Agency Information Collection Activities: Proposed Collection; Comment Request, 4564 [2012-1951]
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4564
Federal Register / Vol. 77, No. 19 / Monday, January 30, 2012 / Notices
Desk Officer. Fax Number: (202) 395–
6974.
Email:
OIRA_submission@omb.eop.gov.
Dated: January 24, 2012.
Martique Jones,
Director, Regulations Development Group,
Division-B, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2012–1945 Filed 1–27–12; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier CMS–855I and CMS–
855R]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
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: Revision of a currently
approved collection. Title of
Information Collection: Medicare
Enrollment Application for Physician
and Non-Physician Practitioners. Use:
Health care practitioners who wish to
enroll in the Medicare program must
complete the CMS 855I enrollment
application. It is submitted at the time
the applicant first requests a Medicare
billing number. The application is used
by the Medicare Administrative
Contractor (MAC), to collect data to
assure the applicant has the necessary
professional and/or business credentials
to provide the health care services for
which they intend to bill Medicare
emcdonald on DSK29S0YB1PROD with NOTICES
AGENCY:
VerDate Mar<15>2010
15:09 Jan 27, 2012
Jkt 226001
including information that allows the
MAC to correctly price, process and pay
the applicant’s claims. It also gathers
information that allows the MAC to
ensure that the practitioner is not
sanctioned from the Medicare program,
or debarred, suspended or excluded
from any other Federal agency or
program. Form Number: CMS–855I
(OCN 0938–0685). Frequency: Once and
Occasionally. Affected Public: Private
Sector (Business or other for-profit and
not-for-profit institutions). Number of
Respondents: 345,000. Total Annual
Responses: 345,000. Total Annual
Hours: 824,000. (For policy questions
regarding this collection contact
Kimberly McPhillips at (410) 786–5374.
For all other issues call (410) 786–1326.)
2. Type of Information Collection
Request: New collection. Title of
Information Collection: Medicare
Enrollment Application—Reassignment
of Medicare Benefits. Use: Health care
practitioners who wish to reassign their
benefits in the Medicare program must
complete the CMS 855R enrollment
application. It is submitted at the time
the physician or non-physician
practitioner first requests reassignment
of his/her Medicare benefits to a group
practice, as well as any subsequent
reassignments or terminations of
established reassignments as requested
by the physician or non-physician
practitioner. The application is used by
the Medicare Administrative Contractor
(MAC) to collect data to assure the
applicant has the necessary information
that allows the MAC to correctly
establish or terminate the reassignment.
Form Number: CMS–855R (OCN 0938New). Frequency: Occasionally.
Affected Public: Private Sector (Business
or other for-profit and not-for-profit
institutions). Number of Respondents:
100,000. Total Annual Responses:
100,000. Total Annual Hours: 50,000.
(For policy questions regarding this
collection contact Kimberly McPhillips
at (410) 786–5374. 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 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
PO 00000
Frm 00024
Fmt 4703
Sfmt 4703
be submitted in one of the following
ways by March 30, 2012:
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 llllRoom C4–26–
05, 7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: January 24, 2012.
Martique Jones,
Director, Regulations Development Group,
Division B, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2012–1951 Filed 1–27–12; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–9970–NC]
Request for Information Regarding the
Reinsurance Program Under the
Affordable Care Act
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Request for information.
AGENCY:
This notice is a request for
information (RFI) to gain market
information on entities that could
administer a transitional reinsurance
program. This RFI will inform one or
more future Requests for Proposals
(RFP). This RFI solicits information
about entities that could function as a
reinsurance entity for the transitional
reinsurance program. CMS or one or
more States may contract for services
required to fulfill the statutory and
regulatory requirements of the
reinsurance entity.
DATES: Submit written or electronic
comments by February 29, 2012.
ADDRESSES: In responding, please refer
to file code CMS–9970–NC. Because of
staff and resource limitations, we cannot
accept comments by facsimile (FAX)
transmission.
You may submit responses in one of
four ways (please choose only one of the
ways listed):
1. Electronically. You may submit
electronic comments on this regulation
SUMMARY:
E:\FR\FM\30JAN1.SGM
30JAN1
]]>Agencies
[Federal Register Volume 77, Number 19 (Monday, January 30, 2012)]
[Notices]
[Page 4564]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-1951]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier CMS-855I and CMS-855R]
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: Revision of a currently
approved collection. Title of Information Collection: Medicare
Enrollment Application for Physician and Non-Physician Practitioners.
Use: Health care practitioners who wish to enroll in the Medicare
program must complete the CMS 855I enrollment application. It is
submitted at the time the applicant first requests a Medicare billing
number. The application is used by the Medicare Administrative
Contractor (MAC), to collect data to assure the applicant has the
necessary professional and/or business credentials to provide the
health care services for which they intend to bill Medicare including
information that allows the MAC to correctly price, process and pay the
applicant's claims. It also gathers information that allows the MAC to
ensure that the practitioner is not sanctioned from the Medicare
program, or debarred, suspended or excluded from any other Federal
agency or program. Form Number: CMS-855I (OCN 0938-0685). Frequency:
Once and Occasionally. Affected Public: Private Sector (Business or
other for-profit and not-for-profit institutions). Number of
Respondents: 345,000. Total Annual Responses: 345,000. Total Annual
Hours: 824,000. (For policy questions regarding this collection contact
Kimberly McPhillips at (410) 786-5374. For all other issues call (410)
786-1326.)
2. Type of Information Collection Request: New collection. Title of
Information Collection: Medicare Enrollment Application--Reassignment
of Medicare Benefits. Use: Health care practitioners who wish to
reassign their benefits in the Medicare program must complete the CMS
855R enrollment application. It is submitted at the time the physician
or non-physician practitioner first requests reassignment of his/her
Medicare benefits to a group practice, as well as any subsequent
reassignments or terminations of established reassignments as requested
by the physician or non-physician practitioner. The application is used
by the Medicare Administrative Contractor (MAC) to collect data to
assure the applicant has the necessary information that allows the MAC
to correctly establish or terminate the reassignment. Form Number: CMS-
855R (OCN 0938-New). Frequency: Occasionally. Affected Public: Private
Sector (Business or other for-profit and not-for-profit institutions).
Number of Respondents: 100,000. Total Annual Responses: 100,000. Total
Annual Hours: 50,000. (For policy questions regarding this collection
contact Kimberly McPhillips at (410) 786-5374. 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 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 March 30, 2012:
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: January 24, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-1951 Filed 1-27-12; 8:45 am]
BILLING CODE 4120-01-P
