[Federal Register Volume 72, Number 141 (Tuesday, July 24, 2007)]
[Notices]
[Pages 40299-40301]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 07-3641]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-179, CMS-R-53, CMS-10207, CMS-10233, and CMS-
10234]


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 without change 
of a currently approved collection; Title of Information Collection: 
Transmittal and Notice of Approval of State Plan Material and 
Supporting Regulations in 42 CFR 430.10-430.20 and 440.167; Use: The 
CMS-179 is used by State agencies to transmit State plan material to 
the Centers for Medicare & Medicaid Services (CMS) for approval prior 
to amending their State plan. The State plan is the method in which 
States inform staff of State policies, standards, procedures and 
instructions. The CMS-179 is currently used by State agencies 
administering the Medicaid program and CMS regional offices (RO). State 
agencies use the form to submit State plan amendments (SPAs) (including 
supporting documentation) to the CMS RO for review and approval prior 
to amending their plan in accordance with 42 CFR 430.10-430.20. The 
CMS-179 includes instructions for completing the form. The inclusion of 
instructions is to assist State agencies in completing the form, 
thereby ensuring a more uniform and timely plan amendment approval 
process. The CMS-179 is the only source available to State agencies for 
submittal/approval of SPAs. This plan amendment approval process is 
necessary to ensure the State plan continues to meet statutory and 
regulatory requirements and thereby ensure the State's eligibility for 
Federal financial participation. CMS will use

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this information to track the estimated Federal budget impact 
associated with the SPAs. This information may result in more accurate 
Federal Medicaid expenditure estimates; Form Number: CMS-179 
(OMB: 0938-0193); Frequency: Reporting: Occasionally; Affected 
Public: State, Local or Tribal Government; Number of Respondents: 56; 
Total Annual Responses: 10; Total Annual Hours: 560.
    2. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Imposition of Cost Sharing Charges Under Medicare and Supporting 
Regulations Contained in 42 CFR Section 447.53; Use: The purpose of 
this collection is to ensure that States impose nominal cost sharing 
charges upon categorically and medically needy individuals as allowed 
by law and implementing regulations. States must identify in their 
State plan the following: (1) The service for which the charge is made; 
(2) The amount of the charge; (3) The basis for determining the charge; 
(4) The method used to collect the charge; (5) The basis for 
determining whether an individual is unable to pay the charge and the 
way in which the individual will be identified to providers; and, (6) 
The procedures for implementing and enforcing the exclusions from cost 
sharing; Form Number: CMS-R-0053 (OMB: 0938-0429); Frequency: 
Reporting: Occasionally; Affected Public: State, Local or Tribal 
Government; Number of Respondents: 56; Total Annual Responses: 2; Total 
Annual Hours: 20.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Physician Self-
Referral Exceptions for Electronic Prescribing and Electronic Health 
Records (CMS-1303-F); Form Number: CMS-10207 (OMB: 0938-1009); 
Use: Section 101 of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (MMA) directs the Secretary to create an 
exception to the physician self-referral prohibition in section 1877 of 
the Act for certain arrangements in which a physician receives 
compensation in the form of items, services (nonmonetary remuneration 
not including cash or cash equivalents) that is necessary and used 
solely to receive and transmit electronic prescription information. In 
addition, using our separate legal authority under section 1877(b)(4) 
of the Act, the regulation CMS-1303-F (71 FR 45140) created a separate 
regulatory exception for certain arrangements involving the provision 
of nonmonetary remuneration in the form of electronic health records 
software or information technology and training services necessary and 
used predominantly to create, maintain, transmit, or receive electronic 
health records. These exceptions are consistent with the President's 
goal of achieving widespread adoption of interoperable electronic 
health records to improve the quality and efficiency of health care 
while maintaining the levels of security and privacy that consumers 
expect.
    The conditions for both exceptions require that arrangements for 
the items and services provided must be set forth in a written 
agreement, be signed by the parties involved, specify the items or 
services being provided and the cost of those items or services, and 
cover all of the electronic prescribing and/or electronic health 
records technology to be provided by the donating entity. We have 
suggested that, instead of one master agreement that is updated with 
each new donation, the parties may choose to create a specific new 
contract and then reference other agreements or cross-reference a 
master list of agreements.
    The requirements associated with the exception for electronic 
prescribing items and services are limited to donations made by 
hospitals to members of their medical staffs; by group practices to 
their physician members; and by PDP sponsors and MA organizations to 
prescribing physicians. The requirements associated with the exception 
for electronic health records software or information technology and 
training services include donations by entities furnishing DHS to 
physicians. The paperwork burden is the creation and execution of the 
written agreements. The burden associated with the written agreement 
requirement is the time and effort necessary for documentation of the 
agreement between the parties, including the signatures of the parties. 
Frequency: Recordkeeping and Reporting--On occasion; Affected Public: 
Business or other for-profit and Not-for-profit institutions; Number of 
Respondents: 27,440; Total Annual Responses: 54,730; Total Annual 
Hours: 17,545.
    4. Type of Information Collection Request: New collection; Title of 
Information Collection: Regional Preferred Provider Organization (RPPO) 
Reconciliation Cost Report; Form Number: CMS-10233 (OMB: 0938-
New); Use: The Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (MMA), Title II, Subtitle C (Offering of 
Medicare Advantage Regional Plans; Medicare Advantage Competition) 
provided for the establishment of Medicare Advantage Regional Plans. 
Subsequently, the Regional Preferred Provider Organization (RPPO) 
program was developed and began contracting with Managed Care 
Organizations (MCOs) and enrolling beneficiaries for the 2006 contract 
year. Section 1858 of the Social Security Act provides for risk sharing 
with RPPOs to be in place for contract years 2006 and 2007. The Code of 
Federal Regulations at 42 CFR 422.458 provides specific direction with 
respect to how the Centers for Medicare and Medicaid Services (CMS) 
will share risk with the RPPOs. The regulations require CMS to collect 
Allowable Cost data, and to compare this data to Target Amounts. If the 
comparison demonstrates that there were either savings or losses in the 
contract year, the regulations provide specific risk corridors to be 
used in determining the Risk Sharing Reconciliation amount due to 
either the plan or CMS. The Risk Sharing Reconciliation cost report 
will be used to collect the information necessary to accurately 
reconcile the payments made to RPPOs for the 2006 and 2007 contract 
years. Frequency: Reporting--Annually; Affected Public: Business or 
other for-profit and Not-for-profit institutions; Number of 
Respondents: 14; Total Annual Responses: 14; Total Annual Hours: 1,120.
    5. Type of Information Collection Request: New collection; Title of 
Information Collection: State Plan Pre-print implementing Section 6087 
of the Deficit Reduction Act: Optional Self-Direction Personal 
Assistance Services (PAS) Program (Cash and Counseling); Form Number: 
CMS-10234 (OMB: 0938-New); Use: Information submitted via the 
State Plan Amendment (SPA) pre-print will be used by the Centers for 
Medicare & Medicaid Services (CMS) Central and Regional Offices to 
analyze a State's proposal to implement Section 6087 of the Deficit 
Reduction Act (DRA). State Medicaid Agencies will complete the SPA pre-
print, and submit it to CMS for a comprehensive analysis. The pre-print 
contains assurances, check-off items, and areas for States to describe 
policies and procedures for subjects such as quality assurance, risk 
management, and voluntary and involuntary disenrollment; Frequency: 
Reporting--Once; Affected Public: State, Local, or Tribal Government; 
Number of Respondents: 56; Total Annual Responses: 30; Total Annual 
Hours: 600.
    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

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address, phone number, OMB number, and CMS document identifier, to 
[email protected], or call the Reports Clearance Office on (410) 
786-1326.
    Written comments and recommendations for the proposed information 
collections must be mailed or faxed within 30 days of this notice 
directly to the OMB desk officer: OMB Human Resources and Housing 
Branch, Attention: Carolyn Lovett, New Executive Office Building, Room 
10235, Washington, DC 20503, Fax Number: (202) 395-6974.

    Dated: July 18, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 07-3641 Filed 7-23-07; 8:45 am]
BILLING CODE 4120-01-P