80 FR 62536 - Submission for OMB Review; Comment Request
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families Federal Register Volume 80, Issue 200 (October 16, 2015)
Administration for Children and Families
Federal Register Volume 80, Issue 200 (October 16, 2015)
| Page Range | 62536-62537 | |
| FR Document | 2015-26320 |
[Federal Register Volume 80, Number 200 (Friday, October 16, 2015)] [Notices] [Pages 62536-62537] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-26320] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Submission for OMB Review; Comment Request Title: Native Language Preservation and Maintenance Grant Application Template Pilot (Funding Application Submission Tool (F.A.S.T. form)) OMB No.: Description: The proposed F.A.S.T. form is intended to be used by applicants in the Administration for Native Americans' Native American Language Preservation and Maintenance grant competition in FY 2016. The F.A.S.T. form is proposed to be piloted as a consolidated and streamlined pre-formatted electronic application form that is user- friendly and has an interactive interface providing structure and clarity for applicants. The proposed F.A.S.T. form is not intended to replace the Funding Opportunity Announcement (FOAs) which will still function as the full text of all funding opportunities for which applications are sought and considered by the Administration for Native Americans. The proposed F.A.S.T. form will be used in a pilot capacity in just one Administration for Native Americans' discretionary program areas: Native American Language Preservation and Maintenance. All applicants applying for funding in that program area will be required to use the F.A.S.T. form during the pilot competition proposed for FY16 unless they request and receive approval to submit a paper application. By using the F.A.S.T. form no applicant will be required to provide any information beyond what is already required by the FOA. Additionally, free training and technical assistance will be available to all applicants on use of the F.A.S.T. form. ANA intends to use the project proposals submitted via the F.A.S.T. form to make funding decisions for Native American Language Preservation and Maintenance grant awards made in the FY 2016 pilot year. In addition, ANA will solicit feedback from applicants and panel reviewers to obtain feedback on the results, outcomes, and their recommendations regarding the F.A.S.T. form as a user friendly method of applying for funding opportunities. If the pilot is successful in making it easier for applicants to apply, ANA will consider potentially expanding use of the F.A.S.T. form to all Administration for Native Americans' discretionary funding areas in subsequent years. Respondents: 40. Annual Burden Estimates ---------------------------------------------------------------------------------------------------------------- Number of Average burden Instrument Number of responses per hours per Total burden respondents respondent response hours ---------------------------------------------------------------------------------------------------------------- F.A.S.T. form............................... 40 28 .50 14 ---------------------------------------------------------------------------------------------------------------- Estimated Total Annual Burden Hours: 560. Additional Information Copies of the proposed collection may be obtained by writing to the Administration for Children and Families, Office of Planning, Research and Evaluation, 370 L'Enfant Promenade SW., Washington, DC 20447, Attn: ACF Reports Clearance Officer. All requests should be identified by the title of the information collection. Email address: infocollection@acf.hhs.gov. OMB Comment OMB is required to make a decision concerning the collection of information between 30 and 60 days after publication of this document in the Federal Register. Therefore, a comment is best assured of having its full effect if OMB receives it within 30 days of publication. Written comments and recommendations for the proposed information collection should be sent directly to the following: Office of Management and Budget, Paperwork Reduction Project, Email: OIRA_SUBMISSION@OMB.EOP.GOV, [[Page 62537]] Attn: Desk Officer for the Administration for Children and Families. Robert Sargis, Reports Clearance Officer. [FR Doc. 2015-26320 Filed 10-15-15; 8:45 am] BILLING CODE 4184-01-P
![62536 Federal Register / Vol. 80, No. 200 / Friday, October 16, 2015 / Notices
(OMB control number: 0938–0997); the CMS–1490S (Patient’s Request for formatted electronic application form
Frequency: On occasion; Affected Medicare Payment) was explicitly that is user-friendly and has an
Public: Private sector (Business or other developed for easy use by beneficiaries interactive interface providing structure
for-profit and Not-for-profit who file their own claims. The form can and clarity for applicants. The proposed
institutions); Number of Respondents: be obtained from any Social Security F.A.S.T. form is not intended to replace
53,111; Total Annual Responses: office or Medicare carrier. Form the Funding Opportunity
181,909,654; Total Annual Hours: Number: CMS–1500(08/05), CMS–1490– Announcement (FOAs) which will still
1,567,455. (For policy questions S (OMB control number: 0938–0999) function as the full text of all funding
regarding this collection contact Matt Frequency: On occasion; Affected opportunities for which applications are
Klischer at 410–786–7488.) Public: State, Local, or Tribal sought and considered by the
4. Type of Information Collection Governments, Private sector (Business Administration for Native Americans.
Request: Extension of a currently or other-for-profit and Not-for-profit The proposed F.A.S.T. form will be
approved collection; Title of institutions); Number of Respondents: used in a pilot capacity in just one
Information Collection: Health 1,448,346; Total Annual Responses: Administration for Native Americans’
Insurance Common Claims Form and 988,005,045; Total Annual Hours: discretionary program areas: Native
Supporting Regulations at 42 CFR part 21,418,336. (For policy questions American Language Preservation and
424, Subpart C; Use: The Form CMS– regarding this collection contact Maintenance. All applicants applying
1500 answers the needs of many health Shannon Seales at 410–786–4089.) for funding in that program area will be
insurers. It is the basic form prescribed required to use the F.A.S.T. form during
Dated: October 13, 2015.
by CMS for the Medicare program for the pilot competition proposed for FY16
claims from physicians and suppliers. William N. Parham, III,
Director, Paperwork Reduction Staff, Office unless they request and receive
The Medicaid State Agencies, approval to submit a paper application.
CHAMPUS/TriCare, Blue Cross/Blue of Strategic Operations and Regulatory
Affairs. By using the F.A.S.T. form no applicant
Shield Plans, the Federal Employees
[FR Doc. 2015–26390 Filed 10–15–15; 8:45 am] will be required to provide any
Health Benefit Plan, and several private
information beyond what is already
health plans also use it; it is the de facto BILLING CODE 4120–01–P
required by the FOA. Additionally, free
standard ‘‘professional’’ claim form.
Medicare carriers use the data training and technical assistance will be
collected on the CMS–1500 and the DEPARTMENT OF HEALTH AND available to all applicants on use of the
CMS–1490S to determine the proper HUMAN SERVICES F.A.S.T. form.
amount of reimbursement for Part B ANA intends to use the project
medical and other health services (as Administration for Children and proposals submitted via the F.A.S.T.
listed in section 1861(s) of the Social Families form to make funding decisions for
Security Act) provided by physicians Native American Language Preservation
Submission for OMB Review; and Maintenance grant awards made in
and suppliers to beneficiaries. The Comment Request
CMS–1500 is submitted by physicians/ the FY 2016 pilot year. In addition,
suppliers for all Part B Medicare. Title: Native Language Preservation ANA will solicit feedback from
Serving as a common claim form, the and Maintenance Grant Application applicants and panel reviewers to obtain
CMS–1500 can be used by other third- Template Pilot (Funding Application feedback on the results, outcomes, and
party payers (commercial and nonprofit Submission Tool (F.A.S.T. form)) their recommendations regarding the
health insurers) and other Federal OMB No.: F.A.S.T. form as a user friendly method
programs (e.g., CHAMPUS/TriCare, Description: The proposed F.A.S.T. of applying for funding opportunities. If
Railroad Retirement Board (RRB), and form is intended to be used by the pilot is successful in making it
Medicaid). However, as the CMS–1500 applicants in the Administration for easier for applicants to apply, ANA will
displays data items required for other Native Americans’ Native American consider potentially expanding use of
third-party payers in addition to Language Preservation and Maintenance the F.A.S.T. form to all Administration
Medicare, the form is considered too grant competition in FY 2016. The for Native Americans’ discretionary
complex for use by beneficiaries when F.A.S.T. form is proposed to be piloted funding areas in subsequent years.
they file their own claims. Therefore, as a consolidated and streamlined pre- Respondents: 40.
ANNUAL BURDEN ESTIMATES
Number of Average
Number of Total burden
Instrument responses per burden hours
respondents hours
respondent per response
F.A.S.T. form ................................................................................................... 40 28 .50 14
Estimated Total Annual Burden Attn: ACF Reports Clearance Officer. All Federal Register. Therefore, a comment
Hours: 560. requests should be identified by the title is best assured of having its full effect
of the information collection. Email if OMB receives it within 30 days of
srobinson on DSK5SPTVN1PROD with NOTICES
Additional Information
address: infocollection@acf.hhs.gov. publication. Written comments and
Copies of the proposed collection may recommendations for the proposed
OMB Comment
be obtained by writing to the information collection should be sent
Administration for Children and OMB is required to make a decision directly to the following: Office of
Families, Office of Planning, Research concerning the collection of information Management and Budget, Paperwork
and Evaluation, 370 L’Enfant between 30 and 60 days after Reduction Project, Email:
Promenade SW., Washington, DC 20447, publication of this document in the OIRA_SUBMISSION@OMB.EOP.GOV,
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![Federal Register / Vol. 80, No. 200 / Friday, October 16, 2015 / Notices 62537
Attn: Desk Officer for the www.regulations.gov will be posted to Agency will review this copy, including
Administration for Children and the docket unchanged. Because your the claimed confidential information, in
Families. comment will be made public, you are its consideration of comments. The
solely responsible for ensuring that your second copy, which will have the
Robert Sargis,
comment does not include any claimed confidential information
Reports Clearance Officer. confidential information that you or a redacted/blacked out, will be available
[FR Doc. 2015–26320 Filed 10–15–15; 8:45 am] third party may not wish to be posted, for public viewing and posted on
BILLING CODE 4184–01–P such as medical information, your or http://www.regulations.gov. Submit
anyone else’s Social Security number, or both copies to the Division of Dockets
confidential business information, such Management. If you do not wish your
DEPARTMENT OF HEALTH AND as a manufacturing process. Please note name and contact information to be
HUMAN SERVICES that if you include your name, contact made publicly available, you can
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Food and Drug Administration identifies you in the body of your sheet and not in the body of your
[Docket No. FDA–2015–D–3474] comments, that information will be comments and you must identify this
posted on http://www.regulations.gov. information as ‘‘confidential.’’ Any
Draft Recommendations for the • If you want to submit a comment information marked as ‘‘confidential’’
Permitted Daily Exposures for Two with confidential information that you will not be disclosed except in
Solvents, Triethylamine and do not wish to be made available to the accordance with 21 CFR 10.20 and other
Methylisobutylketone, According to public, submit the comment as a applicable disclosure law. For more
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Document Created: 2015-12-14 15:23:23
Document Modified: 2015-12-14 15:23:23
| 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 | |
| FR Citation | 80 FR 62536 |
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