[Federal Register Volume 73, Number 18 (Monday, January 28, 2008)]
[Notices]
[Pages 4869-4870]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-1363]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10255, CMS-10112, CMS-R-148 and CMS-287-05]


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: New collection; Title of 
Information Collection: Evaluation of Care and Disease Management Under 
Medicare Advantage. Use: CMS is conducting an evaluation of care and 
disease management programs under Medicare Advantage (MA), which 
includes a survey of all MA plans. The survey will help describe the 
structure and operation of these programs. The survey will gather 
information about MA health plans' care and disease management programs 
that is not available from other sources, such as relations with health 
providers, the use of electronic data systems, characteristics of care 
and disease management programs, population served, physician 
intervention, differences with regular MA plans and special needs 
plans, and evidence of effectiveness and assessment of costs. 
Information is collected through a one-time, self-administered mail 
questionnaire. Form Number: CMS-10255 (OMB 0938-New); 
Frequency: Once; Affected Public: Private sector-Business or other for-
profit and Not-for-profit institutions; Number of Respondents: 475; 
Total Annual Responses: 475; Total Annual Hours: 435.
    2. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Phone Surveys of Products and Services for Medicare Payment Validation 
and Supporting Regulations in 42 CFR 405.502. Use: The phone surveys of 
products and services for Medicare payment validation and supporting 
regulations in 42 CFR 405.502 will be used to identify specific 
products/services provided to Medicare beneficiaries and the costs 
associated with the provision of those products/services. The 
information collected will be used to validate the Medicare payment 
amounts for those products/services and institute revisions of payment 
amounts where necessary.

[[Page 4870]]

The respondents will be the companies that have provided the product/
service under review to Medicare beneficiaries. Form Number: CMS-10112 
(OMB 0938-0939); Frequency: Occasionally; Affected Public: 
Private sector-Business or other for-profit; Number of Respondents: 
4,000; Total Annual Responses: 4,000; Total Annual Hours: 16,000.
    3. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Limitations on Provider Related Donations and Health Care Related 
Taxes; Limitation on Payments for Disproportionate Share Hospitals and 
Supporting Regulations in 42 CFR 433.68, 433.74 and 447.272; Use: This 
information collection is necessary to ensure compliance with Sections 
1903 and 1923 of the Social Security Act for the purpose of preventing 
payments of Federal financial participation on amounts prohibited by 
statute. Form Number: CMS-R-148 (OMB 0938-0618); Frequency: 
Quarterly and occasionally; Affected Public: State, Local or Tribal 
Governments; Number of Respondents: 50; Total Annual Responses: 40; 
Total Annual Hours: 3,200.
    4. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Chain Home Office Cost Statement and supporting Regulations in 42 CFR 
413.17 and 413.20; Use: The Form CMS-287-05 is filed annually by Chain 
Home Offices to report the information necessary for the determination 
of Medicare reimbursement to components of chain organizations. 
However, where providers are components of chain organizations, 
information included in the chain home office cost statement is in 
addition to that included in the provider cost report and is needed to 
determine whether payments are appropriate. Form Number: CMS-287-05 
(OMB 0938-0202); Frequency: Yearly; Affected Public: Business 
or other for-profit and Not-for-profit institutions; Number of 
Respondents: 1,345; Total Annual Responses: 1,345; Total Annual Hours: 
626,770.
    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.
    In commenting on the proposed information collections please 
reference the document identifier or OMB control number. To be assured 
consideration, comments and recommendations must be submitted in one of 
the following ways by March 28, 2008.
    1. Electronically. You may submit your comments electronically to 
http://www.regulations.gov. Follow the instructions for ``Comment or 
Submission'' or ``More Search Options'' to find the information 
collection document(s) accepting comments.
    2. By regular mail. You may mail written comments to the following 
address: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: Document Identifier/OMB 
Control Number ----------, Room C4-26-05, 7500 Security Boulevard, 
Baltimore, Maryland 21244-1850.

    Dated: January 18, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
 [FR Doc. E8-1363 Filed 1-25-08; 8:45 am]
BILLING CODE 4120-01-P