Agency Information Collection Activities: Submission for OMB Review; Comment Request, 14516-14517 [2017-05555]
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14516
Federal Register / Vol. 82, No. 53 / Tuesday, March 21, 2017 / Notices
Dated: March 16, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2017–05541 Filed 3–20–17; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–10632]
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 April 20, 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.
mstockstill on DSK3G9T082PROD with NOTICES
DATES:
VerDate Sep<11>2014
16:47 Mar 20, 2017
Jkt 241001
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
Web site address at https://
www.cms.gov/Regulations-andGuidance/Legislation/Paperwork
ReductionActof1995/PRA-Listing.html.
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: New collection (Request for a
new OMB control number); Title of
Information Collection: Evaluating
Coverage to Care (C2C); Use: CMS OMH
has contracted with the RAND
Corporation to evaluate From Coverage
to Care (C2C). From the beginning of the
Affordable Care Act’s implementation,
the Centers for Medicare & Medicaid
Services, Office of Minority Health
(CMS OMH) recognized that achieving
better health and reduced health care
costs would require individuals to take
an active role in their health care and
regularly use primary and preventive
care services. To address this need, CMS
OMH launched From Coverage to Care
(C2C) in June 2014. C2C was designed
to help consumers understand what it
means to have health insurance
coverage, how to find a provider, when
and where to seek appropriate health
PO 00000
Frm 00016
Fmt 4703
Sfmt 4703
services, and why prevention and
partnering with a provider is important
for achieving optimal health. It was also
designed to equip health care providers
and stakeholders in the community who
support consumers’ connection to care
with the tools needed to promote
consumer engagement and to promote
changes in the health care system that
improve access to care. As part of C2C,
CMS produced a range of consumeroriented materials, both Web-based and
in print. The most in-depth of the print
materials is an eight-step booklet titled
‘‘A Roadmap to Better Care and a
Healthier You.’’ Based on the need for
the information to be communicated in
smaller, more digestible packets,
booklets were developed to correspond
to each of the eight steps. Four of the
most popular pages of the Roadmap
have been made available as single-page
handouts for easier distribution. These
materials are currently available in eight
languages, including English, Spanish,
Arabic, Chinese, Haitian Creole, Korean,
Russian, and Vietnamese.
Since the national launch in 2014,
CMS has disseminated C2C through
speaking engagements, webinars, and
meetings sponsored by CMS regional
offices. CMS fills product orders and
recently completed a redesign of the
C2C Web site. C2C has grown to address
emerging needs of consumers, as well as
stakeholders or organizations that work
with and support consumers, across the
full continuum of health insurance and
care: Plan selection, enrollment, finding
a provider, and engaging in care over
time.
RAND spent the past year designing
and preparing for this evaluation to
assess C2C’s impact on consumer health
insurance literacy and care utilization.
This evaluation will also help CMS
understand how C2C is spread within a
community and disseminated to
consumers, and in turn how best to
maximize C2C’s impact. The next three
years will be dedicated to implementing
the evaluation described in this
submission. We are proposing four data
collection activities: (1) A crosssectional survey of organizations that
have ordered and used the materials
with consumers; (2) A cross-sectional
survey of consumers, drawn from the
Knowledge Networks panel, to measure
the association between C2C and
consumer knowledge and behavior; (3)
semi-structured interviews with staff
from a limited set of community
organizations as part of a case study;
and (4) focus groups of consumers as
part of a case study. The case study will
be conducted in a community where
English is not the preferred language,
and where C2C materials in another
E:\FR\FM\21MRN1.SGM
21MRN1
Federal Register / Vol. 82, No. 53 / Tuesday, March 21, 2017 / Notices
language (e.g., Spanish, Arabic, Chinese,
Haitian Creole, Korean, Russian, and
Vietnamese) were used with consumers.
Form Number: CMS–10632 (OMB
control number: 0938—New);
Frequency: Occasionally; Affected
Public: Individuals or Households;
Number of Respondents: 3,460; Total
Annual Responses: 3,460; Total Annual
Hours: 1,176. (For policy questions
regarding this collection contact Ashley
Peddicord-Austin at 410–786–0757).
Dated: March 16, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2017–05555 Filed 3–20–17; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–40B, CMS–43,
CMS–1763, CMS–10174, CMS–10215, CMS–
R–285]
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
proposed action. Interested persons are
invited to send comments regarding our
burden estimates or any other aspect of
this collection of information, including
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 must be received by
May 22, 2017.
ADDRESSES: When commenting, please
reference the document identifier or
mstockstill on DSK3G9T082PROD with NOTICES
SUMMARY:
VerDate Sep<11>2014
16:47 Mar 20, 2017
Jkt 241001
OMB control number. 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 lll, 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.gov/Regulations-andGuidance/Legislation/Paperwork
ReductionActof1995/PRA-Listing.html.
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–40B Application for Enrollment in
Medicare the Medical Insurance Program
CMS–43 Application for Hospital Insurance
Benefits for Individuals with End Stage
Renal Disease
CMS–1763 Request for Termination of
Premium Hospital and Supplementary
Medical Insurance
CMS–10174 Collection of Prescription Drug
Event Data from Contracted Part D
Providers for Payment
CMS–10215 Medicaid Payment for
Prescription Drugs—Physicians and
Hospital Outpatient Departments
Collecting and Submitting Drug
Identifying Information to State
Medicaid Programs
CMS–R–285 Request for Retirement Benefit
Information
Under the PRA (44 U.S.C. 3501–
3520), federal agencies must obtain
PO 00000
Frm 00017
Fmt 4703
Sfmt 4703
14517
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: Extension without change of a
currently approved collection; Title of
Information Collection: Application for
Enrollment in Medicare the Medical
Insurance Program; Use: The CMS–40B
form is used to establish entitlement to
and enrollment in supplementary
medical insurance for beneficiaries who
already have Part A, but not Part B. The
form solicits information that is used to
determine enrollment for individuals
who meet the requirements in section
1836 of the Social Security Act as well
as the entitlement of the applicant or a
spouse regarding a benefit or annuity
paid by the Social Security
Administration or the Office of
Personnel Management for premium
deduction purposes. The Social Security
Administration will use the collected
information to establish Part B
enrollment. Form Number: CMS–40B
(OMB control number: 0938–1230);
Frequency: Once; Affected Public:
Individuals or households; Number of
Respondents: 200,000; Total Annual
Responses: 200,000; Total Annual
Hours: 50,000. (For policy questions
regarding this collection contact Carla
Patterson at 410–786–8911.)
2. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Application for
Hospital Insurance Benefits for
Individuals with End Stage Renal
Disease; Use: The CMS–43 application
is used (in conjunction with CMS–2728)
to establish entitlement to, and
enrollment in, Medicare Part A (and
Part B) for individuals with end stage
renal disease. The application is
completed by a Social Security
Administration (SSA) claims
representative or field representative
using information provided by the
E:\FR\FM\21MRN1.SGM
21MRN1
Agencies
[Federal Register Volume 82, Number 53 (Tuesday, March 21, 2017)]
[Notices]
[Pages 14516-14517]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-05555]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-10632]
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 April 20, 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.
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 Web site address at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
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: New collection (Request
for a new OMB control number); Title of Information Collection:
Evaluating Coverage to Care (C2C); Use: CMS OMH has contracted with the
RAND Corporation to evaluate From Coverage to Care (C2C). From the
beginning of the Affordable Care Act's implementation, the Centers for
Medicare & Medicaid Services, Office of Minority Health (CMS OMH)
recognized that achieving better health and reduced health care costs
would require individuals to take an active role in their health care
and regularly use primary and preventive care services. To address this
need, CMS OMH launched From Coverage to Care (C2C) in June 2014. C2C
was designed to help consumers understand what it means to have health
insurance coverage, how to find a provider, when and where to seek
appropriate health services, and why prevention and partnering with a
provider is important for achieving optimal health. It was also
designed to equip health care providers and stakeholders in the
community who support consumers' connection to care with the tools
needed to promote consumer engagement and to promote changes in the
health care system that improve access to care. As part of C2C, CMS
produced a range of consumer-oriented materials, both Web-based and in
print. The most in-depth of the print materials is an eight-step
booklet titled ``A Roadmap to Better Care and a Healthier You.'' Based
on the need for the information to be communicated in smaller, more
digestible packets, booklets were developed to correspond to each of
the eight steps. Four of the most popular pages of the Roadmap have
been made available as single-page handouts for easier distribution.
These materials are currently available in eight languages, including
English, Spanish, Arabic, Chinese, Haitian Creole, Korean, Russian, and
Vietnamese.
Since the national launch in 2014, CMS has disseminated C2C through
speaking engagements, webinars, and meetings sponsored by CMS regional
offices. CMS fills product orders and recently completed a redesign of
the C2C Web site. C2C has grown to address emerging needs of consumers,
as well as stakeholders or organizations that work with and support
consumers, across the full continuum of health insurance and care: Plan
selection, enrollment, finding a provider, and engaging in care over
time.
RAND spent the past year designing and preparing for this
evaluation to assess C2C's impact on consumer health insurance literacy
and care utilization. This evaluation will also help CMS understand how
C2C is spread within a community and disseminated to consumers, and in
turn how best to maximize C2C's impact. The next three years will be
dedicated to implementing the evaluation described in this submission.
We are proposing four data collection activities: (1) A cross-sectional
survey of organizations that have ordered and used the materials with
consumers; (2) A cross-sectional survey of consumers, drawn from the
Knowledge Networks panel, to measure the association between C2C and
consumer knowledge and behavior; (3) semi-structured interviews with
staff from a limited set of community organizations as part of a case
study; and (4) focus groups of consumers as part of a case study. The
case study will be conducted in a community where English is not the
preferred language, and where C2C materials in another
[[Page 14517]]
language (e.g., Spanish, Arabic, Chinese, Haitian Creole, Korean,
Russian, and Vietnamese) were used with consumers. Form Number: CMS-
10632 (OMB control number: 0938--New); Frequency: Occasionally;
Affected Public: Individuals or Households; Number of Respondents:
3,460; Total Annual Responses: 3,460; Total Annual Hours: 1,176. (For
policy questions regarding this collection contact Ashley Peddicord-
Austin at 410-786-0757).
Dated: March 16, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2017-05555 Filed 3-20-17; 8:45 am]
BILLING CODE 4120-01-P