Agency Information Collection Activities: Submission for OMB Review; Comment Request, 20402-20403 [2012-8010]
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20402
Federal Register / Vol. 77, No. 65 / Wednesday, April 4, 2012 / Notices
important to explain variability in
success rates across ART programs and
across individuals. Data elements and
definitions currently in use reflect
CDC’s consultations with
representatives of the Society for
Assisted Reproductive Technology
(SART), the American Society for
Reproductive Medicine, and RESOLVE:
the National Infertility Association (a
national, nonprofit consumer
organization), as well as a variety of
individuals with expertise and interest
in this field.
Respondents are the 484 ART
programs in the United States.
Approximately 440 clinics are expected
to report an average of 339 ART cycles
ongoing dialogue to identify
opportunities for improvement in
NASS. During the period of this
Revision request, minor changes to
NASS data definitions or similar
technical adjustments may be proposed
through the Change Request
mechanism.
Starting with 2012 data reporting
year, CDC plans to implement a brief,
one-time optional feedback survey to
clinics for each reporting year. The
purpose of this survey is to obtain
insight into NASS usability issues as
well as respondents’ perspectives on the
usefulness of the information collected.
There are no costs to respondents
other than their time.
each. Ten percent of responding clinics
will be randomly selected to participate
in full validation of selected ART cycle
records and an abbreviated validation of
selected ART cycle records. All
information is collected electronically.
Respondents have the option of entering
data directly into a Web-based National
ART Surveillance System (NASS)
interface or of transmitting systemcompatible files extracted from other
record systems. The ART program
reporting system allows CDC to publish
an annual report to Congress as
specified by the FCSRCA and to provide
information needed by consumers.
CDC, the data collection contractor,
and partner organizations engage in
ESTIMATED ANNUALIZED BURDEN HOURS
Respondents
Form name
Number of
respondents
Number of
responses per
respondent
Average
burden per
response
(in hours)
ART Programs ..................................
NASS ................................................
Feedback Survey .............................
...........................................................
440
176
........................
339
1
........................
39/60
2/60
........................
Total ...........................................
Dated: March 29, 2012.
Ron A. Otten,
Director, Office of Scientific Integrity, Office
of the Associate Director for Science (OADS),
Office of the Director, Centers for Disease
Control and Prevention.
[FR Doc. 2012–8067 Filed 4–3–12; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–855(O)]
Agency Information Collection
Activities: Submission for OMB
Review; 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), 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;
emcdonald on DSK29S0YB1PROD with NOTICES
AGENCY:
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(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
Registration Application; Use: The CMS
855O allows a physician to receive a
Medicare identification number
(without being approved for billing
privileges) for the sole purpose of
ordering and referring Medicare
beneficiaries to Medicare approved
providers and suppliers. This new
Medicare registration application form
allows physicians who do not provide
services to Medicare beneficiaries to be
given a Medicare identification number
without having to supply all the data
required for the submission of Medicare
claims. It also allows the Medicare
program to identify ordering and
referring physicians without having to
validate the amount of data necessary to
determine claims payment eligibility
(such as banking information), while
continuing to identify the physician’s
credentials as valid for ordering and
referring purposes. Since the physicians
and non-physician practitioners
submitting this application are not
enrolling in Medicare to submit claims
PO 00000
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Total burden
(in hours)
96,954
6
96,960
but are only registering with Medicare
as eligible to order and refer, CMS
believes changing the title from
Medicare Enrollment Application to
Medicare Registration Application
better captures the actual purpose of
this form.
Where appropriate, CMS has changed
all references to enrollment or enrolling
to registration and registering and
Medicare billing number to National
Provider Identifier. CMS also added a
check box to allow physicians and nonphysician practitioners to withdraw
from the ordering and referring registry.
A section to collect information on
professional certifications was added for
those practitioners who are not
professionally licensed. Editorial and
formatting corrections were made in
response to prior comments received
during the approval of the current
version of this application. Other minor
editorial and formatting corrections
were made to better clarify the purpose
of this application. Form Number:
CMS–855(O) (OCN: 0938–1135);
Frequency: Occasionally; Affected
Public: Individuals; Number of
Respondents: 48,500; Total Annual
Responses: 48,500; Total Annual Hours:
24,125. (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: Extension of a currently
approved collection; Title of
E:\FR\FM\04APN1.SGM
04APN1
Federal Register / Vol. 77, No. 65 / Wednesday, April 4, 2012 / Notices
Information Collection: Medicare
Enrollment Application; Use: The
primary function of the CMS–855
Medicare enrollment application is to
gather information from a provider or
supplier that tells us who it is, whether
it meets certain qualifications to be a
health care provider or supplier, where
it practices or renders its services, the
identity of the owners of the enrolling
entity, and other information necessary
to establish correct claims payments.
Form Number: CMS–855(A, B, I, R)
(OCN: 0938–0685); Frequency: Yearly;
Affected Public: Private Sector; Business
or other for-profit and not-for-profit
institutions; Number of Respondents:
440,450; Total Annual Responses:
440,450; Total Annual Hours: 856,395.
(For policy questions regarding this
contact Kim 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 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 4, 2012.
OMB, Office of Information and
Regulatory Affairs, Attention: CMS
Desk Officer, Fax Number: (202)
395–6974, Email:
OIRA_submission@omb.eop.gov.
Dated: March 28, 2012.
Martique Jones,
Director, Regulations Development Group,
Division B, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2012–8010 Filed 4–3–12; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
emcdonald on DSK29S0YB1PROD with NOTICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–855(S) and
CMS–855(A,B,I,R); and CMS–10427]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, HHS.
AGENCY:
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15:28 Apr 03, 2012
Jkt 226001
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—
Durable Medical Equipment,
Prosthetics, Orthotics and Supplies
(DMEPOS) Suppliers Use: The primary
function of the CMS 855S Durable
Medical Equipment, Prosthetics,
Orthotics and Supplies (DMEPOS)
supplier enrollment application is to
gather information from a supplier that
tells us who it is, whether it meets
certain qualifications to be a health care
supplier, where it renders its services or
supplies, the identity of the owners of
the enrolling entity, and information
necessary to establish the correct claims
payment. The goal of evaluating and
revising the CMS 855S DMEPOS
supplier enrollment application is to
simplify and clarify the information
collection without jeopardizing our
need to collect specific information. The
majority of the revisions contained in
this submission are non-substantive in
nature such as spelling and formatting
corrections; however, we also removed
duplicate fields and obsolete questions
and provided clarification and
simplified the instructions for the
completing the application. Form
Number: CMS–855(S) (OCN: 0938–
1056); Frequency: Yearly; Affected
Public: Private Sector; Business or other
for-profit and not-for-profit institutions;
Number of Respondents: 43,350; Total
Annual Responses: 43,350; Total
Annual Hours: 113,550 (For policy
questions regarding this contact Kim
McPhillips at 410–786–5374. For all
other issues call 410–786–1326.)
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
PO 00000
Frm 00051
Fmt 4703
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20403
Information Collection: Medicare
Enrollment Application Use: The
primary function of the CMS–855
Medicare enrollment application is to
gather information from a provider or
supplier that tells us who it is, whether
it meets certain qualifications to be a
health care provider or supplier, where
it practices or renders its services, the
identity of the owners of the enrolling
entity, and other information necessary
to establish correct claims payments.
Form Number: CMS–855(A, B, I, R)
(OCN: 0938–0685); Frequency: Yearly;
Affected Public: Private Sector; Business
or other for-profit and not-for-profit
institutions; Number of Respondents:
440,450; Total Annual Responses:
440,450; Total Annual Hours: 856,395
(For policy questions regarding this
contact Kim McPhillips at 410–786–
5374. For all other issues call 410–786–
1326.)
3. Type of Information Collection
Request: New collection; Title of
Information Collection: For-Profit PACE
Study; Use: The Program of All
Inclusive Care of the Elderly (PACE)
aims to provide integrated care and
services to the frail elderly at risk of
institutionalization to enable them to
remain in the community. Under the
Balanced Budget Act of 1997 (BBA), the
not-for-profit PACE plans were
established as permanent providers
under the Medicare and Medicaid
programs. The BBA also mandated a
demonstration of for-profit PACE plans.
This study will estimate the differences
in quality and access to care between
the for-profit and not-for-profit PACE
plans. The data collected in the survey
will be used to measure the outcomes of
interest-differences in access to and
quality of care delivered to PACE
enrollees. To measure these key
outcomes, the survey will collect data
on access to and satisfaction with
healthcare, personal care, and
transportation assistance provided by
the plans. Form Number: CMS–10427
(OCN: 0938–New); Frequency: Yearly;
Affected Public: Individuals. Number of
Respondents: 813. Number of
Responses: 813. Total Annual Hours:
447. (For policy questions regarding this
collection contact Julia Zucco at 410–
786–6670. 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
E:\FR\FM\04APN1.SGM
04APN1
Agencies
[Federal Register Volume 77, Number 65 (Wednesday, April 4, 2012)]
[Notices]
[Pages 20402-20403]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-8010]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-855(O)]
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: Revision of a currently
approved collection; Title of Information Collection: Medicare
Registration Application; Use: The CMS 855O allows a physician to
receive a Medicare identification number (without being approved for
billing privileges) for the sole purpose of ordering and referring
Medicare beneficiaries to Medicare approved providers and suppliers.
This new Medicare registration application form allows physicians who
do not provide services to Medicare beneficiaries to be given a
Medicare identification number without having to supply all the data
required for the submission of Medicare claims. It also allows the
Medicare program to identify ordering and referring physicians without
having to validate the amount of data necessary to determine claims
payment eligibility (such as banking information), while continuing to
identify the physician's credentials as valid for ordering and
referring purposes. Since the physicians and non-physician
practitioners submitting this application are not enrolling in Medicare
to submit claims but are only registering with Medicare as eligible to
order and refer, CMS believes changing the title from Medicare
Enrollment Application to Medicare Registration Application better
captures the actual purpose of this form.
Where appropriate, CMS has changed all references to enrollment or
enrolling to registration and registering and Medicare billing number
to National Provider Identifier. CMS also added a check box to allow
physicians and non-physician practitioners to withdraw from the
ordering and referring registry. A section to collect information on
professional certifications was added for those practitioners who are
not professionally licensed. Editorial and formatting corrections were
made in response to prior comments received during the approval of the
current version of this application. Other minor editorial and
formatting corrections were made to better clarify the purpose of this
application. Form Number: CMS-855(O) (OCN: 0938-1135); Frequency:
Occasionally; Affected Public: Individuals; Number of Respondents:
48,500; Total Annual Responses: 48,500; Total Annual Hours: 24,125.
(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: Extension of a currently
approved collection; Title of
[[Page 20403]]
Information Collection: Medicare Enrollment Application; Use: The
primary function of the CMS-855 Medicare enrollment application is to
gather information from a provider or supplier that tells us who it is,
whether it meets certain qualifications to be a health care provider or
supplier, where it practices or renders its services, the identity of
the owners of the enrolling entity, and other information necessary to
establish correct claims payments. Form Number: CMS-855(A, B, I, R)
(OCN: 0938-0685); Frequency: Yearly; Affected Public: Private Sector;
Business or other for-profit and not-for-profit institutions; Number of
Respondents: 440,450; Total Annual Responses: 440,450; Total Annual
Hours: 856,395. (For policy questions regarding this contact Kim
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 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 4, 2012.
OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk
Officer, Fax Number: (202) 395-6974, Email: OIRA_submission@omb.eop.gov.
Dated: March 28, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-8010 Filed 4-3-12; 8:45 am]
BILLING CODE 4120-01-P