[Federal Register Volume 73, Number 63 (Tuesday, April 1, 2008)]
[Notices]
[Pages 17347-17348]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-6510]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-1696, CMS-10167, CMS-R-306, CMS-10262 and
CMS-10143]
Agency Information Collection Activities: Proposed Collection;
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) 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: Revision of a currently
approved collection; Title of Information Collection: Appointment of
Representative; Use: This form will be completed by beneficiaries,
providers and suppliers who wish to appoint representatives to assist
them with obtaining initial determinations and filing appeals. The
appointment of representative form must be signed by the party making
the appointment and the individual agreeing to accept the appointment.
Form Number: CMS-1696 (OMB 0938-0950); Frequency:
Occasionally; Affected Public: Individuals or households and businesses
or other for-profits; Number of Respondents: 268,268; Total Annual
Responses: 268,268; Total Annual Hours: 67,067.
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Competitive
Acquisition Program for Medicare Part B Drugs: CAP Physician Election
Agreement; Use: The Competitive Acquisition Program (CAP) is required
by Section 303(d) of the Medicare Modernization Act (MMA) which amended
Title XVIII of the Social Security Act (the Act) by adding a new
section 1847(B), which establishes a competitive acquisition program
for the payment for Part B covered drugs and biologicals furnished on
or after January 1, 2006. Physicians are given a choice between buying
and billing these drugs under the average sales price (ASP) system, or
obtaining these drugs from vendors selected in a competitive bidding
process. Section 108 of the Medicare Improvements and Extension Act
under Division B, Title I of the Tax Relief Health Care Act of 2006
amended Section 1847(b)(a)(3) of the Act and requires that CAP
implement a post payment review process.
[[Page 17348]]
The CAP Physician Election Agreement is used annually by physicians
to elect to participate in the CAP or to make changes to the previous
year's selections. The information collected by these documents is used
by CMS, its Medicare contractor, and the approved CAP vendor to meet
programmatic requirements pertaining to physician election as
established by the MMA. Form Number: CMS-10167 (OMB 0938-
0955); Frequency: Yearly; Affected Public: Business or other for-
profits; Number of Respondents: 3,800; Total Annual Responses: 3,800;
Total Annual Hours: 7,600.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Use of Restraint
and Seclusion in Psychiatric Residential Treatment Facilities (PRTFs)
for Individuals Under Age 21; Use: PRTFs are required to report deaths,
serious injuries and attempted suicides to the State Medicaid Agency
and the Protection and Advocacy Organization. They are also required to
provide residents the restraint and seclusion policy in writing, and to
document in the residents' records all activities involving the use of
restraint and seclusion. Form Number: CMS-R-306 (OMB 0938-
0833); Frequency: Annually; Affected Public: Private Sector: Business
or other for-profits; Number of Respondents: 500; Total Annual
Responses: 329,500; Total Annual Hours: 501,750.
4. Type of Information Collection Request: New Collection; Title of
Information Collection: Health Insurance Flexibility and Accountability
(HIFA) Evaluation; Use: The HIFA initiative sought to increase health
coverage of uninsured populations through a flexible waiver process
emphasizing public subsidy of Employer-Sponsored Insurance (ESI).
Testing whether that approach reduces the rate/number of uninsured is
critically important to CMS. The proposed survey of HIFA enrollees in
New Mexico and Oregon would provide the only data available to test
certain fundamental HIFA effects, especially with reference to
reduction of the uninsured population, the effectiveness of premium
assistance for ESI and the possibility of crowd-out of private
coverage. Form Number: CMS-10262 (OMB 0938-NEW); Frequency:
Once; Affected Public: Individuals or households; Number of
Respondents: 800; Total Annual Responses: 800; Total Annual Hours: 400.
5. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Monthly State
File of Medicaid/Medicare Dual Eligible Enrollees; Use: The monthly
file of dual eligible enrollees will be used to determine those duals
with drug benefits for the phased down State contribution process
required by the Medicare Modernization Act of 203. These data are also
used to support Part D subsidy determinations and auto-assignment of
individuals to Part D plans. Form Number: CMS-10143 (OMB 0938-
0958); Frequency: Monthly; Affected Public: State, Local or Tribal
Governments; Number of Respondents: 51; Total Annual Responses: 612;
Total Annual Hours: 6,120.
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 [email protected], or call
the 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 June 2, 2008.
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, Room C4-26-05, 7500 Security
Boulevard, Baltimore, Maryland 21244-1850.
Dated: March 21, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. E8-6510 Filed 3-31-08; 8:45 am]
BILLING CODE 4120-01-P