[Federal Register: November 8, 2002 (Volume 67, Number 217)]
[Notices]
[Page 68139-68140]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr08no02-95]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[CMS-29/30, CMS-317, CMS-319, CMS-2746, and CMS-R-293]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare and Medicaid Services, HHS.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid
Services (CMS) (formerly known as the Health Care Financing
Administration (HCFA), Department of Health and Human Services, is
publishing the following summary of proposed collections for public
comment. Interested persons are invited to send comments regarding this
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.
1. Type of Information Collection Request: Extension of a currently
approved collection.
Title of Information Collection: Request for Certification as Rural
Health Clinic and Rural Health Clinic Survey Report Form and Supporting
Regulations in 42 CFR 491.1-491.11.
[[Page 68140]]
Form No.: CMS-0029/0030 (OMB 0938-0074).
Use: The Form CMS-29 is utilized as an application to be completed
by suppliers of RHC services requesting participation in the Medicare/
Medicaid programs. This form initiates the process of obtaining a
decision as to whether the conditions for certification are met as a
supplier of RHC services. It also promotes data reduction or
introduction to and retrieval from the Online Survey and Certification
and Reporting System (OSCAR) by the CMS Regional Offices (RO). The Form
CMS-30 is an instrument used by the State survey agency to record data
collected in order to determine RHC compliance with individual
conditions of participation and to report it to the Federal government.
The form is primarily a coding worksheet designed to facilitate data
reduction (keypunching) and retrieval into OSCAR at the CMS ROs. The
form includes basic information on compliance (i.e., met, not met and
explanatory statements) and does not require any descriptive
information regarding the survey activity itself.
Frequency: Annually.
Affected Public: State, Local, or Tribal Government.
Number of Respondents: 661.
Total Annual Responses: 661; Total Annual Hours: 1,157.
2. Type of Information Collection Request: Extension of a currently
approved collection.
Title of Information Collection: State Medicaid Eligibility Quality
Control (MEQC) Sampling Plan and Supporting Regulations in 42 CFR
431.800-431.865.
Form No.: CMS-317 (OMB 0938-0146).
Use: The State MEQC sampling plan is necessary for CMS to monitor
the States' operation of the MEQC system for States performing the
traditional sampling process. The sampling plan includes all data
involved in the States' sample selection process--population sizes and
sample frame lists, sample sizes, sample selection procedures, and
claim collection procedures.
Frequency: Semi-annually.
Affected Public: State, Local, or Tribal Government.
Number of Respondents: 55.
Total Annual Responses: 110.
Total Annual Hours: 2,640.
3. Type of Information Collection Request: Extension of a currently
approved collection;
Title of Information Collection: State Medicaid Eligibility Quality
Control (MEQC) Sample Section Lists and Supporting Regulations in 42
CFR 431.800--431.865.
Form No.: CMS-0319 (OMB 0938-0147).
Use: The sample selection lists contain identifying information on
Medicaid beneficiaries and is the basis for the cases that States
review to determine the accuracy of the Medicaid eligibility
determinations. The Regional Office uses this list to monitor State
review activity.
Frequency: Monthly.
Affected Public: State, Local or Tribal Government.
Number of Respondents: 55.
Total Annual Responses: 660.
Total Annual Hours: 5,280.
4. Type of Information Collection Request: Extension of a currently
approved collection.
Title of Information Collection: End Stage Renal Disease Death
Notification 42 CFR 405.2133.
Form No.: CMS-2746 (OMB 0938-0448).
Use: This form is completed by all Medicare approved ESRD
facilities upon the death of an ESRD patient. The form's primary
purpose is to collect fact and cause of death. Reports of deaths are
used to show cause of death and demographic characteristics of these
patients.
Frequency: On occasion.
Affected Public: Business or other for-profit, Not-for-profit
institutions, Federal Government.
Number of Respondents: 4,000.
Total Annual Responses: 56,258.
Total Annual Hours: 9,564.
5. Type of Information Collection Request: Extension of a currently
approved collection.
Title of Information Collection: Medicare Telephone Customer
Satisfaction Survey.
Form No.: CMS-R-293 (OMB 0938-0780).
Use: In response to the National Partnership for Reinventing
Government and Government Performances and Results Act (GPRA), CMS is
implementing a number of initiatives to measure and then improve the
customer service that is provided by Medicare Call Centers, that
service over 21 million calls annually.
Frequency: On occasion, simi-annually, other (single 800
survey).
Affected Public: Individuals or Households; Number of Respondents:
50,000.
Total Annual Responses: 50,000.
Total Annual Hours: 3,500.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS Web
site address at http://cms.hhs.gov/regulations/pra/default.asp, or e-
mail your request, including your address, phone number, OMB number,
and CMS document identifier, to Paperwork@hcfa.gov, or call the Reports
Clearance Office on (410) 786-1326. Written comments and
recommendations for the proposed information collections must be mailed
within 30 days of this notice directly to the OMB desk officer: OMB
Human Resources and Housing Branch, Attention: Brenda Aguilar, New
Executive Office Building, Room 10235, Washington, DC 20503.
Dated: October 31, 2002.
John P. Burke, III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer,
Office of Strategic Operations and Regulatory Affairs, Division of
Regulations Development and Issuances.
[FR Doc. 02-28423 Filed 11-7-02; 8:45 am]
BILLING CODE 4120-03-P