[Federal Register Volume 77, Number 25 (Tuesday, February 7, 2012)]
[Notices]
[Pages 6124-6125]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-2774]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier CMS-668B and CMS-1557]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services.
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) 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 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.
1. Type of Information Collection Request: Extension of a currently
approved collection. Title of Information Collection: Post Clinical
Laboratory Survey Questionnaire and Supporting Regulations in 42 CFR
493.1771, 493.1773, and 493.1777. Use: Form CMS-668B is used by a
Clinical Laboratory Improvement Amendments (CLIA) laboratory to express
its satisfaction with the survey process and to make recommendations
for improvement. Surveyors furnish this form to all laboratories that
receive either an onsite survey or the Alternate Quality Assessment
Survey (i.e., paper survey of quality indicators). CMS Central Office
performs an overview evaluation of the completed forms. Each calendar
year, a summary of the information collected is sent to the State and
CMS Regional Office. Form Number: CMS-668B (OCN 0938-0653). Frequency:
Biennially; Affected Public: Business or other for-profits and not-for-
profit institutions. State, Local, or Tribal Government, Federal
Government. Number of Respondents: 21,000. Total Annual Responses:
10,500. Total Annual Hours: 2,625. (For policy questions regarding this
collection contact Kathleen Todd at (410) 786-3385. For all other
issues call (410) 786-1326.)
2. Type of Information Collection Request: Extension of a currently
approved collection. Title of Information Collection: Survey Report
Form for Clinical Laboratory Improvement Amendments (CLIA) and
Supporting Regulations in 42 CFR 493.1-493.2001. Use: CMS 1557 is used
to report surveyor findings during a CLIA survey. For each type of
survey conducted (i.e., initial certification, recertification,
validation, complaint, addition/deletion of specialty/subspecialty,
transfusion fatality investigation, or revisit inspections) the Survey
Report Form incorporates the requirements specified in the CLIA
regulations. Form Number: CMS-1557 (OCN 0938-0544). Frequency:
Biennially. Affected Public: Business or other for-profit, Not-for-
profit institutions, State, Local or Tribal Governments and Federal
Government. Number of Respondents: 21,000. Total Annual Responses:
10,500. Total Annual Hours: 5,248. (For policy questions regarding this
collection contact Kathleen Todd at (410) 786-3385. For all other
issues call (410) 786-1326.)
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 Email your request, including your address, phone number, OMB
number, and CMS document identifier, to Paperwork@cms.hhs.gov, or call
the
[[Page 6125]]
Reports Clearance Office on (410) 786-1326.
In commenting on the proposed information collections please
reference the document identifier or OMB control number. To be assured
consideration, comments and recommendations must be submitted in one of
the following ways by April 9, 2012:
1. Electronically. You may submit 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) 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.
Dated: January 31, 2012.
Martique Jones,
Director, Regulations Development Group, Division B Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2012-2774 Filed 2-6-12; 8:45 am]
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