[Federal Register Volume 68, Number 249 (Tuesday, December 30, 2003)]
[Notices]
[Pages 75260-75261]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-32044]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-10000, CMS-10091 and CMS-10028A, B, and C]


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

[[Page 75261]]

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: Medicare Consumer 
Assessment of Health Plan Survey-Fee for Service (CAHPS-FFS); Form No.: 
CMS-10000 (OMB 0938-0796); Use: Under the Balanced Budget Act 
of 1997, CMS is required to provide general and plan comparative 
information to beneficiaries that will help them make more informed 
plan choices. A CAHPS fee-for-service survey is needed to provide 
information comparable to those data collected from the CAHPS managed 
care survey; Frequency: Annually; Affected Public: Individuals or 
Households; Number of Respondents: 142,920; Total Annual Responses: 
142,920; Total Annual Hours: 47,640.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: UPIN (Unique 
Physician Identification Number) Participating Physicians Directory; 
Form No.: CMS-10091 (OMB 0938-0905); Use: In November of 2000, 
CMS launched the Participating Physicians Directory on http://www.medicare.gov. This particular directory was created to provide 
beneficiaries with the names, addresses, and specialties of Medicare 
participating physicians who have agreed to accept assignment on all 
Medicare claims and covered services. CMS is adding information from 
already existing sources; in addition, CMS wants to collect a new data 
element ``Accepting New Patients Indicator'' which is essential to a 
beneficiary's search for a physician; Frequency: On occasion; Affected 
Public: Business or other for-profit; Number of Respondents: 10,980; 
Total Annual Responses: 10,980; Total Annual Hours: 915.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: State Health 
Insurance Assistance Program (SHIP) Client Contact Form, Public and 
Media Activity Form, and Resource Report; Form No.: CMS-10028A, B, C 
(OMB 0938-0850); Use: The State Health Insurance Assistance 
Program (SHIP) Client Contract form will be completed by SHIP 
counselors at each counseling event in order to collect SHIP 
performance data. This data will then be accumulated and analyzed to 
measure SHIP performance; Frequency: Semi-annually and annually; 
Affected Public: State, Local, or Tribal Government, Not-for-profit 
institutions, and Federal Government; Number of Respondents: 12,000; 
Total Annual Responses: 1,000,000; Total Annual Hours: 116,747.
    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 [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 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.

    Dated: December 18, 2003.
Melissa Musotto,
Acting, Paperwork Reduction Act Team Leader, CMS Reports Clearance 
Officer, Office of Strategic Operations and Strategic Affairs, Division 
of Regulations Development and Issuances.
[FR Doc. 03-32044 Filed 12-29-03; 8:45 am]
BILLING CODE 4120-03-P