[Federal Register Volume 76, Number 112 (Friday, June 10, 2011)]
[Notices]
[Pages 34075-34076]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-14226]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS-370, CMS-377, and CMS-378; CMS-381; CMS-10145; 
and CMS-10362]


Agency Information Collection Activities: Submission for OMB 
Review; 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), 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: Revision of a currently 
approved collection; Titles of Information Collection: (CMS-370) Health 
Insurance Benefits Agreement, (CMS-377) ASC Request for Certification 
or Update of Certification Information in the Medicare Program,

[[Page 34076]]

and (CMS-378) Ambulatory Surgical Center (ASC) Survey Report Form; Use: 
CMS-370 has not been revised and will continue to be used to establish 
eligibility for payment under Title XVIII of the Social Security Act 
(the ``Act''). As revised, CMS-377 will be used to collect facility-
specific characteristics that facilitate CMS' oversight of ASCs. The 
data also enables CMS to respond to inquiries from the Congress, GAO, 
and the OIG concerning the characteristics of Medicare-participating 
ASCs. The data base that supports survey and certification activities 
will be revised to reflect changes in the data fields on this revised 
form, such as the data on the types of surgical procedures performed in 
the ASC. CMS-378 will be discontinued since it duplicates information 
collected by other means; Form Numbers: CMS-370, -377 and -378 (OCN: 
0938-0266); Frequency: Occasionally; Affected Public: Private Sector: 
Business or other for-profit and Not-for-profit institutions; Number of 
Respondents: 7,213; Total Annual Responses: 1,795; Total Annual Hours: 
648. (For policy questions regarding this collection contact Gail Vong 
at 410-786-0787. For all other issues call 410-786-1326.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Identification of 
Extension Units of Medicare Approved Outpatient Physical Therapy/
Outpatient Speech Pathology (OPT/OSP) Providers and Supporting 
Regulations in 42 CFR 485.701-485.729; Use: The collected information 
is used in conjunction with 42 CFR 485.701 through 485.729 governing 
the operation of providers of outpatient physical therapy and speech-
language pathology services. The provider uses the form to report to 
the State survey agency extension locations that it has added since the 
date of last report. The form is used by the State survey agencies and 
by the CMS regional offices to identify and monitor extension locations 
to ensure their compliance with the Federal requirements for the 
providers of outpatient physical therapy and speech-language pathology 
services; Form Number: CMS-381 (OMB : 0938-0273); Frequency: 
Annually; Affected Public: Private Sector; Business or other for-profit 
and not-for-profit institutions; Number of Respondents: 2,960; Total 
Annual Responses: 2,960; Total Annual Hours: 740. (For policy questions 
regarding this collection contact Georgia Johnson at 410-786-6859. For 
all other issues call 410-786-1326.)
    3. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Medicare Part B Drug and Biological Competitive Acquisition Program 
(CAP) and Supporting Regulations in 42 CFR Sections 414.906, 414.908, 
414.910, 414.914, 414.916, and 414.917; Use: Section 303(d) of the 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 
(MMA) provides an alternative payment methodology for Part B covered 
drugs that are not paid on a cost or prospective payment basis. In 
particular, Section 303(d) of the MMA amends Title XVIII of the Social 
Security Act by adding a new section 1847B, which establishes a 
competitive acquisition program for the acquisition of and payment for 
Part B covered drugs and biologicals furnished on or after January 1, 
2006. Since its inception, additional legislation has augmented the 
CAP. Section 108 of the Medicare Improvements and Extension Act under 
Division B, Title I of the Tax Relief Health Care Act of 2006 (MIEA-
TRHCA) amended Section 1847b(a)(3) of the Social Security Act and 
requires that CAP implement a post payment review process. This 
procedure is done to assure that payment is made for a drug or 
biological under this section only if the drug or biological has been 
administered to a beneficiary. Form Number: CMS-10145 (OCN: 0938-0945); 
Frequency: Weekly, quarterly and occasionally; Affected Public: Private 
sector--Business or other for-profit and Not-for-profit institutions; 
Number of Respondents: 3000; Total Annual Responses: 156,020; Total 
Annual Hours: 31,208. (For policy questions regarding this collection 
contact Karen Hill at 410-786-5607. For all other issues call 410-786-
1326.)
    4. Type of Information Collection Request: New collection; Title of 
Information Collection: Autism Spectrum Disorders (ASD): State of the 
States Services and Supports for People with ASD; Use: The information 
that is collected in the interviews will be used to communicate 
additional information about services available to people with ASD and 
the public policy issues that affect people with ASD to key stakeholder 
audiences. The format of the report will include data tables from 
various State programs and narrative about the data being presented 
based on the interviews with State agency staff. We propose 
interviewing multiple staff in each State because several State 
agencies have an impact on services and supports for people with ASD; 
Form Number: CMS-10362 (OCN: 0938-New); Frequency: Once; Affected 
Public: State, local, or Tribal Governments; Number of Respondents: 
459; Total Annual Responses: 459; Total Annual Hours: 803. (For policy 
questions regarding this collection contact Ellen Blackwell at 410-786-
4498. 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 July 11, 2011.

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

    Dated: June 3, 2011.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 2011-14226 Filed 6-9-11; 8:45 am]
BILLING CODE 4120-01-P