[Federal Register Volume 68, Number 50 (Friday, March 14, 2003)]
[Notices]
[Pages 12356-12357]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-6139]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-368/R144, CMS-R-240, and CMS-566]


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: 
Medicaid Drug Rebate; Form No.: CMS-368/R144 (OMB 0938-0582); 
Use: Section 1927 requires State Medicaid agencies to report to drug 
manufacturers and CMS on the drug utilization for their State and the 
amount of rebate to be paid by the manufacturer; Frequency: Quarterly; 
Affected Public: State, local, or tribal government; Number of 
Respondents: 51; Total Annual Responses: 204; Total Annual Hours: 
6,125.
    (2) Type of Information Collection Request: Extension of a 
currently approved collection; Title of Information Collection: 
Prospective Payments for Hospital Outpatient Services and Supporting 
Regulations in 42 CFR 413.24, 413.65, and 419.42; Form No.: CMS-R-240 
(OMB 0938-0798); Use: As required by sections 4521, 4522, and 
4523 of the Balanced Budget Act of 1997, HCFA-1005FC eliminates the 
formula driven overpayment for certain outpatient hospital services, 
extends reductions in payment for costs of hospital outpatient 
services, and establishes in regulations a prospective payment system 
for hospital outpatient services. The rule also establishes in 
regulations the requirements for designating certain entities as 
provider-based or as a department of a hospital; Frequency: Other--as 
needed; Affected Public: Business or other for-profit, and Not-for-
profit institutions; Number of Respondents: 750; Total Annual 
Responses: 2,272; Total Annual Hours: 41,063.
    (3) Type of Information Collection Request: Extension of a 
currently approved collection; Title of Information Collection: 
Medicare Managed Care Disenrollment Form; Form No.: CMS-566 (0938-
0507); Use: This form provides Medicare beneficiaries the option to 
disenroll from their Medicare managed care plan through a neutral third 
party. CMS and SSA have established an agreement via a formal 
Memorandum of Understanding for SSA to process beneficiary 
disenrollments from Medicare managed care plans. Prior to 1999, the 
Social Security Act provided Medicare beneficiaries enrolled in 
Medicare managed care plans with the option of disenrolling from the 
plan at a Social Security Field Office; however, section 4001 of the 
Balanced Budget Act of 1997 amended the Social Security Act, removing 
this requirement from the statute; Frequency: On Occasion; Affected 
Public: Individuals or Households, Business or other for-profit, Not-
for-profit institutions, and Federal Government; Number of Respondents: 
85,000; Total Annual Responses: 85,000; Total Annual Hours: 2,805.
    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

[[Page 12357]]

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 N2-14-26, 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850.

    Dated: March 6, 2003.
John P. Burke, III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer, 
Office of Strategic Operations and Strategic Affairs, Division of 
Regulations Development and Issuances.
[FR Doc. 03-6139 Filed 3-13-03; 8:45 am]
BILLING CODE 4120-03-P