[Federal Register Volume 72, Number 183 (Friday, September 21, 2007)]
[Notices]
[Pages 54042-54043]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-18468]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-379, CMS-10102, and CMS-R-235]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

AGENCY: Centers for Medicare & Medicaid Services, Department of Health 
and Human 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), 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 of a currently 
approved collection; Title of Information Collection: Financial 
Statement of Debtor and Supporting Regulations in 42 CFR, Section 
405.376; Use: Section 42 CFR 405.376(g) requires that, `` * * * In 
determining whether a claim will be compromised, or collection action 
terminated, CMS will consider the following factors: * * * age and 
health of the debtor, present and potential income, inheritance 
prospects, possible concealment or fraudulent transfer of assets * * 
*'' Sections 1842(a)(1)(B) and (C) of the Social Security Act and 42 
CFR 405.376(g), provide the authority for collection of this 
information.
    In some instances a physician/supplier who is notified of a debt 
may allege inability to immediately repay the debt in full and may 
request an extended repayment schedule. Alternatively, the debtor may 
request a compromise settlement for less than the full amount due. 
Before establishing an extended repayment schedule or compromise 
settlement, the CMS's Regional Offices and the carrier must evaluate 
the provider's capacity to pay the debt. Accordingly, the provider is 
requested to complete a ``Financial Statement of Debtor'' form, CMS-
379. Form Number: CMS-379 (OMB: 0938-0270); Frequency: 
Reporting: Yearly; Affected Public: Business or other for-profit; 
Number of Respondents: 500; Total Annual Responses: 500; Total Annual 
Hours: 1000.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: National 
Implementation of Hospital Consumer Assessment of Health Providers and 
Systems (HCAHPS); Use: The intent of the HCAHPS initiative is to 
provide a standardized survey instrument and data collection 
methodology for measuring patients' perspectives on hospital care. 
While many hospitals collect information on patient satisfaction, there 
is no national standard for collecting or publicly reporting this 
information that would enable valid comparisons to be made across all 
hospitals. In order to make ``apples to apples'' comparisons to support 
consumer choice, it is necessary to introduce a standard measurement 
approach. Hospital Consumer Assessment of Healthcare Providers and 
Systems, also known as the CAHPS Hospital Survey (HCAHPS) can be viewed 
as a core set of questions that hospitals can combine with their 
customized items. HCAHPS was developed and is being implemented under 
the auspices of the Hospital Quality Alliance, a private/public 
partnership that includes hospital associations, consumer groups, 
payors and government agencies that share a common interest in 
reporting on hospital quality.
    Beginning in July 2007, participation in HCAHPS can affect the 
annual payment update for the inpatient prospective payment system 
(IPPS) hospitals participating in the Reporting Hospital Quality Data 
Annual Payment Update (RHQDAPU) program; Form Number: CMS-10102 
(OMB: 0938-0981); Frequency: Reporting: Monthly; Affected 
Public: Individuals or households; Number of Respondents: 2,820,000; 
Total Annual Responses: 2,820,000; Total Annual Hours: 285,200.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Data Use 
Agreement Information Collection Requirements, Model Language and 
Supporting Regulations in 45 CFR Section 5b. Use: The Data Use 
Agreement (DUA) is needed as part of the review of each CMS data 
request to

[[Page 54043]]

ensure compliance with the requirements of the Privacy Act for 
disclosure of data that contain individually-identifiable information. 
In addition, the DUA is used to maintain appropriate accounting and 
tracking of disclosures of records from Privacy Act systems of records. 
While the burden has not changed, we revised the DUA to The DUA was 
updated to include language to ensure the agreement is a binding 
agreement between CMS and the User, to ensure the data is being 
encrypted and appropriate protections are in place at all times, and to 
ensure appropriate actions are immediately taken if there is a data 
breach or incident. Form Number: CMS-R-0235 (OMB: 0938-0734); 
Frequency: Reporting--On occasion; Affected Public: Not-for-profit 
institutions; Number of Respondents: 1,500; Total Annual Responses: 
1,500; Total Annual Hours: 750.
    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.
    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: September 13, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
 [FR Doc. E7-18468 Filed 9-20-07; 8:45 am]
BILLING CODE 4120-01-P