[Federal Register Volume 68, Number 12 (Friday, January 17, 2003)]
[Notices]
[Pages 2558-2559]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-1054]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifiers: CMS-R-72, CMS-10042, CMS-10081]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare and Medicaid Services.
    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: Information Collection 
Requirements in 42 CFR 478.18, 478.34, 478.36, and 478.42, QIO 
Reconsiderations and Appeals; Form No.: CMS-R-72 (OMB 0938-
0443); Use: These regulations contain procedures for QIOs (formerly 
known as PROs) to use in reconsideration of initial determinations. The 
information requirements contained in these regulations are on QIOs to 
provide information to parties requesting a reconsideration. These 
parties will use the information as guidelines for appeal rights in 
instances where issues are still in dispute.; Frequency: On occasion; 
Affected Public: Individuals or Households and Business or other for-
profit; Number of Respondents: 2,509; Total Annual Responses: 5,228; 
Total Annual Hours: 2,882.
    (2) Type of Information Collection Request: New Collection; Title 
of Information Collection: Medicare Part A Provider and Durable Medical 
Equipment Supplier Satisfaction Survey; Form No.: CMS-10042 
(OMB 0938-NEW); Use: This is a request for clearance of a 
survey questionnaire to conduct a standardized random sample of Part A 
providers' and DME suppliers' satisfaction of their experience with 
their Medicare contractor's performance in its administration of the 
Medicare-fee-for-service program. The purpose of this study is to 
develop a baseline measure of providers' and suppliers' satisfaction 
with Medicare contractors by administering a survey to 15,000 providers 
and suppliers, 5,000 serviced by each of the following contractors: 
Connecticut General Life Insurance Company (CIGNA)-D, Palmetto 
Government Business Administrators (PBGA)-D, and United Government 
Services, LLC (UGS)-Part A. The data collected will be interpreted to 
produce indicators of the contractor's quality of performance.; 
Frequency: Annually; Affected Public: Business or other for-profit, and 
Not-for-profit institutions; Number of Respondents: 4,500; Total Annual 
Responses: 4,500; Total Annual Hours: 1,125.
    (3) Type of Information Request: New Collection; Title of 
Information Collection: Data Collection for Administering the Survey 
for the Evaluation of the Demonstration to Maintain Independence and

[[Page 2559]]

Employment (DMIE); Form No.: CMS-10081 (OMB 0938-NEW); Use: 
The DMIE Programs, funded by CMS under Title II of the Federal Ticket 
to Work Legislation, provide Medicaid coverage to low-income working 
populations. The Survey Evaluation is designed to assess the impact of 
the Mississippi DMIE program on access to care, health status and 
quality of life, workforce participation, etc.; Frequency: Annually; 
Affected Public: Individuals or Households, and State, Local, or Tribal 
Gov.; Number of Respondents: 928; Total Annual Responses: 928; Total 
Annual Hours: 253.
    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://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 60 days of this notice directly to the CMS Paperwork Clearance 
Officer designated at the following address: CMS, Office of Strategic 
Operations and Regulatory Affairs, Division of Regulations Development 
and Issuances, Attention: Dawn Willinghan, Room: C5-14-03, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: January 9, 2003.
John P. Burke, III,
CMS Reports Clearance Officer, Office of Strategic Operations and 
Strategic Affairs, Division of Regulations Development and Issuances.
[FR Doc. 03-1054 Filed 1-16-03; 8:45 am]
BILLING CODE 4120-03-P