[Federal Register Volume 73, Number 164 (Friday, August 22, 2008)]
[Notices]
[Pages 49677-49679]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-19393]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-381, CMS-1893 and 1856, CMS-10249, CMS-10264, 
CMS-10266, and CMS-855S]


Agency Information Collection Activities: Submission for OMB 
Review; 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), 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: Identification of Extension Units 
of Outpatient Physical Therapy (OPT)/Outpatient Speech Pathology (OSP) 
Providers;
    Use: Medicare requires OPT/OSP providers to be surveyed to 
determine compliance with Federal regulations. All locations where OPT/
OSP providers furnish services must meet these requirements. The CMS-
381 is the form used to identify all the OPT/OSP locations.
    Form Number: CMS-381 (OMB 0938-0273);
    Frequency: Yearly;
    Affected Public: State, Local, or Tribal Governments;
    Number of Respondents: 495;
    Total Annual Responses: 495;
    Total Annual Hours: 866.
    2. Type of Information Collection Request: Extension of a currently 
approved collection;
    Title of Information Collection: Outpatient Physical Therapy Speech 
Pathology Survey Report and

[[Page 49678]]

Supporting Regulations in 42 CFR 485.701-485.729.
    Use: The Medicare program requires OPT providers to meet certain 
health and safety requirements. The request for certification form is 
used by State agency surveyors to determine if minimum Medicare 
eligibility requirements are met. The survey report form records the 
results of the on-site survey.
    Form Number: CMS-1856 and 1893 (OMB 0938-0065);
    Frequency: Yearly and occasionally;
    Affected Public: State, Local, or Tribal Governments;
    Number of Respondents: 495;
    Total Annual Responses: 495;
    Total Annual Hours: 866.
    3. Type of Information Collection Request: New Collection;
    Title of Information Collection: Administrative Requirements for 
Section 6071 of the Deficit Reduction Act of 2005 (DRA);
    Use: CMS will use an Operational Protocol Instruction Guide and 
template for the development of Operational Protocols for the States 
selected to participate in the Money Follows the Person (MFP) 
Rebalancing Demonstration. The guide will provide instruction on the 
required elements of the State's Operational Protocol, which must be 
submitted and approved before a State may enroll individuals in the 
State's demonstration program or begin to claim service dollars. 
Section 6071(c)(9) of the DRA requires the States to provide 
information and assurances that total expenditures under the State 
Medicaid program for home and community-based long-term care services 
will not be less for any fiscal year during the MFP demonstration 
project than for the greater of such expenditures for fiscal year 2005 
or any succeeding fiscal year before the first of the year of the MFP 
demonstration project. Accordingly, States are required to submit 
Maintenance of Effort (MOE) forms and MFP Budget forms on an annual 
basis. Additionally, in order to receive enhanced FMAP, States are 
required to submit the MFP Demonstration Financial Forms on a quarterly 
basis. Section 6071(g) of the DRA requires a national evaluation of the 
MFP demonstration project and a final report to the President and 
Congress. For the national evaluation, States will be required to 
submit semi-annual reports that describe their progress in implementing 
their MFP programs and rebalancing their long-term care systems. In 
addition, States will be required to submit on a quarterly basis an MFP 
Finders File, which will include eligibility records for all MFP 
participants, and an MFP Services File, which will include records for 
each service funded with MFP grant funds. (NOTE: This collection 
package has been revised since the 60-day Federal Register notice 
published on August 31, 2007. The 30-day collection package includes 
two additional instruments: (1) MFP Quality of Life (QOL) Survey; and, 
(2) MFP Semi-annual Progress Report. The MFP QOL Survey is a collection 
of qualitative data from MFP participants, and the MFP Semi-annual 
Progress Report is a mechanism for CMS Project Officers to monitor MFP 
grantees.)
    Form Number: CMS-10249 (OMB: 0938-NEW);
    Frequency: Reporting--Yearly, Quarterly, Semi-annually and Once;
    Affected Public: States, Local or Tribal Governments;
    Number of Respondents: 31;
    Total Annual Responses: 360;
    Total Annual Hours: 9,360.
    4. Type of Information Collection Request: New collection;
    Title of Information Collection: Medicare Registration Summary and 
Medication History Personal Health Record Evaluation;
    Use: In 2006, the American Health Information Community (AHIC) 
Consumer Empowerment Workgroup (CEWG) made a recommendation to CMS to 
pilot programs that measure and demonstrate the value of Personal 
Health Records (PHRs) for patients with chronic diseases and their 
clinicians. For this information collection, CMS has proposed to 
evaluate the uptake, use, and perceived value of a Registration Summary 
and Medication History PHR tool for Medicare Managed Care and/or Part D 
Drug Plan Beneficiaries. Seven commercial health plans volunteered to 
integrate the PHR pilot tool within their existing PHRs, and these 
plans are offering the tool to member beneficiaries at no cost. CMS 
will examine how the PHRs were used by the beneficiaries, caregivers 
and providers and if they were perceived to improve the quality of the 
beneficiary/provider communication; timeliness of preventive 
screenings; and ease of use or value of information to individuals with 
chronic conditions.
    Form Number: CMS-10264 (OMB 0938-New);
    Frequency: Once;
    Affected Public: Individuals or households, Private Sector;
    Number of Respondents: 2,167;
    Total Annual Responses: 2,167;
    Total Annual Hours: 1083.5.
    5. Type of Information Collection Request: New collection;
    Title of Information Collection: Conditions of Participation: 
Requirements for Approval and Reapproval of Transplant Centers to 
Perform Organ Transplants and Supporting Regulations in 42 CFR 482.74, 
482.94, 482.100, 482.102, 488.61;
    Use: The Conditions of Participation and accompanying requirements 
specified in the regulations are used by our surveyors as a basis for 
determining whether a transplant center qualifies for approval or re-
approval under Medicare. CMS and the healthcare industry believe that 
the availability to the facility of the type of records and general 
content of records is standard medical practice and is necessary in 
order to ensure the well-being and safety of patients and professional 
treatment accountability.
    Form Number: CMS-10266 (OMB 0938-New);
    Frequency: Yearly;
    Affected Public: Business or other for-profits and not-for-profit 
institutions;
    Number of Respondents: 514;
    Total Annual Responses: 3,270;
    Total Annual Hours: 9,334.
    6. Type of Information Collection Request: New collection;
    Title of Information Collection: Medicare Enrollment Application--
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) 
Suppliers and Supporting Regulations in 42 CFR 424.57 and 424.58;
    Use: CMS is revising the CMS-855 Medicare Enrollment Applications 
Package (OMB No. 0938-0685) to remove the CMS-855S application from its 
collection. CMS has found that the regulations governing the standards 
required of suppliers of durable medical equipment, prosthetics, 
orthotics and supplies (DMEPOS) are revised and increased more 
frequently than the other provider types reimbursed by Medicare. 
Consequently, CMS must revise the CMS 855S application for DMEPOS 
suppliers more often than the CMS 855A, CMS 855B, CMS 855I and CMS 855R 
enrollment applications. The ability to revise the CMS 855S separately 
from the other CMS 855 enrollment applications will lessen the burden 
on both CMS and the public as only one subset of suppliers will be 
affected by CMS 855S revisions. CMS intends to maintain the continuity 
of the CMS 855 enrollment applications by using the same formats and 
lay-out of the current CMS 855 enrollment applications, regardless of 
the separation of the CMS 855S from the collective enrollment 
application package. The primary function of the CMS 855S DMEPOS 
supplier enrollment application is to gather

[[Page 49679]]

information from a supplier that tells us who it is, whether it meets 
certain qualifications to be a health care supplier, where it renders 
its services or supplies, the identity of the owners of the enrolling 
entity, and information necessary to establish the correct claims 
payment.
    Form Number: CMS-855S (OMB 0938-New);
    Frequency: Yearly;
    Affected Public: Business or other for-profits and not-for-profit 
institutions;
    Number of Respondents: 126,134;
    Total Annual Responses: 126,134;
    Total Annual Hours: 149,234.
    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.
    To be assured consideration, comments and recommendations for the 
proposed information collections must be received by the OMB desk 
officer at the address below, no later than 5 p.m. on September 22, 
2008.

OMB Human Resources and Housing Branch, Attention: OMB Desk Officer, 
New Executive Office Building, Room 10235, Washington, DC 20503, Fax 
Number: (202) 395-6974.

    Dated: August 14, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
 [FR Doc. E8-19393 Filed 8-21-08; 8:45 am]
BILLING CODE 4120-01-P