81 FR 91177 - Agency Information Collection Activities: Submission for OMB Review; Comment Request
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 81, Issue 242 (December 16, 2016)
Centers for Medicare & Medicaid Services
Federal Register Volume 81, Issue 242 (December 16, 2016)
| Page Range | 91177-91178 | |
| FR Document | 2016-30349 |
[Federal Register Volume 81, Number 242 (Friday, December 16, 2016)] [Notices] [Pages 91177-91178] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2016-30349] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifiers: CMS-2744] Agency Information Collection Activities: Submission for OMB Review; 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 (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: 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 on the collection(s) of information must be received by the OMB desk officer by January 17, 2017. 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: OIRA_ [email protected]. [[Page 91178]] 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 previously approved collection; Title of Information Collection: End Stage Renal Disease (ESRD) Medical Information Facility Survey; Use: The ESRD Program Management and Medical Information System (PMMIS) Facility Certification/Survey Record contains provider-specific and aggregate patient population data on beneficiaries treated by that provider obtained from the Annual Facility Survey form (CMS-2744). The Facility Certification portion of the record captures certification and other information about ESRD facilities approved by Medicare to provide kidney dialysis and transplant services. The Facility Survey portion of the record captures activities performed during the calendar year as well as aggregate year-end population counts for both Medicare beneficiaries and non-Medicare patients. The survey includes the collection on hemodialysis patients dialyzing more than 4 times per week, vocational rehabilitation and staffing. The aggregate patient information is collected from each Medicare-approved provider of dialysis and kidney transplant services. The information is used to assess and evaluate the local, regional and national levels of medical and social impact of ESRD care and is used extensively by researchers and suppliers of services for trend analysis. Form Number: CMS-2744 (OMB control number: 0938-0447); Frequency: Yearly; Affected Public: Business or other for-profit, Not-for-profit institutions; Number of Respondents: 5,964; Total Annual Responses: 5,964; Total Annual Hours: 47,712. (For policy questions regarding this collection contact Renee Dupee at 410-786-6747) Dated: December 13, 2016. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2016-30349 Filed 12-15-16; 8:45 am] BILLING CODE 4120-01-P
![Federal Register / Vol. 81, No. 242 / Friday, December 16, 2016 / Notices 91177
contact Roland Herrera at 410–786– applicable State law (provided by the Dated: December 13, 2016.
0668.) State); and (d) the provider’s or William N. Parham, III,
7. Type of Information Collection organization’s policies and procedures Director, Paperwork Reduction Staff, Office
Request: Revision of a previously for implementing an advance directive. of Strategic Operations and Regulatory
approved collection; Title of Form Number: CMS–10507 (OMB Affairs.
Information Collection: Healthcare control number: 0938–1251); Frequency: [FR Doc. 2016–30340 Filed 12–15–16; 8:45 am]
Fraud Prevention Partnership (HFPP): Occasionally; Affected Public: Private BILLING CODE 4120–01–P
Data Sharing and Information Exchange; sector (Business or other for-profits);
Use: The advance directives Number of Respondents: 20; Total
requirement was enacted because Annual Responses: 20; Total Annual DEPARTMENT OF HEALTH AND
Congress wanted individuals to know Hours: 160. (For policy questions HUMAN SERVICES
that they have a right to make health regarding this collection contact Marnie
care decisions and to refuse treatment Dorsey at 410–786–5942.) Centers for Medicare & Medicaid
even when they are unable to 8. Type of Information Collection Services
communicate. Steps have been taken at Request: Extension of a currently
[Document Identifiers: CMS–2744]
both the Federal and State level, to approved collection; Title of
afford greater opportunity for the Information Collection: Medicaid Agency Information Collection
individual to participate in decisions Disproportionate Share Hospital (DSH) Activities: Submission for OMB
made concerning the medical treatment Annual Reporting Requirements; Use: Review; Comment Request
to be received by an adult patient in the States are required to submit an annual
event that the patient is unable to report that identifies each AGENCY: Centers for Medicare &
communicate to others, a preference disproportionate share hospital (DSH) Medicaid Services, HHS.
about medical treatment. The individual that received a DSH payment under the ACTION: Notice.
may make his preference known state’s Medicaid program in the
through the use of an advance directive, preceding fiscal year and the amount of SUMMARY: The Centers for Medicare &
which is a written instruction prepared DSH payments paid to that hospital in Medicaid Services (CMS) is announcing
in advance, such as a living will or the same year along with other an opportunity for the public to
durable power of attorney. This information that the Secretary comment on CMS’ intention to collect
information is documented in a determines necessary to ensure the information from the public. Under the
prominent part of the individual’s appropriateness of DSH payments; Form Paperwork Reduction Act of 1995
medical record. Advance directives as Number: CMS–R–266 (OMB control (PRA), federal agencies are required to
described in the Patient Self- number: 0938–0746); Frequency: Yearly; publish notice in the Federal Register
Determination Act have increased the Affected Public: State, Local, or Tribal concerning each proposed collection of
individual’s control over decisions Governments; Number of Respondents: information, including each proposed
concerning medical treatment. Sections 51; Total Annual Responses: 51; Total extension or reinstatement of an existing
4206 of the Omnibus Budget Annual Hours: 2,142. (For policy collection of information, and to allow
Reconciliation Act of 1990 defined an questions regarding this collection a second opportunity for public
advance directive as a written contact Robert Lane at 410–786–2015.) comment on the notice. Interested
instruction recognized under State law 9. Type of Information Collection persons are invited to send comments
relating to the provision of health care Request: Revision of a currently regarding the burden estimate or any
when an individual is incapacitated approved collection; Title of other aspect of this collection of
(those persons unable to communicate Information Collection: Conditions of information, including any of the
their wishes regarding medical Participation for Comprehensive following subjects: the necessity and
treatment). Outpatient Rehabilitation Facilities utility of the proposed information
All states have enacted legislation (CORFs) and Supporting Regulations; collection for the proper performance of
defining a patient’s right to make Use: The Conditions of Participation the agency’s functions; the accuracy of
decisions regarding medical care, (CoPs) and accompanying requirements the estimated burden; ways to enhance
including the right to accept or refuse specified in the regulations are used by the quality, utility, and clarity of the
medical or surgical treatment and the our surveyors as a basis for determining information to be collected; and the use
right to formulate advance directives. whether a comprehensive outpatient of automated collection techniques or
Participating hospitals, skilled nursing rehabilitation facility (CORF) qualifies other forms of information technology to
facilities, nursing facilities, home health to be awarded a Medicare provider minimize the information collection
agencies, providers of home health care, agreement. We believe the health care burden.
hospices, religious nonmedical health industry practice demonstrates that the
care institutions, and prepaid or eligible patient clinical records and general DATES: Comments on the collection(s) of
organizations (including Health Care content of records are necessary to information must be received by the
Prepayment Plans (HCPPs) and ensure the well-being and safety of OMB desk officer by January 17, 2017.
Medicare Advantage Organizations patients and that professional treatment ADDRESSES: When commenting on the
(MAOs) such as Coordinated Care Plans, and accountability are a normal part of proposed information collections,
Demonstration Projects, Chronic Care industry practice. Form Number: CMS– please reference the document identifier
Demonstration Projects, Program of All 10282 (OMB control number: 0938– or OMB control number. To be assured
Inclusive Care for the Elderly, Private 1091); Frequency: Yearly; Affected consideration, comments and
mstockstill on DSK3G9T082PROD with NOTICES
Fee for Service, and Medical Savings Public: Private sector—Business or other recommendations must be received by
Accounts must provide written for-profit and Not-for-profit institutions; the OMB desk officer via one of the
information, at explicit time frames, to Number of Respondents: 549; Total following transmissions: OMB, Office of
all adult individuals about: (a) The right Annual Responses: 549; Total Annual Information and Regulatory Affairs,
to accept or refuse medical or surgical Hours: 6,945. (For policy questions Attention: CMS Desk Officer, Fax
treatments; (b) the right to formulate an regarding this collection contact Number: (202) 395–5806 OR Email:
advance directive; (c) a description of Jacqueline Leach at 410–786–4282.) OIRA_ submission@omb.eop.gov.
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![91178 Federal Register / Vol. 81, No. 242 / Friday, December 16, 2016 / Notices
To obtain copies of a supporting the following proposed collection(s) of Number of Respondents: 5,964; Total
statement and any related forms for the information for public comment: Annual Responses: 5,964; Total Annual
proposed collection(s) summarized in 1. Type of Information Collection Hours: 47,712. (For policy questions
this notice, you may make your request Request: Extension of a previously regarding this collection contact Renee
using one of following: approved collection; Title of Dupee at 410–786–6747)
1. Access CMS’ Web site address at Information Collection: End Stage Renal Dated: December 13, 2016.
http://www.cms.hhs.gov/ Disease (ESRD) Medical Information
William N. Parham, III,
PaperworkReductionActof1995. Facility Survey; Use: The ESRD Program
Management and Medical Information Director, Paperwork Reduction Staff, Office
2. Email your request, including your of Strategic Operations and Regulatory
address, phone number, OMB number, System (PMMIS) Facility Certification/
Affairs.
and CMS document identifier, to Survey Record contains provider-
[FR Doc. 2016–30349 Filed 12–15–16; 8:45 am]
Paperwork@cms.hhs.gov. specific and aggregate patient
BILLING CODE 4120–01–P
3. Call the Reports Clearance Office at population data on beneficiaries treated
(410) 786–1326. by that provider obtained from the
Annual Facility Survey form (CMS–
FOR FURTHER INFORMATION CONTACT: DEPARTMENT OF HEALTH AND
2744). The Facility Certification portion
Reports Clearance Office at (410) 786– of the record captures certification and HUMAN SERVICES
1326. other information about ESRD facilities Administration for Children and
SUPPLEMENTARY INFORMATION: Under the approved by Medicare to provide Families
Paperwork Reduction Act of 1995 (PRA) kidney dialysis and transplant services.
(44 U.S.C. 3501–3520), federal agencies The Facility Survey portion of the Submission for OMB Review;
must obtain approval from the Office of record captures activities performed Comment Request
Management and Budget (OMB) for each during the calendar year as well as
collection of information they conduct aggregate year-end population counts Title: OCSE–75 Tribal Child Support
or sponsor. The term ‘‘collection of for both Medicare beneficiaries and non- Enforcement Program Annual Data
information’’ is defined in 44 U.S.C. Medicare patients. The survey includes Report.
3502(3) and 5 CFR 1320.3(c) and the collection on hemodialysis patients OMB No.: 0970–0320.
includes agency requests or dialyzing more than 4 times per week, Description: The data collected by
requirements that members of the public vocational rehabilitation and staffing. form OCSE–75 are used to prepare the
submit reports, keep records, or provide The aggregate patient information is OCSE preliminary and annual data
information to a third party. Section collected from each Medicare-approved reports. In addition, Tribes
3506(c)(2)(A) of the PRA (44 U.S.C. provider of dialysis and kidney administering CSE programs under Title
3506(c)(2)(A)) requires federal agencies transplant services. The information is IV–D of the Social Security Act are
to publish a 30-day notice in the used to assess and evaluate the local, required to report program status and
Federal Register concerning each regional and national levels of medical accomplishments in an annual narrative
proposed collection of information, and social impact of ESRD care and is report and submit the OCSE–75 report
including each proposed extension or used extensively by researchers and annually.
reinstatement of an existing collection suppliers of services for trend analysis. Respondents: Tribal Child Support
of information, before submitting the Form Number: CMS–2744 (OMB control Enforcement Organizations or the
collection to OMB for approval. To number: 0938–0447); Frequency: Yearly; Department/Agency/Bureau responsible
comply with this requirement, CMS is Affected Public: Business or other for- for Child Support Enforcement in each
publishing this notice that summarizes profit, Not-for-profit institutions; tribe.
ANNUAL BURDEN ESTIMATES
Number of Average
Number of Total burden
Instrument responses per burden hours
respondents hours
respondent per response
OCSE–75 ......................................................................................................... 63 1 63 3,969
Estimated Total Annual Burden publication of this document in the Desk Officer for the Administration for
Hours: 3,969. Federal Register. Therefore, a comment Children and Families.
Additional Information: is best assured of having its full effect
Robert Sargis,
Copies of the proposed collection may if OMB receives it within 30 days of
be obtained by writing to the publication. Written comments and Reports Clearance Officer.
Administration for Children and recommendations for the proposed [FR Doc. 2016–30291 Filed 12–15–16; 8:45 am]
Families, Office of Planning, Research information collection should be sent BILLING CODE 4184–01–P
and Evaluation, 330 C Street SW., directly to the following: Office of
Washington, DC 20201. Attention Management and Budget, Paperwork
Reports Clearance Officer. All requests
mstockstill on DSK3G9T082PROD with NOTICES
Reduction Project, Email: OIRA_
should be identified by the title of the SUBMISSION@OMB.EOP.GOV, Attn:
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
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Document Created: 2018-02-14 09:07:55
Document Modified: 2018-02-14 09:07:55
| 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 January 17, 2017. | |
| Contact | Reports Clearance Office at (410) 786- 1326. | |
| FR Citation | 81 FR 91177 |
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