[Federal Register Volume 73, Number 129 (Thursday, July 3, 2008)]
[Notices]
[Page 38227]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-15152]



[[Page 38227]]

-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-8003, CMS-10268, and CMS-855(A,B,I,R)]


Agency Information Collection Activities: Proposed Collection; 
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) 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: Home and 
Community Based Waiver Requests and Supporting Regulations in 42 CFR 
440.180 and 441.300-310; Use: Under a Secretarial waiver, States may 
offer a wide array of home and community-based services to individuals 
who would otherwise require institutionalization. States requesting a 
waiver must provide certain assurances, documentation and cost and 
utilization estimates which are reviewed, approved and maintained for 
the purpose of identifying/verifying States' compliance with such 
statutory and regulatory requirements. Form Number: CMS-8003 
(OMB 0938-0449); Frequency: Occasionally; Affected Public: 
State, Local or Tribal Governments; Number of Respondents: 50; Total 
Annual Responses: 136; Total Annual Hours: 8,010.
    2. Type of Information Collection Request: New collection; Title of 
Information Collection: Consolidated Renal Operations in a Web Enabled 
Network (CROWNWeb) Third-party Submission Authorization Form; Use: The 
Consolidated Renal Operations in a Web Enabled Network (CROWNWeb) 
Third-Party Submission Authorization form is to be completed by 
``Facility Administrators'' (administrators of CMS-certified dialysis 
facilities) if they intend to authorize a third party (a business with 
which the facility is associated, or an independent vendor) to submit 
data to CMS to comply with the recently revised Conditions for Coverage 
of dialysis facilities. The CROWNWeb system is the system used as the 
collection point of data necessary for entitlement of ESRD patients to 
Medicare benefits and for Federal Government monitoring and assessing 
of the quality and types of care provided to renal patients. The 
information collected through the CWTPSA form will allow CMS and its 
contractors to receive data from authorized parties acting on behalf of 
CMS-certified dialysis facilities. CMS anticipates that roughly 3000 
signed forms will be received by February 2009, and that the total 
number of forms may reach 5100 by February 2012. Form Number: CMS-10268 
(OMB 0938-New); Frequency: Monthly; Affected Public: Business 
or other for-profits and not-for-profit institutions; Number of 
Respondents: 5,100; Total Annual Responses: 5,100; Total Annual Hours: 
425.
    3. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Medicare 
Enrollment Application; Form Number: CMS-855 (A, B, I, R)(OMB: 
0938-0685); Use: The primary function of the Medicare enrollment 
application is to gather information from a provider or supplier that 
tells us who it is, whether it meets certain qualifications to be a 
health care provider or supplier, where it practices or renders its 
services, the identity of the owners of the enrolling entity, and 
information necessary to establish correct claims payments. We are 
revising this currently approved information collection. The goal of 
the revisions to this information collection request (ICR) is to adjust 
the burden associated with this ICR to account for the removal of the 
CMS-855(S) application. Frequency: Recordkeeping and Reporting--On 
occasion; Affected Public: Business or other for-profit and not-for-
profit institutions; Number of Respondents: 400,000; Total Annual 
Responses: 400,000; Total Annual Hours: 785,702.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS's 
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 September 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, Attention: Document Identifier/OMB 
Control Number----, Room C4-26-05, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.

    Dated: June 26, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E8-15152 Filed 7-2-08; 8:45 am]
BILLING CODE 4120-01-P