[Federal Register: January 16, 2004 (Volume 69, Number 11)]
[Notices]
[Page 2600-2601]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr16ja04-67]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[Document Identifier: CMS-2786M, R, and S-Y, CMS-10097, CMS-R-204, CMS-
9044, CMS-P-0015A, CMS-R-13]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
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: Revision of a currently
approved collection; Title of Information Collection: Fire Safety
Survey Report Forms and Supporting Regulations in 42 CFR 488.26 and
442.30; Form No.: CMS-2786 M, R, and S-Y (OMB 0938-0242); Use:
CMS surveys facilities to determine compliance with the Life Safety
Code of 2000. The providers must make documentation proving compliance
available to the surveyors; Frequency: Annually; Affected Public:
Business or other for-profit, not-for-profit institutions; Number of
Respondents: 27,900; Total Annual Responses: 27,900; Total Annual
Hours: 2325.
2. Type of Information Collection Request: New collection; Title of
Information Collection: Medicare Contractor Provider Satisfaction
Survey; Form No.: CMS-10097 (OMB 0938-NEW); Use: CMS needs
standard data about Medicare provider's satisfaction with their
Medicare contractors, who are charged with all Medicare claims
processing and related activities on behalf of the Agency. Respondents
will be staff representatives of hospitals, skilled nursing facilities,
rural health clinics, home health agencies, end-stage renal disease
clinics, physicians, non-physicians, durable medical equipment
suppliers, laboratories and ambulance providers. The survey will be
used as a mechanism for evaluating and improving Medicare providers'
satisfaction with their Medicare contractors. The results will provide
CMS with a comprehensive review of contractor-provider business
relations from the perspective of the ``customer'' or provider. The
information will help the Agency appropriately address provider
concerns about Medicare Contractors' performance, aid in business/
contracting decisions, and assist or guide contractors in identifying/
implementing ``best practices'' or quality improvement initiatives.;
Frequency: On occasion; Affected Public: Business or other for-profit
and not-for-profit institutions; Number of Respondents: 6,052; Total
Annual Responses: 6,052; Total Annual Hours: 3,331.
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Data Collection
for the Second Generation Social Health Maintenance Organization
Demonstration; Form No.: CMS-R-204 (OMB 0938-0709; Use: The
Centers for Medicare and Medicaid Services will continue to use the
data collected under this effort to support the operational needs of
the Congressionally-mandated and administratively extended Second
Generation of the Social Health Maintenance Organization Demonstration;
Frequency: Annually; Affected Public: Individuals or households; Number
of Respondents: 15,000; Total Annual Responses: 15,000; Total Annual
Hours: 3,000.
4. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Provider
Reimbursement Manual, Part 1--Chapter 27, Sections 2721, 2722 and 2725,
Request for Exception to End Stage Renal Disease Composite Rates and
Supporting Regulations in 42 CFR 413.170 and 413.184; Form No.: CMS-
9044 (OMB 0938-0296); Use: This information collection
describes the information End Stage Renal Disease facilities must
submit in justifying an exception request to their composite rate for
outpatient dialysis services; Frequency: On occasion; Affected Public:
Business or other for-profit, not-for-profit institutions, and Federal
government; Number of Respondents: 125; Total Annual Responses: 125;
Total Annual Hours: 6,000.
5. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare Current
Beneficiary Survey (MCBS): Rounds 38-46; Form No.: CMS-P-0015A
(OMB 0938-0568); Use: The MCBS is a continuous, multipurpose
survey of a nationally representative sample of aged and disabled
persons enrolled in Medicare. The survey provides a comprehensive
source of information on beneficiary characteristics, needs,
utilization, and satisfaction with Medicare-related activities;
Frequency: Other: 3 times a year; Affected Public: Individuals or
households, business or other for-profit, and not-for-profit
institutions; Number of Respondents: 16,500; Total Annual Responses:
49,500; Total Annual Hours: 50,325.
6. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Conditions of
Coverage for Organ Procurement Organizations (OPOs) and Supporting
Regulations in 42 CFR, Sections 486.304, 486.306, 486.307, 486.310,
486.316, 486.318, and 486.325; Form No.: CMS-R-13 (OMB 0938-
0688); Use: Organ Procurement Organizations are required to submit
accurate data to CMS concerning population and information on donors
and organs on an annual basis in order to assure maximum effectiveness
in the procurement and distribution of organs; Frequency: Annually;
Affected Public: Not-for-profit institutions; Number of
[[Page 2601]]
Respondents: 59; Total Annual Responses: 59; Total Annual Hours: 118.
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: January 8, 2004.
John P. Burke, III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer,
Office of Strategic Operations and Strategic Affairs, Division of
Regulations Development and Issuances.
[FR Doc. 04-983 Filed 1-15-04; 8:45 am]
BILLING CODE 4120-03-P