[Federal Register Volume 68, Number 158 (Friday, August 15, 2003)]
[Notices]
[Page 48922]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-20816]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-10095]


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 (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.
    1. Type of Information Collection Request: New Collection; Title of 
Information Collection: ``Detailed Explanation of Non-Coverage'' 42 CFR 
422.626(e)(1), and ``Important Message of Non-Coverage'' 42 CFR 
625(b)(1); Form No.: CMS-10095 (OMB 0938-NEW); Use: Pursuant 
of 42 CFR 422.624(b)(1), providers in skilled nursing facilities, home 
health agencies, and comprehensive outpatient rehabilitation facilities 
must deliver to M+C enrollees a 2-day advance notice of termination of 
services. Per requirements at 42 CFR 422.626(e)(1), M+C organizations 
must deliver detailed notices to the QIO and enrollees upon request for 
appeal of the termination of services. These notices fulfill the 
regulatory requirement; Frequency: Other: distribution; Affected 
Public: Business or other-for-profit, Not-for-profit institutions, 
Federal Government, and Individuals or Households.; Number of 
Respondents: 155; Total Annual Responses: 12,000; Total Annual Hours: 
18,000.
    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: August 7, 2003.
Dawn Willinghan,
Acting CMS Reports Clearance Officer, Division of Regulations 
Development and Issuances, Office of Strategic Operations and Strategic 
Affairs.
[FR Doc. 03-20816 Filed 8-14-03; 8:45 am]
BILLING CODE 4120-03-P