[Federal Register: October 7, 2005 (Volume 70, Number 194)]
[Notices]
[Page 58708]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr07oc05-60]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-1557 and CMS-1880/1882 and CMS 10142]
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: Survey Report
Form Clinical Laboratory Improvement Amendments (CLIA) and supporting
regulations under 42 CFR 493.1-493.2001; Form Number: CMS-1557
(OMB: 0938-0544); Use: This form is used by the State agency
to determine a laboratory's compliance with CLIA. This information is
needed for a laboratory's CLIA certification and recertification;
Frequency: Recordkeeping and Reporting--Biennially; Affected Public:
Business or other for-profit, Not-for-profit institutions, Federal,
State, Local or Tribal Government; Number of Respondents: 25,000; Total
Annual Responses: 12,500; Total Annual Hours: 6,250.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: The Request for
Certification as a Supplier of Portable X-Ray Services and Portable X-
Ray Survey Report Form under the Medicare and Medicaid Program--
Portable X-Ray Survey Report and Supporting Regulations under 42 CFR
486.100-486.110; Form Number: CMS-1880/1882 (OMB: 0938-0027);
Use: The Medicare program requires portable X-ray suppliers to be
surveyed for health and safety standards. The CMS-1882 is the survey
form that records survey results. The CMS-1880 is used by the surveyor
to determine if a portable X-ray applicant meets the eligibility
requirements. This information serves as a screen for the State survey
agency to determine if the portable X-ray supplier has the basic
capabilities to participate in the Medicare program. CMS will use this
information to make certification decisions; Frequency: Reporting--On
occasion; Affected Public: Business or other for-profit; Number of
Respondents: 655; Total Annual Responses: 98; Total Annual Hours: 172.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Bid Pricing Tool
(BPT) for Medicare Advantage and Prescription Drug Plans (PDP)
contained in 42 Code of Federal Regulation (CFR): 422.250, 422.252,
422.254, 422.256, 422.258, 422.262, 422.264, 422.266, 422.270, 422.300,
422.304, 422.306, 422.308, 422.310, 422.312, 422.314, 422.316, 422.318,
422.320, 422.322, 422.324, 423.251, 423.258, 423.265, 423.272, 423.279,
423.286, 423.293, 423.301, 423.308, 423.315, 423.322, 423.329, 423.336,
423.343, 423.346, 423.350 ; Form Number: CMS-10142 (OMB: 0938-
0944); Use: Under the Medicare Modernization Act, Medicare Advantage
Organizations (MAO) and Prescription Drug Plans (PDP) are required to
submit an actuarial pricing bid to CMS for approval. The BPT software
is used by MAOs and PDPs to price their plan benefit package. The BPT
software is used by CMS to review and approve the plan pricing proposed
by each organization; Frequency: Reporting `` On occasion, Annually and
As required by new legislation; Affected Public: Business or other for-
profit and not-for-profit institutions; Number of Respondents: 350;
Total Annual Responses: 350; Total Annual Hours: 12,050.
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.
To be assured consideration, comments and recommendations for the
proposed information collections must be received at the address below,
no later than 5 p.m. on December 6, 2005.
CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development, Attention: Melissa Musotto, Room
C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Dated: September 30, 2005.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 05-20228 Filed 10-6-05; 8:45 am]
BILLING CODE 4120-01-P