Agency Information Collection Activities: Submission for OMB Review; Comment Request, 91177-91178 [2016-30349]
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Federal Register / Vol. 81, No. 242 / Friday, December 16, 2016 / Notices
contact Roland Herrera at 410–786–
0668.)
7. Type of Information Collection
Request: Revision of a previously
approved collection; Title of
Information Collection: Healthcare
Fraud Prevention Partnership (HFPP):
Data Sharing and Information Exchange;
Use: The advance directives
requirement was enacted because
Congress wanted individuals to know
that they have a right to make health
care decisions and to refuse treatment
even when they are unable to
communicate. Steps have been taken at
both the Federal and State level, to
afford greater opportunity for the
individual to participate in decisions
made concerning the medical treatment
to be received by an adult patient in the
event that the patient is unable to
communicate to others, a preference
about medical treatment. The individual
may make his preference known
through the use of an advance directive,
which is a written instruction prepared
in advance, such as a living will or
durable power of attorney. This
information is documented in a
prominent part of the individual’s
medical record. Advance directives as
described in the Patient SelfDetermination Act have increased the
individual’s control over decisions
concerning medical treatment. Sections
4206 of the Omnibus Budget
Reconciliation Act of 1990 defined an
advance directive as a written
instruction recognized under State law
relating to the provision of health care
when an individual is incapacitated
(those persons unable to communicate
their wishes regarding medical
treatment).
All states have enacted legislation
defining a patient’s right to make
decisions regarding medical care,
including the right to accept or refuse
medical or surgical treatment and the
right to formulate advance directives.
Participating hospitals, skilled nursing
facilities, nursing facilities, home health
agencies, providers of home health care,
hospices, religious nonmedical health
care institutions, and prepaid or eligible
organizations (including Health Care
Prepayment Plans (HCPPs) and
Medicare Advantage Organizations
(MAOs) such as Coordinated Care Plans,
Demonstration Projects, Chronic Care
Demonstration Projects, Program of All
Inclusive Care for the Elderly, Private
Fee for Service, and Medical Savings
Accounts must provide written
information, at explicit time frames, to
all adult individuals about: (a) The right
to accept or refuse medical or surgical
treatments; (b) the right to formulate an
advance directive; (c) a description of
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applicable State law (provided by the
State); and (d) the provider’s or
organization’s policies and procedures
for implementing an advance directive.
Form Number: CMS–10507 (OMB
control number: 0938–1251); Frequency:
Occasionally; Affected Public: Private
sector (Business or other for-profits);
Number of Respondents: 20; Total
Annual Responses: 20; Total Annual
Hours: 160. (For policy questions
regarding this collection contact Marnie
Dorsey at 410–786–5942.)
8. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Medicaid
Disproportionate Share Hospital (DSH)
Annual Reporting Requirements; Use:
States are required to submit an annual
report that identifies each
disproportionate share hospital (DSH)
that received a DSH payment under the
state’s Medicaid program in the
preceding fiscal year and the amount of
DSH payments paid to that hospital in
the same year along with other
information that the Secretary
determines necessary to ensure the
appropriateness of DSH payments; Form
Number: CMS–R–266 (OMB control
number: 0938–0746); Frequency: Yearly;
Affected Public: State, Local, or Tribal
Governments; Number of Respondents:
51; Total Annual Responses: 51; Total
Annual Hours: 2,142. (For policy
questions regarding this collection
contact Robert Lane at 410–786–2015.)
9. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Conditions of
Participation for Comprehensive
Outpatient Rehabilitation Facilities
(CORFs) and Supporting Regulations;
Use: The Conditions of Participation
(CoPs) and accompanying requirements
specified in the regulations are used by
our surveyors as a basis for determining
whether a comprehensive outpatient
rehabilitation facility (CORF) qualifies
to be awarded a Medicare provider
agreement. We believe the health care
industry practice demonstrates that the
patient clinical records and general
content of records are necessary to
ensure the well-being and safety of
patients and that professional treatment
and accountability are a normal part of
industry practice. Form Number: CMS–
10282 (OMB control number: 0938–
1091); Frequency: Yearly; Affected
Public: Private sector—Business or other
for-profit and Not-for-profit institutions;
Number of Respondents: 549; Total
Annual Responses: 549; Total Annual
Hours: 6,945. (For policy questions
regarding this collection contact
Jacqueline Leach at 410–786–4282.)
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91177
Dated: December 13, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2016–30340 Filed 12–15–16; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–2744]
Agency Information Collection
Activities: Submission for OMB
Review; 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
(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: the necessity and
utility of the proposed information
collection for the proper performance of
the agency’s functions; the accuracy of
the estimated burden; ways to enhance
the quality, utility, and clarity of the
information to be collected; and the use
of automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
SUMMARY:
Comments on the collection(s) of
information must be received by the
OMB desk officer by January 17, 2017.
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.
DATES:
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91178
Federal Register / Vol. 81, No. 242 / Friday, December 16, 2016 / 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/
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.
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
SUPPLEMENTARY INFORMATION:
the following proposed collection(s) of
information for public comment:
1. Type of Information Collection
Request: Extension of a previously
approved collection; Title of
Information Collection: End Stage Renal
Disease (ESRD) Medical Information
Facility Survey; Use: The ESRD Program
Management and Medical Information
System (PMMIS) Facility Certification/
Survey Record contains providerspecific and aggregate patient
population data on beneficiaries treated
by that provider obtained from the
Annual Facility Survey form (CMS–
2744). The Facility Certification portion
of the record captures certification and
other information about ESRD facilities
approved by Medicare to provide
kidney dialysis and transplant services.
The Facility Survey portion of the
record captures activities performed
during the calendar year as well as
aggregate year-end population counts
for both Medicare beneficiaries and nonMedicare patients. The survey includes
the collection on hemodialysis patients
dialyzing more than 4 times per week,
vocational rehabilitation and staffing.
The aggregate patient information is
collected from each Medicare-approved
provider of dialysis and kidney
transplant services. The information is
used to assess and evaluate the local,
regional and national levels of medical
and social impact of ESRD care and is
used extensively by researchers and
suppliers of services for trend analysis.
Form Number: CMS–2744 (OMB control
number: 0938–0447); Frequency: Yearly;
Affected Public: Business or other forprofit, Not-for-profit institutions;
Number of Respondents: 5,964; Total
Annual Responses: 5,964; Total Annual
Hours: 47,712. (For policy questions
regarding this collection contact Renee
Dupee at 410–786–6747)
Dated: December 13, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2016–30349 Filed 12–15–16; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Submission for OMB Review;
Comment Request
Title: OCSE–75 Tribal Child Support
Enforcement Program Annual Data
Report.
OMB No.: 0970–0320.
Description: The data collected by
form OCSE–75 are used to prepare the
OCSE preliminary and annual data
reports. In addition, Tribes
administering CSE programs under Title
IV–D of the Social Security Act are
required to report program status and
accomplishments in an annual narrative
report and submit the OCSE–75 report
annually.
Respondents: Tribal Child Support
Enforcement Organizations or the
Department/Agency/Bureau responsible
for Child Support Enforcement in each
tribe.
ANNUAL BURDEN ESTIMATES
Number of
respondents
Number of
responses per
respondent
Average
burden hours
per response
Total burden
hours
OCSE–75 .........................................................................................................
mstockstill on DSK3G9T082PROD with NOTICES
Instrument
63
1
63
3,969
Estimated Total Annual Burden
Hours: 3,969.
Additional Information:
Copies of the proposed collection may
be obtained by writing to the
Administration for Children and
Families, Office of Planning, Research
and Evaluation, 330 C Street SW.,
Washington, DC 20201. Attention
Reports Clearance Officer. All requests
should be identified by the title of the
information collection. Email address:
infocollection@acf.hhs.gov.
OMB Comment:
OMB is required to make a decision
concerning the collection of information
between 30 and 60 days after
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18:42 Dec 15, 2016
Jkt 241001
publication of this document in the
Federal Register. Therefore, a comment
is best assured of having its full effect
if OMB receives it within 30 days of
publication. Written comments and
recommendations for the proposed
information collection should be sent
directly to the following: Office of
Management and Budget, Paperwork
Reduction Project, Email: OIRA_
SUBMISSION@OMB.EOP.GOV, Attn:
PO 00000
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Desk Officer for the Administration for
Children and Families.
Robert Sargis,
Reports Clearance Officer.
[FR Doc. 2016–30291 Filed 12–15–16; 8:45 am]
BILLING CODE 4184–01–P
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Agencies
[Federal Register Volume 81, Number 242 (Friday, December 16, 2016)]
[Notices]
[Pages 91177-91178]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-30349]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-2744]
Agency Information Collection Activities: Submission for OMB
Review; 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 (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: the
necessity and utility of the proposed information collection for the
proper performance of the agency's functions; the accuracy of the
estimated burden; ways to enhance the quality, utility, and clarity of
the information to be collected; and 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 January 17, 2017.
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.
[[Page 91178]]
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: Extension of a
previously approved collection; Title of Information Collection: End
Stage Renal Disease (ESRD) Medical Information Facility Survey; Use:
The ESRD Program Management and Medical Information System (PMMIS)
Facility Certification/Survey Record contains provider-specific and
aggregate patient population data on beneficiaries treated by that
provider obtained from the Annual Facility Survey form (CMS-2744). The
Facility Certification portion of the record captures certification and
other information about ESRD facilities approved by Medicare to provide
kidney dialysis and transplant services. The Facility Survey portion of
the record captures activities performed during the calendar year as
well as aggregate year-end population counts for both Medicare
beneficiaries and non-Medicare patients. The survey includes the
collection on hemodialysis patients dialyzing more than 4 times per
week, vocational rehabilitation and staffing. The aggregate patient
information is collected from each Medicare-approved provider of
dialysis and kidney transplant services. The information is used to
assess and evaluate the local, regional and national levels of medical
and social impact of ESRD care and is used extensively by researchers
and suppliers of services for trend analysis. Form Number: CMS-2744
(OMB control number: 0938-0447); Frequency: Yearly; Affected Public:
Business or other for-profit, Not-for-profit institutions; Number of
Respondents: 5,964; Total Annual Responses: 5,964; Total Annual Hours:
47,712. (For policy questions regarding this collection contact Renee
Dupee at 410-786-6747)
Dated: December 13, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2016-30349 Filed 12-15-16; 8:45 am]
BILLING CODE 4120-01-P