[Federal Register Volume 77, Number 15 (Tuesday, January 24, 2012)]
[Notices]
[Page 3477]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-1355]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-372(S)]


Agency Information Collection Activities: Proposed Collection; 
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) 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 without change 
of a currently approved collection; Title of Information Collection: 
Annual Report on Home and Community Based Services Waivers and 
Supporting Regulations in 42 CFR 440.180 and 441.300-310; Use: CMS is 
asking the States to report financial and statistical information 
concerning the numbers of Medicaid beneficiaries receiving waiver 
services, the type of services provided and the costs of those 
services. The information is usually taken from State Medicaid agency 
data processing systems. This data is summarized and may be submitted 
to CMS through the 372 web-based form. The report is used by CMS to 
compare actual data in the approved waiver estimates and, in 
conjunction with the waiver compliance review reports, the information 
provided is compared to that in the Medicaid Statistical Information 
System (CMS-R-284, OCN 0938-0345) report and Federal financial 
participation claimed on a State's Quarterly Expenditure Report (CMS-
64, OCN 0938-0067), to determine whether to continue the State's home 
and community-based services waiver. States' estimates of cost and 
utilization for renewal purposes are based upon the data compiled in 
the CMS Form 372(S) reports; Form Number: CMS-372(S) (OCN 0938-0272); 
Frequency: Yearly; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 49; Total Annual Responses: 305; 
Total Annual Hours: 13,115. (For policy questions regarding this 
collection contact Ralph Lollar at (410) 786-0777. 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 email 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 26, 2012:
    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 CMS-372(S) (OCN 0938-0272), Room C4-26-05, 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850.

    Dated: January 18, 2012.
Martique Jones,
Director, Regulations Development Group, Division B Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2012-1355 Filed 1-23-12; 8:45 am]
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