[Federal Register Volume 68, Number 105 (Monday, June 2, 2003)]
[Notices]
[Pages 32757-32758]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-13666]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-367, a, b, and c; CMS-R-38, CMS-566, CMS-
10077, and CMS-10072]


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: Medicaid Drug 
Rebate Program--Manufacturers; Form No.: CMS-367a,b,c (OMB 
0938-0578); Use: Section 1927 requires drug manufacturers to enter into 
and have in effect a rebate agreement with the Federal Government for 
States to receive funding for drugs dispensed to Medicaid recipients; 
Frequency: Quarterly; Affected Public: Business or other for-profit; 
Number of Respondents: 570; Total Annual Responses: 2,280; Total Annual 
Hours: 54,780.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Conditions for 
Coverage for Rural Health Clinics--42 CFR 491.9 Subpart A; Form No.: 
CMS-R-38 (OMB 0938-0334); Use: This information is needed to 
determine if rural health clinics meet the requirements for approval 
for Medicare Participation.; Frequency: Initial Application for 
Medicare approval; Affected Public: Business or other for-profit, 
State, Local, or Tribal Gov't., and not-for-profit institutions, 
Individuals or households, Farms, and Federal Government; Number of 
Respondents: 3,305; Total Annual Responses: 3,305; Total Annual Hours: 
8,580.
    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.
    4. Type of Information Collection Request: New Collection; Title of 
Information Collection: ``Medicare Decisions and Your Rights''; Form 
No.: CMS-10077 (OMB 0938-NEW); Use Pursuant to 42 CFR 422.568 
(c), M+C practitioners must deliver notices to enrollees informing them 
of their right to obtain a detailed notice regarding services from 
their M+C organizations. This notice fulfills the regulatory 
requirement.; Frequency: Other (distribution); Affected Public: 
Individuals or Households, Business or other for-profit, Not-for-profit 
institutions, Federal Government; Number of Respondents: 155; Total 
Annual Responses: 5,000,000; Total Annual Hours: 83,333.
    5. Type of Information Collection Request: New Collection; Title of 
Information Collection: MSInteractive Survey Tool for cms.hhs.gov; Form 
No.: CMS-10072 (OMB 0938-NEW); Use CMS has developed a survey 
tool using MSInteractive to obtain feedback from users accessing 
cms.hhs.gov website to guide future improvements; Frequency: on 
occasion; Affected Public: Individuals or Households, Business or

[[Page 32758]]

other for-profit; Number of Respondents: 7000; Total Annual Responses: 
7000; Total Annual Hours: 583.
    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 cms.hhs.gov">Paperwork@cms.hhs.gov, 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, Fax 
Number: (202) 395-6974.

    Dated: May 22, 2003.
Dawn Willinghan,
CMS Reports Clearance Officer, Division of Regulations Development and 
Issuances, Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 03-13666 Filed 5-30-03; 8:45 am]
BILLING CODE 4120-03-P