[Federal Register Volume 68, Number 121 (Tuesday, June 24, 2003)]
[Notices]
[Page 37503]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-15828]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-10094]


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 (CMS) (formerly known as the Health Care Financing 
Administration (CMS)), 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: New Collection.
    Title of Information Collection: Evaluation of the Medicaid Health 
Reform Demonstrations.
    Form No.: CMS-10094 (OMB 0938-NEW).
    Use: This survey is part of an evaluation of the State of Vermont's 
pharmacy assistance programs, which principally serve low income 
Medicare beneficiaries who do not have other coverage for prescription 
drugs. The surveys will explore the issues of self-selection into the 
pharmacy programs, motivations for joining or not joining, the extent 
of pharmacy coverage among low income Medicare beneficiaries who are 
not enrolled and the impact of coverage on Medicare spending. The 
Vermont evaluation is part of a larger evaluation of section 1115 
Medicaid demonstration programs in five states. (The other states are 
California, Kentucky, Minnesota and New York. The survey will take 
place only in Vermont.)
    Frequency: Other: One-time.
    Affected Public: Individuals or Households.
    Number of Respondents: 11,310.
    Total Annual Responses: 11,310.
    Total Annual Hours: 1,087.
    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: June 12, 2003.
Dawn Willinghan,
CMS Reports Clearance Officer, Division of Regulations Development and 
Issuances, Office of Strategic Operations and Strategic Affairs.
[FR Doc. 03-15828 Filed 6-23-03; 8:45 am]
BILLING CODE 4120-03-P