[Federal Register: November 18, 2005 (Volume 70, Number 222)]
[Notices]
[Page 69974-69975]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr18no05-60]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10130, CMS-10164 and CMS 10156]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services.
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), 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 function; (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: Federal Funding
of Emergency Health Services (section 1011): Provider Payment
Determination and Request for section 1011 On-Call Payments; Form No.:
CMS-10130 (OMB 0938-0952); Use: Section 1011 of MMA provides
that the Secretary will establish a process for eligible providers to
request payment. The Secretary must directly pay hospitals, physicians,
and ambulance providers (including Indian Health Service, Indian tribe
and tribal organizations) for their otherwise un-reimbursed costs of
providing services required by Section 1867 of the Social Security Act
(EMTALA) and related hospital inpatient, outpatient and ambulance
services. Payments may be made only for services furnished to
[[Page 69975]]
certain individuals described in the statute as: (1) Undocumented
aliens; (2) aliens who have been paroled into the United States at a
United States port of entry for the purpose of receiving eligible
services; and (3) Mexican citizens permitted to enter the United States
for not more than 30 days under the authority of a biometric machine
readable border crossing identification card (also referred to as a
``laser visa'') issued in accordance with the requirements of
regulations prescribed under a specific section of the Immigration and
Nationality Act as published in the Bureau of Customs and Border
Protection's interim final rule dated August 13, 2004.; Frequency:
Other--as needed; Affected Public: Business or other for-profit, Not-
for-profit institutions, and State, Local or Tribal Governments; Number
of Respondents: 7,503,000; Total Annual Responses: 7,512,000; Total
Annual Hours: 634,000.
2. Type of Information Collection Request: New Collection; Title of
Information Collection: Electronic Data Interchange (EDI) Enrollment
Form and Centers for Medicare and Medicaid Services EDI Registration
Form; Form No.: CMS-10164 (OMB 0938-NEW); Use: CMS is
requiring that providers who wish to conduct Electronic Data
Interchange (EDI) transactions, specifically the HIPAA Eligibility
Inquiry and Response (270/271) directly with CMS at the Baltimore data
center, provide certain information related to their organization and/
or organizations conducting EDI business on their behalf. Health care
providers, clearinghouses, and health plans that wish to access the
Medicare system for the purposes of conducting other EDI business
transactions are also required to complete this form. Furthermore, CMS
has incorporated changes to the collection as a result of public
comments. One specific comment resulted in the combining of the
information collected related to Medicare Modernization Act (MMA)
section 1011 and Medicare Fee-For Service Part A and Part B. Both
programs collect similar information for the purposes of provider
enrollment and trading partner profile information related to the
exchange of EDI transactions. To further reduce the burden on providers
enrolling in either the MMA section 1011 and/or the Medicare Fee-For
Service program the CMS-10164 collection will change terms from
``Carrier/FI'' to ``Medicare contractor''. The purpose is to
generically refer to the organization that CMS contracts with to
operate the specific program function such as MMA section 1011 or
Medicare Part A, Medicare Part B for a specific jurisdiction. The
information will be used to assure that profile data for those entities
that access the section 1011 and/or Medicare system are entered
appropriately. Frequency: Recordkeeping and Reporting--Other (As-
Needed); Affected Public: Business or other for-profit, Not-for-profit
institutions; Number of Respondents: 1,220,000; Total Annual Responses:
1,220,000; Total Annual Hours: 400,000.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Retiree Drug
Subsidy (RDS) Application and Instructions; Form Number: CMS'10156
(OMB: 0938'' 0957); Use: Under the Medicare Prescription Drug,
Improvement, and Modernization Act (MMA) of 2003 and implementing
regulations at 42 CFR subpart R plan sponsors (employers,unions) who
offer prescription drug coverage to their qualified covered retirees
are eligible to receive a 28% taxfree subsidy for allowable drug costs.
In order to qualify, plan sponsors must submit a complete application
to CMS with a list of retirees for whom it intends to collect the
subsidy; Frequency: Quarterly, Monthly, Annually; Affected Public:
Business or other for-profit, Not-for-profit institutions, Federal,
State, local and/or tribal Government; Number of Respondents: 50,000;
Total Annual Responses: 50,000; Total Annual Hours: 2,025,000.
To obtain copies of the supporting statement and any related forms
for these 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 by the OMB Desk
Officer at the address below, no later than 5 p.m. on December 19,
2005. OMB Human Resources and Housing Branch, Attention: Carolyn
Lovett, CMS Desk Officer,New Executive Office Building, Room
10235,Washington, DC 20503.
Dated: November 9, 2005.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 05-22904 Filed 11-17-05; 8:45 am]
BILLING CODE 4120-01-P