[Federal Register Volume 70, Number 116 (Friday, June 17, 2005)]
[Notices]
[Pages 35256-35257]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-11931]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-262, CMS-R-254, CMS-1450, CMS-10146, CMS-
10147, CMS-10154, and CMS-10160]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & 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 & Medicaid 
Services (CMS) 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: Extension of a currently 
approved collection; Title of Information Collection: Plan Benefit 
Package (PBP) and Formulary Submission for Medicare Advantage (MA) 
Plans and Prescription Drug Plans (PDPs); Form No.: CMS-R-262 (OMB 
 0938-0763); Use: Under the Medicare Modernization Act (MMA), 
Medicare Advantage (MA) and Prescription Drug Plan (PDP) organizations 
are required to submit plan benefit package information to CMS for 
approval. Organizations will provide this information through the 
submission of the formulary and the PBP software; Frequency: On 
occasion, annually and other (as required by new legislation); Affected 
Public: Business or other for-profit and Not-for-profit institutions; 
Number of Respondents: 470; Total Annual Responses: 2,092; Total Annual 
Hours: 5,546.
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: National Medicare 
Education Program (NMEP); Form No.: CMS-R-254 (OMB  0938-
0738); Use: The NMEP was developed to inform people with Medicare, 
their family members, and other interested parties about their Medicare 
options. The Medicare Modernization Act of 2003 expanded the program to 
include among other things, a new Prescription Drug Benefit; therefore, 
this package has been revised to include this information. The NMEP 
employs numerous communication channels to educate people with Medicare 
and help them make more informed decisions concerning the Medicare 
program benefits; health plan choices; supplemental health insurance; 
rights, responsibilities, and protections; and preventive health 
services. As part of the NMEP, CMS must provide information to this 
population about the Medicare program and their Health Plan options, as 
well as information about the new prescription drug coverage to help 
them choose the option that is right for them. This survey seeks to 
assess the awareness, knowledge, understanding and experiences of 
people with Medicare regarding the Medicare program overall and these 
new initiatives; Frequency: On occasion; Affected Public: Individuals 
or Households; Number of Respondents: 5,700; Total Annual Responses: 
5,700; Total Annual Hours: 1,425.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare Uniform 
Institutional Provider Bill and Supporting Regulations in 42 CFR 424.5; 
Form No.: CMS-1450 (OMB  0938-0279); Use: Section 42 CFR 
424.5(a)(5) requires providers of services to submit claims prior to 
Medicare reimbursement. Charges are coded by revenue codes. The bill 
specifies diagnoses according to the International Classification of 
Diseases, Ninth Edition (ICD-9-CM) code. Inpatient procedures are 
identified by ICD-9-CM codes, and outpatient procedures are described 
using the Healthcare Common Procedure Coding System (HCPCS). These are 
standard systems of identification for all major health insurance 
claims payers. Submission of information on the CMS-1450 permits 
Medicare intermediaries to receive consistent data for proper payment; 
Frequency: On occasion; Affected Public: Not-for-profit institutions, 
Business or other for profit; Number of Respondents: 51,629; Total 
Annual Responses: 174,461,278; Total Annual Hours: 1,997,581.
    4. Type of Information Collection Request: New Collection; Title of 
Information Collection: Notice of Denial of Medicare Prescription Drug 
Coverage; Form No.: CMS-10146 (OMB  0938-NEW); Use: Pursuant 
to 42 CFR 423.568(c), if a Part D plan denies drug coverage, in whole 
or in part, the Part D plan must give the enrollee written notice of 
the coverage determination; Frequency: Other: Distribution; Affected 
Public: Business or other for profit, Not-for-profit institutions; 
Individuals or Households and Federal Government; Number of 
Respondents: 450; Total Annual Responses: 1,056,000; Total Annual 
Hours: 528,000.
    5. Type of Information Collection Request: New Collection; Title of 
Information Collection: Medicare Prescription Drug Coverage and Your 
Rights; Form No.: CMS-10147 (OMB  0938-NEW); Use: Pursuant to 
42 CFR 423.562(a)(3), a Part D plan sponsor must arrange with its 
network pharmacies to post or distribute notices informing enrollees to 
contact their plan to request a coverage determination or an exception 
if the enrollee disagrees with the information provided by the 
pharmacy; Frequency: Other: Distribution; Affected Public: Business or 
other for profit, Not-for-profit institutions; Individuals or 
Households and Federal Government; Number of Respondents: 41,000; Total 
Annual Responses: 35,000,000; Total Annual Hours: 583,333.
    6. Type of Information Collection Request: New collection; Title of 
Information Collection: Physician Assessment of Hospital Quality 
Reports; Form No.: CMS-10154 (OMB  0938-NEW); Use: This 
assessment will monitor the attitudes and behaviors of physicians as 
they relate to the concerns of their patients who have been exposed to 
hospital quality-of-care reports at CMS's Web site; Affected Public: 
Individuals or Households; Number of Respondents: 1730; Total Annual 
Responses: 1730; Total Annual Hours: 345.75.
    7. Type of Information Collection Request: New collection; Title of 
Information Collection: The Personal Responsibility Survey; Form No.: 
CMS-10160 (OMB  0938-NEW); Use: New focus on personalizing 
messages by

[[Page 35257]]

relating health care choices with individual beliefs may help guide 
these educational efforts. The intent of this survey is to understand 
the role personal responsibility plays when people with Medicare make 
health care decisions; Affected Public: Individuals or Households; 
Number of Respondents: 1580; Total Annual Responses: 1580; Total Annual 
Hours: 300.
    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 60 days of this notice to the address 
below: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: Melissa Musotto, PRA 
Analyst, Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 
21244-1850.

    Dated: June 10, 2005.
Jimmy Wickliffe,
Reports Clearance Officer, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 05-11931 Filed 6-16-05; 8:45 am]
BILLING CODE 4120-01-P