Agency Information Collection Activities: Proposed Collection; Comment Request, 65656-65657 [2013-26083]
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65656
Federal Register / Vol. 78, No. 212 / Friday, November 1, 2013 / Notices
will be more widely disseminated to
coal mine operators so they can
implement similar discussion groups at
their mines.
There is no cost to respondents other
than their time. The total estimated
annualized burden hours are 798.
ESTIMATED ANNUALIZED BURDEN HOURS
Number of
responses
per
respondent
Number of
respondents
Average
burden per
response
(in hours)
Type of respondents
Form name
Mine Safety Operators ....................................
Script for Phone and/or Email Mine Recruitment Script.
Recruitment Script for Individual Miners ........
5
1
5/60
209
1
3/60
Week 1 PDM Pre-Survey ...............................
109
1
15/60
Week 2 Participant Worksheet ......................
Week 3–5 Participant Worksheets .................
Week 6 PDM Post-Survey .............................
Facilitator Weekly Meeting Manual ................
Interview Guide for Miners’ Utilization of
PDM Feedback.
Daily respirable coal mine dust exposure
data.
.........................................................................
109
327
109
109
29
1
3
1
6
1
15/60
15/60
15/60
30/60
1
5
45
5/60
4
45
5/60
Week 1 PDM Pre-Survey ...............................
Week 6 PDM Post-Survey .............................
Interview Guide for Miners’ Utilization of
PDM Feedback.
100
100
20
1
1
1
15/60
15/60
1
Individual Miners from Experimental and
Control Groups.
Experimental Groups (from five different
mines).
Mine Safety Operators for Experimental
Groups (from five different mines).
Mine Safety Operators for Control Groups
(from four different mines).
Control Groups (from four different mines) ....
LeRoy Richardson,
Chief, Information Collection Review Office,
Office of Scientific Integrity, Office of the
Associate Director for Science, Office of the
Director, Centers for Disease Control and
Prevention.
[FR Doc. 2013–26114 Filed 10–31–13; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–1561, CMS–
417, CMS–10433, and CMS–R–262]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, HHS.
ACTION: Notice.
AGENCY:
The Centers for Medicare &
Medicaid Services (CMS) is announcing
an opportunity for the public to
comment on CMS’ intention to collect
information from the public. Under the
Paperwork Reduction Act of 1995 (the
PRA), federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information (including each proposed
extension or reinstatement of an existing
collection of information) and to allow
60 days for public comment on the
emcdonald on DSK67QTVN1PROD with NOTICES
SUMMARY:
VerDate Mar<15>2010
17:40 Oct 31, 2013
Jkt 232001
proposed action. Interested persons are
invited to send comments regarding our
burden estimates 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.
DATES: Comments must be received by
December 31, 2013.
ADDRESSES: When commenting, please
reference the document identifier or
OMB control number (OCN). To be
assured consideration, comments and
recommendations must be submitted in
any one of the following ways:
1. Electronically. You may send 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) that are 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
PO 00000
Frm 00052
Fmt 4703
Sfmt 4703
Control Number l; Room C4–26–05
7500 Security Boulevard; Baltimore,
Maryland 21244–1850.
To obtain copies of a supporting
statement and any related forms for the
proposed collection(s) summarized in
this notice, you may make your request
using one of following:
1. Access CMS’ Web site address at
https://www.cms.hhs.gov/
PaperworkReductionActof1995.
2. Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
Reports Clearance Office at (410) 786–
1326
SUPPLEMENTARY INFORMATION:
Contents
This notice sets out a summary of the
use and burden associated with the
following information collections. More
detailed information can be found in
each collection’s supporting statement
and associated materials (see
ADDRESSES).
CMS–1561 Provider Agreement—CMS
Form 1561 and 1561A and
Supporting Regulations
CMS–417 Hospice Request for
Certification and Supporting
Regulations
CMS–10433 Initial Plan Data
Collection to Support Qualified
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Federal Register / Vol. 78, No. 212 / Friday, November 1, 2013 / Notices
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Health Plan (QHP) Certification and
Other Financial Management and
Exchange Operations
CMS–R–262 CY 2015 Plan Benefit
Package (PBP), Formulary, and
Supporting Regulations
Under the PRA (44 U.S.C. 3501–
3520), federal agencies must obtain
approval from the Office of Management
and Budget (OMB) for each collection of
information they conduct or sponsor.
The term ‘‘collection of information’’ is
defined in 44 U.S.C. 3502(3) and 5 CFR
1320.3(c) and includes agency requests
or requirements that members of the
public submit reports, keep records, or
provide information to a third party.
Section 3506(c)(2)(A) of the PRA
requires federal agencies to publish a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension or reinstatement of an existing
collection of information, before
submitting the collection to OMB for
approval. To comply with this
requirement, CMS is publishing this
notice.
Information Collections
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 in that is
allows us to ensure that applicants are
in compliance with the requirements.
Applicants will be required to sign the
completed form and provide operational
information to us to assure that they
continue to meet the requirements after
approval. Form Number: CMS–1561
(OCN: 0938–0832); Frequency: Yearly;
Affected Public: Private Sector—
Business or other for-profits and Notfor-profit institutions; Number of
Respondents: 3,000; Total Annual
Responses: 3,000; Total Annual Hours:
500. (For policy questions regarding this
collection contact Shonte Carter at 410–
786–3532).
2. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Hospice Request
for Certification and Supporting
Regulations; Use: The Hospice Request
for Certification Form is the
identification and screening form used
to initiate the certification process and
to determine if the provider has
sufficient personnel to participate in the
Medicare program. Form Number:
CMS–417 (OCN: 0938–0313);
Frequency: Annually; Affected Public:
VerDate Mar<15>2010
17:40 Oct 31, 2013
Jkt 232001
Private Sector—Business or other forprofits; Number of Respondents: 3,807;
Total Annual Responses: 3,807; Total
Annual Hours: 952. (For policy
questions regarding this collection
contact Patricia Sevast at 410–786–
8135).
3. Title of Information Collection:
Initial Plan Data Collection to Support
Qualified Health Plan (QHP)
Certification and Other Financial
Management and Exchange Operations;
Type of Information Collection Request:
Revision of a currently approved
collection; Use: As required by the
CMS–9989–F, Patient Protection and
Affordable Care Act; Establishment of
Exchanges and Qualified Health Plans;
Exchange Standards for Employers (77
FR 18310) (Exchange Establishment
Rule), published on March 27, 2012,
each Exchange must assume
responsibilities related to the
certification and offering of Qualified
Health Plans (QHPs). To offer insurance
through an Exchange, a health insurance
issuer must have its health plans
certified as QHPs by the Exchange. A
QHP must meet certain minimum
certification standards, such as those
pertaining to essential community
providers, essential health benefits, and
actuarial value. In order to meet those
standards, the Exchange is responsible
for collecting data and validating that
QHPs meet these minimum
requirements as described in the
Exchange rule under 45 CFR parts 155
and 156, based on the Affordable Care
Act, as well as other requirements
determined by the Exchange. In
addition to data collection for the
certification of QHPs, the reinsurance
and risk adjustment programs outlined
by the Affordable Care Act, detailed in
45 CFR part 153, as established by
CMS–9975–F, Patient Protection and
Affordable Care Act; Standards for
Reinsurance, Risk Corridors, and Risk
Adjustment (77 FR 17220), published in
March 23, 2012, have general
information reporting requirements that
apply to issuers, group health plans,
third party administrators, and plan
offerings outside of the Exchanges.
Subsequent regulations for these
programs including the final HHS
Notice of Benefit and Payment
Parameters for 2014 and the Program
Integrity: Exchange, Premium
Stabilization Programs, and Market
Standards; Amendments to the HHS
Notice of Benefit and Payment
Parameters for 2014 provide further
reporting requirements. The Office of
Management and Budget (OMB) issued
OMB Control Number 0938–1187 for
this Paperwork Reduction Act (PRA)
PO 00000
Frm 00053
Fmt 4703
Sfmt 9990
65657
package on March 13, 2013. Based on
experience with the first year of data
collection, we propose revisions to data
elements being collected and the burden
estimates for years two and three. Form
Number: CMS–10433 (OCN: 0938–
1187); Frequency: Annually; Affected
Public: States and Private Sector—
Business or other for-profits and Notfor-profit institutions; Number of
Respondents: 27,225; Number of
Responses: 27,225; Total Annual Hours:
216,028. (For questions regarding the
collection contact Danielle Chestang at
(410) 786–7815.)
4. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: CY 2015 Plan
Benefit Package (PBP), Formulary, and
Supporting Regulations; Use: We
require Medicare Advantage and
Prescription Drug Plan organizations
submit a completed plan benefit
package (PBP) and formulary as part of
the annual bidding process. During this
process, organizations prepare their
proposed plan benefit packages for the
upcoming contract year and submit
them to us for review and approval. We
publish beneficiary education
information using a variety of formats.
Specific education initiatives that
utilize PBP and formulary data include
web application tools on medicare.gov
and the plan benefit insert in the
Medicare & You handbook. In addition,
organizations utilize the PBP data to
generate their Summary of Benefits
marketing information. Form Number:
CMS–R–262 (OCN: 0938–0763);
Frequency: Yearly; Affected Public:
Private sector—Business or other forprofits and Not-for-profit institutions;
Number of Respondents: 652; Total
Annual Responses: 6,265; Total Annual
Hours: 57,477. (For policy questions
regarding this collection contact Kristy
Holtje at 410–786–2209).
Dated: October 29, 2013.
Martique Jones,
Deputy Director, Regulations Development
Group Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2013–26083 Filed 10–31–13; 8:45 am]
BILLING CODE 4120–01–P
E:\FR\FM\01NON1.SGM
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Agencies
[Federal Register Volume 78, Number 212 (Friday, November 1, 2013)]
[Notices]
[Pages 65656-65657]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-26083]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-1561, CMS-417, CMS-10433, and CMS-R-262]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is
announcing an opportunity for the public to comment on CMS' intention
to collect information from the public. Under the Paperwork Reduction
Act of 1995 (the PRA), federal agencies are required to publish notice
in the Federal Register concerning each proposed collection of
information (including each proposed extension or reinstatement of an
existing collection of information) and to allow 60 days for public
comment on the proposed action. Interested persons are invited to send
comments regarding our burden estimates 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.
DATES: Comments must be received by December 31, 2013.
ADDRESSES: When commenting, please reference the document identifier or
OMB control number (OCN). To be assured consideration, comments and
recommendations must be submitted in any one of the following ways:
1. Electronically. You may send 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) that are 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.
To obtain copies of a supporting statement and any related forms
for the proposed collection(s) summarized in this notice, you may make
your request using one of following:
1. Access CMS' Web site address at https://www.cms.hhs.gov/PaperworkReductionActof1995.
2. Email your request, including your address, phone number, OMB
number, and CMS document identifier, to Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at (410) 786-1326.
FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326
SUPPLEMENTARY INFORMATION:
Contents
This notice sets out a summary of the use and burden associated
with the following information collections. More detailed information
can be found in each collection's supporting statement and associated
materials (see ADDRESSES).
CMS-1561 Provider Agreement--CMS Form 1561 and 1561A and Supporting
Regulations
CMS-417 Hospice Request for Certification and Supporting Regulations
CMS-10433 Initial Plan Data Collection to Support Qualified
[[Page 65657]]
Health Plan (QHP) Certification and Other Financial Management and
Exchange Operations
CMS-R-262 CY 2015 Plan Benefit Package (PBP), Formulary, and Supporting
Regulations
Under the PRA (44 U.S.C. 3501-3520), federal agencies must obtain
approval from the Office of Management and Budget (OMB) for each
collection of information they conduct or sponsor. The term
``collection of information'' is defined in 44 U.S.C. 3502(3) and 5 CFR
1320.3(c) and includes agency requests or requirements that members of
the public submit reports, keep records, or provide information to a
third party. Section 3506(c)(2)(A) of the PRA requires federal agencies
to publish a 60-day notice in the Federal Register concerning each
proposed collection of information, including each proposed extension
or reinstatement of an existing collection of information, before
submitting the collection to OMB for approval. To comply with this
requirement, CMS is publishing this notice.
Information Collections
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 in that is allows us to ensure that
applicants are in compliance with the requirements. Applicants will be
required to sign the completed form and provide operational information
to us to assure that they continue to meet the requirements after
approval. Form Number: CMS-1561 (OCN: 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 Shonte Carter at 410-786-3532).
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Hospice Request
for Certification and Supporting Regulations; Use: The Hospice Request
for Certification Form is the identification and screening form used to
initiate the certification process and to determine if the provider has
sufficient personnel to participate in the Medicare program. Form
Number: CMS-417 (OCN: 0938-0313); Frequency: Annually; Affected Public:
Private Sector--Business or other for-profits; Number of Respondents:
3,807; Total Annual Responses: 3,807; Total Annual Hours: 952. (For
policy questions regarding this collection contact Patricia Sevast at
410-786-8135).
3. Title of Information Collection: Initial Plan Data Collection to
Support Qualified Health Plan (QHP) Certification and Other Financial
Management and Exchange Operations; Type of Information Collection
Request: Revision of a currently approved collection; Use: As required
by the CMS-9989-F, Patient Protection and Affordable Care Act;
Establishment of Exchanges and Qualified Health Plans; Exchange
Standards for Employers (77 FR 18310) (Exchange Establishment Rule),
published on March 27, 2012, each Exchange must assume responsibilities
related to the certification and offering of Qualified Health Plans
(QHPs). To offer insurance through an Exchange, a health insurance
issuer must have its health plans certified as QHPs by the Exchange. A
QHP must meet certain minimum certification standards, such as those
pertaining to essential community providers, essential health benefits,
and actuarial value. In order to meet those standards, the Exchange is
responsible for collecting data and validating that QHPs meet these
minimum requirements as described in the Exchange rule under 45 CFR
parts 155 and 156, based on the Affordable Care Act, as well as other
requirements determined by the Exchange. In addition to data collection
for the certification of QHPs, the reinsurance and risk adjustment
programs outlined by the Affordable Care Act, detailed in 45 CFR part
153, as established by CMS-9975-F, Patient Protection and Affordable
Care Act; Standards for Reinsurance, Risk Corridors, and Risk
Adjustment (77 FR 17220), published in March 23, 2012, have general
information reporting requirements that apply to issuers, group health
plans, third party administrators, and plan offerings outside of the
Exchanges. Subsequent regulations for these programs including the
final HHS Notice of Benefit and Payment Parameters for 2014 and the
Program Integrity: Exchange, Premium Stabilization Programs, and Market
Standards; Amendments to the HHS Notice of Benefit and Payment
Parameters for 2014 provide further reporting requirements. The Office
of Management and Budget (OMB) issued OMB Control Number 0938-1187 for
this Paperwork Reduction Act (PRA) package on March 13, 2013. Based on
experience with the first year of data collection, we propose revisions
to data elements being collected and the burden estimates for years two
and three. Form Number: CMS-10433 (OCN: 0938-1187); Frequency:
Annually; Affected Public: States and Private Sector--Business or other
for-profits and Not-for-profit institutions; Number of Respondents:
27,225; Number of Responses: 27,225; Total Annual Hours: 216,028. (For
questions regarding the collection contact Danielle Chestang at (410)
786-7815.)
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: CY 2015 Plan
Benefit Package (PBP), Formulary, and Supporting Regulations; Use: We
require Medicare Advantage and Prescription Drug Plan organizations
submit a completed plan benefit package (PBP) and formulary as part of
the annual bidding process. During this process, organizations prepare
their proposed plan benefit packages for the upcoming contract year and
submit them to us for review and approval. We publish beneficiary
education information using a variety of formats. Specific education
initiatives that utilize PBP and formulary data include web application
tools on medicare.gov and the plan benefit insert in the Medicare & You
handbook. In addition, organizations utilize the PBP data to generate
their Summary of Benefits marketing information. Form Number: CMS-R-262
(OCN: 0938-0763); Frequency: Yearly; Affected Public: Private sector--
Business or other for-profits and Not-for-profit institutions; Number
of Respondents: 652; Total Annual Responses: 6,265; Total Annual Hours:
57,477. (For policy questions regarding this collection contact Kristy
Holtje at 410-786-2209).
Dated: October 29, 2013.
Martique Jones,
Deputy Director, Regulations Development Group Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2013-26083 Filed 10-31-13; 8:45 am]
BILLING CODE 4120-01-P