[Federal Register Volume 71, Number 57 (Friday, March 24, 2006)]
[Notices]
[Pages 14898-14900]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-2808]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10137, CMS-10080, CMS-R-296, CMS-1763, and 
CMS-10116]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

    Agency: Centers for Medicare & Medicaid Services.
    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: Application for 
Prescription Drug Plans (PDP); Application for Medicare Advantage 
Prescription Drug (MA-PD) Plans; Application for Cost Plans to Offer 
Qualified Prescription Drug Coverage; Application for PACE Organization 
to Offer Qualified Prescription Drug

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Coverage; Application for Employer Group Waiver Plans to Offer 
Prescription Drug Coverage; Service Area Expansion Application to Offer 
Prescription Drug Coverage in a New Region; Use: Coverage for the 
prescription drug benefit will be provided through contracted 
prescription drug plans (PDPs) or through Medicare Advantage (MA) plans 
that offer integrated prescription drug and health care coverage (MA-PD 
plans). Cost Plans that are regulated under Section 1876 of the Social 
Security Act, Employer Group Waiver Plans (EGWP) and PACE plans may 
also provide a Part D benefit. Organizations wishing to provide 
services under the Prescription Drug Benefit Program must complete an 
application, negotiate rates, and receive final approval from CMS. 
Existing Part D Sponsors may also expand their contracted service area 
by completing the Service Area Expansion (SAE) application; Form 
Number: CMS-10137 (OMB: 0938-0936); Frequency: Reporting--
Other--depending on program areas and data requirements; Affected 
Public: Business or other for-profit, Not-for-profit institutions, 
Federal government; Number of Respondents: 101; Total Annual Responses: 
101; Total Annual Hours: 3,828.
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Publications Use 
Study; Use: The Balanced Budget Act (BBA) of 1997 increased the number 
and type of health insurance options available to Medicare 
beneficiaries and implemented new preventative health care benefits. 
The BBA also gave CMS a greater responsibility to help Medicare 
beneficiaries better understand these increased health care options and 
benefits. This research is designed to strengthen the information 
dissemination efforts by CMS to meet beneficiaries' needs. The current 
study expands on previous methodology to include surveys of not only 
print-based publications but of Web-based publications as well. CMS is 
mandated to provide a range of information about Medicare health care 
options, benefits, rights and regulations. This research will evaluate 
how well CMS is currently meeting this mandate; Form Number: CMS-10080 
(OMB: 0938-0892); Frequency: Recordkeeping and Reporting: 
Quarterly; Affected Public: Individuals or households; Number of 
Respondents: 3880; Total Annual Responses: 3880; Total Annual Hours: 
1,356.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Home Health 
Advance Beneficiary Notice (HHABN) and Supporting Regulations in 42 CFR 
411.404 and 484.10(a) and (e); Use: Home Health Agencies (HHAs) are 
required to provide written notice to Medicare beneficiaries in advance 
of initiating, terminating or reducing beneficiary service. The notice 
is designed to ensure that beneficiaries receive complete and useful 
information to enable them to make informed consumer decisions. HHAs 
must now issue HHABNs in a broader set of circumstances in conjunction 
with their responsibilities under the home health Conditions of 
Participation (COPs) consistent with U.S. Court of Appeals (2nd 
Circuit) in the Lutwin v. Thompson court decision. The notice must be 
issued timely and provide clear and accurate information about the 
specified services which may no longer be covered by Medicare, 
including the reason(s) that Medicare denied payment for those 
services. Form Number: CMS-R--296 (OMB: 0938-0781); Frequency: 
Recordkeeping, Third party disclosure and Reporting: On occasion, 
Other: As needed; Affected Public: Individuals or households, Business 
or other for-profit and Not-for-profit institutions; Number of 
Respondents: 6928; Total Annual Responses: 216,000; Total Annual Hours: 
21,600.
    4. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Request for 
Termination of Premium Hospital and/or Supplementary Medical Insurance 
and Supporting Regulations in 42 CFR 406.28 & 407.27; Use: Under 42 CFR 
sections 406.28(a) and 407.27(c) a Medicare beneficiary, wishing to 
voluntarily terminate enrollment in Medicare Supplementary Medical 
Insurance and/or Premium-Hospital Insurance can file a written request 
with CMS or the Social Security Administration. The form, Request for 
Termination of Premium Hospital and/or Supplementary Medical Insurance, 
was developed to comply with these requirements. Form Number: CMS-1763 
(OMB: 0938-0025); Frequency: Reporting: Other: One Time Only; 
Affected Public: Individuals or households, Federal, State, Local or 
Tribal Government; Number of Respondents: 14,000; Total Annual 
Responses: 14,000; Total Annual Hours: 5,833.
    5. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Conditions of 
Payment of Power Mobility Devices, including Power Wheelchairs and 
Power-Operated Vehicles (CMS-3017-IFC); Use: CMS-3017-IFC (Conditions 
for Payment of Power Mobility Devices, including Power Wheelchairs and 
Power-Operated Vehicles) provides further guidance with respect to the 
prescribing of, and payment for, Power Mobility Devices (PMDs). This 
rule defines the term ``power mobility devices (PMDs)'' as power 
wheelchairs and power operated vehicles (POVs or scooters). This rule 
conforms our regulations to section 302(a)(2)(E)(iv) of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). 
The MMA mandated: (1) A face-to-face examination of the individual be 
conducted by a physician (as defined in section 1861(r)(1) of the 
Social Security Act (the Act)), a physician assistant, a nurse 
practitioner or a clinical nurse specialist (as those terms are defined 
in section 1861(aa)(5) of the Act; and (2) that payment may not be made 
for a power wheelchair unless the physician or treating practitioner 
has written a prescription for the item. With this information 
collection request, CMS is seeking approval for the collection 
requirements associated with CMS-3017-IFC (70 FR 50940); Form Number: 
CMS-10116 (OMB: 0938-0971); Frequency: Recordkeeping and 
Reporting--On occasion; Affected Public: Business or other for-profit, 
Not-for-profit institutions, Federal government, State, Local, or 
Tribal governments; Number of Respondents: 17,000; Total Annual 
Responses: 37,400; Total Annual Hours: 37,400.
    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 23, 2006.
    CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development--B, Attention: William N. Parham, 
III, Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-
1850.


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    Dated: March 17, 2006.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 06-2808 Filed 3-23-06; 8:45 am]
BILLING CODE 4120-01-P