[Federal Register Volume 69, Number 11 (Friday, January 16, 2004)]
[Notices]
[Pages 2600-2601]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-983]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-2786M, R, and S-Y, CMS-10097, CMS-R-204, CMS-
9044, CMS-P-0015A, CMS-R-13]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

    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: Revision 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 S-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.
    2. Type of Information Collection Request: New collection; Title of 
Information Collection: Medicare Contractor Provider Satisfaction 
Survey; Form No.: CMS-10097 (OMB 0938-NEW); Use: CMS needs 
standard data about Medicare provider's satisfaction with their 
Medicare contractors, who are charged with all Medicare claims 
processing and related activities on behalf of the Agency. Respondents 
will be staff representatives of hospitals, skilled nursing facilities, 
rural health clinics, home health agencies, end-stage renal disease 
clinics, physicians, non-physicians, durable medical equipment 
suppliers, laboratories and ambulance providers. The survey will be 
used as a mechanism for evaluating and improving Medicare providers' 
satisfaction with their Medicare contractors. The results will provide 
CMS with a comprehensive review of contractor-provider business 
relations from the perspective of the ``customer'' or provider. The 
information will help the Agency appropriately address provider 
concerns about Medicare Contractors' performance, aid in business/
contracting decisions, and assist or guide contractors in identifying/
implementing ``best practices'' or quality improvement initiatives.; 
Frequency: On occasion; Affected Public: Business or other for-profit 
and not-for-profit institutions; Number of Respondents: 6,052; Total 
Annual Responses: 6,052; Total Annual Hours: 3,331.
    3. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Data Collection 
for the Second Generation Social Health Maintenance Organization 
Demonstration; Form No.: CMS-R-204 (OMB 0938-0709; Use: The 
Centers for Medicare and Medicaid Services will continue to use the 
data collected under this effort to support the operational needs of 
the Congressionally-mandated and administratively extended Second 
Generation of the Social Health Maintenance Organization Demonstration; 
Frequency: Annually; Affected Public: Individuals or households; Number 
of Respondents: 15,000; Total Annual Responses: 15,000; Total Annual 
Hours: 3,000.
    4. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Provider 
Reimbursement Manual, Part 1--Chapter 27, Sections 2721, 2722 and 2725, 
Request for Exception to End Stage Renal Disease Composite Rates and 
Supporting Regulations in 42 CFR 413.170 and 413.184; Form No.: CMS-
9044 (OMB 0938-0296); Use: This information collection 
describes the information End Stage Renal Disease facilities must 
submit in justifying an exception request to their composite rate for 
outpatient dialysis services; Frequency: On occasion; Affected Public: 
Business or other for-profit, not-for-profit institutions, and Federal 
government; Number of Respondents: 125; Total Annual Responses: 125; 
Total Annual Hours: 6,000.
    5. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare Current 
Beneficiary Survey (MCBS): Rounds 38-46; Form No.: CMS-P-0015A 
(OMB 0938-0568); Use: The MCBS is a continuous, multipurpose 
survey of a nationally representative sample of aged and disabled 
persons enrolled in Medicare. The survey provides a comprehensive 
source of information on beneficiary characteristics, needs, 
utilization, and satisfaction with Medicare-related activities; 
Frequency: Other: 3 times a year; Affected Public: Individuals or 
households, business or other for-profit, and not-for-profit 
institutions; Number of Respondents: 16,500; Total Annual Responses: 
49,500; Total Annual Hours: 50,325.
    6. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Conditions of 
Coverage for Organ Procurement Organizations (OPOs) and Supporting 
Regulations in 42 CFR, Sections 486.304, 486.306, 486.307, 486.310, 
486.316, 486.318, and 486.325; Form No.: CMS-R-13 (OMB 0938-
0688); Use: Organ Procurement Organizations are required to submit 
accurate data to CMS concerning population and information on donors 
and organs on an annual basis in order to assure maximum effectiveness 
in the procurement and distribution of organs; Frequency: Annually; 
Affected Public: Not-for-profit institutions; Number of

[[Page 2601]]

Respondents: 59; Total Annual Responses: 59; Total Annual Hours: 118.
    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: January 8, 2004.
John P. Burke, III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer, 
Office of Strategic Operations and Strategic Affairs, Division of 
Regulations Development and Issuances.
[FR Doc. 04-983 Filed 1-15-04; 8:45 am]
BILLING CODE 4120-03-P