[Federal Register Volume 70, Number 121 (Friday, June 24, 2005)]
[Notices]
[Page 36613]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-12492]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10130]


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: Federal Funding 
of Emergency Health Services (Section 1011): Provider Payment 
Determination and Request for Section 1011 On-Call Payments; Form No.: 
CMS-10130 (OMB  0938-0952); Use: Section 1011 of MMA provides 
that the Secretary will establish a process for eligible providers to 
request payment. The Secretary must directly pay hospitals, physicians, 
and ambulance providers (including Indian Health Service, Indian tribe 
and tribal organizations) for their otherwise un-reimbursed costs of 
providing services required by Section 1867 of the Social Security Act 
(EMTALA) and related hospital inpatient, outpatient and ambulance 
services. Payments may be made only for services furnished to certain 
individuals described in the statute as: (1) Undocumented aliens; (2) 
aliens who have been paroled into the United States at a United States 
port of entry for the purpose of receiving eligible services; and (3) 
Mexican citizens permitted to enter the United States for not more than 
72 hours under the authority of a biometric machine readable border 
crossing identification card (also referred to as a ``laser visa'') 
issued in accordance with the requirements of regulations prescribed 
under a specific section of the Immigration and Nationality Act.; 
Affected Public: Business or other for-profit, Not-for-profit 
institutions, and State, Local or Tribal Governments; Number of 
Respondents: 7,503,000; Total Annual Responses: 7,512,000; Total Annual 
Hours: 634,000.
    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: William N. Parham, III, 
PRA Analyst, Room C5-13-27, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.

    Dated: June 17, 2005.
Michelle Shortt,
Acting Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 05-12492 Filed 6-23-05; 8:45 am]
BILLING CODE 4120-01-P