Agency Information Collection Activities: Proposed Collection; Comment Request, 6726-6727 [2015-02414]
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Federal Register / Vol. 80, No. 25 / Friday, February 6, 2015 / Notices
CDC and the evaluation contractor
will use the Internet usage data and the
survey information collected from study
participants to examine the statistical
relationships between confirmed
exposure (or non-exposure) to the
campaign’s digital and social media
known limitations of the methodology,
such as use of a convenience sample of
respondents.
OMB approval is requested for one
year. Participation is voluntary and
there are no costs to respondents other
than their time.
advertising and outcomes of interest for
campaign evaluation. The study will
provide CDC with new, timely, and
relevant information regarding the reach
and efficacy of the digital advertising
component of the campaign in 2015. All
findings will be interpreted in light of
ESTIMATED ANNUALIZED BURDEN HOURS
Number of
responses per
respondent
Number of
respondents
Average
burden per
response
(in hours)
Total burden
(in hours)
Type of respondent
Form name
Market Research Panelists ...............
Screening and Consent Questionnaire.
Digital Media and Tobacco Outcomes Questionnaire (Wave 1).
Digital Media and Tobacco Outcomes Questionnaire (Wave 2).
50,000
1
2/60
1,667
5,000
1
20/60
1,667
2,400
1
20/60
800
...........................................................
........................
........................
........................
4,134
Adult Panelists Who Are Tobacco
Smokers.
Total ...........................................
Leroy A. 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. 2015–02327 Filed 2–5–15; 8:45 am]
BILLING CODE 4163–18–P
Centers for Medicare & Medicaid
Services
[Document Identifiers CMS–10410, CMS–R–
74, CMS–2552–10 and CMS–855R]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services.
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
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
asabaliauskas on DSK5VPTVN1PROD with NOTICES
VerDate Sep<11>2014
18:52 Feb 05, 2015
Jkt 235001
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.
Comments must be received by
April 7, 2015.
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 llllll, 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,
Contents
DATES:
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
SUMMARY:
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.
PO 00000
Frm 00046
Fmt 4703
Sfmt 4703
SUPPLEMENTARY INFORMATION:
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–10410 Medicaid Program; Eligibility
Changes under the Affordable Care Act
of 2010
CMS–R–74 Income and Eligibility
Verification System Reporting and
Supporting Regulations
CMS–2552–10 Hospital and Hospital
Health Care Complex Cost Report
CMS–855R Medicare Enrollment
Application: Reassignment of Medicare
Benefits
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
E:\FR\FM\06FEN1.SGM
06FEN1
Federal Register / Vol. 80, No. 25 / Friday, February 6, 2015 / Notices
asabaliauskas on DSK5VPTVN1PROD with NOTICES
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: Extension of a currently
approved collection; Title of
Information Collection: Medicaid
Program; Eligibility Changes under the
Affordable Care Act of 2010; Use: The
eligibility systems are essential to the
goal of increasing coverage in insurance
affordability programs while reducing
administrative burden on states and
consumers. The electronic transmission
and automation of data transfers are key
elements in managing the expected
insurance affordability program
caseload that started in 2014.
Accomplishing the same work without
these information collection
requirements would not be feasible.
Form Number: CMS–10410 (OMB
control number 0938–1147); Frequency:
Occasionally; Affected Public:
Individuals or households, and State,
Local, and Tribal Governments; Number
of Respondents: 25,500,096; Total
Annual Responses: 76,500,149; Total
Annual Hours: 21,278,142. (For policy
questions regarding this collection
contact Brenda Sheppard at 410–786–
8534).
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Income and
Eligibility Verification System Reporting
and Supporting Regulations; Use: A
state Medicaid agency that currently
obtains and uses information from
certain sources, or with more frequency
than specified, could continue to do so
to the extent that the verifications are
useful and not redundant. An agency
that has found it effective to verify all
wage or benefit information with
another agency or with the recipient is
encouraged to continue these practices
if it chooses. On the other hand, the
agency may implement an approved
targeting plan under 42 CFR 435.953.
The agency’s experience should guide
its decision whether to exceed these
regulatory requirements on income and
eligibility verification. While states may
target resources when verifying income
of course, agencies are still held
accountable for their accuracy in
eligibility determinations. Form
Number: CMS–R–74 (OMB control
number 0938–0467); Frequency:
Occasionally; Affected Public: State,
Local, or Tribal Governments; Number
of Respondents: 50; Total Annual
Responses: 71; Total Annual Hours:
VerDate Sep<11>2014
18:52 Feb 05, 2015
Jkt 235001
134,865. (For policy questions regarding
this collection contact Brenda Sheppard
at 410–786–8534).
3. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Hospital and
Hospital Health Care Complex Cost
Report; Use: Providers of services
participating in the Medicare program
are required under sections 1815(a) and
1861(v)(1)(A) of the Social Security Act
(42 U.S.C. 1395g) to submit annual
information to achieve settlement of
costs for health care services rendered to
Medicare beneficiaries. In addition,
regulations at 42 CFR 413.20 and 413.24
require adequate cost data and cost
reports from providers on an annual
basis.
We are requesting the Office of
Management and Budget review and
approve this revision to the Form CMS–
2552–10, Hospital and Hospital Health
Care Complex Cost Report. These cost
reports are filed annually by hospitals
participating in the Medicare program to
determine the reasonable costs incurred
to provide medical services to patients.
The revisions made to the hospital cost
report are in accordance with the
statutory requirement for hospice
payment reform in § 3132 of the Patient
Protection and Affordable Care Act
(ACA) (March 23, 2010) and the
statutory requirement establishing a
prospective payment system for
Federally Qualified Health Centers in
§ 10501(i)(3)(A) of the ACA, codified in
section 1834(o) of the Act. Form
Number: CMS–2552–10 (OMB control
number 0938–0050); Frequency: Yearly;
Affected Public: State, Local, or Tribal
Governments, private sector (for-profit
and not-for-profit institutions); Number
of Respondents: 6,157; Total Annual
Responses: 6,157; Total Annual Hours:
4,143,661. (For policy questions
regarding this collection contact Gail
Duncan at 410–786–7278).
4. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare
Enrollment Application: Reassignment
of Medicare Benefits; Use: The primary
function of the CMS 855R enrollment
application is to allow physicians and
non-physician practitioners to reassign
their Medicare benefits to a group
practice and to gather information from
the individual that tells us who he/she
is, where he or she renders services, and
information necessary to establish
correct claims payment. The goal of
periodically evaluating and revising the
CMS 855R enrollment application is to
simplify and clarify the information
PO 00000
Frm 00047
Fmt 4703
Sfmt 4703
6727
collection without jeopardizing our
need to collect specific information.
At this time, CMS is making very few
minor revisions to the CMS 855R
(Reassignment of Benefits) Medicare
enrollment application (OMB No. 0938–
1179). Two sections within the form are
being reversed to maintain sync with
online and paper forms. The previously
approved CMS 855R section 2 collected
information regarding the individual
practitioner who is reassigning benefits
and section 3 collected information
regarding the organization/group
receiving the reassigned benefits. These
two sections have been reversed so that
section 2 now collects information on
the regarding the organization/group
receiving the reassigned benefits and
section 3 now collects information on
the individual practitioner who is
reassigning benefits. No information or
data collection within these sections
was revised. The sections were merely
re-sequenced and re-numbered to
maintain sync between online and
paper forms. With the exception of this
section reversal and adding the word
‘‘optional’’ to sections 4 and 5 (primary
practice location and contact person
information), there are no other
revisions. These revisions offer no new
data collection in this revision package.
The addition of the optional choice in
sections 4 and 5 could potentially
reduce the burden to providers who
choose not to complete either or both
optional sections. Form Number: CMS–
855R (OMB control number 0938–1179);
Frequency: Occasionally; Affected
Public: State, Local, or Tribal
Governments, private sector (for-profit
and not-for-profit institutions); Number
of Respondents: 379,619; Total Annual
Responses: 379,619; Total Annual
Hours: 94,905. (For policy questions
regarding this collection contact Kim
McPhillips at 410–786–5374).
Dated: February 3, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2015–02414 Filed 2–5–15; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Community Living
Administration on Intellectual and
Developmental Disabilities (AIDD);
Notice of Meeting
President’s Committee for
People with Intellectual Disabilities
(PCPID).
AGENCY:
E:\FR\FM\06FEN1.SGM
06FEN1
]]>Agencies
[Federal Register Volume 80, Number 25 (Friday, February 6, 2015)]
[Notices]
[Pages 6726-6727]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2015-02414]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers CMS-10410, CMS-R-74, CMS-2552-10 and CMS-855R]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services.
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 April 7, 2015.
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-10410 Medicaid Program; Eligibility Changes under the Affordable
Care Act of 2010
CMS-R-74 Income and Eligibility Verification System Reporting and
Supporting Regulations
CMS-2552-10 Hospital and Hospital Health Care Complex Cost Report
CMS-855R Medicare Enrollment Application: Reassignment of Medicare
Benefits
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
[[Page 6727]]
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: Extension of a currently
approved collection; Title of Information Collection: Medicaid Program;
Eligibility Changes under the Affordable Care Act of 2010; Use: The
eligibility systems are essential to the goal of increasing coverage in
insurance affordability programs while reducing administrative burden
on states and consumers. The electronic transmission and automation of
data transfers are key elements in managing the expected insurance
affordability program caseload that started in 2014. Accomplishing the
same work without these information collection requirements would not
be feasible. Form Number: CMS-10410 (OMB control number 0938-1147);
Frequency: Occasionally; Affected Public: Individuals or households,
and State, Local, and Tribal Governments; Number of Respondents:
25,500,096; Total Annual Responses: 76,500,149; Total Annual Hours:
21,278,142. (For policy questions regarding this collection contact
Brenda Sheppard at 410-786-8534).
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Income and
Eligibility Verification System Reporting and Supporting Regulations;
Use: A state Medicaid agency that currently obtains and uses
information from certain sources, or with more frequency than
specified, could continue to do so to the extent that the verifications
are useful and not redundant. An agency that has found it effective to
verify all wage or benefit information with another agency or with the
recipient is encouraged to continue these practices if it chooses. On
the other hand, the agency may implement an approved targeting plan
under 42 CFR 435.953. The agency's experience should guide its decision
whether to exceed these regulatory requirements on income and
eligibility verification. While states may target resources when
verifying income of course, agencies are still held accountable for
their accuracy in eligibility determinations. Form Number: CMS-R-74
(OMB control number 0938-0467); Frequency: Occasionally; Affected
Public: State, Local, or Tribal Governments; Number of Respondents: 50;
Total Annual Responses: 71; Total Annual Hours: 134,865. (For policy
questions regarding this collection contact Brenda Sheppard at 410-786-
8534).
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Hospital and
Hospital Health Care Complex Cost Report; Use: Providers of services
participating in the Medicare program are required under sections
1815(a) and 1861(v)(1)(A) of the Social Security Act (42 U.S.C. 1395g)
to submit annual information to achieve settlement of costs for health
care services rendered to Medicare beneficiaries. In addition,
regulations at 42 CFR 413.20 and 413.24 require adequate cost data and
cost reports from providers on an annual basis.
We are requesting the Office of Management and Budget review and
approve this revision to the Form CMS-2552-10, Hospital and Hospital
Health Care Complex Cost Report. These cost reports are filed annually
by hospitals participating in the Medicare program to determine the
reasonable costs incurred to provide medical services to patients. The
revisions made to the hospital cost report are in accordance with the
statutory requirement for hospice payment reform in Sec. 3132 of the
Patient Protection and Affordable Care Act (ACA) (March 23, 2010) and
the statutory requirement establishing a prospective payment system for
Federally Qualified Health Centers in Sec. 10501(i)(3)(A) of the ACA,
codified in section 1834(o) of the Act. Form Number: CMS-2552-10 (OMB
control number 0938-0050); Frequency: Yearly; Affected Public: State,
Local, or Tribal Governments, private sector (for-profit and not-for-
profit institutions); Number of Respondents: 6,157; Total Annual
Responses: 6,157; Total Annual Hours: 4,143,661. (For policy questions
regarding this collection contact Gail Duncan at 410-786-7278).
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare
Enrollment Application: Reassignment of Medicare Benefits; Use: The
primary function of the CMS 855R enrollment application is to allow
physicians and non-physician practitioners to reassign their Medicare
benefits to a group practice and to gather information from the
individual that tells us who he/she is, where he or she renders
services, and information necessary to establish correct claims
payment. The goal of periodically evaluating and revising the CMS 855R
enrollment application is to simplify and clarify the information
collection without jeopardizing our need to collect specific
information.
At this time, CMS is making very few minor revisions to the CMS
855R (Reassignment of Benefits) Medicare enrollment application (OMB
No. 0938-1179). Two sections within the form are being reversed to
maintain sync with online and paper forms. The previously approved CMS
855R section 2 collected information regarding the individual
practitioner who is reassigning benefits and section 3 collected
information regarding the organization/group receiving the reassigned
benefits. These two sections have been reversed so that section 2 now
collects information on the regarding the organization/group receiving
the reassigned benefits and section 3 now collects information on the
individual practitioner who is reassigning benefits. No information or
data collection within these sections was revised. The sections were
merely re-sequenced and re-numbered to maintain sync between online and
paper forms. With the exception of this section reversal and adding the
word ``optional'' to sections 4 and 5 (primary practice location and
contact person information), there are no other revisions. These
revisions offer no new data collection in this revision package. The
addition of the optional choice in sections 4 and 5 could potentially
reduce the burden to providers who choose not to complete either or
both optional sections. Form Number: CMS-855R (OMB control number 0938-
1179); Frequency: Occasionally; Affected Public: State, Local, or
Tribal Governments, private sector (for-profit and not-for-profit
institutions); Number of Respondents: 379,619; Total Annual Responses:
379,619; Total Annual Hours: 94,905. (For policy questions regarding
this collection contact Kim McPhillips at 410-786-5374).
Dated: February 3, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2015-02414 Filed 2-5-15; 8:45 am]
BILLING CODE 4120-01-P
