[Federal Register: December 19, 2008 (Volume 73, Number 245)]
[Notices]               
[Page 77701-77702]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr19de08-100]                         

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10175, CMS-10236, and CMS-179]

 
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

[[Page 77702]]

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: Reinstatement without 
change of a previously approved collection; Title of Information 
Collection: Certification Statement for Electronic File Interchange 
Organizations (EFIOs); Use: Health care providers can currently obtain 
a National Provider Identifier (NPI) via a paper application or over 
the Internet through the National Plan and Provider Enumeration System 
(NPPES). These applications must be submitted individually, on a per-
provider basis. The Electronic File Interchange (EFI) process allows 
provider-designated electronic file interchange organizations (EFIOs) 
to capture multiple providers' NPI application information on a single 
electronic file for submission to NPPES. This process is also referred 
to as ``bulk enumeration.'' To ensure that the EFIO has the authority 
to act on behalf of each provider and complies with other Federal 
requirements, an authorized official of the EFIO must sign a 
certification statement and mail it to the Centers for Medicare and 
Medicaid Services (CMS). Form Number: CMS-10175 (OMB 0938-
0984); Frequency: Once; Affected Public: Private Sector--Business or 
other for-profits; Number of Respondents: 300; Total Annual Responses: 
300; Total Annual Hours: 300.
    2. Type of Information Collection Request: New collection; Title of 
Information Collection: Disclosure of Financial Relationships Report 
(``DFRR''); Use: Section 1877(f) of the Social Security Act requires 
that each entity providing covered items or services for which payment 
may be made shall provide the Secretary with information concerning the 
entity's ownership and investment interests, and compensation 
arrangements, in such form, manner, and at such times as the Secretary 
shall specify. The DFRR collection instrument will be used by CMS to 
(1) identify arrangements that potentially may not be in compliance 
with the physician self-referral statute and implementing regulations; 
and (2) to identify examples and areas of non-compliance that may 
assist us in any future rulemaking concerning the reporting 
requirements and other physician self-referral provisions. Form Number: 
CMS-10236 (OMB 0938-New); Frequency: Once; Affected Public: 
Private Sector--Business or other for-profits and Not-for-profit 
institutions; Number of Respondents: 400; Total Annual Responses: 400; 
Total Annual Hours: 40,000.
    3. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Transmittal and 
Notice of Approval of State Plan Material and Medicaid State Plan--Base 
Plan, Attachments and Supplemental Pages and Supporting Regulations in 
42 CFR 430.10-430.20 and 440.167; Use: The Medicaid State base plan 
pages and attachments are documents utilized by State and territorial 
agencies which have the responsibility for administering the Medicaid 
program. The Medicaid State plan is comprised of ``pages'' and 
organized by subject matter which includes Medicaid eligibility 
services, payment for services, and general, financial and personnel 
administration. When States seek to change selected pages of their 
State plans, the page(s) are transmitted to CMS for review and approval 
by the CMS Central and Regional Offices prior to amending its State 
plan. Form Number: CMS-179 (OMB 0938-0193); Frequency: Once 
and as needed; Affected Public: State, Local, or Tribal Governments; 
Number of Respondents: 56; Total Annual Responses: 4,681; Total Annual 
Hours: 9,271.
    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 by the OMB desk 
officer at the address below, no later than 5 p.m. on January 20, 2009.

OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, New Executive Office Building, Room 10235, Washington, DC 
20503, Fax Number: (202) 395-6974.

    Dated: December 12, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E8-30327 Filed 12-18-08; 8:45 am]

BILLING CODE 4120-01-P