[Federal Register Volume 71, Number 28 (Friday, February 10, 2006)]
[Notices]
[Page 7048]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-1820]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-359, 360, R-55; CMS-368, R-144; and CMS-643]


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: Comprehensive 
Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms 
and Information Collection Requirements at 42 CFR 485.56, 485.58, 
485.60, 485.64, 485.66 and 410.105; Use: In order for a provider to 
participate in the Medicare program as a CORF, a provider must meet the 
Federal conditions of participation. The form CMS-359 is utilized as an 
application for facilities wishing to participate in the Medicare/
Medicaid program as CORFs. This form initiates the process of obtaining 
a decision as to whether the conditions of participation are met. The 
form CMS-360 is an instrument used by the State survey agency to record 
data collected in order to determine the provider compliance with 
individual conditions of participation and to report it to the Federal 
government; Form Numbers: CMS-359, 360, R-55 (OMB: 0938-0267); 
Frequency: Reporting--On occasion; Affected Public: State, Local, or 
Tribal government and Business or other for-profit; Number of 
Respondents: 630; Total Annual Responses: 630; Total Annual Hours: 
300,046.
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: State Medicaid 
Drug Rebate; Use: Section 1927 of the Social Security Act requires each 
State Medicaid agency to report quarterly prescription drug utilization 
information to drug manufacturers and to the Centers for Medicare and 
Medicaid Services. As part of this information, the State Medicaid 
agencies are required to report the total Medicaid rebate amount they 
claim they are owed by each drug manufacturer for each covered 
prescription drug product each quarter; Form Numbers: CMS-368, R-144 
(OMB: 0938-0582); Frequency: Reporting--Quarterly; Affected 
Public: State, Local, or Tribal government; Number of Respondents: 51; 
Total Annual Responses: 204; Total Annual Hours: 9,389.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Hospice Survey 
and Deficiencies Report Form and Supporting Regulations at 42 CFR 
442.30 and 488.26; Use: In order to participate in the Medicare 
program, a hospice must meet certain Federal health and safety 
conditions of participation. This form is used by State surveyors to 
record data about a hospice's compliance with these conditions of 
participation in order to initiate the certification or recertification 
process; Form Number: CMS-643 (OMB: 0938-0379); Frequency: 
Reporting--Annually; Affected Public: Not-for-profit institutions and 
Business or other for-profit; Number of Respondents: 2,293; Total 
Annual Responses: 475; Total Annual Hours: 238.
    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/PaperworkReductionActof1995, 
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 at the address below, 
no later than 5 p.m. on April 11, 2006. CMS, Office of Strategic 
Operations and Regulatory Affairs, Division of Regulations 
Development--A, Attention: Melissa Musotto (CMS-359, 360, R-55; CMS-
368, R-144; and CMS-643) Room C4-26-05, 7500 Security Boulevard, 
Baltimore, Maryland 21244-1850.

    Dated: January 31, 2006.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
 [FR Doc. E6-1820 Filed 2-9-06; 8:45 am]
BILLING CODE 4120-01-P