[Federal Register Volume 76, Number 34 (Friday, February 18, 2011)]
[Notices]
[Page 9579]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-3749]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10251]
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: Integrated
Medicare and Medicaid State Plan Preprint; Form No.: CMS-10251
(OMB: 0938-1047); Use: The Integrated Care Preprint is an
optional tool for use by States to highlight the arrangements provided
between the State and Medicare Advantage Special Needs Plans that are
also providing Medicaid services. The preprint also provides the
opportunity for States to confirm that their integrated care model
complies with Federal statutory and regulatory requirements. State
Medicaid Agencies may complete the preprint and CMS will review the
information provided to determine if the State has properly completed
and explained their integrated care arrangements and that the
appropriate assurances have been met; Frequency: Once; Affected Public:
State, Local, or Tribal Governments; Number of Respondents: 56; Total
Annual Responses: 10; Total Annual Hours: 200. (For policy questions
regarding this collection contact Mary Pat Farkas at 410-786-5731. 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 at 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 April 19, 2011:
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.
Martique Jones,
Director, Regulations Development Group, Division B, Office of
Strategic Operations and Regulatory Affairs.
[FR Doc. 2011-3749 Filed 2-17-11; 8:45 am]
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