[Federal Register Volume 67, Number 217 (Friday, November 8, 2002)]
[Notices]
[Pages 68139-68140]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-28423]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[CMS-29/30, CMS-317, CMS-319, CMS-2746, and CMS-R-293]


Agency Information Collection Activities: Submission for OMB 
Review; 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 (CMS) (formerly known as the Health Care Financing 
Administration (HCFA), 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.
    1. Type of Information Collection Request: Extension of a currently 
approved collection.
    Title of Information Collection: Request for Certification as Rural 
Health Clinic and Rural Health Clinic Survey Report Form and Supporting 
Regulations in 42 CFR 491.1-491.11.

[[Page 68140]]

    Form No.: CMS-0029/0030 (OMB 0938-0074).
    Use: The Form CMS-29 is utilized as an application to be completed 
by suppliers of RHC services requesting participation in the Medicare/
Medicaid programs. This form initiates the process of obtaining a 
decision as to whether the conditions for certification are met as a 
supplier of RHC services. It also promotes data reduction or 
introduction to and retrieval from the Online Survey and Certification 
and Reporting System (OSCAR) by the CMS Regional Offices (RO). The Form 
CMS-30 is an instrument used by the State survey agency to record data 
collected in order to determine RHC compliance with individual 
conditions of participation and to report it to the Federal government. 
The form is primarily a coding worksheet designed to facilitate data 
reduction (keypunching) and retrieval into OSCAR at the CMS ROs. The 
form includes basic information on compliance (i.e., met, not met and 
explanatory statements) and does not require any descriptive 
information regarding the survey activity itself.
    Frequency: Annually.
    Affected Public: State, Local, or Tribal Government.
    Number of Respondents: 661.
    Total Annual Responses: 661; Total Annual Hours: 1,157.
    2. Type of Information Collection Request: Extension of a currently 
approved collection.
    Title of Information Collection: State Medicaid Eligibility Quality 
Control (MEQC) Sampling Plan and Supporting Regulations in 42 CFR 
431.800-431.865.
    Form No.: CMS-317 (OMB 0938-0146).
    Use: The State MEQC sampling plan is necessary for CMS to monitor 
the States' operation of the MEQC system for States performing the 
traditional sampling process. The sampling plan includes all data 
involved in the States' sample selection process--population sizes and 
sample frame lists, sample sizes, sample selection procedures, and 
claim collection procedures.
    Frequency: Semi-annually.
    Affected Public: State, Local, or Tribal Government.
    Number of Respondents: 55.
    Total Annual Responses: 110.
    Total Annual Hours: 2,640.
    3. Type of Information Collection Request: Extension of a currently 
approved collection;
    Title of Information Collection: State Medicaid Eligibility Quality 
Control (MEQC) Sample Section Lists and Supporting Regulations in 42 
CFR 431.800--431.865.
    Form No.: CMS-0319 (OMB 0938-0147).
    Use: The sample selection lists contain identifying information on 
Medicaid beneficiaries and is the basis for the cases that States 
review to determine the accuracy of the Medicaid eligibility 
determinations. The Regional Office uses this list to monitor State 
review activity.
    Frequency: Monthly.
    Affected Public: State, Local or Tribal Government.
    Number of Respondents: 55.
    Total Annual Responses: 660.
    Total Annual Hours: 5,280.
    4. Type of Information Collection Request: Extension of a currently 
approved collection.
    Title of Information Collection: End Stage Renal Disease Death 
Notification 42 CFR 405.2133.
    Form No.: CMS-2746 (OMB 0938-0448).
    Use: This form is completed by all Medicare approved ESRD 
facilities upon the death of an ESRD patient. The form's primary 
purpose is to collect fact and cause of death. Reports of deaths are 
used to show cause of death and demographic characteristics of these 
patients.
    Frequency: On occasion.
    Affected Public: Business or other for-profit, Not-for-profit 
institutions, Federal Government.
    Number of Respondents: 4,000.
    Total Annual Responses: 56,258.
    Total Annual Hours: 9,564.
    5. Type of Information Collection Request: Extension of a currently 
approved collection.
    Title of Information Collection: Medicare Telephone Customer 
Satisfaction Survey.
    Form No.: CMS-R-293 (OMB 0938-0780).
    Use: In response to the National Partnership for Reinventing 
Government and Government Performances and Results Act (GPRA), CMS is 
implementing a number of initiatives to measure and then improve the 
customer service that is provided by Medicare Call Centers, that 
service over 21 million calls annually.
    Frequency: On occasion, simi-annually, other (single 800 
survey).
    Affected Public: Individuals or Households; Number of Respondents: 
50,000.
    Total Annual Responses: 50,000.
    Total Annual Hours: 3,500.
    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://cms.hhs.gov/regulations/pra/default.asp, 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 30 days of this notice directly to the OMB desk officer: OMB 
Human Resources and Housing Branch, Attention: Brenda Aguilar, New 
Executive Office Building, Room 10235, Washington, DC 20503.

    Dated: October 31, 2002.
John P. Burke, III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer, 
Office of Strategic Operations and Regulatory Affairs, Division of 
Regulations Development and Issuances.
[FR Doc. 02-28423 Filed 11-7-02; 8:45 am]
BILLING CODE 4120-03-P