[Federal Register Volume 74, Number 156 (Friday, August 14, 2009)]
[Notices]
[Pages 41141-41142]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-19537]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10050, CMS-1450(UB-04), CMS-276 and CMS-R-
254]


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

AGENCY: Centers for Medicare & Medicaid Services, HHS.

    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid 
Services (CMS), Department of Health and Human Services, is publishing 
the following summary of proposed collections for public comment. 
Interested persons are invited to send comments regarding this 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 function; (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.
    1. Type of Information Collection Request: Revision of the 
currently approved collection; Title of Information Collection: New 
Enrollee Survey; Use: The New Enrollee survey was developed to gather 
information from newly enrolled Medicare beneficiaries about their 
Medicare knowledge and needs. CMS is seeking understanding about what 
types of information new enrollees need and what they know about 
Medicare. Included in the survey are questions regarding how well 
informed new enrollees are about Medicare and what information they 
have received about the Medicare program. Information gathered in this 
survey will be used only for purposes of targeting and improving 
communications with newly eligible Medicare beneficiaries. Form Number: 
CMS-10050 (OMB: 0938-0869); Frequency: Reporting--Quarterly; 
Affected Public: Individuals or Households; Number of Respondents: 
1200; Total Annual Responses: 1200; Total Annual Hours: 300. (For 
policy questions regarding this collection contact Renee Clarke at 410-
786-0006. For all other issues call 410-786-1326.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare Uniform 
Institutional Provider Bill and Supporting Regulations in 42 CFR 424.5; 
Use: Section 42 CFR 424.5(a)(5) requires providers of services to 
submit a claim for payment prior to any Medicare reimbursement. Charges 
billed are coded by revenue codes. The bill specifies diagnoses 
according to the International Classification of Diseases, Ninth 
Edition (ICD-9-CM) code. Inpatient procedures are identified by ICD-9-
CM codes, and outpatient procedures are described using the CMS Common 
Procedure Coding System (HCPCS). These are standard systems of 
identification for all major health insurance claims payers. Submission 
of information on the CMS-1450 permits Medicare intermediaries to 
receive consistent data for proper payment. Form Numbers: CMS-1450 (UB-
04)(OMB: 0938-0997); Frequency: Reporting--On occasion; 
Affected Public: Not-for-profit institutions, Business or other for-
profit; Number of Respondents: 53,111; Total Annual Responses: 
181,909,654; Total Annual Hours: 1,567,455. (For policy questions 
regarding this collection contact Matt Klischer at 410-786-7488. For 
all other issues call 410-786-1326.)
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Prepaid Health 
Plan Cost Report; Use: Health Maintenance Organizations and Competitive 
Medical Plans (HMO/CMPs) contracting with the Secretary under Section 
1876 of the Social Security Act are required to submit a budget and 
enrollment forecast, four quarterly reports and a final certified cost 
report. Health Care Prepayment Plans (HCPPs) contracting with the 
Secretary under Section 1833 of the Social Security Act are required to 
submit a budget and enrollment forecast, mid-year report, and final 
cost report. An HMO/CMP is a health care delivery system that furnishes 
directly or arranges for the delivery of the full spectrum of health 
services to an enrolled population. A HCPP is a health care delivery 
system that furnishes directly or arranges for the delivery of certain 
physician and diagnostics services up to the full spectrum of non-
provider Part B health services to an enrolled population. These 
reports will be used to establish the reasonable cost of delivering 
covered services furnished to Medicare enrollees by an HMO/CMP or 
HCPP.; Form Numbers: CMS-276 (OMB: 0938-0165); Frequency: 
Recordkeeping, Reporting--Quarterly and Annually; Affected Public: 
Business or other for-profit; Number of Respondents: 35; Total Annual 
Responses: 128; Total Annual Hours: 5,285. (For policy questions 
regarding this collection contact Temeshia Johnson at 410-786-8692. For 
all other issues call 410-786-1326.)
    4. Type of Information Collection Request: Reinstatement of a 
currently approved collection; Title of

[[Page 41142]]

Information Collection: National Medicare & You Education Program 
(NMEP) Survey of Medicare Beneficiaries Use: The Centers for Medicare 
and Medicaid Services is requesting a reinstatement of this information 
collection request to continue to collect information from Medicare 
beneficiaries, caregivers, health care providers, and health 
information providers. The collection of information was inadvertently 
discontinued in December 2008; however, as stated earlier, we are 
currently seeking a reinstatement with change as we have revised the 
collection instrument. It is critical for this agency to obtain 
feedback from the aforementioned groups so that the agency can 
accurately assess the needs of the Medicare audience. Using random 
digit dial and/or an administrative sample, members of the Medicare 
audience will be called and asked to complete the survey via telephone. 
The results of this survey will be compiled and studied so that 
communication may be amended to benefit Medicare's audience. The survey 
has the following objectives: to assess satisfaction with and knowledge 
of the Medicare program; to gather information on health behaviors and 
quality of health care; to determine the most used source for Medicare 
information; and to gather information from health care provider and 
health information providers. Form Number: CMS-R-254 (OMB 
0938-0738); Frequency: Once; Affected Public: Individuals and 
Households, Private Sector--Business or other for-profits; Number of 
Respondents: 7,000; Total Annual Responses: 7,000; Total Annual Hours: 
1,750.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS Web 
Site address at http://www.cms.hhs.gov/PaperworkReductionActof1995, or 
E-mail your request, including your address, phone number, OMB number, 
and CMS document identifier, to Paperwork@cms.hhs.gov, or call the 
Reports Clearance Office on (410) 786-1326.
    To be assured consideration, comments and recommendations for the 
proposed information collections must be received by the OMB desk 
officer at the address below, no later than 5 p.m. on September 14, 
2009: OMB, Office of Information and Regulatory Affairs, Attention: CMS 
Desk Officer, Fax Number: (202) 395-6974, E-mail: OIRA_submission@omb.eop.gov.

    Dated: August 7, 2009.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E9-19537 Filed 8-13-09; 8:45 am]
BILLING CODE 4120-01-P