Agency Information Collection Activities: Submission for OMB Review; Comment Request, 59773-59774 [2014-23614]
Download as PDF
Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Notices
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/Paperwork
ReductionActof1995.
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–10538 Prior Authorization Form
for Beneficiaries Enrolled in Hospice
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.
mstockstill on DSK4VPTVN1PROD with NOTICES
Information Collection
1. Type of Information Collection
Request: New collection (Request for a
new OMB control number); Title of
Information Collection: Prior
Authorization Form for Beneficiaries
Enrolled in Hospice; Use: The form
would be completed by the prescriber or
the beneficiary’s hospice, or if the
prescriber or hospice provides the
information verbally to the Part D
sponsor, the form would be completed
by the sponsor. Information provided on
the form would be used by the Part D
sponsor to establish coverage of the drug
VerDate Sep<11>2014
18:08 Oct 02, 2014
Jkt 235001
under Medicare Part D. Per statute,
drugs that are necessary for the
palliation and management of the
terminal illness and related conditions
are not eligible for payment under Part
D. The standard form provides a vehicle
for the hospice provider, prescriber or
sponsor to document that the drug
prescribed is ‘‘unrelated’’ to the
terminal illness and related conditions.
It also gives a hospice organization the
option to communicate a beneficiary’s
change in hospice status and care plan
to Part D sponsors. Form Number: CMS–
10538 (OMB control number 0938-New;
Frequency: Occasionally; Affected
Public: Private sector (business or other
for-profits); Number of Respondents:
424; Total Annual Responses: 376,487;
Total Annual Hours: 31,374. (For policy
questions regarding this collection
contact Shelly Winston at 410–786–
3694).
Dated: September 30, 2014.
Martique Jones,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2014–23613 Filed 10–2–14; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10237, CMS–
10357 and CMS–10499]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
ACTION:
Notice.
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
(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
a second opportunity for public
comment on the notice. Interested
persons are invited to send comments
regarding the 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
SUMMARY:
PO 00000
Frm 00035
Fmt 4703
Sfmt 4703
59773
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 on the collection(s) of
information must be received by the
OMB desk officer by November 3, 2014.
ADDRESSES: When commenting on the
proposed information collections,
please reference the document identifier
or OMB control number. To be assured
consideration, comments and
recommendations must be received by
the OMB desk officer via one of the
following transmissions: OMB, Office of
Information and Regulatory Affairs,
Attention: CMS Desk Officer, Fax
Number: (202) 395–5806 or Email:
OIRA_submission@omb.eop.gov.
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: Under the
Paperwork Reduction Act of 1995 (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 (44 U.S.C.
3506(c)(2)(A)) requires federal agencies
to publish a 30-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 that summarizes
the following proposed collection(s) of
information for public comment:
1. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Part C—
E:\FR\FM\03OCN1.SGM
03OCN1
mstockstill on DSK4VPTVN1PROD with NOTICES
59774
Federal Register / Vol. 79, No. 192 / Friday, October 3, 2014 / Notices
Medicare Advantage and 1876 Cost Plan
Expansion Application; Use: The
information will be collected under the
solicitation of Part C applications from
MA, EGWP Plan, and Cost Plan
applicants and will be used to ensure
that applicants meet our requirements
and support the determination of
contract awards. Participation in all
programs is voluntary in nature; only
organizations that are interested in
participating in the program will
respond to the solicitation. The MA–
PDs that voluntarily participate in the
Part C program must submit a Part D
application and successful bid. The
package has been revised subsequent to
the publication of the 30-day Federal
Register notice (July 11, 2014; 79 FR
40105). Form Number: CMS–10237
(OMB control number: 0938–0935);
Frequency: Yearly; Affected Public:
Private sector—Business or other forprofits and Not-for-profit institutions;
Number of Respondents: 566; Total
Annual Responses: 566; Total Annual
Hours: 22,625. (For policy questions
regarding this collection contact Melissa
Staud at 410–786–3669).
2. Type of Information Collection
Request: Reinstatement without change
of a previously approved collection:
Title of Information Collection: Letter
Requesting Waiver of Medicare/
Medicaid Enrollment Application Fee;
Submission of Fingerprints; Submission
of Medicaid Identifying Information;
Medicaid Site Visit and Rescreening;
Use: Section 6401 of the Affordable Care
Act (ACA) establishes a number of
important payment safeguard
provisions. The provisions are designed
to improve the integrity of the Medicare,
Medicaid, and Children’s Health
Insurance Programs (CHIP) so as to
reduce fraud, waste and abuse. The
provisions include the following:
• Medicare Enrollment Application
Fee Waiver Request: Certain providers
and suppliers enrolling in Medicare will
be required to submit a fee with their
application. Under 42 CFR 424.514, if
the applicant believes it has a hardship
that justifies a waiver of the application
fee, it may submit a letter describing
said hardship.
• Fingerprints: Certain providers and
suppliers enrolling in Medicare,
Medicaid, and CHIP will be required to
submit fingerprints—either digitally or
via the FD–258 standard fingerprint
card—of their owners.
• Suspension of Medicaid Payments:
A State Medicaid agency shall suspend
all Medicaid payments to a provider
when there is a pending investigation of
a credible allegation of Medicaid fraud
against an individual or entity, unless it
has good cause not to suspend payments
VerDate Sep<11>2014
18:08 Oct 02, 2014
Jkt 235001
or to suspend payment only in part. The
State Medicaid agency may suspend
payments without first notifying the
provider of its intention to suspend
such payments. A provider may request,
and must be granted, administrative
review where State law so requires.
• Collection of Social Security
Numbers (SSNs) and Dates of Birth
(DOBs) for Medicaid and CHIP
Providers: The State Medicaid agency or
CHIP agency must require that all
persons with an ownership or control
interest in a Medicaid or CHIP provider
submit their SSNs and DOBs.
• Site Visits for Medicaid-only or
CHIP-only providers: A State Medicaid
agency or CHIP agency must conduct
on-site visits for providers it determines
to be ‘‘moderate’’ or ‘‘high’’ categorical
risk.
• Rescreening of Medicaid and CHIP
Providers Every 5 Years: A State
Medicaid agency or CHIP agency must
screen all providers at least every 5
years. This is consistent with the
Medicare requirement in current 42 CFR
424.515 that providers and suppliers
revalidate their enrollment information
at least every 5 years.
Form Number: CMS–10357 (OMB
control number: 0938–1137); Frequency:
On occasion; Affected Public: Private
sector—Business or for-profit and Notfor-profit institutions and State, Local,
or Tribal Governments; Number of
Respondents: 960,981; Total Annual
Responses: 960,981; Total Annual
Hours: 1,248,082. (For policy questions
regarding this collection contact Frank
Whelan at 410–786–1302).
3. Type of Information Collection
Request: New collection (Request for a
new OMB control number); Title of
Information Collection: Public Health
Agency/Registry Readiness to Support
Meaningful Use; Use: The Medicare and
Medicaid Electronic Health Record
(EHR) Incentive Programs provide
incentives for the meaningful use of
Certified Electronic Health Record
Technology (CEHRT). We defined
meaningful use as a set of objectives and
measures in either Stage 1 or Stage 2
depending on how long an eligible
provider has participated in the
program. Both Stage 1 (3 objectives) and
Stage 2 (5 objectives) of meaningful use
contain objectives and measures that
require eligible providers to determine
the readiness of public health agencies
and registries to receive electronic data
from CEHRT. Public comments on the
notice of proposed rulemaking for Stage
2 of meaningful use (77 FR 13697)
asserted that the burden for each
individual eligible provider to
determine the readiness of multiple
public health agencies and registries
PO 00000
Frm 00036
Fmt 4703
Sfmt 4703
could be nearly eliminated if we were
to maintain a database on the readiness
of public health agencies and registries.
In the final rule for Stage 2 of
meaningful use (77 FR 53967), we
agreed that the burden on eligible
providers, public health agencies and
registries would be greatly reduced and
established that we would create such a
database and it would serve as the
definitive information source for
determining public health agency and
registry readiness to receive electronic
data associated with the public health
meaningful use objectives. The
information will be made publicly
available on the CMS Web site
(www.cms.gov/EHRincentiveprograms)
in order to provide a centralized
repository of this information to eligible
providers and eliminate there multiple
individual inquiries to multiple public
health agencies and registries. Form
Number: CMS–10499 (OMB control
number: 0938—New); Frequency:
Yearly; Affected Public: Private sector—
Business or other for-profits and Notfor-profit institutions; Number of
Respondents: 250; Total Annual
Responses: 250; Total Annual Hours:
83. (For policy questions regarding this
collection contact Kathleen Connors de
Laguna at 410–786–2256).
Dated: September 30, 2014.
Martique Jones,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2014–23614 Filed 10–2–14; 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: Reunification Procedures for
Unaccompanied Alien Children.
OMB No.: 0970–0278.
Description: Following the passage of
the 2002 Homeland Security Act (Pub.
L. 107–296), the Administration for
Children and Families (ACF), Office of
Refugee Resettlement (ORR), is charged
with the care and placement of
unaccompanied alien children in
Federal custody, and implementing a
policy for the release of these children,
when appropriate, upon the request of
suitable sponsors while awaiting
immigration proceedings. In order for
ORR to make determinations regarding
the release of these children, the
E:\FR\FM\03OCN1.SGM
03OCN1
Agencies
[Federal Register Volume 79, Number 192 (Friday, October 3, 2014)]
[Notices]
[Pages 59773-59774]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-23614]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10237, CMS-10357 and CMS-10499]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
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 (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 a second opportunity
for public comment on the notice. Interested persons are invited to
send comments regarding the 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.
DATES: Comments on the collection(s) of information must be received by
the OMB desk officer by November 3, 2014.
ADDRESSES: When commenting on the proposed information collections,
please reference the document identifier or OMB control number. To be
assured consideration, comments and recommendations must be received by
the OMB desk officer via one of the following transmissions: OMB,
Office of Information and Regulatory Affairs, Attention: CMS Desk
Officer, Fax Number: (202) 395-5806 or Email:
OIRA_submission@omb.eop.gov.
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: Under the Paperwork Reduction Act of 1995
(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 (44 U.S.C. 3506(c)(2)(A)) requires
federal agencies to publish a 30-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 that
summarizes the following proposed collection(s) of information for
public comment:
1. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Part C--
[[Page 59774]]
Medicare Advantage and 1876 Cost Plan Expansion Application; Use: The
information will be collected under the solicitation of Part C
applications from MA, EGWP Plan, and Cost Plan applicants and will be
used to ensure that applicants meet our requirements and support the
determination of contract awards. Participation in all programs is
voluntary in nature; only organizations that are interested in
participating in the program will respond to the solicitation. The MA-
PDs that voluntarily participate in the Part C program must submit a
Part D application and successful bid. The package has been revised
subsequent to the publication of the 30-day Federal Register notice
(July 11, 2014; 79 FR 40105). Form Number: CMS-10237 (OMB control
number: 0938-0935); Frequency: Yearly; Affected Public: Private
sector--Business or other for-profits and Not-for-profit institutions;
Number of Respondents: 566; Total Annual Responses: 566; Total Annual
Hours: 22,625. (For policy questions regarding this collection contact
Melissa Staud at 410-786-3669).
2. Type of Information Collection Request: Reinstatement without
change of a previously approved collection: Title of Information
Collection: Letter Requesting Waiver of Medicare/Medicaid Enrollment
Application Fee; Submission of Fingerprints; Submission of Medicaid
Identifying Information; Medicaid Site Visit and Rescreening; Use:
Section 6401 of the Affordable Care Act (ACA) establishes a number of
important payment safeguard provisions. The provisions are designed to
improve the integrity of the Medicare, Medicaid, and Children's Health
Insurance Programs (CHIP) so as to reduce fraud, waste and abuse. The
provisions include the following:
Medicare Enrollment Application Fee Waiver Request:
Certain providers and suppliers enrolling in Medicare will be required
to submit a fee with their application. Under 42 CFR 424.514, if the
applicant believes it has a hardship that justifies a waiver of the
application fee, it may submit a letter describing said hardship.
Fingerprints: Certain providers and suppliers enrolling in
Medicare, Medicaid, and CHIP will be required to submit fingerprints--
either digitally or via the FD-258 standard fingerprint card--of their
owners.
Suspension of Medicaid Payments: A State Medicaid agency
shall suspend all Medicaid payments to a provider when there is a
pending investigation of a credible allegation of Medicaid fraud
against an individual or entity, unless it has good cause not to
suspend payments or to suspend payment only in part. The State Medicaid
agency may suspend payments without first notifying the provider of its
intention to suspend such payments. A provider may request, and must be
granted, administrative review where State law so requires.
Collection of Social Security Numbers (SSNs) and Dates of
Birth (DOBs) for Medicaid and CHIP Providers: The State Medicaid agency
or CHIP agency must require that all persons with an ownership or
control interest in a Medicaid or CHIP provider submit their SSNs and
DOBs.
Site Visits for Medicaid-only or CHIP-only providers: A
State Medicaid agency or CHIP agency must conduct on-site visits for
providers it determines to be ``moderate'' or ``high'' categorical
risk.
Rescreening of Medicaid and CHIP Providers Every 5 Years:
A State Medicaid agency or CHIP agency must screen all providers at
least every 5 years. This is consistent with the Medicare requirement
in current 42 CFR 424.515 that providers and suppliers revalidate their
enrollment information at least every 5 years.
Form Number: CMS-10357 (OMB control number: 0938-1137); Frequency:
On occasion; Affected Public: Private sector--Business or for-profit
and Not-for-profit institutions and State, Local, or Tribal
Governments; Number of Respondents: 960,981; Total Annual Responses:
960,981; Total Annual Hours: 1,248,082. (For policy questions regarding
this collection contact Frank Whelan at 410-786-1302).
3. Type of Information Collection Request: New collection (Request
for a new OMB control number); Title of Information Collection: Public
Health Agency/Registry Readiness to Support Meaningful Use; Use: The
Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs
provide incentives for the meaningful use of Certified Electronic
Health Record Technology (CEHRT). We defined meaningful use as a set of
objectives and measures in either Stage 1 or Stage 2 depending on how
long an eligible provider has participated in the program. Both Stage 1
(3 objectives) and Stage 2 (5 objectives) of meaningful use contain
objectives and measures that require eligible providers to determine
the readiness of public health agencies and registries to receive
electronic data from CEHRT. Public comments on the notice of proposed
rulemaking for Stage 2 of meaningful use (77 FR 13697) asserted that
the burden for each individual eligible provider to determine the
readiness of multiple public health agencies and registries could be
nearly eliminated if we were to maintain a database on the readiness of
public health agencies and registries. In the final rule for Stage 2 of
meaningful use (77 FR 53967), we agreed that the burden on eligible
providers, public health agencies and registries would be greatly
reduced and established that we would create such a database and it
would serve as the definitive information source for determining public
health agency and registry readiness to receive electronic data
associated with the public health meaningful use objectives. The
information will be made publicly available on the CMS Web site
(www.cms.gov/EHRincentiveprograms) in order to provide a centralized
repository of this information to eligible providers and eliminate
there multiple individual inquiries to multiple public health agencies
and registries. Form Number: CMS-10499 (OMB control number: 0938--New);
Frequency: Yearly; Affected Public: Private sector--Business or other
for-profits and Not-for-profit institutions; Number of Respondents:
250; Total Annual Responses: 250; Total Annual Hours: 83. (For policy
questions regarding this collection contact Kathleen Connors de Laguna
at 410-786-2256).
Dated: September 30, 2014.
Martique Jones,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 2014-23614 Filed 10-2-14; 8:45 am]
BILLING CODE 4120-01-P