[Federal Register Volume 72, Number 61 (Friday, March 30, 2007)]
[Notices]
[Page 15138]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-5748]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10117, 10118, 10119, 10135, 10136 and 10214]


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 without change 
of a currently approved collection; Title of Information Collection: 
Medicare Advantage Applications: Medicare Advantage (MA) Application 
Coordinated Care Plans (CMS-10117), Medicare Advantage (MA) Application 
Private Fee-For-Service Plans (CMS-10118); Medicare Advantage (MA) 
Application Regional PPO Plans (CMS-10119); Medicare Advantage (MA) 
Application Service Area Expansion (SAE) for Coordinated Care Plans: 
Private Fee For Service Plans (CMS-10135); Medical Savings Account 
Plans (CMS-10136), and Employer Group Waiver Plans (CMS-10214); Form 
Number: CMS-10117, 10118, 10119, 10135, 10136 and 10214 (OMB: 
0938-0935); Use: An entity seeking a contract as an MA organization 
must be able to provide Medicare's basic benefits plus meet the 
organizational requirements set out under the regulations at 42 CFR 
Part 422. An applicant must demonstrate that it can meet the benefit 
and other requirements within the specific geographic area it is 
requesting. The application forms are designed to give CMS the 
information needed to determine a health plan's compliance with the 
regulations at 42 CFR Part 422. The MA application forms will be used 
by CMS to determine whether an entity is eligible to enter into a 
contract to provide services to Medicare beneficiaries; Frequency: 
Reporting--Once; Affected Public: Business or other for-profit and Not-
for-profit institutions; Number of Respondents: 220; Total Annual 
Responses: 220; Total Annual Hours: 5580.
    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 29, 2007.
    CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development--C, Attention: Bonnie L Harkless, 
Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: March 22, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
 [FR Doc. E7-5748 Filed 3-29-07; 8:45 am]
BILLING CODE 4120-01-P