[Federal Register Volume 74, Number 175 (Friday, September 11, 2009)]
[Notices]
[Pages 46774-46775]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-21954]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10078, CMS-10288, CMS-10289 and CMS-10097]


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 without change 
of a currently approved collection; Title of Information Collection: 
Matching Grants to States for the Operation of High Risk Pools; Use: 
CMS is requiring this information as a condition of eligibility for 
grants that were authorized in the Trade Act of 2002, the Deficit 
Reduction Act of 2005 and the State High Risk Pool Funding Extension 
Act of 2006. The information is necessary to determine if a State 
applicant meets the necessary eligibility criteria for a grant as 
required by law. The respondents will be States that have a high risk 
pool as defined in sections 2741, 2744, or 2745 of the Public Health 
Service Act. The grants will provide funds to States that incur losses 
in the operation of high risk pools. High risk pools are set up by 
States to provide health insurance to individuals that cannot obtain 
health insurance in the private market because of a history of illness; 
Form Numbers: CMS-10078 (OMB: 0938-0887); Frequency: 
Recordkeeping, Reporting--Occasionally; Affected Public: State, Local 
and Tribal Governments; Number of Respondents: 31; Total Annual 
Responses: 31; Total Annual Hours: 1,240. (For policy questions 
regarding this collection contact Paul Scholz at 410-786-6178. For all 
other issues call 410-786-1326.)
    2. Type of Information Collection Request: New Collection; Title of 
Information Collection: State Plan Pre-Print to Implement Required 
Dental Benefits Pursuant of Children's Health Insurance Program 
Reauthorizing Act (CHIPRA) 2009; Use: Section 501 of CHIPRA 2009 amends 
XXI and requires that ``child health assistance provide to a targeted 
low-income child shall include coverage of dental services necessary to 
prevent disease and promote oral health, restore oral structures to 
health and function, and treat emergency conditions.'' States that 
provide coverage in a separate Children's Health Insurance Program may 
choose between two methods of providing the dental services required in 
Section 501. The State may define the services in the dental benefit 
package and demonstrate that it includes all the required services. 
Alternatively, the State may provide a dental benefit package that is 
equivalent to one of the three benchmark packages described in the 
statute. In order to implement one of these options and comply with the 
statute, States must amend their State Plan using the State Plan pre-
print. Form Number: CMS-10288 (OMB: 0938-NEW); Frequency: 
Reporting One-time; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 51; Total Annual Responses: 51; 
Total Annual Hours: 1530. (For policy questions regarding this 
collection contact Nancy Goetschius at 410-786-0707. For all other 
issues call 410-786-1326.)
    3. Type of Information Collection Request: New Collection; Title of 
Information Collection: Optional Dental-only Supplemental Coverage 
State Plan Amendment Template; Use: CHIPRA 2009 provides States with an 
option to provide supplemental dental-only coverage to children who 
would be eligible to enroll in the State's Children's Health Insurance 
Program (CHIP), except that they already have health insurance 
coverage, either through a group health plan or employer sponsored 
insurance. If the health insurance plan the child is enrolled in does 
not provide dental benefits, the State may provide the child with the 
same State-defined dental package or benchmark benefit plan provided to 
children who are eligible for the entire CHIP benefit package. The 
child will only be entitled to the dental services provided to other 
CHIP children.
    In order to choose this option, States must comply with all other

[[Page 46775]]

requirements of the statute regarding cost sharing, income eligibility 
level, absence of a waiting list for their entire CHIP program (not 
just for dental coverage), and not providing more favorable treatment 
to children eligible for the supplemental dental benefit under this 
option. In order to implement this option States must amend their State 
Plan using the Supplemental Dental Benefits State Plan Amendment 
Template. Form Number: CMS-10289 (OMB: 0938-NEW); Frequency: 
Reporting One-time; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 51; Total Annual Responses: 51; 
Total Annual Hours: 1020. (For policy questions regarding this 
collection contact Nancy Goetschius at 410-786-0707. For all other 
issues call 410-786-1326.)
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: The Medicare 
Contractor Provider Satisfaction Survey (MCPSS); Use: Section 911 of 
the Medicare Prescription Drug, Improvement, and Modernization Act of 
2003 (MMA) mandated that CMS develop contract performance requirements 
and standards for measuring provider satisfaction. CMS developed the 
MCPSS to meet this requirement. Each year CMS obtains information from 
Medicare providers and suppliers via a survey about satisfaction, 
attitudes, and perceptions regarding the services provided by Medicare 
fee-for-service (FFS) contractors, i.e., carriers, fiscal 
intermediaries (FIs), regional home health intermediaries (RHHIs), 
durable medical equipment Medicare administrative contractors (DME 
MACs) and Part A/Part B MACs. The survey focuses on basic business 
functions provided by the Medicare contractors, such as provider 
inquiries, provider outreach and education, claims processing, appeals, 
provider enrollment, medical review, and provider audit and 
reimbursement. CMS uses the survey to monitor its contractors and to 
provide incentives for improved performance.
    CMS seeks to minimally revise the survey instrument for the 2010 
administration. CMS would like to obtain more focused feedback on the 
providers' perception of their interactions with their contractor. By 
narrowing the focus of the questions, CMS can provide more specific 
feedback to the contractors in targeted areas of performance. Form 
Number: CMS-10097 (OMB: 0938-0915); Frequency: Reporting--
Yearly; Affected Public: Business or other for-profits and Not-for-
profit institutions; Number of Respondents: 25,000; Total Annual 
Responses: 25,000; Total Annual Hours: 9,349. (For policy questions 
regarding this collection contact Teresa Mundell at 410-786-9176. For 
all other issues call 410-786-1326.)
    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 October 13, 2009.

OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-6974, E-mail: [email protected].

    Dated: September 4, 2009.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E9-21954 Filed 9-10-09; 8:45 am]
BILLING CODE 4120-01-P