[Federal Register: October 13, 2006 (Volume 71, Number 198)]
[Notices]
[Page 60532-60533]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr13oc06-83]
[[Page 60532]]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-43, CMS-R-142, CMS-4040 & 4040-SP, CMS-10210,
and CMS-R-284]
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: Application for
Hospital Insurance Benefits for individuals with End Stage Renal
Disease; Use: 42 CFR 406.13 outlines the requirements for entitlement
to Medicare Part A (hospital insurance [HI]) and Part B (supplementary
medical insurance [SMI]) for individuals with End Stage Renal Disease
(ESRD). 42 CFR 406.7 lists the CMS-43 form, Application for Hospital
Insurance Benefits for Individuals with End Stage Renal Disease, as the
application to be used by individuals applying for Medicare under the
ESRD provisions of the Act. The form CMS-43 elicits the information
that the Social Security Administration and the Centers for Medicare &
Medicaid Services need to determine entitlement to Medicare based on
the ESRD requirements of the law and regulations. Form Number: CMS-43
(OMB: 0938-0800); Frequency: Reporting--Once; Affected Public:
Individuals or households; Number of Respondents: 60,000; Total Annual
Responses: 60,000; Total Annual Hours: 25,989.60.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Examination and
Treatment for Emergency Medical Conditions and Women in Labor Act
(EMTALA) and Supporting Regulations in 42 CFR 482.12, 488.18, 489.20,
and 489.24; Use: As mandated by Congress, the information collection
requirements found in supporting regulations in 42 CFR 482.12, 488.18,
489.20, and 489.24, aim to prevent hospitals from inappropriately
transferring individuals with emergency medical conditions. These
requirements are supported by two other current statutes. Section
1861(e)(9) of the Act permits the Secretary to impose on hospitals such
other requirements as he finds necessary in the interests of the health
and safety of individuals who are furnished services in the
institution. It is under this authority that the Secretary has
obligated hospitals that participate in Medicare to report when they
receive patients that have been inappropriately transferred. Under
section 1866(b)(2)(A) and (B) of the Social Security Act (the Act), the
Secretary may terminate the provider agreement of a hospital that is
not complying substantially with the statute and regulations under
title XVIII or that no longer substantially meets the provisions of
section 1861 of the Act. Form Number: CMS-R-142 (OMB: 0938-
0667); Frequency: Recordkeeping and Reporting--On occasion; Affected
Public: Individuals or households, Business or other for-profit, Not-
for-profit, State, Local or Tribal Governments, Federal Government;
Number of Respondents: 5,600; Total Annual Responses: 5,600; Total
Annual Hours: 1.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Request for
Enrollment in Supplementary Medical Insurance; Use: 42 CFR 407.10 lists
the alternative requirements for enrollment in Part B for any
individual who is not entitled to hospital insurance under Part A but
has attained age 65 and is either a citizen of the United States (U.S.)
or an alien lawfully admitted for permanent residence who has lived in
the U.S. continually for 5 years. 42 CFR 407.11 lists the CMS-4040
form, Request for Enrollment in Supplementary Medical Insurance, as the
application to be used by individuals not eligible for monthly benefits
or free Part A. Form CMS-4040 elicits the information that the Social
Security Administration and Centers for Medicare & Medicaid Services
need to determine entitlement to Part B only. Form Number: CMS-4040,
4040-SP (OMB: 0938-0245); Frequency: Reporting--Once; Affected
Public: Individuals or households; Number of Respondents: 10,000; Total
Annual Responses: 10,000; Total Annual Hours: 25,000.
4. Type of Information Collection Request: New collection; Title of
Information Collection: Hospital Reporting Initiative--Hospital Quality
Measures (Surgical Care Improvement (SCIP) Measures/Mortality Measures;
Use: The purpose of this information collection request is to collect
data to produce valid, reliable, comparable and salient quality
measures to provide a potent stimulus for clinicians and providers to
improve the quality of care they provide. The reporting of Surgical
Care Improvement (SCIP) measures is currently being collected from
hospitals for activities associated with the Quality Improvement
Organization (QIO) Program. Section 5001(a) of Public Law 109-171 of
the Deficit Reduction Act sets out new requirements under the Reporting
Hospital Quality Data for Annual Payment Update program. This program
was initially established under section 501(b) of the MMA which offers
monetary incentives for hospitals participating in the reporting of
quality data. The Act requires that we expand the existing ``starter
set'' of 10 quality measures that we have used since 2003. Although,
this effort increases the volume of data currently reported into the
QIO Clinical Data Warehouse; it however, does not place a substantial
data collection burden on hospitals. A substantial percentage of
hospitals are voluntarily submitting these SCIP measures currently. In
contrast to the SCIP quality measures, no additional data collection
from hospitals will be required from the mortality measures. All three
mortality measures can be calculated based on Medicare inpatient and
outpatient claims data that are already reported to the Medicare
program for payment purposes. Form Number: CMS-10210 (OMB:
0938-NEW); Frequency: Recordkeeping, Reporting, Third-Party
Disclosure--Quarterly; Affected Public: Business or other for-profit,
Not-for-profit; Number of Respondents: 3,700; Total Annual Responses:
3,700; Total Annual Hours: 587,500.
5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicaid
Statistical Information System; Use: State data are reported by the
Federally mandated electronic process, known as Medicaid Statistical
Information System
[[Page 60533]]
(MSIS). These data are the basis of actuarial forecasts for Medicaid
service utilization and costs; of analysis and cost savings estimates
required for legislative initiatives relating to Medicaid; and for
responding to requests for information from CMS components, the
Department, Congress and other customers. Form Number: CMS-R-284
(OMB: 0938-0345); Frequency: Quarterly; Affected Public:
State, Local or Tribal Government; Number of Respondents: 53; Total
Annual Responses: 212; Total Annual Hours: 3,392.
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/PaperworkReductionActof1995,
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 12, 2006.
CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development--C, Attention: Bonnie L Harkless,
Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Dated: October 4, 2006.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. E6-17035 Filed 10-12-06; 8:45 am]
BILLING CODE 4120-01-P