[Federal Register Volume 68, Number 177 (Friday, September 12, 2003)]
[Notices]
[Pages 53741-53742]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-23213]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[CMS-10096, CMS-2786]


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 (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: New Collection; Title of 
Information Collection: Medicare Health Survey (MHS); Form No.: CMS-
10096 (OMB 0938-NEW); Use: The Centers for Medicare and 
Medicaid Services has developed a survey, the Medicare Health Survey, 
that is similar to the Health Outcomes Survey (HOS). The main purpose 
of the MHS is to collect information that may be used to adjust 
Medicare payment. This approach has been tested for PACE (as mandated 
by BBA) and other organizations that serve frail populations and 
frailty adjusted payments will be made to PACE and certain 
demonstrations starting in 2004. CMS is currently investigating the 
feasibility of applying frailty adjustment to the M+C program in the 
future. To

[[Page 53742]]

conduct the necessary research, CMS needs functional impairment 
information for a national sample of FFS beneficiaries. The information 
will be used for two purposes; to develop appropriate adjustments to 
the ratebook for levels of functional impairment, and to recalibrate 
the frailty payment model using FFS data. Adjusting the ratebook is 
necessary to ensure accurate payment while recalibration of the frailty 
model based on the MHS will properly align the calibration of the model 
and the data collection method, thereby avoiding payment error 
associated with the mode of administration issues; Frequency: Annually; 
Affected Public: Individuals or Households; Number of Respondents: 
50,000; Total Annual Responses: 35,000; Total Annual Hours: 5,833.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Fire Safety 
Survey Report Forms and Supporting Regulations in 42 CFR 488.26 and 
442.30; Form No.: CMS-2786 M, R, and T-Y (OMB 0938-0242); Use: 
CMS surveys facilities to determine compliance with the Life Safety 
Code of 2000. The providers must make documentation proving compliance 
available to the surveyors; Frequency: Annually; Affected Public: 
Business or other for-profit, Not-for-profit institutions; Number of 
Respondents: 27,900; Total Annual Responses: 27,900; Total Annual 
Hours: 2325.
    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: September 5, 2003.
Julie Brown,
CMS Reports Clearance Officer, Office of Strategic Operations and 
Strategic Affairs, Division of Regulations Development and Issuances.
[FR Doc. 03-23213 Filed 9-11-03; 8:45 am]
BILLING CODE 4120-03-P