80 FR 46284 - 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 149 (August 4, 2015)

Page Range		46284-46284
FR Document		2015-19075

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 149 (Tuesday, August 4, 2015)

[Federal Register Volume 80, Number 149 (Tuesday, August 4, 2015)]
[Notices]
[Page 46284]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-19075]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS-224-14]


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

ACTION: Notice.

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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 September 3, 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: New collection (Request 
for a new OMB control number); Title of Information Collection: 
Federally Qualified Health Center Cost Report Form; Use: Providers of 
services participating in the Medicare program are required under 
sections 1815(a) and 1861(v)(1)(A) of the Act (42 U.S.C. 1395g) to 
submit annual information to achieve settlement of costs for health 
care services rendered to Medicare beneficiaries. In addition, 
regulations at 42 CFR 413.20 and 413.24 require adequate cost data and 
cost reports from providers on an annual basis. The form CMS-224-14 
cost report is needed to determine a provider's reasonable costs 
incurred in furnishing medical services to Medicare beneficiaries and 
reimbursement due to or from a provider. Form Number: CMS-224-14 (OMB 
control number 0938--New); Frequency: Yearly; Affected Public: Private 
sector--For-profit and Not-for-profit institutions; Number of 
Respondents: 1,296; Total Annual Responses: 1,296; Total Annual Hours: 
75,168. (For policy questions regarding this collection contact Julie 
Stankivic at 410-786-5725).

    Dated: July 30, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2015-19075 Filed 8-3-15; 8:45 am]
BILLING CODE 4120-01-P

46284 Federal Register / Vol. 80, No. 149 / Tuesday, August 4, 2015 / Notices

ESTIMATED ANNUALIZED BURDEN HOURS—Continued
Number of Avg. burden
Type of Number of Total burden
Form name responses per per response
respondent respondents (in hrs.)
respondent (in hrs.)

Trainees participating in the Work@ Wave 2 Trainee Reaction Survey .... 200 1 15/60 50
Health® Program Wave 2.
Work@Health® Instructors/Coaches Instructor/Coach Group Discussion 7 1 30/60 4
Guide.
Total ........................................... .......................................................... ........................ ........................ ........................ 1,064

Leroy A. Richardson, please reference the document identifier Information Collection: Federally
Chief, Information Collection Review Office, or OMB control number. To be assured Qualified Health Center Cost Report
Office of Scientific Integrity, Office of the consideration, comments and Form; Use: Providers of services
Associate Director for Science, Office of the recommendations must be received by participating in the Medicare program
Director, Centers for Disease Control and the OMB desk officer via one of the are required under sections 1815(a) and
Prevention.
following transmissions: OMB, Office of 1861(v)(1)(A) of the Act (42 U.S.C.
[FR Doc. 2015–19042 Filed 8–3–15; 8:45 am] Information and Regulatory Affairs, 1395g) to submit annual information to
BILLING CODE 4163–18–P Attention: CMS Desk Officer, Fax achieve settlement of costs for health
Number: (202) 395–5806 or, Email: care services rendered to Medicare
OIRA_submission@omb.eop.gov. beneficiaries. In addition, regulations at
DEPARTMENT OF HEALTH AND To obtain copies of a supporting 42 CFR 413.20 and 413.24 require
HUMAN SERVICES statement and any related forms for the adequate cost data and cost reports from
Centers for Medicare & Medicaid proposed collection(s) summarized in providers on an annual basis. The form
Services this notice, you may make your request CMS–224–14 cost report is needed to
using one of following: determine a provider’s reasonable costs
[Document Identifier CMS–224–14] 1. Access CMS’ Web site address at incurred in furnishing medical services
http://www.cms.hhs.gov/Paperwork to Medicare beneficiaries and
Agency Information Collection ReductionActof1995. reimbursement due to or from a
Activities: Submission for OMB 2. Email your request, including your provider. Form Number: CMS–224–14
Review; Comment Request address, phone number, OMB number, (OMB control number 0938—New);
and CMS document identifier, to Frequency: Yearly; Affected Public:
ACTION: Notice.
Paperwork@cms.hhs.gov. Private sector—For-profit and Not-for-
SUMMARY: The Centers for Medicare & 3. Call the Reports Clearance Office at profit institutions; Number of
Medicaid Services (CMS) is announcing (410) 786–1326. Respondents: 1,296; Total Annual
an opportunity for the public to FOR FURTHER INFORMATION CONTACT: Responses: 1,296; Total Annual Hours:
comment on CMS’ intention to collect Reports Clearance Office at (410) 786– 75,168. (For policy questions regarding
information from the public. Under the 1326. this collection contact Julie Stankivic at
Paperwork Reduction Act of 1995 SUPPLEMENTARY INFORMATION: Under the 410–786–5725).
(PRA), federal agencies are required to Paperwork Reduction Act of 1995 (PRA) Dated: July 30, 2015.
publish notice in the Federal Register (44 U.S.C. 3501–3520), federal agencies William N. Parham, III,
concerning each proposed collection of must obtain approval from the Office of Director, Paperwork Reduction Staff, Office
information, including each proposed Management and Budget (OMB) for each of Strategic Operations and Regulatory
extension or reinstatement of an existing collection of information they conduct Affairs.
collection of information, and to allow or sponsor. The term ‘‘collection of [FR Doc. 2015–19075 Filed 8–3–15; 8:45 am]
a second opportunity for public information’’ is defined in 44 U.S.C. BILLING CODE 4120–01–P
comment on the notice. Interested 3502(3) and 5 CFR 1320.3(c) and
persons are invited to send comments includes agency requests or
regarding the burden estimate or any requirements that members of the public DEPARTMENT OF HEALTH AND
other aspect of this collection of submit reports, keep records, or provide HUMAN SERVICES
information, including any of the information to a third party. Section
following subjects: (1) The necessity and 3506(c)(2)(A) of the PRA (44 U.S.C. Administration for Children and
utility of the proposed information 3506(c)(2)(A)) requires federal agencies Families
collection for the proper performance of to publish a 30-day notice in the
the agency’s functions; (2) the accuracy Federal Register concerning each Submission for OMB Review;
of the estimated burden; (3) ways to proposed collection of information, Comment Request
enhance the quality, utility, and clarity including each proposed extension or Title: Initial Medical Exam Form and
of the information to be collected; and reinstatement of an existing collection Initial Dental Exam Form.
(4) the use of automated collection of information, before submitting the OMB No.: 0970–NEW.
techniques or other forms of information collection to OMB for approval. To Description: The Administration for
technology to minimize the information
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comply with this requirement, CMS is Children and Families’ Office of Refugee
collection burden. publishing this notice that summarizes Resettlement (ORR) places
DATES: Comments on the collection(s) of the following proposed collection(s) of unaccompanied minors in their custody
information must be received by the information for public comment: in licensed care provider facilities until
OMB desk officer by September 3, 2015. 1. Type of Information Collection reunification with a qualified sponsor.
ADDRESSES: When commenting on the Request: New collection (Request for a Care provider facilities are required to
proposed information collections, new OMB control number); Title of provide children with services such as

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Document Created: 2015-12-18 14:51:54
Document Modified: 2015-12-18 14:51:54

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 September 3, 2015.
Contact		Reports Clearance Office at (410) 786- 1326.
FR Citation		80 FR 46284

80 FR 46284 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Medicare & Medicaid Services

Federal Register Volume 80, Issue 149 (August 4, 2015)

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