[Federal Register Volume 75, Number 103 (Friday, May 28, 2010)]
[Notices]
[Pages 30030-30031]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-12624]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10314, CMS-264-94, CMS-1728-94, CMS-10240 and
CMS-P-0015A]
Agency Information Collection Activities: Proposed Collection;
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) 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: New collection; Title of
Information Collection: Medicare Savings Program Protection from
Medicaid Estate Recovery--State Plan Pre-print under Title XIX. Form
No: CMS-10314 (OMB 0938-New); Use: Section 115 of the Medicare
Improvements for Patients and Providers Act (MIPPA)--2008, provides new
protections from Medicaid estate recovery for limited categories of
dual eligibles age 55 and over. To offer these protections, States have
to amend their Medicaid State plans to reflect these new limits on
estate recovery. To reduce paperwork burden and expedite this process,
CMS is providing States with a pre-printed document (i.e., a State plan
preprint) which neither needs nor requires any insertion of language or
even completion of a check-off box. As Section 115 simply mandates
compliance (there is no option not to comply), States only need return
the preprint page (as prepared by CMS) to CMS, as a requested amendment
to their State Plan. This is a one-time only submission, with little
burden imposition and complete electronic routing to and from States.
Frequency: Reporting--Once; Affected Public: State, Local or Tribal
Governments; Number of Respondents: 51; Total Annual Responses: 51;
Total Annual Hours: 102. (For policy questions regarding this
collection contact Nancy Dieter at 410-786-7219. For all other issues
call 410-786-1326.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Independent Renal
Dialysis Facility Cost Report; Use: The Independent Renal Dialysis
Facility Cost Report, is filed annually by providers participating in
the Medicare program to identify the specific items of cost and
statistics of facility operation that independent renal dialysis
facilities are required to report. Form Number: CMS-265-94
(OMB: 0938-0236); Frequency: Yearly; Affected Public: Business
or other for-profits and Not-for-profit institutions; Number of
Respondents: 5,508; Total Annual Responses: 5,508; Total Annual Hours:
275,400. (For policy questions regarding this collection contact Gail
Duncan at 410-786-7278. For all other issues call 410-786-1326.)
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Home Health
Agency Cost Report; Use: These cost report forms are filed annually by
freestanding providers participating in the Medicare program to effect
year end cost settlement for providing services to Medicare
beneficiaries. The data submitted on the cost reports supports
management of Federal programs. Providers receiving Medicare
reimbursement must provide adequate cost data based on financial and
statistical records which can be verified by qualified auditors. The
data from these cost reporting forms will be used for the purpose of
evaluating current levels of Medicare reimbursement. Form Number: CMS-
1728-94 (OMB: 0938-0022); Frequency: Yearly; Affected Public:
Business or other for-profits and Not-for-profit institutions; Number
of Respondents: 7,479; Total Annual Responses: 7,479; Total Annual
Hours: 1,690,254. (For policy questions regarding this collection
contact Angela Havrilla at 410-786-4516. For all other issues call 410-
786-1326.)
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Data Collection
for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration; Use:
The goal of the NHVBP Demonstration is to use financial incentives to
improve the quality of care in nursing homes. The main purpose of the
NHVBP data collection effort is to gather information that will enable
CMS to determine which nursing homes will be eligible to receive
incentive payments under the NHVBP Demonstration. Information will be
collected from nursing homes participating in the demonstration on an
ongoing basis. CMS will collect payroll-based staffing, agency staffing
and resident census information to help assess the quality of care in
participating nursing homes. CMS will determine which homes qualify for
an incentive payment based on their relative performance in terms of
quality. Form Number: CMS-10240 (OMB: 0938-1039); Frequency:
Quarterly; Affected Public: Business or other for-profits and Not-for-
profit institutions; Number of Respondents: 178; Total Annual
Responses: 712; Total Annual
[[Page 30031]]
Hours: 5,530. (For policy questions regarding this collection contact
Ron Lambert at 410-786-6624. For all other issues call 410-786-1326.)
5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare Current
Beneficiary Survey; Use: The Medicare Current Beneficiary Survey (MCBS)
serves to measure what impact the changes have on the program and its
beneficiaries. The MCBS is a comprehensive data collection effort that
fills an information gap in the Centers for Medicare and Medicaid
Services, and is depended on to help manage the program. Being able to
examine various characteristics and to chart evolving trends offers
policy makers a reliable tool for making informed decisions. The MCBS
is used to identify potential new policy direction or modifications to
the Medicare program and once those program enhancements are
implemented, monitor the impact of those changes. The central goals of
the MCBS are to determine medical care expenditures and sources of
payment for all services, including copayments, deductibles, and non-
covered services; to ascertain all types of health insurance coverage
and relate coverage to actual payments; and to trace processes over
time, such as changes in health status, spending down to Medicaid
eligibility, and the impacts of program changes. Form Number: CMS-P-
0015A (OMB: 0938-0568); Frequency: Yearly; Affected Public:
Business or other for-profits and Not-for-profit institutions; Number
of Respondents: 16,217; Total Annual Responses: 48,650; Total Annual
Hours: 57,062. (For policy questions regarding this collection contact
William Long at 410-786-7927. For all other issues call 410-786-1326.)
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS'
Web Site at http://www.cms.hhs.gov/PaperworkReductionActof1995, or E-
mail your request, including your address, phone number, OMB number,
and CMS document identifier, to [email protected], or call the
Reports Clearance Office on (410) 786-1326.
In commenting on the proposed information collections please
reference the document identifier or OMB control number. To be assured
consideration, comments and recommendations must be submitted in one of
the following ways by July 27, 2010:
1. Electronically. You may submit your comments electronically to
http://www.regulations.gov. Follow the instructions for ``Comment or
Submission'' or ``More Search Options'' to find the information
collection document(s) accepting comments.
2. By regular mail. You may mail written comments to the following
address: CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development, Attention: Document Identifier/OMB
Control Number, Room C4-26-05, 7500 Security Boulevard, Baltimore,
Maryland 21244-1850.
Dated: May 21, 2010.
Martique Jones,
Director, Regulations Development Division-B, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2010-12624 Filed 5-27-10; 8:45 am]
BILLING CODE 4120-01-P