[Federal Register Volume 71, Number 52 (Friday, March 17, 2006)]
[Notices]
[Page 13854]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-3845]



[[Page 13854]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-284 and CMS-10069]


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: Medicaid 
Statistical Information System; Use: State data are reported by the 
federally mandated electronic process, known as Medicaid Statistical 
Information System (MSIS). These data are the basis of actuarial 
forecasts for Medicaid service utilization and costs; of analysis and 
cost savings estimates required for legislative initiatives relating to 
Medicaid; and for responding to requests for information from CMS 
components, the Department, Congress and other customers.; Form Number: 
CMS-R-284 (OMB: 0938-0345); Frequency: Quarterly; Affected 
Public: State, Local or Tribal Government; Number of Respondents: 53; 
Total Annual Responses: 212; Total Annual Hours: 2,120.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare Waiver 
Demonstration Application; Use: The Medicare Waiver Demonstration 
Application will be used to collect standard information needed to 
implement congressionally mandated and administration high priority 
demonstrations. The application will be used to gather information 
about the characteristics of the applicant's organization, benefits, 
and services they propose to offer, success in operating the model, and 
evidence that the model is likely to be successful in the Medicare 
program. The standard application will be used for all waiver 
demonstrations and will reduce the burden on applicants, provide for 
consistent and timely information collections across demonstrations, 
and provide a user-friendly format for respondents; Form Number: CMS-
10069 (OMB: 0938-0880); Frequency: Reporting--On Occasion; 
Affected Public: Business or other for-profit, Not-for-profit 
institutions; Number of Respondents: 75; Total Annual Responses: 75; 
Total Annual Hours: 6000.
    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 May 16, 2006.
    CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development--A, Attention: Melissa Musotto, 
Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: March 10, 2006.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E6-3845 Filed 3-16-06; 8:45 am]
BILLING CODE 4120-01-P