[Federal Register Volume 73, Number 209 (Tuesday, October 28, 2008)]
[Notices]
[Pages 64004-64006]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-25691]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law (Pub. L.) 
104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995. 
This notice includes revisions to existing OMB-approved information 
collections.
    SSA is soliciting comments on the accuracy of the agency's burden 
estimate; the need for the information; its practical utility; ways to 
enhance its quality, utility, and clarity; and ways to minimize the 
burden on respondents, including the use of automated collection 
techniques or other forms of information technology. Mail, e-mail, or 
fax your comments and recommendations on the information collection(s) 
to the OMB Desk Officer and the SSA Reports Clearance Officer to the 
addresses or fax numbers listed below.

(OMB), Office of Management and Budget, Attn: Desk Officer for SSA, 
Fax: 202-395-6974, E-mail address: [email protected].

(SSA), Social Security Administration, DCBFM, Attn: Reports Clearance 
Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235, 
Fax: 410-965-6400, E-mail address: [email protected].
    The information collections below are pending at SSA. SSA will 
submit them to OMB within 60 days from the date of this notice. 
Therefore, your comments would be most helpful if you submit them to 
SSA within 60 days from the date of this publication. Individuals can 
obtain copies of these collection instruments by calling the SSA 
Reports Clearance Officer at 410-965-0454 or by writing to the e-mail 
address listed above.
    1. Application for EXTRA Help with Medicare Prescription Drug Plan 
Costs--20 CFR 418.3101--0960-0696. The Medicare Modernization Act of 
2003 mandated the creation of the Medicare Part D prescription drug 
coverage program and provided for certain subsidies for eligible 
Medicare beneficiaries to help pay for the costs of prescription drugs. 
SSA uses Form SSA-1020 (and the i1020, its electronic counterpart), the 
Application for Extra Help with Medicare Prescription Drug Plan Costs, 
to collect information to make Part D subsidy eligibility 
determinations.
    In compliance with Public Law 110-275, beginning in January 2010, 
SSA will use a new version of Form SSA-1020. In this new version, SSA 
will eliminate questions about the value of life insurance policies and 
in-kind support and maintenance, and we will ask applicants about their 
interest in applying for the Medicare Savings Program. This information 
collection request (ICR) is for the new version we will use in 2010. 
The respondents are Medicare beneficiaries who are applying for the 
Medicare Part D subsidy.

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                                                                               Average burden       Estimated
                Form type                     Number of       Frequency of      per response      annual burden
                                             respondents        response          (minutes)          (hours)
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SSA-1020 (paper application form).......           560,000                 1                30           280,000
i1020 (online application)..............           240,000                 1                25           100,000
Field office interview..................           200,000                 1                30           100,000
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    Totals..............................         1,000,000  ................  ................           480,000
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    2. Medicare Subsidy Quality Review Forms--20 CFR 418(b)(5)--0960-
0707. The Medicare Modernization Act of 2003 mandated the creation of 
the Medicare Part D prescription drug coverage program and provided for 
certain subsidies for eligible Medicare beneficiaries to help pay for 
the costs of prescription drugs. As part of its stewardship duties of 
the Medicare Part D subsidy program, SSA must conduct periodic quality 
review checks of the

[[Page 64005]]

information Medicare beneficiaries report on their subsidy applications 
(Form SSA-1020). SSA uses the Medicare Quality Review program to 
conduct these checks.
    Beginning in January 2010, SSA will revise the Medicare Quality 
Review system to comply with Public Law 110-275. Specifically, we will: 
(1) Eliminate the use of Form SSA-9309, the Life Insurance Verification 
form; and (2) remove any questions about life insurance policy values 
and in-kind support and maintenance from the other forms in the 
collection. This ICR is for the revised Medicare Quality Review System, 
which we will not use until January 2010. The respondents are 
applicants for the Medicare Part D subsidy whom we have chosen to 
undergo a Quality Review.

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                                                                               Average burden
            Form No. and name                 Number of       Frequency of      per response    Estimated annual
                                             respondents        response          (minutes)      burden (hours)
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 SSA-9301 (Medicare Subsidy Quality                  5,000                 1                30             2,500
 Review Case Analysis Questionnaire)....
 SSA-9302 (Notice of Quality Review                  5,000                 1                15             1,250
 Acknowledgement Form for those with
 Phones)................................
 SSA-9303 (Notice of Quality Review                    500                 1                15               125
 Acknowledgement Form for those without
 Phones)................................
 SSA-9304 (Checklist of Required          ................  ................  ................
 Information; burden accounted for with
 forms SSA-9302, SSA-9303, SSA-9311, SSA-
 9314)..................................
 SSA-9308 (Request for Information).....            10,000                 1                15             2,500
 SSA-9310 (Request for Documents).......             5,000                 1                 5               417
 SSA-9311 (Notice of Appointment--                     450                 1                15               113
 Denial--Reviewer Will Call)............
 SSA-9312 (Notice of Appointment--                      50                 1                15                13
 Denial--Please Call Reviewer)..........
 SSA-8510 (Authorization to the Social               5,000                 1                 5               417
 Security Administration to Obtain
 Personal Information)..................
 SSA-9313 (Notice of Quality Review                  2,500                 1                15               625
 Acknowledgement Form for those with
 Phones)................................
 SSA-9314 (Notice of Quality Review                    500                 1                15               125
 Acknowledgement Form for those without
 Phones)................................
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     Totals.............................            34,000  ................  ................             8,085
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    3. Redetermination of Eligibility for Help with Medicare 
Prescription Drug Plan Costs--0960-0723. As required by the Medicare 
Modernization Act of 2003 (Pub. L. 108-173), SSA conducts low-income 
subsidy eligibility redeterminations for Medicare beneficiaries who 
filed for the subsidy and were determined by SSA to be eligible. SSA 
will conduct subsidy eligibility redeterminations under two 
circumstances: (1) When an individual completes Form SSA-1026-OCR-SM-
SCE to report a subsidy changing event (marriage, separation from a 
spouse, separated spouses resume living together, divorce, annulment, 
or death); and (2) when SSA uses Form SSA-1026-OCR-SM-REDE to conduct 
an annual review of individuals who became entitled during the prior 12 
months, an annual review of a percentage of individuals who are 
eligible for more than 12 months, and a review of individuals who 
report a change in income, resources, or household size that may affect 
the subsidy amount.
    In compliance with Public Law 110-275, SSA will use a new version 
of Form SSA-1026 beginning in January 2010. In this new version, SSA 
will eliminate questions about the value of life insurance policies and 
in-kind support and maintenance. The respondents are current recipients 
of the Medicare Part D low-income subsidy who will undergo an 
eligibility redetermination for one of the reasons mentioned above.

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                                                              Frequency of     Average burden   Estimated annual
                  Form                        Number of       response (per     per  response      burden (in
                                             respondents          year)         (in minutes)         hours)
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 SSA-1026-OCR-SM-SCE....................            11,984                 1                18             3,595
SSA-1026-OCR-SM-REDE or SSA-1026-B......           249,652                 1                18            74,896
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    Total...............................           261,636  ................  ................            78,491
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[[Page 64006]]

    Dated: October 22, 2008.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E8-25691 Filed 10-27-08; 8:45 am]
BILLING CODE 4191-02-P