[Federal Register: June 17, 2005 (Volume 70, Number 116)]
[Notices]
[Page 35256-35257]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr17jn05-60]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-R-262, CMS-R-254, CMS-1450, CMS-10146, CMS-
10147, CMS-10154, and CMS-10160]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & 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 & Medicaid
Services (CMS) 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: Plan Benefit
Package (PBP) and Formulary Submission for Medicare Advantage (MA)
Plans and Prescription Drug Plans (PDPs); Form No.: CMS-R-262 (OMB
0938-0763); Use: Under the Medicare Modernization Act (MMA),
Medicare Advantage (MA) and Prescription Drug Plan (PDP) organizations
are required to submit plan benefit package information to CMS for
approval. Organizations will provide this information through the
submission of the formulary and the PBP software; Frequency: On
occasion, annually and other (as required by new legislation); Affected
Public: Business or other for-profit and Not-for-profit institutions;
Number of Respondents: 470; Total Annual Responses: 2,092; Total Annual
Hours: 5,546.
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: National Medicare
Education Program (NMEP); Form No.: CMS-R-254 (OMB 0938-
0738); Use: The NMEP was developed to inform people with Medicare,
their family members, and other interested parties about their Medicare
options. The Medicare Modernization Act of 2003 expanded the program to
include among other things, a new Prescription Drug Benefit; therefore,
this package has been revised to include this information. The NMEP
employs numerous communication channels to educate people with Medicare
and help them make more informed decisions concerning the Medicare
program benefits; health plan choices; supplemental health insurance;
rights, responsibilities, and protections; and preventive health
services. As part of the NMEP, CMS must provide information to this
population about the Medicare program and their Health Plan options, as
well as information about the new prescription drug coverage to help
them choose the option that is right for them. This survey seeks to
assess the awareness, knowledge, understanding and experiences of
people with Medicare regarding the Medicare program overall and these
new initiatives; Frequency: On occasion; Affected Public: Individuals
or Households; Number of Respondents: 5,700; Total Annual Responses:
5,700; Total Annual Hours: 1,425.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare Uniform
Institutional Provider Bill and Supporting Regulations in 42 CFR 424.5;
Form No.: CMS-1450 (OMB 0938-0279); Use: Section 42 CFR
424.5(a)(5) requires providers of services to submit claims prior to
Medicare reimbursement. Charges are coded by revenue codes. The bill
specifies diagnoses according to the International Classification of
Diseases, Ninth Edition (ICD-9-CM) code. Inpatient procedures are
identified by ICD-9-CM codes, and outpatient procedures are described
using the Healthcare Common Procedure Coding System (HCPCS). These are
standard systems of identification for all major health insurance
claims payers. Submission of information on the CMS-1450 permits
Medicare intermediaries to receive consistent data for proper payment;
Frequency: On occasion; Affected Public: Not-for-profit institutions,
Business or other for profit; Number of Respondents: 51,629; Total
Annual Responses: 174,461,278; Total Annual Hours: 1,997,581.
4. Type of Information Collection Request: New Collection; Title of
Information Collection: Notice of Denial of Medicare Prescription Drug
Coverage; Form No.: CMS-10146 (OMB 0938-NEW); Use: Pursuant
to 42 CFR 423.568(c), if a Part D plan denies drug coverage, in whole
or in part, the Part D plan must give the enrollee written notice of
the coverage determination; Frequency: Other: Distribution; Affected
Public: Business or other for profit, Not-for-profit institutions;
Individuals or Households and Federal Government; Number of
Respondents: 450; Total Annual Responses: 1,056,000; Total Annual
Hours: 528,000.
5. Type of Information Collection Request: New Collection; Title of
Information Collection: Medicare Prescription Drug Coverage and Your
Rights; Form No.: CMS-10147 (OMB 0938-NEW); Use: Pursuant to
42 CFR 423.562(a)(3), a Part D plan sponsor must arrange with its
network pharmacies to post or distribute notices informing enrollees to
contact their plan to request a coverage determination or an exception
if the enrollee disagrees with the information provided by the
pharmacy; Frequency: Other: Distribution; Affected Public: Business or
other for profit, Not-for-profit institutions; Individuals or
Households and Federal Government; Number of Respondents: 41,000; Total
Annual Responses: 35,000,000; Total Annual Hours: 583,333.
6. Type of Information Collection Request: New collection; Title of
Information Collection: Physician Assessment of Hospital Quality
Reports; Form No.: CMS-10154 (OMB 0938-NEW); Use: This
assessment will monitor the attitudes and behaviors of physicians as
they relate to the concerns of their patients who have been exposed to
hospital quality-of-care reports at CMS's Web site; Affected Public:
Individuals or Households; Number of Respondents: 1730; Total Annual
Responses: 1730; Total Annual Hours: 345.75.
7. Type of Information Collection Request: New collection; Title of
Information Collection: The Personal Responsibility Survey; Form No.:
CMS-10160 (OMB 0938-NEW); Use: New focus on personalizing
messages by
[[Page 35257]]
relating health care choices with individual beliefs may help guide
these educational efforts. The intent of this survey is to understand
the role personal responsibility plays when people with Medicare make
health care decisions; Affected Public: Individuals or Households;
Number of Respondents: 1580; Total Annual Responses: 1580; Total Annual
Hours: 300.
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://www.cms.hhs.gov/regulations/pra/, 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 60 days of this notice to the address
below: CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development, Attention: Melissa Musotto, PRA
Analyst, Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland
21244-1850.
Dated: June 10, 2005.
Jimmy Wickliffe,
Reports Clearance Officer, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 05-11931 Filed 6-16-05; 8:45 am]
BILLING CODE 4120-01-P