[Federal Register Volume 70, Number 241 (Friday, December 16, 2005)]
[Notices]
[Page 74817]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-24112]



[[Page 74817]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS 1880/1882, CMS 10142 and CMS 10036]


Agency Information Collection Activities: Submission for OMB 
Review; 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), 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: The Request for 
Certification as a Supplier of Portable X-Ray Services and Portable X-
Ray Survey Report Form under the Medicare and Medicaid Program--
Portable X-Ray Survey Report and Supporting Regulations under 42 CFR 
486.100-486.110; Form Number: CMS-1880/1882 (OMB: 0938-0027); 
Use: The Medicare program requires portable X-ray suppliers to be 
surveyed for health and safety standards. The CMS-1882 is the survey 
form that records survey results. The CMS-1880 is used by the surveyor 
to determine if a portable X-ray applicant meets the eligibility 
requirements. This information serves as a screen for the State survey 
agency to determine if the portable X-ray supplier has the basic 
capabilities to participate in the Medicare program. CMS will use this 
information to make certification decisions; Frequency: Reporting--On 
occasion; Affected Public: Business or other for-profit; Number of 
Respondents: 655; Total Annual Responses: 98; Total Annual Hours: 172.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Bid Pricing Tool 
(BPT) for Medicare Advantage and Prescription Drug Plans (PDP) 
contained in 42 Code of Federal Regulation (CFR): 422.250, 422.252, 
422.254, 422.256, 422.258, 422.262, 422.264, 422.266, 422.270, 422.300, 
422.304, 422.306, 422.308, 422.310, 422.312, 422.314, 422.316, 422.318, 
422.320, 422.322, 422.324, 423.251, 423.258, 423.265, 423.272, 423.279, 
423.286, 423.293, 423.301, 423.308, 423.315, 423.322, 423.329, 423.336, 
423.343, 423.346, 423.350; Form Number: CMS-10142 (OMB: 0938-
0944); Use: Under the Medicare Modernization Act, Medicare Advantage 
Organizations (MAO) and Prescription Drug Plans (PDP) are required to 
submit an actuarial pricing bid to CMS for approval. The BPT software 
is used by MAOs and PDPs to price their plan benefit package. The BPT 
software is used by CMS to review and approve the plan pricing proposed 
by each organization; Frequency: Reporting--On occasion, Annually and 
As required by new legislation; Affected Public: Business or other for-
profit and Not-for-profit institutions; Number of Respondents: 350; 
Total Annual Responses: 350; Total Annual Hours: 12,050.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Inpatient 
Rehabilitation Assessment Instrument and Data Set for Prospective 
Payment System for Inpatient Rehabilitation Facilities and Supporting 
Regulations in 42 CFR Sections 412.23, 412.604, 412.606, 412.610, 
412.614, 412.618, 412.626, 413.64; Form Number: CMS-10036 
(OMB: 0938-0842); Use: This is a request to use the Inpatient 
Rehabilitation Facilities-Patient Assessment Instrument (IRF-PAI) and 
its supporting manual for the implementation phase of the Inpatient 
Rehabilitation) Prospective Payment System (PPS). This payment system 
is to cover both operating and capital costs for inpatient 
rehabilitation hospital services. It will apply to rehabilitation units 
of acute care hospitals as well as to rehabilitation hospitals, both of 
which are exempt from the current Inpatient PPS which is generally 
applicable for inpatient hospital services. Use of this instrument will 
enable CMS to implement a classification and payment system for the 
legislatively mandated inpatient rehabilitation hospital and the 
aforementioned exempt units. Frequency: Recordkeeping, Third party 
disclosure and Reporting--On occasion; Affected Public: Business or 
other for-profit and Not-for-profit institutions; Number of 
Respondents: 1,165; Total Annual Responses: 390,000; Total Annual 
Hours: 421,939.
    To obtain copies of the supporting statement and any related forms 
for these 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.
    To be assured consideration, comments and recommendations for the 
proposed information collections must be received by the OMB Desk 
Officer at the address below, no later than 5 p.m. on January 17, 2006.
    OMB Human Resources and Housing Branch, Attention: Carolyn Lovett, 
CMS Desk Officer, New Executive Office Building, Room 10235, 
Washington, DC 20503.

    Dated: December 9, 2005.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 05-24112 Filed 12-15-05; 8:45 am]
BILLING CODE 4120-01-P