[Federal Register: June 2, 2003 (Volume 68, Number 105)]
[Notices]
[Page 32757-32758]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr02jn03-89]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[Document Identifier: CMS-367, a, b, and c; CMS-R-38, CMS-566, CMS-
10077, and CMS-10072]
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: Medicaid Drug
Rebate Program--Manufacturers; Form No.: CMS-367a,b,c (OMB
0938-0578); Use: Section 1927 requires drug manufacturers to enter into
and have in effect a rebate agreement with the Federal Government for
States to receive funding for drugs dispensed to Medicaid recipients;
Frequency: Quarterly; Affected Public: Business or other for-profit;
Number of Respondents: 570; Total Annual Responses: 2,280; Total Annual
Hours: 54,780.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Conditions for
Coverage for Rural Health Clinics--42 CFR 491.9 Subpart A; Form No.:
CMS-R-38 (OMB 0938-0334); Use: This information is needed to
determine if rural health clinics meet the requirements for approval
for Medicare Participation.; Frequency: Initial Application for
Medicare approval; Affected Public: Business or other for-profit,
State, Local, or Tribal Gov't., and not-for-profit institutions,
Individuals or households, Farms, and Federal Government; Number of
Respondents: 3,305; Total Annual Responses: 3,305; Total Annual Hours:
8,580.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare Managed
Care Disenrollment Form; Form No.: CMS-566 (0938-0507); Use: This form
provides Medicare beneficiaries the option to disenroll from their
Medicare managed care plan through a neutral third party. CMS and SSA
have established an agreement via a formal Memorandum of Understanding
for SSA to process beneficiary disenrollments from Medicare managed
care plans. Prior to 1999, the Social Security Act provided Medicare
beneficiaries enrolled in Medicare managed care plans with the option
of disenrolling from the plan at a Social Security Field Office;
however, Section 4001 of the Balanced Budget Act of 1997 amended the
Social Security Act, removing this requirement from the statute;
Frequency: On Occasion; Affected Public: Individuals or Households,
Business or other for-profit, Not-for-profit institutions, and Federal
Government; Number of Respondents: 85,000; Total Annual Responses:
85,000; Total Annual Hours: 2,805.
4. Type of Information Collection Request: New Collection; Title of
Information Collection: ``Medicare Decisions and Your Rights''; Form
No.: CMS-10077 (OMB 0938-NEW); Use Pursuant to 42 CFR 422.568
(c), M+C practitioners must deliver notices to enrollees informing them
of their right to obtain a detailed notice regarding services from
their M+C organizations. This notice fulfills the regulatory
requirement.; Frequency: Other (distribution); Affected Public:
Individuals or Households, Business or other for-profit, Not-for-profit
institutions, Federal Government; Number of Respondents: 155; Total
Annual Responses: 5,000,000; Total Annual Hours: 83,333.
5. Type of Information Collection Request: New Collection; Title of
Information Collection: MSInteractive Survey Tool for cms.hhs.gov; Form
No.: CMS-10072 (OMB 0938-NEW); Use CMS has developed a survey
tool using MSInteractive to obtain feedback from users accessing
cms.hhs.gov website to guide future improvements; Frequency: on
occasion; Affected Public: Individuals or Households, Business or
[[Page 32758]]
other for-profit; Number of Respondents: 7000; Total Annual Responses:
7000; Total Annual Hours: 583.
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@cms.hhs.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, Fax
Number: (202) 395-6974.
Dated: May 22, 2003.
Dawn Willinghan,
CMS Reports Clearance Officer, Division of Regulations Development and
Issuances, Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 03-13666 Filed 5-30-03; 8:45 am]
BILLING CODE 4120-03-P