[Federal Register Volume 79, Number 119 (Friday, June 20, 2014)]
[Notices]
[Pages 35354-35356]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-14484]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-381, CMS-R-21 and CMS-R-148]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

ACTION: Notice.

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

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 (the 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 60 days for public 
comment on the proposed action. Interested persons are invited to send 
comments regarding our burden estimates 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

[[Page 35355]]

minimize the information collection burden.

DATES: Comments must be received by August 19, 2014.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number (OCN). To be assured consideration, comments and 
recommendations must be submitted in any one of the following ways:
    1. Electronically. You may send 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) that are 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.
    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:

Contents

    This notice sets out a summary of the use and burden associated 
with the following information collections. More detailed information 
can be found in each collection's supporting statement and associated 
materials (see ADDRESSES).

CMS-381 Identification of Extension Units of Medicare Approved 
Outpatient Physical Therapy/Outpatient Speech Pathology (OPT/OSP) 
Providers and Supporting Regulations
CMS-R-21 Withholding Medicare Payments to Recover Medicaid Overpayments 
and Supporting Regulations in 42 CFR 447.31
CMS-R-148 Limitations on Provider Related Donations and Health Care 
Related Taxes; Limitation on Payment to Disproportionate Share 
Hospitals

    Under the Paperwork Reduction Act (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 requires federal agencies to publish a 60-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.

Information Collection

    1. Type of Information Collection Request: Revision 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; Use: 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 our 
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 control number: 0938-0273); Frequency: 
Annually; Affected Public: Private Sector; Business or other for-profit 
and not-for-profit institutions; Number of Respondents: 2,260; Total 
Annual Responses: 2,260; Total Annual Hours: 565. (For policy questions 
regarding this collection contact James Cowher at 410-786-1948.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Withholding 
Medicare Payments to Recover Medicaid Overpayments and Supporting 
Regulations in 42 CFR 447.31; Use: Certain Medicaid providers that are 
subject to offsets for the collection of Medicaid overpayments may 
terminate or substantially reduce their participation in Medicaid, 
leaving the state Medicaid agency unable to recover the amounts due. 
Recovery procedures allow for determining the amount of overpayments 
and offsetting the overpayments by withholding the provider's Medicare 
payments. To effectuate the withholding, the state agency must provide 
their respective CMS regional office with certain documentation that 
identifies the provider and the Medicaid overpayment amount. The agency 
must also demonstrate that the provider was notified of the overpayment 
and that demand for the overpayment was made. An opportunity to appeal 
the overpayment determination must be afforded to the provider by the 
Medicaid state agency. Lastly, Medicaid state agencies must notify CMS 
when to terminate the withholding.
    Form Number: CMS-R-21 (OCN: 0938-0287); Frequency: Occasionally; 
Affected Public: State, Local, or Tribal Governments; Number of 
Respondents: 54; Total Annual Responses: 27; Total Annual Hours: 81. 
(For policy questions regarding this collection contact Stuart 
Goldstein at 410-786-0694).
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Limitations on 
Provider Related Donations and Health Care Related Taxes; Limitation on 
Payment to Disproportionate Share Hospitals; Use: States may request a 
waiver of either or both the broad based and uniformity tax program 
requirements. Each state must demonstrate that its tax program(s) do 
not violate the hold harmless provision. Additionally, state Medicaid 
agencies must report (quarterly) on health care related taxes collected 
and the source of provider related donations received by the state or 
unit of local government. Each state must maintain, in readily 
reviewable form, supporting documentation that provides a detailed 
description of each donation and tax program being reported, as well as 
the source and use of all donations received and collected. Without 
this information, the amount of Federal financial participation payable 
to a state cannot be determined.
    Form Number: CMS-R-148 (OCN: 0938-0618); Frequency: Quarterly and 
occasionally; Affected Public: State, Local, or Tribal Governments; 
Number of Respondents: 50; Total Annual Responses: 40; Total Annual 
Hours: 3,200. (For policy questions regarding this collection contact 
Stuart Goldstein at 410-786-0694).


[[Page 35356]]


    Dated: June 17, 2014.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2014-14484 Filed 6-19-14; 8:45 am]
BILLING CODE 4120-01-P