[Federal Register Volume 66, Number 198 (Friday, October 12, 2001)]
[Notices]
[Pages 52139-52140]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-25688]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10026]


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

    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid 
Services (CMS), Department of Health and Human Services, has submitted 
to the Office of Management and Budget (OMB) the following proposal for 
the collection of information. 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: (1) 
The necessity and utility of the proposed information collection for 
the proper performance of

[[Page 52140]]

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.
    Type of Information Collection Request: Reinstatement, without 
change, of a previously approved collection for which approval has 
expired.
    Title of Information Collection: Survey of Medicare Beneficiaries 
Who Involuntarily Disenroll from their Health Plan.
    Form No.: CMS-10026 (OMB# 0938-0817).
    Use: In January 2002, many managed care plans are expected to 
withdraw from Medicare or reduce their service area. This will continue 
a trend that began in January 1999. CMS wishes to survey approximately 
3,600 affected beneficiaries in early 2002 to determine how they were 
impacted by the withdrawals and whether they received sufficient 
information about options for replacing their managed care coverage.
    Frequency: Other: One-Time.
    Affected Public: Individuals or Households.
    Number of Respondents: 3,600.
    Total Annual Responses: 3,600.
    Total Annual Hours: 684.
    To obtain copies of the supporting statement for the proposed 
paperwork collections referenced above, access CMS's Web Site address 
at http://www.hcfa.gov/regs/prdact95.htm, or e-mail your request, 
including your address and phone number, to [email protected], or call 
the Reports Clearance Office on (410) 786-1326. Written comments and 
recommendations for the proposed information collections must be mailed 
within 30 days of this notice directly to the OMB Desk Officer 
designated at the following address: OMB Human Resources and Housing 
Branch, Attention: Allison Eydt, New Executive Office Building, Room 
10235, Washington, DC 20503.

    Dated: September 25, 2001.
John P. Burke III,
CMS Reports Clearance Officer, CMS, Office of Information Services, 
Security and Standards Group, Division of CMS Enterprise Standards.
[FR Doc. 01-25688 Filed 10-11-01; 8:45 am]
BILLING CODE 4120-03-P