[Federal Register Volume 73, Number 51 (Friday, March 14, 2008)]
[Notices]
[Pages 13910-13911]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-5071]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-211, CMS-10258, CMS-209, CMS-10259, and 
CMS-R-266]


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 of a currently 
approved collection; Title of Information Collection: Model Application 
Template for State Child Health Plan Under Title XXI of the Social 
Security Act, State Children's Health Insurance Program, Instructions 
for Model Application Template; Use: States are required to submit 
Title XXI plans and amendments for approval by the Secretary pursuant 
to section 2102 of the Social Security Act in order to receive funds 
for initiating and expanding health insurance coverage for uninsured 
children. The model application template is used to assist States in 
submitting a State Child Health Plan and amendments to that plan. Form 
Number: CMS-R-211 (OMB 0938-0707); Frequency: Yearly and 
occasionally; Affected Public: State, Local or Tribal Governments; 
Number of Respondents: 56; Total Annual Responses: 40; Total Annual 
Hours: 3,200.
    2. Type of Information Collection Request: New collection; Title of 
Information Collection: Survey of State Medicaid Agencies: Innovative 
Approaches to Collecting Citizenship Documentation; Use: The purpose of 
the survey is to collect information from State Medicaid agencies on 
innovative approaches used to collect citizenship documentation from 
Medicaid applicants and recipients. Prior to the Deficit Reduction Act 
of 2005 (DRA), Medicaid applicants could self-attest to citizenship. As 
of July 1, 2006, applicants and recipients are required to provide 
original documentation of citizenship. For some states, this new 
requirement is challenging because there has been a general movement 
towards virtual applications by phone,

[[Page 13911]]

mail, or online submission. CMS is using this survey to identify 
innovative ways that states have taken advantage of existing 
information within the state system such as matching data, forming 
unique partnerships, or holding training sessions to facilitate 
effective and efficient collection of citizenship documentation. CMS 
will use the information collected with the survey to compile a 
snapshot of the innovative and unique approaches states are employing 
to meet the citizenship documentation requirements of the DRA. The 
results will be incorporated into a final comprehensive report that 
will be used as an outreach tool that will then be distributed to 
states. Form Number: CMS-10258 (OMB 0938-NEW); Frequency: 
Once; Affected Public: State, Local or Tribal Governments; Number of 
Respondents: 100; Total Annual Responses: 100; Total Annual Hours: 25.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Laboratory 
Personnel Report (CLIA) and Supporting Regulations in 42 CFR 493.1-
493.2001; Use: This form is used by the State agency to determine a 
laboratory's compliance with personnel qualifications under CLIA. This 
information is needed for a laboratory's CLIA certification and 
recertification. Form Number: CMS-209 (OMB 0938-0151); 
Frequency: Biennially; Affected Public: Private Sector: Business or 
other for-profits, Not-for-profit institutions; State, Local or Tribal 
Governments; and Federal Government Number of Respondents: 21,000; 
Total Annual Responses: 10,500; Total Annual Hours: 5,248.
    4. Type of Information Collection Request: New collection; Title of 
Information Collection: State Plan Amendment template for 1915(i) State 
Plan Home and Community-Based Services (HCBS) Benefit; Use: Section 
6086 of the Deficit Reduction Act (DRA), expanded access to HCBS for 
the elderly and disabled and added a new section 1915(i) to the Social 
Security Act. Under 1915(i), States can amend their State plans to add 
these services. The template includes the information needed by CMS to 
determine whether the State's services will meet the requirements under 
1915(i). Form Number: CMS-10259 (OMB 0938-NEW); Frequency: 
Once; Affected Public: State, Local or Tribal Governments; Number of 
Respondents: 56; Total Annual Responses: 3; Total Annual Hours: 240.
    5. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicaid 
Disproportionate Share Hospital Annual Reporting; Use: Section 
1923(j)(i) of the Social Security Act requires States to submit an 
annual report that identifies each disproportionate share hospital 
(DSH) that received a DSH payment under the State's Medicaid program in 
the preceding fiscal year and the amount of DSH payments paid to that 
hospital in the same year and such other information as the Secretary 
determines necessary to ensure the appropriateness of DSH payments. The 
information supplied will satisfy the requirements under section 
1923(a)(2)(D) of the Act as well. Form Number: CMS-R-266 (OMB 
0938-0746); Frequency: Yearly; Affected Public: State, Local or Tribal 
Governments; Number of Respondents: 52; Total Annual Responses: 52; 
Total Annual Hours: 1976.
    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 May 13, 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 0938-0707, Room C4-26-05, 7500 Security Boulevard, 
Baltimore, Maryland 21244-1850.

    Dated: March 7, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
 [FR Doc. E8-5071 Filed 3-13-08; 8:45 am]
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