80 FR 21720 - Agency Information Collection Activities: Proposed Collection; Comment Request
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 80, Issue 75 (April 20, 2015)
Centers for Medicare & Medicaid Services
Federal Register Volume 80, Issue 75 (April 20, 2015)
| Page Range | 21720-21721 | |
| FR Document | 2015-09008 |
[Federal Register Volume 80, Number 75 (Monday, April 20, 2015)] [Notices] [Pages 21720-21721] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-09008] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifier: CMS-179] Agency Information Collection Activities: Proposed Collection; Comment Request AGENCY: Centers for Medicare & Medicaid Services, HHS. 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 (the 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 60 days for public comment on the proposed action. Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including any of the following subjects: The necessity and utility of the proposed information collection for the proper performance of the agency's functions; the accuracy of the estimated burden; ways to enhance the quality, utility, and clarity of the information to be collected; and the use of automated collection techniques or other forms of information technology to minimize the information collection burden. DATES: Comments must be received by June 19, 2015. ADDRESSES: When commenting, please reference the document identifier or OMB control number. To be assured consideration, comments and recommendations must be submitted in any one of the following ways: 1. Electronically. You may send 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) that are 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. 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: Contents This notice sets out a summary of the use and burden associated with the following information collections. More detailed information can be found in each collection's supporting statement and associated materials (see ADDRESSES). [[Page 21721]] CMS-179 State Plan Under Title XIX of the Social Security Act (Base Plan Pages, Attachments, Supplements to Attachments) Under the 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 requires federal agencies to publish a 60-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. Information Collection 1. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Medicaid State Plan Base Plan Pages; Use: State Medicaid agencies complete the plan pages while we review the information to determine if the state has met all of the requirements of the provisions the states choose to implement. If the requirements are met, we will approve the amendments to the state's Medicaid plan giving the state the authority to implement the flexibilities. For a state to receive Medicaid Title XIX funding, there must be an approved Title XIX state plan. Form Number: CMS-179 (OMB control number 0938-0193); Frequency: Occasionally; Affected Public: State, Local, and Tribal Governments; Number of Respondents: 56; Total Annual Responses: 1,120; Total Annual Hours: 22,400. (For policy questions regarding this collection contact Annette Pearson at 410-786-6958.) Dated: April 15, 2015. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2015-09008 Filed 4-17-15; 8:45 am] BILLING CODE 4120-01-P
![21720 Federal Register / Vol. 80, No. 75 / Monday, April 20, 2015 / Notices
Transfer Order—Surplus Personal B. Annual Reporting Burden this collection of information, including
Property and Continuation Sheet, Respondents: 20,110. any of the following subjects: The
Standard Form (SF) 123. Responses per Respondent: 1. necessity and utility of the proposed
DATES: Submit comments on or before: Total Number of Respondents: 20,110. information collection for the proper
June 19, 2015. Hours per Response: 0.019. performance of the agency’s functions;
Total Burden Hours: 382. the accuracy of the estimated burden;
ADDRESSES: Submit comments ways to enhance the quality, utility, and
identified by Information Collection C. Public Comments clarity of the information to be
3090–0014, Transfer Order—Surplus Public comments are particularly collected; and the use of automated
Personal Property and Continuation invited on: Whether this collection of collection techniques or other forms of
Sheet, Standard Form (SF) 123, by any information is necessary and whether it information technology to minimize the
of the following methods: will have practical utility; whether our information collection burden.
• Regulations.gov: http:// estimate of the public burden of this
www.regulations.gov. Submit comments DATES: Comments must be received by
collection of information is accurate,
via the Federal eRulemaking portal by June 19, 2015.
and based on valid assumptions and
searching the OMB control number. methodology; ways to enhance the ADDRESSES: When commenting, please
Select the link ‘‘Comment Now’’ that quality, utility, and clarity of the reference the document identifier or
corresponds with ‘‘Information information to be collected. OMB control number. To be assured
Collection 3090–0014, Transfer Order— Obtaining Copies of Proposals: consideration, comments and
Surplus Personal Property and Requesters may obtain a copy of the recommendations must be submitted in
Continuation Sheet, Standard Form (SF) information collection documents from any one of the following ways:
123’’. Follow the instructions provided the General Services Administration, 1. Electronically. You may send your
on the screen. Please include your Regulatory Secretariat Division (MVCB), comments electronically to http://
name, company name (if any), and 1800 F Street NW., Washington, DC www.regulations.gov. Follow the
‘‘Information Collection 3090–0014, 20006, telephone 202–501–4755. Please instructions for ‘‘Comment or
Transfer Order—Surplus Personal cite OMB Control No. 3090–0014, Submission’’ or ‘‘More Search Options’’
Property and Continuation Sheet, Transfer Order—Surplus Personal to find the information collection
Standard Form (SF) 123,’’ on your Property and Continuation Sheet, document(s) that are accepting
attached document. Standard Form (SF) 123, in all comments.
• Fax: 202–501–4067. correspondence.
2. By regular mail. You may mail
• Mail: General Services Dated: April 13, 2015. written comments to the following
Administration, Regulatory Secretariat David A. Shive, address: CMS, Office of Strategic
Division (MVCB), 1800 F Street NW., Acting, Chief Information Officer. Operations and Regulatory Affairs,
Washington, DC 20405. ATTN: Ms. [FR Doc. 2015–08994 Filed 4–17–15; 8:45 am] Division of Regulations Development,
Flowers/IC 3090–0014. BILLING CODE 6820–34–P Attention: Document Identifier/OMB
Instructions: Please submit comments Control Number llllll, Room
only and cite Information Collection C4–26–05, 7500 Security Boulevard,
3090–0014, Transfer Order—Surplus DEPARTMENT OF HEALTH AND Baltimore, Maryland 21244–1850.
Personal Property and Continuation HUMAN SERVICES To obtain copies of a supporting
Sheet, Standard Form (SF) 123, in all
statement and any related forms for the
correspondence related to this Centers for Medicare & Medicaid proposed collection(s) summarized in
collection. All comments received will Services this notice, you may make your request
be posted without change to http://
[Document Identifier: CMS–179] using one of following:
www.regulations.gov, including any
personal and/or business confidential 1. Access CMS’ Web site address at
Agency Information Collection http://www.cms.hhs.gov/Paperwork
information provided. Activities: Proposed Collection; ReductionActof1995.
FOR FURTHER INFORMATION CONTACT: Comment Request
Joyce Spalding, Property Disposal 2. Email your request, including your
Specialist, Federal Acquisition Service, AGENCY: Centers for Medicare & address, phone number, OMB number,
at telephone 703–605–2888 or via email Medicaid Services, HHS. and CMS document identifier, to
to joyce.spalding@gsa.gov. ACTION: Notice. Paperwork@cms.hhs.gov.
SUPPLEMENTARY INFORMATION: SUMMARY: The Centers for Medicare & 3. Call the Reports Clearance Office at
Medicaid Services (CMS) is announcing (410) 786–1326.
A. Purpose
an opportunity for the public to FOR FURTHER INFORMATION CONTACT:
The Transfer Order—Surplus Personal comment on CMS’ intention to collect Reports Clearance Office at (410) 786–
Property and Continuation Sheet, information from the public. Under the 1326.
Standard form (SF) 123, is used by Paperwork Reduction Act of 1995 (the
public agencies, nonprofit educational PRA), federal agencies are required to SUPPLEMENTARY INFORMATION:
or public health activities, programs for publish notice in the Federal Register Contents
mstockstill on DSK4VPTVN1PROD with NOTICES
the elderly, service educational concerning each proposed collection of
activities, and public airports to apply information (including each proposed This notice sets out a summary of the
for donation of Federal surplus personal extension or reinstatement of an existing use and burden associated with the
property. The SF 123 serves as the collection of information) and to allow following information collections. More
transfer instrument and includes item 60 days for public comment on the detailed information can be found in
descriptions, transportation proposed action. Interested persons are each collection’s supporting statement
instructions, nondiscrimination invited to send comments regarding our and associated materials (see
assurances, and approval signatures. burden estimates or any other aspect of ADDRESSES).
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![Federal Register / Vol. 80, No. 75 / Monday, April 20, 2015 / Notices 21721
CMS–179 State Plan Under Title XIX DEPARTMENT OF HEALTH AND and CMS document identifier, to
of the Social Security Act (Base Plan HUMAN SERVICES Paperwork@cms.hhs.gov.
Pages, Attachments, Supplements to 3. Call the Reports Clearance Office at
Attachments) Centers for Medicare & Medicaid (410) 786–1326.
Services FOR FURTHER INFORMATION CONTACT:
Under the PRA (44 U.S.C. 3501– Reports Clearance Office at (410) 786–
[Document Identifier: CMS–855R, CMS–
3520), federal agencies must obtain 10394, CMS–10371, CMS–10472 and CMS– 1326.
approval from the Office of Management 10494] SUPPLEMENTARY INFORMATION: Under the
and Budget (OMB) for each collection of Paperwork Reduction Act of 1995 (PRA)
information they conduct or sponsor. Agency Information Collection
(44 U.S.C. 3501–3520), federal agencies
The term ‘‘collection of information’’ is Activities: Submission for OMB must obtain approval from the Office of
defined in 44 U.S.C. 3502(3) and 5 CFR Review; Comment Request Management and Budget (OMB) for each
1320.3(c) and includes agency requests collection of information they conduct
ACTION: Notice.
or requirements that members of the or sponsor. The term ‘‘collection of
public submit reports, keep records, or SUMMARY: The Centers for Medicare & information’’ is defined in 44 U.S.C.
provide information to a third party. Medicaid Services (CMS) is announcing 3502(3) and 5 CFR 1320.3(c) and
Section 3506(c)(2)(A) of the PRA an opportunity for the public to includes agency requests or
requires federal agencies to publish a comment on CMS’ intention to collect requirements that members of the public
60-day notice in the Federal Register information from the public. Under the submit reports, keep records, or provide
concerning each proposed collection of Paperwork Reduction Act of 1995 information to a third party. Section
information, including each proposed (PRA), federal agencies are required to 3506(c)(2)(A) of the PRA (44 U.S.C.
extension or reinstatement of an existing publish notice in the Federal Register 3506(c)(2)(A)) requires federal agencies
collection of information, before concerning each proposed collection of to publish a 30-day notice in the
submitting the collection to OMB for information, including each proposed Federal Register concerning each
approval. To comply with this extension or reinstatement of an existing proposed collection of information,
requirement, CMS is publishing this collection of information, and to allow including each proposed extension or
a second opportunity for public reinstatement of an existing collection
notice.
comment on the notice. Interested of information, before submitting the
Information Collection persons are invited to send comments collection to OMB for approval. To
regarding the burden estimate or any comply with this requirement, CMS is
1. Type of Information Collection other aspect of this collection of publishing this notice that summarizes
Request: Extension of a currently information, including any of the the following proposed collection(s) of
approved collection; Title of following subjects: (1) The necessity and information for public comment:
Information Collection: Medicaid State utility of the proposed information 1. Type of Information Collection
Plan Base Plan Pages; Use: State collection for the proper performance of Request: Revision of a currently
Medicaid agencies complete the plan the agency’s functions; (2) the accuracy approved collection; Title of
pages while we review the information of the estimated burden; (3) ways to Information Collection: Medicare
to determine if the state has met all of enhance the quality, utility, and clarity Enrollment Application: Reassignment
the requirements of the provisions the of the information to be collected; and of Medicare Benefits; Use: The primary
states choose to implement. If the (4) the use of automated collection function of the CMS 855R enrollment
requirements are met, we will approve techniques or other forms of information application is to allow physicians and
the amendments to the state’s Medicaid technology to minimize the information non-physician practitioners to reassign
plan giving the state the authority to collection burden. their Medicare benefits to a group
implement the flexibilities. For a state to DATES: Comments on the collection(s) of practice and to gather information from
receive Medicaid Title XIX funding, information must be received by the the individual that tells us who he/she
there must be an approved Title XIX OMB desk officer by May 20, 2015. is, where he or she renders services, and
state plan. Form Number: CMS–179 ADDRESSES: When commenting on the information necessary to establish
proposed information collections, correct claims payment. The goal of
(OMB control number 0938–0193);
please reference the document identifier periodically evaluating and revising the
Frequency: Occasionally; Affected
or OMB control number. To be assured CMS–855R enrollment application is to
Public: State, Local, and Tribal
consideration, comments and simplify and clarify the information
Governments; Number of Respondents: collection without jeopardizing our
56; Total Annual Responses: 1,120; recommendations must be received by
the OMB desk officer via one of the need to collect specific information. At
Total Annual Hours: 22,400. (For policy this time, CMS is making very few
following transmissions: OMB, Office of
questions regarding this collection minor revisions to the CMS–855R
Information and Regulatory Affairs,
contact Annette Pearson at 410–786– (Reassignment of Benefits) Medicare
Attention: CMS Desk Officer, Fax
6958.) enrollment application (OMB No. 0938–
Number: (202) 395–5806 OR, Email:
Dated: April 15, 2015. OIRA_submission@omb.eop.gov. 1179). Two sections within the form are
William N. Parham, III, To obtain copies of a supporting being reversed to maintain sync with
statement and any related forms for the online and paper forms. The previously
Director, Paperwork Reduction Staff, Office
mstockstill on DSK4VPTVN1PROD with NOTICES
proposed collection(s) summarized in approved CMS 855R section 2 collected
of Strategic Operations and Regulatory
Affairs. this notice, you may make your request information regarding the individual
using one of following: practitioner who is reassigning benefits
[FR Doc. 2015–09008 Filed 4–17–15; 8:45 am]
1. Access CMS’ Web site address at and section 3 collected information
BILLING CODE 4120–01–P
http://www.cms.hhs.gov/Paperwork regarding the organization/group
ReductionActof1995. receiving the reassigned benefits. These
2. Email your request, including your two sections have been reversed so that
address, phone number, OMB number, section 2 now collects information on
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Document Created: 2018-02-21 10:12:46
Document Modified: 2018-02-21 10:12:46
| 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 must be received by June 19, 2015. | |
| Contact | Reports Clearance Office at (410) 786- 1326. | |
| FR Citation | 80 FR 21720 |
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