Agency Information Collection Activities: Proposed Collection; Comment Request, 18916-18917 [2014-07582]

Download as PDF 18916 Federal Register / Vol. 79, No. 65 / Friday, April 4, 2014 / Notices approved collection; Title of Information Collection: Disclosure for the In-Office Ancillary Services Exception; Use: Physicians who provide certain imaging services (magnetic resonance imaging, computed tomography, and positron emission tomography) under the in-office ancillary services exception to the physician self-referral prohibition are required to create the disclosure notice as well as the list of other imaging suppliers to be provided to the patient. The patient will then be able to use the disclosure notice and list of suppliers in making an informed decision about his or her course of care for the imaging service. The physician must maintain a record of the disclosure in the patient’s medical record. If we were investigating the referrals of a physician providing advanced imaging services under the inoffice ancillary services exception, we would review the written disclosure in order to determine if the physician satisfied the requirement. Form Number: CMS–10332 (OCN: 0938– 1133); Frequency: Occasionally; Affected Public: Private sector— Business or other for-profits; Number of Respondents: 71,000; Total Annual Responses: 71,106; Total Annual Hours: 125,383. (For policy questions regarding this collection contact Jacqueline Proctor at 410–786–8852). Dated: April 1, 2014. Martique Jones, Deputy Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2014–07575 Filed 4–3–14; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifiers: CMS–437 and CMS– 10332] 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 mstockstill on DSK4VPTVN1PROD with NOTICES SUMMARY: VerDate Mar<15>2010 17:37 Apr 03, 2014 Jkt 232001 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 June 3, 2014. 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 http:// 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 llll 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 http://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 PO 00000 Frm 00040 Fmt 4703 Sfmt 4703 following information collections. More detailed information can be found in each collection’s supporting statement and associated materials (see ADDRESSES). CMS–437 Psychiatric Unit Criteria Work Sheet and Supporting Regulations CMS–10332 Disclosure for the InOffice Ancillary Services Exception 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 Collection 1. Type of Information Collection Request: Reinstatement with Change of a currently approved collection; Title of Information Collection: Psychiatric Unit Criteria Work Sheet and Supporting Regulations; Use: Certain hospital units are excluded from the Medicare Prospective Payment System (PPS). The exclusion of units is not optional on the part of the provider but is required by section 1886(d)(1)(B) of the Social Security Act. That section excludes psychiatric hospitals, rehabilitation hospitals, hospitals whose inpatients are predominantly individuals under 18 years of age (children’s hospitals), and psychiatric and rehabilitation units which are a distinct part of a hospital. We propose to continue the current process of performing initial verifications and annual reverifications to determine that psychiatric units continue to comply with the regulatory criteria at 42 CFR 412.25 and 42 CFR 412.27 of the PPS regulations. These regulations state the criteria that distinct part units must meet for exclusion. If, as a result of the regular survey process a hospital is certified as a psychiatric hospital by the State survey agency (SA), then it automatically satisfies the regulatory criteria for exclusion. Thus, no additional E:\FR\FM\04APN1.SGM 04APN1 18917 Federal Register / Vol. 79, No. 65 / Friday, April 4, 2014 / Notices verification is required for psychiatric hospitals. Some verification is needed, however, to ensure that other types of hospitals and units meet the criteria for exclusion. Consequently, we instructed the Fiscal Intermediaries (FIs) and SAs to perform certain verification activities, beginning in October 1983 when PPS was implemented. We originally developed the CMS–437 as an SA Worksheet for verifying exclusions from PPS for psychiatric units. Since April 9, 1994, PPS-excluded psychiatric units already excluded from the PPS have met CMS’s annual requirement for PPS-exclusion by selfattesting that they remain in compliance with the PPS exclusion criteria. Under the current procedure, all psychiatric units applying for first-time exclusion are surveyed by the SAs. The SAs also perform surveys to investigate complaint allegations and conduct annual sample reverification surveys on 5 percent of all psychiatric units. The aforementioned exclusions continue to exist and thus we propose to continue to use the Criteria Worksheet, Forms CMS–437, for verifying first-time exclusions from the PPS, for complaint surveys, for its annual 5 percent validation sample, and for facility selfattestation. These forms are related to the survey and certification and Medicare approval of the PPS-excluded units. Form Number: CMS–437 (OCN: 0938–0358); Frequency: Annually; Affected Public: Private sector— Business or other for-profits; Number of Respondents: 1,614; Total Annual Responses: 1,614; Total Annual Hours: Dated: April 1, 2014. Martique Jones, Deputy Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs. 404. (For policy questions regarding this collection contact Donald Howard at 410–786–6764.) 2. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Disclosure for the In-Office Ancillary Services Exception; Use: Physicians who provide certain imaging services (magnetic resonance imaging, computed tomography, and positron emission tomography) under the in-office ancillary services exception to the physician self-referral prohibition are required to create the disclosure notice as well as the list of other imaging suppliers to be provided to the patient. The patient will then be able to use the disclosure notice and list of suppliers in making an informed decision about his or her course of care for the imaging service. The physician must maintain a record of the disclosure in the patient’s medical record. If we were investigating the referrals of a physician providing advanced imaging services under the inoffice ancillary services exception, we would review the written disclosure in order to determine if the physician satisfied the requirement. Form Number: CMS–10332 (OCN: 0938– 1133); Frequency: Occasionally; Affected Public: Private sector— Business or other for-profits; Number of Respondents: 71,000; Total Annual Responses: 71,106; Total Annual Hours: 125,383. (For policy questions regarding this collection contact Jacqueline Proctor at 410–786–8852). [FR Doc. 2014–07582 Filed 4–3–14; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Proposed Information Collection Activity; Comment Request Proposed Projects Title: Family Violence Prevention and Services: Grants to States; Native American Tribes and Alaskan Native Villages; and State Domestic Violence Coalitions OMB No.: 0970–0280 Description: The Family Violence Prevention and Services Act (FVPSA), 42 U.S.C. 10401 et seq., authorizes the Department of Health and Human Services to award grants to States, Tribes—and Tribal Organizations, and State Domestic Violence Coalitions for family violence prevention and intervention activities. The proposed information collection activities will be used to make grant award decisions and to monitor grant performance. Respondents: State Agencies Administering FVPSA Grants; Tribal Governments and Tribal Organizations; and State Domestic Violence Coalitions. ANNUAL BURDEN ESTIMATES Number of responses per respondent Number of respondents Instrument Average burden hours per response Total burden hours 53 150 56 53 150 56 1 1 1 1 1 1 10 5 10 10 10 10 530 750 560 530 1,500 560 Estimated Total Annual Burden Hours ..................................................... mstockstill on DSK4VPTVN1PROD with NOTICES State Grant Application .................................................................................... Tribal Grant Application ................................................................................... State Domestic Violence Coalition Application ................................................ State FVPSA Grant Performance Progress Report ........................................ Tribal FVPSA Grant Performance Progress Report ........................................ State Domestic Violence Coalition Performance Progress Report ................. ........................ ........................ ........................ 4,430 In compliance with the requirements of Section 506(c)(2)(A) of the Paperwork Reduction Act of 1995, the Administration for Children and Families is soliciting public comment on the specific aspects of the information collection described above. Copies of the proposed collection of information can be obtained and comments may be forwarded by writing to the Administration for Children and Families, Office of Planning, Research VerDate Mar<15>2010 17:37 Apr 03, 2014 Jkt 232001 and Evaluation, 370 L’Enfant Promenade SW., Washington, DC 20447, Attn: ACF Reports Clearance Officer. Email address: infocollection@ acf.hhs.gov. All requests should be identified by the title of the information collection. The Department specifically requests comments on: (a) Whether the proposed collection of information is necessary for the proper performance of the functions of the agency, including PO 00000 Frm 00041 Fmt 4703 Sfmt 4703 whether the information shall have practical utility; (b) the accuracy of the agency’s estimate of the burden of the proposed collection of information; (c) the quality, utility, and clarity of the information to be collected; and (d) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or other forms of information technology. Consideration will be given to E:\FR\FM\04APN1.SGM 04APN1

Agencies

[Federal Register Volume 79, Number 65 (Friday, April 4, 2014)]
[Notices]
[Pages 18916-18917]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-07582]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-437 and CMS-10332]


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 June 3, 2014.

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 
http://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 http://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-437 Psychiatric Unit Criteria Work Sheet and Supporting Regulations

CMS-10332 Disclosure for the In-Office Ancillary Services Exception

    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 Collection

    1. Type of Information Collection Request: Reinstatement with 
Change of a currently approved collection; Title of Information 
Collection: Psychiatric Unit Criteria Work Sheet and Supporting 
Regulations; Use: Certain hospital units are excluded from the Medicare 
Prospective Payment System (PPS). The exclusion of units is not 
optional on the part of the provider but is required by section 
1886(d)(1)(B) of the Social Security Act. That section excludes 
psychiatric hospitals, rehabilitation hospitals, hospitals whose 
inpatients are predominantly individuals under 18 years of age 
(children's hospitals), and psychiatric and rehabilitation units which 
are a distinct part of a hospital.
    We propose to continue the current process of performing initial 
verifications and annual reverifications to determine that psychiatric 
units continue to comply with the regulatory criteria at 42 CFR 412.25 
and 42 CFR 412.27 of the PPS regulations. These regulations state the 
criteria that distinct part units must meet for exclusion.
    If, as a result of the regular survey process a hospital is 
certified as a psychiatric hospital by the State survey agency (SA), 
then it automatically satisfies the regulatory criteria for exclusion. 
Thus, no additional

[[Page 18917]]

verification is required for psychiatric hospitals. Some verification 
is needed, however, to ensure that other types of hospitals and units 
meet the criteria for exclusion. Consequently, we instructed the Fiscal 
Intermediaries (FIs) and SAs to perform certain verification 
activities, beginning in October 1983 when PPS was implemented. We 
originally developed the CMS-437 as an SA Worksheet for verifying 
exclusions from PPS for psychiatric units.
    Since April 9, 1994, PPS-excluded psychiatric units already 
excluded from the PPS have met CMS's annual requirement for PPS-
exclusion by self-attesting that they remain in compliance with the PPS 
exclusion criteria. Under the current procedure, all psychiatric units 
applying for first-time exclusion are surveyed by the SAs. The SAs also 
perform surveys to investigate complaint allegations and conduct annual 
sample reverification surveys on 5 percent of all psychiatric units. 
The aforementioned exclusions continue to exist and thus we propose to 
continue to use the Criteria Worksheet, Forms CMS-437, for verifying 
first-time exclusions from the PPS, for complaint surveys, for its 
annual 5 percent validation sample, and for facility self-attestation. 
These forms are related to the survey and certification and Medicare 
approval of the PPS-excluded units. Form Number: CMS-437 (OCN: 0938-
0358); Frequency: Annually; Affected Public: Private sector--Business 
or other for-profits; Number of Respondents: 1,614; Total Annual 
Responses: 1,614; Total Annual Hours: 404. (For policy questions 
regarding this collection contact Donald Howard at 410-786-6764.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Disclosure for 
the In-Office Ancillary Services Exception; Use: Physicians who provide 
certain imaging services (magnetic resonance imaging, computed 
tomography, and positron emission tomography) under the in-office 
ancillary services exception to the physician self-referral prohibition 
are required to create the disclosure notice as well as the list of 
other imaging suppliers to be provided to the patient. The patient will 
then be able to use the disclosure notice and list of suppliers in 
making an informed decision about his or her course of care for the 
imaging service. The physician must maintain a record of the disclosure 
in the patient's medical record. If we were investigating the referrals 
of a physician providing advanced imaging services under the in-office 
ancillary services exception, we would review the written disclosure in 
order to determine if the physician satisfied the requirement. Form 
Number: CMS-10332 (OCN: 0938-1133); Frequency: Occasionally; Affected 
Public: Private sector--Business or other for-profits; Number of 
Respondents: 71,000; Total Annual Responses: 71,106; Total Annual 
Hours: 125,383. (For policy questions regarding this collection contact 
Jacqueline Proctor at 410-786-8852).

    Dated: April 1, 2014.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2014-07582 Filed 4-3-14; 8:45 am]
BILLING CODE 4120-01-P