[Federal Register Volume 79, Number 12 (Friday, January 17, 2014)]
[Notices]
[Pages 3208-3209]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-00915]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-1561, CMS-R-216, and CMS-R-262]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

ACTION: Notice.

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SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is 
announcing an opportunity for the public to comment on CMS' intention 
to collect information from the public. Under the Paperwork Reduction 
Act of 1995 (PRA), federal agencies are required to publish notice in 
the Federal Register concerning each proposed collection of 
information, including each proposed extension or reinstatement of an 
existing collection of information, and to allow a second opportunity 
for public comment on the notice. Interested persons are invited to 
send comments regarding the 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.

DATES: Comments on the collection(s) of information must be received by 
the OMB desk officer by February 18, 2014:

ADDRESSES: When commenting on the proposed information collections, 
please reference the document identifier or OMB control number. To be 
assured consideration, comments and recommendations must be received by 
the OMB desk officer via one of the following transmissions: OMB, 
Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-5806 OR, Email: [email protected].
    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, you may make 
your request using one of following:
    1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to [email protected].
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. The term ``collection of 
information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and 
includes agency requests or requirements that members of the public 
submit reports, keep records, or provide information to a third party. 
Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires 
federal agencies to publish a 30-day notice in the Federal Register 
concerning each proposed collection of information, including each 
proposed extension or reinstatement of an existing collection of 
information, before submitting the collection to OMB for approval. To 
comply with this requirement, CMS is publishing this notice that 
summarizes the following proposed collection(s) of information for 
public comment:
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Health Insurance 
Benefit Agreement; Use: Applicants to the Medicare program are required 
to agree to provide services in accordance with federal requirements. 
The CMS-1561 is essential in that is allows us to ensure that 
applicants are in compliance with the requirements. Applicants will be 
required to sign the completed form and provide operational information 
to us to assure that they continue to meet the requirements after 
approval. Form Number: CMS-1561 (OCN: 0938-0832); Frequency: Yearly; 
Affected Public: Private sector--(Business or other for-profits and 
Not-for-profit institutions); Number of Respondents: 3,000; Total 
Annual Responses: 3,000; Total Annual Hours: 500. (For policy questions 
regarding this collection contact Shonte Carter at 410-786-3532).
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Procedures for 
Advisory Opinions Concerning Physicians' Referrals and Supporting 
Regulations; Use: The information collection requirements contained in 
42 CFR 411.372 and 411.373 allow us to consider requests for advisory 
opinions

[[Page 3209]]

and provide accurate and useful opinions. The information is read and 
analyzed to develop and issue an advisory opinion to the individual or 
entity that submitted the information. Form Number: CMS-R-216 (OCN: 
0938-0714); Frequency: Occasionally; Affected Public: Private sector 
(Business or other for-profits and Not-for-profit institutions); Number 
of Respondents: 25; Total Annual Responses: 25; Total Annual Hours: 
500. (For policy questions regarding this collection contact Jacqueline 
Proctor at 410-786-0661).
    3. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: CY 2015 Plan 
Benefit Package (PBP), Formulary, and Supporting Regulations; Use: We 
require Medicare Advantage and Prescription Drug Plan organizations 
submit a completed plan benefit package (PBP) and formulary as part of 
the annual bidding process. During this process, organizations prepare 
their proposed plan benefit packages for the upcoming contract year and 
submit them to us for review and approval. We publish beneficiary 
education information using a variety of formats. Specific education 
initiatives that utilize PBP and formulary data include web application 
tools on medicare.gov and the plan benefit insert in the Medicare & You 
handbook. In addition, organizations utilize the PBP data to generate 
their Summary of Benefits marketing information. The package has been 
revised subsequent to the publication of the 60-day Federal Register 
notice (78 FR 65656); Form Number: CMS-R-262 (OCN: 0938-0763); 
Frequency: Yearly; Affected Public: Private sector (Business or other 
for-profits and Not-for-profit institutions); Number of Respondents: 
652; Total Annual Responses: 6,265; Total Annual Hours: 57,477. (For 
policy questions regarding this collection contact Kristy Holtje at 
410-786-2209).

    Dated: January 14, 2014.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2014-00915 Filed 1-16-14; 8:45 am]
BILLING CODE 4120-01-P