[Federal Register Volume 75, Number 199 (Friday, October 15, 2010)]
[Notices]
[Page 63485]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-25932]
[[Page 63485]]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-1561, CMS-R-308, CMS-10335 and CMS-R-53]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
In compliance with the requirement of section 3506I(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: Health Insurance
Benefit Agreement; Use: Applicants to the Medicare program are required
to agree to provide services in accordance with Federal requirements.
The CMS-1561 is essential for CMS to ensure that applicants are in
compliance with the requirements. Applicants will be required to sign
the completed form and provide operational information to CMS to assure
that they continue to meet the requirements after approval. Form
Number: CMS-1561 (OMB: 0938-0832); Frequency: Yearly; Affected
Public: Private Sector: Business or other for-profits and Not-for-
profit institutions; Number of Respondents: 3,000; Total Annual
Responses: 3,000; Total Annual Hours: 500. (For policy questions
regarding this collection contact JoAnn Perry at 410-786-3336. For all
other issues call
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Children's Health
Insurance Program; Use: States are required to submit title XXI plans
and amendments for approval by the Secretary pursuant to section 2102
of the Social Security Act in order to receive funds for initiating and
expanding health insurance coverage for uninsured children. States are
also required to submit State expenditure and statistical reports,
annual reports and State evaluations to the Secretary as outlined in
title XXI of the Social Security Act. Form Number: CMS-R-308
(OMB: 0938-0841); Frequency: Yearly, Quarterly, Once and/or
Occasionally; Affected Public: State, Local, or Tribal Governments;
Number of Respondents: 56; Total Annual Responses: 1,114,124 Total
Annual Hours: 864,973. (For policy questions regarding this collection
contact Nancy Goetschius at 410-786-0707. For all other issues call
410-786-1326.) 410-786-1326.)
3. Type of Information Collection Request: New collection; Title of
Information Collection: Current State Practices Related to Payments to
Providers for Health Care- Acquired Conditions; Use: The Patient
Protection and Affordable Care Act of 2010 (Affordable Care Act),
enacted March 23, 2010 includes provisions prohibiting Federal
Financial Participation to States for payments for health care-acquired
conditions (HCACs). Section 2702(a) specifically requires that the
Secretary identify current State practices that prohibit payment for
HCACs and incorporate those practices or elements of those practices
which she determines appropriate for application to the Medicaid
program. In accordance with section 2702(a) of the Affordable Care Act,
CMS is issuing this survey to States to obtain information on current
State Medicaid practices for prohibiting payments for HCACs. Form
Number: CMS-10335 (OMB: 0938-New); Frequency: Once; Affected
Public: State, Local, or Tribal Governments; Number of Respondents: 50
Total Annual Responses: 50; Total Annual Hours: 50 (For policy
questions regarding this collection contact Venesa Day at 410-786-8281.
For all other issues call 410-786-1326.)
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Imposition of
Cost Sharing Charges under Medicaid and Supporting Regulations in 42
CFR 447.53; Use: The purpose of this collection is to ensure that
States impose normal cost sharing charges upon categorically and
medically needy individuals as allowed by law and implementing
regulations. States must identify in their State plan the service for
which the charge is made, the amount of the charge, the basis for
determining the charge, the basis for determining whether an individual
is unable to pay the charge and the way in which the individual will be
identified to providers, and the procedures for implementing and
enforcing the exclusions from cost sharing. Form Number: CMS-R-53
(OMB: 0938-0429); Frequency: Occasionally; Affected Public:
State, Local, or Tribal Governments; Number of Respondents: 56; Total
Annual Responses: 2; Total Annual Hours: 20. (For policy questions
regarding this collection contact Barbara Washington at 410-786-9964.
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 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 [email protected], 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 November 15,
2010.
OMB, Office of Information and Regulatory Affairs, Attention: CMS
Desk Officer, Fax Number: (202) 395-6974, E-mail: [email protected].
Dated: October 8, 2010.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 2010-25932 Filed 10-14-10; 8:45 am]
BILLING CODE 4120-01-P