[Federal Register Volume 67, Number 27 (Friday, February 8, 2002)]
[Notices]
[Page 6034]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-3028]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[CMS-R-295]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare and 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 and Medicaid 
Services (formerly the Health Care Financing Administration), 
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 
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: Revision of a currently 
approved collection; Title of Information Collection: Medicare CAHPS 
Disenrollment Survey; Form No.: CMS-R-295 (OMB# 0938-0779); Use: CMS is 
required by the Balanced Budget Act (BBA) of 1997 to provide 
disenrollment information on Medicare + Choice health plans to Medicare 
beneficiaries for the purpose of informed choice. To faithfully execute 
this requirement, CMS needs to survey Medicare beneficiaries who have 
disenrolled from their plans during the past year to obtain their 
ratings of their former plans (assessment survey) and the reasons why 
they left (reasons survey). The survey results will be reported to all 
beneficiaries in print and on the Internet.; Frequency: Quarterly; 
Affected Public: Individuals or Households; Number of Respondents: 
112,800; Total Annual Responses: 90,240; Total Annual Hours: 42,112.
    To obtain copies of the supporting statement and any related forms 
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, phone number, OMB number, and CMS 
document identifier, 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 60 days of this notice directly to the CMS Paperwork Clearance 
Officer designated at the following address: CMS, Office of Information 
Services, Security and Standards Group, Division of CMS Enterprise 
Standards, Attention: Melissa Musotto, Room N2-14-26, 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850.

    Dated: January 30, 2002.
John P. Burke, III,
CMS Reports Clearance Officer, CMS Office of Information Services, 
Security and Standards Group, Division of CMS Enterprise Standards.
[FR Doc. 02-3028 Filed 2-7-02; 8:45 am]
BILLING CODE 4120-03-P