[Federal Register Volume 75, Number 19 (Friday, January 29, 2010)]
[Notices]
[Page 4826]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-1916]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-2746]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid 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: End Stage Renal 
Disease Death Notification Public Law 95-292; 42 CFR 405.2133, 45 CFR 
5-5b; 20 CFR Parts 401 and 422E Use: The ESRD Death Notification (CMS-
2746) is completed by all Medicare-approved ESRD facilities upon the 
death of an ESRD patient. Its primary purpose is to collect fact of 
death and cause of death of ESRD patients. Certain other identifying 
information (e.g., name, Medicare claim number, and date of birth) is 
required for matching purposes. Federal regulations require that the 
ESRD Networks examine the mortality rates of every Medicare-approved 
facility within its area of responsibility. The Death Form provides the 
necessary data to assist the ESRD Networks in making decisions that 
result in improved patient care and in cost-effective distribution of 
ESRD resources. The data is used by the ESRD Networks to verify 
facility deaths and to monitor facility performance. Form Number: CMS-
2746 (OMB: 0938-0448); Frequency: On occasion; Affected 
Public: Business or other for-profit, Not-for-profit institutions; 
Number of Respondents: 5,173; Total Annual Responses: 82,768; Total 
Annual Hours: 41,384. (For policy questions regarding this collection 
contact Connie Cole at 410-786-0257. 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 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 March 30, 2010:
    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: January 22, 2010.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 2010-1916 Filed 1-28-10; 8:45 am]
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