80 FR 16686 - 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 60 (March 30, 2015)
Centers for Medicare & Medicaid Services
Federal Register Volume 80, Issue 60 (March 30, 2015)
| Page Range | 16686-16687 | |
| FR Document | 2015-07219 |
[Federal Register Volume 80, Number 60 (Monday, March 30, 2015)] [Notices] [Pages 16686-16687] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-07219] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifiers: CMS-29, CMS-10221 and CMS-R-263] 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 April 29, 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 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: Verification of Clinic Data--Rural Health Clinic Form and Supporting Regulations; Use: The form is utilized as an application to be completed by suppliers of Rural Health Clinic (RHC) services requesting participation in the Medicare program. This form initiates the process of obtaining a decision as to whether the conditions for certification are met as a supplier of RHC services. It also promotes data reduction or introduction to and retrieval from the Automated Survey Process Environment (ASPEN) and related survey and certification databases by the CMS Regional Offices. Should any question arise regarding the structure of the organization, this information is readily available. Form Number: CMS-29 (OMB control number 0938-0074); Frequency: Occasionally (initially and then every six years); Affected Public: Private Sector (Business or other for-profit and Not-for-profit institutions); Number of Respondents: 900; Total Annual Responses: 900; Total Annual Hours: 150. (For policy questions regarding this collection contact Shont[eacute] Carter at 410-786-3532.) 2. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Site Investigation for Independent Diagnostic Testing Facilities (IDTFs); Use: We enroll Independent Diagnostic Testing Facilities (IDTFs) into the Medicare program via a uniform application, the CMS 855B. Implementation of enhanced procedures for verifying the enrollment information has improved the enrollment process as well as identified and prevented fraudulent IDTFs from entering the Medicare program. As part of this process, verification of compliance with IDTF performance standards is necessary. The primary function of the site investigation form for IDTFs is to provide a standardized, uniform tool to gather information from an IDTF that tells us whether it meets certain standards to be a IDTF (as found in 42 CFR 410.33(g)) and where it practices or renders its services. The site investigation form has been used in the past to aid in verifying compliance with the required performance standards found in 42 CFR 410.33(g). No revisions have been made to this form since the last submission for OMB approval. Form Number: CMS-10221 (OMB Control Number: 0938-1029); Frequency: Occasionally; Affected Public: Private Sector (Business or other for- profits and Not-for-profit institutions); Number of Respondents: 900; Total Annual Responses: 900; Total Annual Hours: 1,800. (For policy questions regarding this collection contact Kim McPhillips at 410-786- 5374). 3. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Site Investigation for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS); Use: We enroll suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) into the Medicare program via a uniform application, the CMS 855S. Implementation of enhanced procedures for verifying the enrollment information has improved the enrollment process as well as identified and prevented fraudulent DMEPOS suppliers from entering the Medicare program. As part of this process, verification of compliance with supplier standards is necessary. The primary function of the site investigation form is to provide a standardized, uniform tool to gather information from a DMEPOS [[Page 16687]] supplier that tells us whether it meets certain qualifications to be a DMEPOS supplier (as found in 42 CFR 424.57(c)) and where it practices or renders its services. The site investigation form has been used in the past to aid in verifying compliance with the required supplier standards found in 42 CFR 424.57(c). No revisions have been made to this form since the last submission for OMB approval. Form Number: CMS- R-263 (OMB Control Number: 0938-0749); Frequency: Occasionally; Affected Public: Private Sector (Business or other for-profits and Not- for-profit institutions); Number of Respondents: 30,000; Total Annual Responses: 30,000; Total Annual Hours: 15,000. (For policy questions regarding this collection contact Kim McPhillips at 410-786-5374). Dated: March 25, 2015. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2015-07219 Filed 3-27-15; 8:45 am] BILLING CODE 4120-01-P
![16686 Federal Register / Vol. 80, No. 60 / Monday, March 30, 2015 / Notices
Dated: March 24, 2015. this notice, you may make your request 900; Total Annual Responses: 900; Total
Sylvia M. Burwell, using one of following: Annual Hours: 150. (For policy
Secretary of Health and Human Services. 1. Access CMS’ Web site address at questions regarding this collection
[FR Doc. 2015–07235 Filed 3–27–15; 8:45 am] http://www.cms.hhs.gov/Paperwork contact Shonté Carter at 410–786–3532.)
BILLING CODE 4150–28–P
ReductionActof1995. 2. Type of Information Collection
2. Email your request, including your Request: Extension of a currently
address, phone number, OMB number, approved collection; Title of
DEPARTMENT OF HEALTH AND and CMS document identifier, to Information Collection: Site
HUMAN SERVICES Paperwork@cms.hhs.gov. Investigation for Independent
3. Call the Reports Clearance Office at Diagnostic Testing Facilities (IDTFs);
Centers for Medicare & Medicaid (410) 786–1326. Use: We enroll Independent Diagnostic
Services FOR FURTHER INFORMATION CONTACT: Testing Facilities (IDTFs) into the
Reports Clearance Office at (410) 786– Medicare program via a uniform
[Document Identifiers: CMS–29, CMS–10221 1326. application, the CMS 855B.
and CMS–R–263] Implementation of enhanced procedures
SUPPLEMENTARY INFORMATION: Under the
for verifying the enrollment information
Agency Information Collection Paperwork Reduction Act of 1995 (PRA)
has improved the enrollment process as
Activities: Submission for OMB (44 U.S.C. 3501–3520), federal agencies
well as identified and prevented
Review; Comment Request must obtain approval from the Office of
fraudulent IDTFs from entering the
Management and Budget (OMB) for each
ACTION: Notice. Medicare program. As part of this
collection of information they conduct
process, verification of compliance with
or sponsor. The term ‘‘collection of
SUMMARY: The Centers for Medicare & IDTF performance standards is
information’’ is defined in 44 U.S.C. necessary. The primary function of the
Medicaid Services (CMS) is announcing
3502(3) and 5 CFR 1320.3(c) and site investigation form for IDTFs is to
an opportunity for the public to
includes agency requests or provide a standardized, uniform tool to
comment on CMS’ intention to collect
requirements that members of the public gather information from an IDTF that
information from the public. Under the
submit reports, keep records, or provide tells us whether it meets certain
Paperwork Reduction Act of 1995
information to a third party. Section standards to be a IDTF (as found in 42
(PRA), federal agencies are required to
3506(c)(2)(A) of the PRA (44 U.S.C. CFR 410.33(g)) and where it practices or
publish notice in the Federal Register
3506(c)(2)(A)) requires federal agencies renders its services. The site
concerning each proposed collection of
to publish a 30-day notice in the investigation form has been used in the
information, including each proposed
Federal Register concerning each past to aid in verifying compliance with
extension or reinstatement of an existing
proposed collection of information, the required performance standards
collection of information, and to allow
including each proposed extension or found in 42 CFR 410.33(g). No revisions
a second opportunity for public
reinstatement of an existing collection have been made to this form since the
comment on the notice. Interested
of information, before submitting the last submission for OMB approval. Form
persons are invited to send comments
collection to OMB for approval. To Number: CMS–10221 (OMB Control
regarding the burden estimate or any
comply with this requirement, CMS is Number: 0938–1029); Frequency:
other aspect of this collection of
publishing this notice that summarizes Occasionally; Affected Public: Private
information, including any of the
the following proposed collection(s) of Sector (Business or other for-profits and
following subjects: (1) The necessity and
information for public comment: Not-for-profit institutions); Number of
utility of the proposed information 1. Type of Information Collection
collection for the proper performance of Respondents: 900; Total Annual
Request: Extension of a currently Responses: 900; Total Annual Hours:
the agency’s functions; (2) the accuracy approved collection; Title of
of the estimated burden; (3) ways to 1,800. (For policy questions regarding
Information Collection: Verification of this collection contact Kim McPhillips
enhance the quality, utility, and clarity Clinic Data—Rural Health Clinic Form
of the information to be collected; and at 410–786–5374).
and Supporting Regulations; Use: The 3. Type of Information Collection
(4) the use of automated collection form is utilized as an application to be
techniques or other forms of information Request: Extension of a currently
completed by suppliers of Rural Health approved collection; Title of
technology to minimize the information Clinic (RHC) services requesting
collection burden. Information Collection: Site
participation in the Medicare program. Investigation for Suppliers of Durable
DATES: Comments on the collection(s) of This form initiates the process of Medical Equipment, Prosthetics,
information must be received by the obtaining a decision as to whether the Orthotics and Supplies (DMEPOS); Use:
OMB desk officer by April 29, 2015. conditions for certification are met as a We enroll suppliers of durable medical
ADDRESSES: When commenting on the supplier of RHC services. It also equipment, prosthetics, orthotics, and
proposed information collections, promotes data reduction or introduction supplies (DMEPOS) into the Medicare
please reference the document identifier to and retrieval from the Automated program via a uniform application, the
or OMB control number. To be assured Survey Process Environment (ASPEN) CMS 855S. Implementation of enhanced
consideration, comments and and related survey and certification procedures for verifying the enrollment
recommendations must be received by databases by the CMS Regional Offices. information has improved the
the OMB desk officer via one of the Should any question arise regarding the enrollment process as well as identified
mstockstill on DSK4VPTVN1PROD with NOTICES
following transmissions: OMB, Office of structure of the organization, this and prevented fraudulent DMEPOS
Information and Regulatory Affairs, information is readily available. Form suppliers from entering the Medicare
Attention: CMS Desk Officer, Fax Number: CMS–29 (OMB control number program. As part of this process,
Number: (202) 395–5806 OR Email: 0938–0074); Frequency: Occasionally verification of compliance with supplier
OIRA_submission@omb.eop.gov. (initially and then every six years); standards is necessary. The primary
To obtain copies of a supporting Affected Public: Private Sector (Business function of the site investigation form is
statement and any related forms for the or other for-profit and Not-for-profit to provide a standardized, uniform tool
proposed collection(s) summarized in institutions); Number of Respondents: to gather information from a DMEPOS
VerDate Sep<11>2014 19:57 Mar 27, 2015 Jkt 235001 PO 00000 Frm 00071 Fmt 4703 Sfmt 4703 E:\FR\FM\30MRN1.SGM 30MRN1](https://thefederalregister.org/doc/80_FR_16746/page/1.svg)
![Federal Register / Vol. 80, No. 60 / Monday, March 30, 2015 / Notices 16687
supplier that tells us whether it meets utility, and clarity of the information to approval from the Office of Management
certain qualifications to be a DMEPOS be collected; and (4) the use of and Budget (OMB) for each collection of
supplier (as found in 42 CFR 424.57(c)) automated collection techniques or information they conduct or sponsor.
and where it practices or renders its other forms of information technology to The term ‘‘collection of information’’ is
services. The site investigation form has minimize the information collection defined in 44 U.S.C. 3502(3) and 5 CFR
been used in the past to aid in verifying burden. 1320.3(c) and includes agency requests
compliance with the required supplier DATES: Comments must be received by or requirements that members of the
standards found in 42 CFR 424.57(c). No May 29, 2015. public submit reports, keep records, or
revisions have been made to this form provide information to a third party.
ADDRESSES: When commenting, please
since the last submission for OMB Section 3506(c)(2)(A) of the PRA
reference the document identifier or
approval. Form Number: CMS–R–263 requires federal agencies to publish a
OMB control number. To be assured
(OMB Control Number: 0938–0749); 60-day notice in the Federal Register
consideration, comments and
Frequency: Occasionally; Affected concerning each proposed collection of
recommendations must be submitted in
Public: Private Sector (Business or other information, including each proposed
any one of the following ways:
for-profits and Not-for-profit 1. Electronically. You may send your extension or reinstatement of an existing
institutions); Number of Respondents: comments electronically to http:// collection of information, before
30,000; Total Annual Responses: www.regulations.gov. Follow the submitting the collection to OMB for
30,000; Total Annual Hours: 15,000. instructions for ‘‘Comment or approval. To comply with this
(For policy questions regarding this Submission’’ or ‘‘More Search Options’’ requirement, CMS is publishing this
collection contact Kim McPhillips at to find the information collection notice.
410–786–5374). document(s) that are accepting Information Collection
Dated: March 25, 2015. comments. 1. Title of Information Collection:
William N. Parham, III, 2. By regular mail. You may mail
Information Collection for Machine
Director, Paperwork Reduction Staff, Office written comments to the following
Readable Data for Provider Network and
of Strategic Operations and Regulatory address: CMS, Office of Strategic
Prescription Formulary Content for FFM
Affairs. Operations and Regulatory Affairs,
QHPs; Type of Information Collection
[FR Doc. 2015–07219 Filed 3–27–15; 8:45 am] Division of Regulations Development,
Request: New collection (Request for a
BILLING CODE 4120–01–P Attention: Document Identifier/OMB
new OMB control number); Use: For
Control Number lll, Room C4–26–
plan years beginning on or after January
05, 7500 Security Boulevard, Baltimore,
1, 2016, qualified health plan (QHP)
DEPARTMENT OF HEALTH AND Maryland 21244–1850.
To obtain copies of a supporting issuers must make available provider
HUMAN SERVICES
statement and any related forms for the and formulary data in a machine-
Centers for Medicare & Medicaid proposed collection(s) summarized in readable format. As required by the final
Services this notice, you may make your request rule Patient Protection and Affordable
using one of following: Care Act; HHS Notice of Benefit and
[Document Identifier: CMS–10558 and CMS– Payment Parameters for 2016 (CMS–
10463] 1. Access CMS’ Web site address at
http://www.cms.hhs.gov/ 9944–F), 80 Federal Register 10750
PaperworkReductionActof1995. February 27, 2015, QHP issuers in the
Agency Information Collection
2. Email your request, including your Federally-facilitated Marketplaces
Activities: Proposed Collection;
address, phone number, OMB number, (FFMs) are required to publish
Comment Request
and CMS document identifier, to information regarding their formulary
AGENCY: Centers for Medicare & Paperwork@cms.hhs.gov. drug lists and provider directories on its
Medicaid Services, HHS. 3. Call the Reports Clearance Office at Web site in an HHS-specified format, in
ACTION: Notice. (410) 786–1326. a format and at times determined by
FOR FURTHER INFORMATION CONTACT: HHS. Form Number: CMS–10558 (0938-
SUMMARY: The Centers for Medicare & New); Frequency: Monthly; Affected
Reports Clearance Office at (410) 786–
Medicaid Services (CMS) is announcing Public: Private Sector (Business or other
1326.
an opportunity for the public to For-profits and Not-for-Profit
comment on CMS’ intention to collect SUPPLEMENTARY INFORMATION: institutions); Number of Respondents:
information from the public. Under the Contents 475; Number of Responses: 36; Total
Paperwork Reduction Act of 1995 (the Annual Hours: 79,800. (For questions
PRA), federal agencies are required to This notice sets out a summary of the
regarding this collection, contact Lisa-
publish notice in the Federal Register use and burden associated with the
Ann Bailey at (301) 492- 4169.)
concerning each proposed collection of following information collections. More 2. Type of Information Collection
information (including each proposed detailed information can be found in Request: Revision of a currently
extension or reinstatement of an existing each collection’s supporting statement approved information collection; Title
collection of information) and to allow and associated materials (see of Information Collection: Cooperative
60 days for public comment on the ADDRESSES). Agreement to Support Navigators in
proposed action. Interested persons are CMS–10558 Information Collection for Federally-facilitated and State
invited to send comments regarding our Machine Readable Data for Provider Partnership Exchanges; Use: Section
Network and Prescription
mstockstill on DSK4VPTVN1PROD with NOTICES
burden estimates or any other aspect of 1311(i) of the Affordable Care Act
this collection of information, including Formulary Content for FFM QHPs requires Exchanges to establish a
any of the following subjects: (1) The CMS–10463 Cooperative Agreement to Navigator grant program as part of its
necessity and utility of the proposed Support Navigators in Federally- function to provide consumers with
information collection for the proper Facilitated and State Partnership assistance when they need it. Navigators
performance of the agency’s functions; Exchanges will assist consumers by providing
(2) the accuracy of the estimated Under the PRA (44 U.S.C. 3501– education about and facilitating
burden; (3) ways to enhance the quality, 3520), federal agencies must obtain selection of qualified health plans
VerDate Sep<11>2014 19:57 Mar 27, 2015 Jkt 235001 PO 00000 Frm 00072 Fmt 4703 Sfmt 4703 E:\FR\FM\30MRN1.SGM 30MRN1](https://thefederalregister.org/doc/80_FR_16746/page/2.svg)
Document Created: 2015-12-18 11:32:59
Document Modified: 2015-12-18 11:32:59
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Dates | Comments on the collection(s) of information must be received by the OMB desk officer by April 29, 2015. | |
| Contact | Reports Clearance Office at (410) 786- 1326. | |
| FR Citation | 80 FR 16686 |
2025 Federal Register | Disclaimer | Privacy Policy
USC | CFR | eCFR