[Federal Register Volume 81, Number 1 (Monday, January 4, 2016)]
[Notices]
[Pages 92-93]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-32965]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-359/360]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services.
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 (the 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 60 days for public
comment on the proposed action. Interested persons are
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invited to send comments regarding our burden estimates 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 must be received by March 4, 2016.
ADDRESSES: When commenting, please reference the document identifier or
OMB control number. To be assured consideration, comments and
recommendations must be submitted in any one of the following ways:
1. Electronically. You may send 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) that are 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.
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:
Contents
This notice sets out a summary of the use and burden associated
with the following information collections. More detailed information
can be found in each collection's supporting statement and associated
materials (see ADDRESSES).
CMS-359/360 Comprehensive Outpatient Rehabilitation Facility (CORF)
Eligibility and Survey Forms and Supporting Regulations
Under the 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 requires federal agencies
to publish a 60-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.
1. Type of Information Collection Request: Extension of a currently
approved information collection; Title of Information Collection:
Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and
Survey Forms and Supporting Regulations; Use: The form CMS-359 is used
as the application for health care providers seeking to participate in
the Medicare program as a Comprehensive Outpatient Rehabilitation
Facility (CORF). This form initiates the process for facilities to
become certified as a CORF and it provides the CMS Regional Office
State Survey Agency staff identifying information regarding the
applicant that is stored in the Automated Survey Processing Environment
(ASPEN) system.
The form CMS-360 is a survey tool used by the State Survey Agencies
to record information in order to determine a provider's compliance
with the CORF Conditions of Participation (CoPs) and to report this
information to the Federal government. The form includes basic
information on the CoP requirements, check boxes to indicate the level
of compliance, and a section for recording notes. We have the
responsibility and authority for certification decisions which are
based on provider compliance with the CoPs and this form supports this
process. Form Number: CMS-359/360 (OMB Control Number: 0938-0267);
Frequency: Occasionally; Affected Public: Private Sector (Business or
other for-profits); Number of Respondents: 50; Number of Responses: 50;
Total Annual Hours: 123.
(For questions regarding this collection contact James Cowher (410)
786-1948.)
Dated: December 28, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2015-32965 Filed 12-31-15; 8:45 am]
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