80_FR_10726 80 FR 10687 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

80 FR 10687 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services

Federal Register Volume 80, Issue 39 (February 27, 2015)

Page Range10687-10688
FR Document2015-04113

The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice. Interested persons are invited to send comments regarding the 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.

Federal Register, Volume 80 Issue 39 (Friday, February 27, 2015)
[Federal Register Volume 80, Number 39 (Friday, February 27, 2015)]
[Notices]
[Pages 10687-10688]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-04113]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS-10341 and CMS-10522]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is 
announcing an opportunity for the public to comment on CMS' intention 
to collect information from the public. Under the Paperwork Reduction 
Act of 1995 (PRA), federal agencies are required to publish notice in 
the Federal Register concerning each proposed collection of 
information, including each proposed extension or reinstatement of an 
existing collection of information, and to allow a second opportunity 
for public comment on the notice. Interested persons are invited to 
send comments regarding the 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.

DATES: Comments on the collection(s) of information must be received by 
the OMB desk officer by March 30, 2015.

ADDRESSES: When commenting on the proposed information collections, 
please reference the document identifier or OMB control number. To be 
assured consideration, comments and recommendations must be received by 
the OMB desk officer via one of the following transmissions: OMB, 
Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-5806 or Email: 
[email protected].
    To obtain copies of a supporting statement and any related forms 
for the

[[Page 10688]]

proposed collection(s) summarized in this notice, you may make your 
request using one of following:
    1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to [email protected].
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. The term ``collection of 
information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and 
includes agency requests or requirements that members of the public 
submit reports, keep records, or provide information to a third party. 
Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires 
federal agencies to publish a 30-day notice in the Federal Register 
concerning each proposed collection of information, including each 
proposed extension or reinstatement of an existing collection of 
information, before submitting the collection to OMB for approval. To 
comply with this requirement, CMS is publishing this notice that 
summarizes the following proposed collection(s) of information for 
public comment:
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Affordable Care 
Act Information and Collection Requirements for Section 1115 
Demonstration Projects; Use: This collection is necessary to ensure 
that states comply with regulatory and statutory requirements related 
to the development, implementation and evaluation of demonstration 
projects. States seeking waiver authority under Section 1115 are 
required to meet certain requirements for public notice, the evaluation 
of demonstration projects, and reports to the Secretary on the 
implementation of approved demonstrations. Form Number: CMS-10341 (OMB 
control number 0938-1162); Frequency: Yearly; Affected Public: State, 
Local, or Tribal Governments; Number of Respondents: 37; Total Annual 
Responses: 130; Total Annual Hours: 13,910. (For policy questions 
regarding this collection contact Lane Terwilliger at 410-786-2059.)
    2. Type of Information Collection Request: New collection (Request 
for a new OMB control number); Title of Information Collection: 
Executive Summary Form for Research Identifiable Data; Use: The Centers 
for Medicare & Medicaid Services (CMS) is responsible for administering 
the Medicare, Medicaid and State Children's Health Insurance Programs. 
We collect data to support the Agency's mission and operations. These 
data include information about Medicare beneficiaries, Medicare claims, 
Medicare providers, and Medicaid eligibility and claims. We disclose 
the identifiable data consistent with the routine uses identified in 
the Privacy Act Systems of Records notices that are published in the 
Federal Register and the limitations on uses and disclosures that are 
set out in the HIPAA Privacy Rule.
    All requests for identifiable data are received and reviewed by the 
Division of Privacy Operations & Compliance (DPOC) in the Office of E-
Health Standards and Services. The DPOC staff and the CMS Privacy 
Officer review the requests to determine if there is legal 
authorization for disclosure of the data. If legal authorization 
exists, the request is reviewed to ensure that the minimal data 
necessary is requested and approved for the project. Requests for 
identifiable data for research purposes must be submitted to and 
approved by the CMS Privacy Board. To assist the CMS Privacy Board with 
its review of research data requests, OIPDA has developed the Executive 
Summary (ES) forms. The ES collects all the information that the CMS 
Privacy Board needs to review and make a determination on whether the 
request meets the requirements for release of identifiable data for 
research purposes. We currently have three versions of the ES Form and 
an ES Supplement for Requestors of the National Death Index (NDI) 
Causes of Death Variables. Each meets the need for a different type of 
requestor. Form Number: CMS-10522 (OMB control number: 0938-New); 
Frequency: On occasion; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 325; Total Annual Responses: 325; 
Total Annual Hours: 650. (For policy questions regarding this 
collection contact Kim Elmo at 410-786-0161.)

    Dated: February 24, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2015-04113 Filed 2-26-15; 8:45 am]
BILLING CODE 4120-01-P



                                                                                Federal Register / Vol. 80, No. 39 / Friday, February 27, 2015 / Notices                                                10687

                                                  minimize the information collection                     Section 3506(c)(2)(A) of the PRA                         Dated: February 24, 2015.
                                                  burden.                                                 requires federal agencies to publish a                William N. Parham, III
                                                  DATES: Comments must be received by                     60-day notice in the Federal Register                 Director, Paperwork Reduction Staff, Office
                                                  April 28, 2015.                                         concerning each proposed collection of                of Strategic Operations and Regulatory
                                                                                                          information, including each proposed                  Affairs.
                                                  ADDRESSES: When commenting, please
                                                                                                          extension or reinstatement of an existing             [FR Doc. 2015–04115 Filed 2–26–15; 8:45 am]
                                                  reference the document identifier or
                                                  OMB control number. To be assured                       collection of information, before                     BILLING CODE 4120–01–P

                                                  consideration, comments and                             submitting the collection to OMB for
                                                  recommendations must be submitted in                    approval. To comply with this
                                                                                                                                                                DEPARTMENT OF HEALTH AND
                                                  any one of the following ways:                          requirement, CMS is publishing this
                                                                                                                                                                HUMAN SERVICES
                                                    1. Electronically. You may send your                  notice.
                                                  comments electronically to http://                                                                            Centers for Medicare & Medicaid
                                                  www.regulations.gov. Follow the                         Information Collection
                                                                                                                                                                Services
                                                  instructions for ‘‘Comment or                             1. Type of Information Collection
                                                  Submission’’ or ‘‘More Search Options’’                                                                       [Document Identifier CMS–10341 and CMS–
                                                                                                          Request: Extension of a currently                     10522]
                                                  to find the information collection                      approved collection; Title of
                                                  document(s) that are accepting                          Information Collection: Appointment of                Agency Information Collection
                                                  comments.                                                                                                     Activities: Submission for OMB
                                                                                                          Representative; Use: The Appointment
                                                    2. By regular mail. You may mail                                                                            Review; Comment Request
                                                  written comments to the following                       of Representative form is completed by
                                                  address: CMS, Office of Strategic                       beneficiaries, providers and suppliers,
                                                                                                                                                                ACTION:   Notice.
                                                  Operations and Regulatory Affairs,                      and any party seeking to appoint a
                                                  Division of Regulations Development,                    representative to assist them with their              SUMMARY:    The Centers for Medicare &
                                                  Attention: Document Identifier/OMB                      initial determinations and filing                     Medicaid Services (CMS) is announcing
                                                  Control Number ____, Room C4–26–05,                     appeals. This extension request                       an opportunity for the public to
                                                  7500 Security Boulevard, Baltimore,                     proposes non-substantive changes to the               comment on CMS’ intention to collect
                                                  Maryland 21244–1850.                                    form. Form Number: CMS–1696 (OMB                      information from the public. Under the
                                                    To obtain copies of a supporting                      control number 0938–0950); Frequency:                 Paperwork Reduction Act of 1995
                                                  statement and any related forms for the                 Once; Affected Public: Individuals and                (PRA), federal agencies are required to
                                                  proposed collection(s) summarized in                    households and the Private sector                     publish notice in the Federal Register
                                                  this notice, you may make your request                  (Business or other for-profits); Number               concerning each proposed collection of
                                                  using one of following:                                 of Respondents: 4,073,960; Total                      information, including each proposed
                                                    1. Access CMS’ Web site address at                    Annual Responses: 407,396; Total                      extension or reinstatement of an existing
                                                  http://www.cms.hhs.gov/                                 Annual Hours: 101,849. (For policy                    collection of information, and to allow
                                                  PaperworkReductionActof1995.                                                                                  a second opportunity for public
                                                                                                          questions regarding this collection
                                                    2. Email your request, including your                                                                       comment on the notice. Interested
                                                                                                          contact Katherine Hosna at 410–786–
                                                  address, phone number, OMB number,                                                                            persons are invited to send comments
                                                                                                          4993).
                                                  and CMS document identifier, to                                                                               regarding the burden estimate or any
                                                  Paperwork@cms.hhs.gov.                                    2. Type of Information Collection                   other aspect of this collection of
                                                    3. Call the Reports Clearance Office at               Request: Extension of a currently                     information, including any of the
                                                  (410) 786–1326.                                         approved collection; Title of                         following subjects: (1) The necessity and
                                                  FOR FURTHER INFORMATION CONTACT:                        Information Collection: Medicare Fee-                 utility of the proposed information
                                                  Reports Clearance Office at (410) 786–                  for-Service Prepayment Medical                        collection for the proper performance of
                                                  1326.                                                   Review; Use: The information required                 the agency’s functions; (2) the accuracy
                                                                                                          under this collection is requested by                 of the estimated burden; (3) ways to
                                                  SUPPLEMENTARY INFORMATION:
                                                                                                          Medicare contractors to determine                     enhance the quality, utility, and clarity
                                                  Contents                                                proper payment or if there is a suspicion             of the information to be collected; and
                                                    This notice sets out a summary of the                 of fraud. Medicare contractors request                (4) the use of automated collection
                                                  use and burden associated with the                      the information from providers or                     techniques or other forms of information
                                                  following information collections. More                 suppliers submitting claims for payment               technology to minimize the information
                                                  detailed information can be found in                    from the Medicare program when data                   collection burden.
                                                  each collection’s supporting statement                  analysis indicates aberrant billing                   DATES: Comments on the collection(s) of
                                                  and associated materials (see                           patterns or other information which                   information must be received by the
                                                  ADDRESSES).                                             may present a vulnerability to the                    OMB desk officer by March 30, 2015.
                                                                                                          Medicare program. Form Number:                        ADDRESSES: When commenting on the
                                                  CMS–1696 Appointment of                                                                                       proposed information collections,
                                                  Representative                                          CMS–10417 (OMB control number:
                                                                                                          0938–0969); Frequency: Occasionally;                  please reference the document identifier
                                                    Under the PRA (44 U.S.C. 3501–                                                                              or OMB control number. To be assured
                                                                                                          Affected Public: Private Sector (Business
                                                  3520), federal agencies must obtain                                                                           consideration, comments and
                                                                                                          or other for-profit and Not-for-profit
                                                  approval from the Office of Management                                                                        recommendations must be received by
                                                                                                          institutions); Number of Respondents:
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                                                  and Budget (OMB) for each collection of                                                                       the OMB desk officer via one of the
                                                  information they conduct or sponsor.                    3,211,800; Total Annual Responses:
                                                                                                                                                                following transmissions: OMB, Office of
                                                  The term ‘‘collection of information’’ is               3,211,800; Total Annual Hours:                        Information and Regulatory Affairs,
                                                  defined in 44 U.S.C. 3502(3) and 5 CFR                  1,597,950. (For policy questions                      Attention: CMS Desk Officer, Fax
                                                  1320.3(c) and includes agency requests                  regarding this collection contact Debbie              Number: (202) 395–5806 or Email:
                                                  or requirements that members of the                     Skinner at 410–786–7480.)                             OIRA_submission@omb.eop.gov.
                                                  public submit reports, keep records, or                                                                          To obtain copies of a supporting
                                                  provide information to a third party.                                                                         statement and any related forms for the


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                                                  10688                         Federal Register / Vol. 80, No. 39 / Friday, February 27, 2015 / Notices

                                                  proposed collection(s) summarized in                    contact Lane Terwilliger at 410–786–                     Dated: February 24, 2015.
                                                  this notice, you may make your request                  2059.)                                                William N. Parham, III,
                                                  using one of following:                                    2. Type of Information Collection                  Director, Paperwork Reduction Staff, Office
                                                    1. Access CMS’ Web site address at                    Request: New collection (Request for a                of Strategic Operations and Regulatory
                                                  http://www.cms.hhs.gov/                                                                                       Affairs.
                                                                                                          new OMB control number); Title of
                                                  PaperworkReductionActof1995.                            Information Collection: Executive
                                                                                                                                                                [FR Doc. 2015–04113 Filed 2–26–15; 8:45 am]
                                                    2. Email your request, including your                 Summary Form for Research Identifiable                BILLING CODE 4120–01–P
                                                  address, phone number, OMB number,                      Data; Use: The Centers for Medicare &
                                                  and CMS document identifier, to                         Medicaid Services (CMS) is responsible
                                                  Paperwork@cms.hhs.gov.                                                                                        DEPARTMENT OF HEALTH AND
                                                                                                          for administering the Medicare,                       HUMAN SERVICES
                                                    3. Call the Reports Clearance Office at               Medicaid and State Children’s Health
                                                  (410) 786–1326.                                         Insurance Programs. We collect data to                Centers for Medicare & Medicaid
                                                  FOR FURTHER INFORMATION CONTACT:                        support the Agency’s mission and                      Services
                                                  Reports Clearance Office at (410) 786–                  operations. These data include                        [CMS–7036–N]
                                                  1326.                                                   information about Medicare
                                                  SUPPLEMENTARY INFORMATION:      Under the               beneficiaries, Medicare claims,                       Health Insurance Marketplace,
                                                  Paperwork Reduction Act of 1995 (PRA)                   Medicare providers, and Medicaid                      Medicare, Medicaid, and Children’s
                                                  (44 U.S.C. 3501–3520), federal agencies                 eligibility and claims. We disclose the               Health Insurance Programs; Renewal
                                                  must obtain approval from the Office of                 identifiable data consistent with the                 of the Advisory Panel on Outreach and
                                                  Management and Budget (OMB) for each                    routine uses identified in the Privacy                Education (APOE) and Request for
                                                  collection of information they conduct                  Act Systems of Records notices that are               Nominations
                                                  or sponsor. The term ‘‘collection of                    published in the Federal Register and                 AGENCY: Centers for Medicare &
                                                  information’’ is defined in 44 U.S.C.                   the limitations on uses and disclosures               Medicaid Services (CMS), HHS.
                                                  3502(3) and 5 CFR 1320.3(c) and                         that are set out in the HIPAA Privacy
                                                                                                                                                                ACTION: Notice.
                                                  includes agency requests or                             Rule.
                                                  requirements that members of the public                                                                       SUMMARY:   This notice announces the
                                                                                                             All requests for identifiable data are
                                                  submit reports, keep records, or provide                                                                      renewal of the Advisory Panel (the
                                                                                                          received and reviewed by the Division
                                                  information to a third party. Section                                                                         Panel) on Outreach and Education
                                                                                                          of Privacy Operations & Compliance
                                                  3506(c)(2)(A) of the PRA (44 U.S.C.                                                                           (APOE) charter. It also requests
                                                  3506(c)(2)(A)) requires federal agencies                (DPOC) in the Office of E-Health
                                                                                                          Standards and Services. The DPOC staff                nominations for individuals to serve on
                                                  to publish a 30-day notice in the                                                                             the APOE.
                                                  Federal Register concerning each                        and the CMS Privacy Officer review the
                                                                                                          requests to determine if there is legal               DATES: Nominations will be considered
                                                  proposed collection of information,
                                                                                                          authorization for disclosure of the data.             if we receive them at the appropriate
                                                  including each proposed extension or
                                                                                                          If legal authorization exists, the request            address, provided in the ADDRESSES
                                                  reinstatement of an existing collection
                                                                                                          is reviewed to ensure that the minimal                section of this notice, no later than 5
                                                  of information, before submitting the
                                                                                                          data necessary is requested and                       p.m., Eastern Daylight Time (e.d.t.) on
                                                  collection to OMB for approval. To
                                                                                                          approved for the project. Requests for                March 30, 2015.
                                                  comply with this requirement, CMS is
                                                  publishing this notice that summarizes                  identifiable data for research purposes               ADDRESSES: Mail nominations to the
                                                  the following proposed collection(s) of                 must be submitted to and approved by                  following address: Abigail Huffman,
                                                  information for public comment:                         the CMS Privacy Board. To assist the                  Designated Federal Official, Office of
                                                    1. Type of Information Collection                     CMS Privacy Board with its review of                  Communications, CMS, 7500 Security
                                                  Request: Extension of a currently                                                                             Boulevard, Mail Stop S1–13–05,
                                                                                                          research data requests, OIPDA has
                                                  approved collection; Title of                                                                                 Baltimore, MD 21244–1850 or email
                                                                                                          developed the Executive Summary (ES)
                                                  Information Collection: Affordable Care                                                                       nominations to
                                                                                                          forms. The ES collects all the
                                                  Act Information and Collection                                                                                Abigail.Huffman1@cms.hhs.gov.
                                                                                                          information that the CMS Privacy Board
                                                  Requirements for Section 1115                           needs to review and make a                            FOR FURTHER INFORMATION CONTACT:
                                                  Demonstration Projects; Use: This                       determination on whether the request                  Abigail Huffman, Designated Federal
                                                  collection is necessary to ensure that                  meets the requirements for release of                 Official, Office of Communications,
                                                  states comply with regulatory and                       identifiable data for research purposes.              CMS, 7500 Security Boulevard, Mail
                                                  statutory requirements related to the                   We currently have three versions of the               Stop S1–13–05, Baltimore, MD 21244,
                                                  development, implementation and                         ES Form and an ES Supplement for                      410–786–0897, email
                                                  evaluation of demonstration projects.                                                                         Abigail.Huffman1@cms.hhs.gov or visit
                                                                                                          Requestors of the National Death Index
                                                  States seeking waiver authority under                                                                         the Web site at http://www.cms.gov/
                                                                                                          (NDI) Causes of Death Variables. Each
                                                  Section 1115 are required to meet                                                                             Regulations-and-Guidance/Guidance/
                                                                                                          meets the need for a different type of                FACA/APOE.html. Press inquiries are
                                                  certain requirements for public notice,
                                                                                                          requestor. Form Number: CMS–10522                     handled through the CMS Press Office
                                                  the evaluation of demonstration
                                                  projects, and reports to the Secretary on               (OMB control number: 0938–New);                       at (202) 690–6145.
                                                  the implementation of approved                          Frequency: On occasion; Affected
                                                                                                                                                                SUPPLEMENTARY INFORMATION:
                                                                                                          Public: State, Local, or Tribal
mstockstill on DSK4VPTVN1PROD with NOTICES




                                                  demonstrations. Form Number: CMS–
                                                  10341 (OMB control number 0938–                         Governments; Number of Respondents:                   I. Background
                                                  1162); Frequency: Yearly; Affected                      325; Total Annual Responses: 325; Total                 The Advisory Panel (the Panel) on
                                                  Public: State, Local, or Tribal                         Annual Hours: 650. (For policy                        Medicare Education (the predecessor to
                                                  Governments; Number of Respondents:                     questions regarding this collection                   the APOE) was created in 1999 to advise
                                                  37; Total Annual Responses: 130; Total                  contact Kim Elmo at 410–786–0161.)                    and make recommendations to the
                                                  Annual Hours: 13,910. (For policy                                                                             Secretary of the U.S. Department of
                                                  questions regarding this collection                                                                           Health and Human Services (HHS), and


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Document Created: 2015-12-18 13:14:32
Document Modified: 2015-12-18 13:14:32
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesComments on the collection(s) of information must be received by the OMB desk officer by March 30, 2015.
ContactReports Clearance Office at (410) 786- 1326.
FR Citation80 FR 10687 

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