[Federal Register Volume 70, Number 33 (Friday, February 18, 2005)]
[Notices]
[Page 8376]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-3127]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10115, CMS-2552 and CMS-R-148]


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

AGENCY: Centers for Medicare & Medicaid Services.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid 
Services (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 function; (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: Federal Funding 
of Emergency Health Services (Section 1011): Enrollment Application; 
Use: These information collections will allow hospitals and other 
providers to enroll to receive payment for Section 1011 claim 
submissions. Section 1011 provides $250 million per year for fiscal 
years 2005-2008 for payments to eligible providers for emergency health 
services provided to undocumented aliens and other specified aliens; 
Form Number: CMS-10115 (OMB: 0938-0929); Frequency: Other: as 
needed; Affected Public: Business or other for-profit, Not-for-profit 
institutions, and State, local or tribal govt.; Number of Respondents: 
62,500; Total Annual Responses: 62,500; Total Annual Hours: 31,250.
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Hospital and 
Health Care Complexes Cost Report and Supporting Regulations in 42 CFR 
413.20 and 413.24; Use: This form is completed by Hospitals and Health 
Care Complexes participating in the Medicare program. Hospitals and 
Health Care Complexes use this form to report the health care costs for 
services they provide. The information reported on this form is used by 
CMS to determine the amount of reimbursable costs for services rendered 
to Medicare beneficiaries. The revisions to this form contain the 
provisions for implementing section 422 of the MMA. Section 422 deals 
with the calculation of GME and IME payments for redistribution of 
unused resident slots; Form Number: CMS-2552-96 (OMB 0938-
0050); Frequency: Annually; Affected Public: Business or other for-
profit, Not-for-profit institutions, and State, local or tribal 
government; Number of Respondents: 6,111; Total Annual Responses: 
6,111; Total Annual Hours: 4,046,782.
    3. Type of Information Collection Request: Reinstatement, without 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Limitations on Provider 
Related Donations and Health Care Related Taxes; Limitation on payments 
to Disproportionate Share Hospitals; Medicaid and Supporting 
Regulations in 42 CFR 433.68, 433.74, and 447.272; Use: This 
information collection is necessary to ensure compliance with Sections 
1903 and 1923 of the Social Security Act for the purpose of preventing 
payment of federal financial participation on amounts prohibited by the 
statute. State Medicaid agencies must report quarterly on the source of 
provider related donations received by the State or unit of local 
government, and health care related taxes collected. Failure to collect 
the funding data on a quarterly basis may result in Federal funds not 
being returned promptly and properly to the Federal Government; Form 
Number: CMS-R-148 (OMB: 0938-0618); Frequency: Quarterly and 
as needed; Affected Public: State, Local or Tribal Government; Number 
of Respondents: 50; Total Annual Responses: 40; Total Annual Hours: 
3,200.
    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://www.cms.hhs.gov/regulations/pra/, 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: Christopher Martin, New Executive Office Building, Room 
10235, Washington, DC 20503.

    Dated: February 11, 2005.
Michelle Shortt,
Acting Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 05-3127 Filed 2-17-05; 8:45 am]
BILLING CODE 4120-03-P