[Federal Register Volume 73, Number 63 (Tuesday, April 1, 2008)]
[Notices]
[Pages 17347-17348]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-6510]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-1696, CMS-10167, CMS-R-306, CMS-10262 and 
CMS-10143]


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: Revision of a currently 
approved collection; Title of Information Collection: Appointment of 
Representative; Use: This form will be completed by beneficiaries, 
providers and suppliers who wish to appoint representatives to assist 
them with obtaining initial determinations and filing appeals. The 
appointment of representative form must be signed by the party making 
the appointment and the individual agreeing to accept the appointment. 
Form Number: CMS-1696 (OMB 0938-0950); Frequency: 
Occasionally; Affected Public: Individuals or households and businesses 
or other for-profits; Number of Respondents: 268,268; Total Annual 
Responses: 268,268; Total Annual Hours: 67,067.
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Competitive 
Acquisition Program for Medicare Part B Drugs: CAP Physician Election 
Agreement; Use: The Competitive Acquisition Program (CAP) is required 
by Section 303(d) of the Medicare Modernization Act (MMA) which amended 
Title XVIII of the Social Security Act (the Act) by adding a new 
section 1847(B), which establishes a competitive acquisition program 
for the payment for Part B covered drugs and biologicals furnished on 
or after January 1, 2006. Physicians are given a choice between buying 
and billing these drugs under the average sales price (ASP) system, or 
obtaining these drugs from vendors selected in a competitive bidding 
process. Section 108 of the Medicare Improvements and Extension Act 
under Division B, Title I of the Tax Relief Health Care Act of 2006 
amended Section 1847(b)(a)(3) of the Act and requires that CAP 
implement a post payment review process.

[[Page 17348]]

    The CAP Physician Election Agreement is used annually by physicians 
to elect to participate in the CAP or to make changes to the previous 
year's selections. The information collected by these documents is used 
by CMS, its Medicare contractor, and the approved CAP vendor to meet 
programmatic requirements pertaining to physician election as 
established by the MMA. Form Number: CMS-10167 (OMB 0938-
0955); Frequency: Yearly; Affected Public: Business or other for-
profits; Number of Respondents: 3,800; Total Annual Responses: 3,800; 
Total Annual Hours: 7,600.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Use of Restraint 
and Seclusion in Psychiatric Residential Treatment Facilities (PRTFs) 
for Individuals Under Age 21; Use: PRTFs are required to report deaths, 
serious injuries and attempted suicides to the State Medicaid Agency 
and the Protection and Advocacy Organization. They are also required to 
provide residents the restraint and seclusion policy in writing, and to 
document in the residents' records all activities involving the use of 
restraint and seclusion. Form Number: CMS-R-306 (OMB 0938-
0833); Frequency: Annually; Affected Public: Private Sector: Business 
or other for-profits; Number of Respondents: 500; Total Annual 
Responses: 329,500; Total Annual Hours: 501,750.
    4. Type of Information Collection Request: New Collection; Title of 
Information Collection: Health Insurance Flexibility and Accountability 
(HIFA) Evaluation; Use: The HIFA initiative sought to increase health 
coverage of uninsured populations through a flexible waiver process 
emphasizing public subsidy of Employer-Sponsored Insurance (ESI). 
Testing whether that approach reduces the rate/number of uninsured is 
critically important to CMS. The proposed survey of HIFA enrollees in 
New Mexico and Oregon would provide the only data available to test 
certain fundamental HIFA effects, especially with reference to 
reduction of the uninsured population, the effectiveness of premium 
assistance for ESI and the possibility of crowd-out of private 
coverage. Form Number: CMS-10262 (OMB 0938-NEW); Frequency: 
Once; Affected Public: Individuals or households; Number of 
Respondents: 800; Total Annual Responses: 800; Total Annual Hours: 400.
    5. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Monthly State 
File of Medicaid/Medicare Dual Eligible Enrollees; Use: The monthly 
file of dual eligible enrollees will be used to determine those duals 
with drug benefits for the phased down State contribution process 
required by the Medicare Modernization Act of 203. These data are also 
used to support Part D subsidy determinations and auto-assignment of 
individuals to Part D plans. Form Number: CMS-10143 (OMB 0938-
0958); Frequency: Monthly; Affected Public: State, Local or Tribal 
Governments; Number of Respondents: 51; Total Annual Responses: 612; 
Total Annual Hours: 6,120.
    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 June 2, 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, Room C4-26-05, 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850.

    Dated: March 21, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
 [FR Doc. E8-6510 Filed 3-31-08; 8:45 am]
BILLING CODE 4120-01-P