,000 or less (sometimes
referred to as ‘‘mini-med plans’’) and for
group policies that primarily cover
employees working outside the United
States (referred to as ‘‘expatriate plans’’),
the IFR applies a special circumstance
adjustment to the MLR data for the 2011
MLR reporting year. In order to evaluate
the appropriateness of this special
circumstance adjustment for years 2012
and beyond, issuers that provide such
policies are required to submit quarterly
MLR data to the Secretary for the 2011
MLR reporting year. We received several
comments in response to the emergency
30-day comment period that was
associated with CMS–10373. We have
taken into consideration all of the
revisions that were proposed and have
amended the quarterly reporting form to
include issuer contact information and
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]]>Agencies
[Federal Register Volume 76, Number 117 (Friday, June 17, 2011)]
[Notices]
[Pages 35444-35445]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-15057]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier CMS-1856 and CMS-1893]
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: 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-language
pathology services requesting participation in the Medicare and
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
[[Page 35445]]
speech-language pathology services. It is used by the State agencies to
enter new provider into the Automated Survey Process Environment
(ASPEN). 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 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 July 18, 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: June 14, 2011.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 2011-15057 Filed 6-16-11; 8:45 am]
BILLING CODE 4120-01-P
