[Federal Register Volume 80, Number 60 (Monday, March 30, 2015)]
[Notices]
[Pages 16686-16687]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-07219]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-29, CMS-10221 and CMS-R-263]


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 April 29, 2015.

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: Verification of 
Clinic Data--Rural Health Clinic Form and Supporting Regulations; Use: 
The form is utilized as an application to be completed by suppliers of 
Rural Health Clinic (RHC) services requesting participation in the 
Medicare program. This form initiates the process of obtaining a 
decision as to whether the conditions for certification are met as a 
supplier of RHC services. It also promotes data reduction or 
introduction to and retrieval from the Automated Survey Process 
Environment (ASPEN) and related survey and certification databases by 
the CMS Regional Offices. Should any question arise regarding the 
structure of the organization, this information is readily available. 
Form Number: CMS-29 (OMB control number 0938-0074); Frequency: 
Occasionally (initially and then every six years); Affected Public: 
Private Sector (Business or other for-profit and Not-for-profit 
institutions); Number of Respondents: 900; Total Annual Responses: 900; 
Total Annual Hours: 150. (For policy questions regarding this 
collection contact Shont[eacute] Carter at 410-786-3532.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Site 
Investigation for Independent Diagnostic Testing Facilities (IDTFs); 
Use: We enroll Independent Diagnostic Testing Facilities (IDTFs) into 
the Medicare program via a uniform application, the CMS 855B. 
Implementation of enhanced procedures for verifying the enrollment 
information has improved the enrollment process as well as identified 
and prevented fraudulent IDTFs from entering the Medicare program. As 
part of this process, verification of compliance with IDTF performance 
standards is necessary. The primary function of the site investigation 
form for IDTFs is to provide a standardized, uniform tool to gather 
information from an IDTF that tells us whether it meets certain 
standards to be a IDTF (as found in 42 CFR 410.33(g)) and where it 
practices or renders its services. The site investigation form has been 
used in the past to aid in verifying compliance with the required 
performance standards found in 42 CFR 410.33(g). No revisions have been 
made to this form since the last submission for OMB approval. Form 
Number: CMS-10221 (OMB Control Number: 0938-1029); Frequency: 
Occasionally; Affected Public: Private Sector (Business or other for-
profits and Not-for-profit institutions); Number of Respondents: 900; 
Total Annual Responses: 900; Total Annual Hours: 1,800. (For policy 
questions regarding this collection contact Kim McPhillips at 410-786-
5374).
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Site 
Investigation for Suppliers of Durable Medical Equipment, Prosthetics, 
Orthotics and Supplies (DMEPOS); Use: We enroll suppliers of durable 
medical equipment, prosthetics, orthotics, and supplies (DMEPOS) into 
the Medicare program via a uniform application, the CMS 855S. 
Implementation of enhanced procedures for verifying the enrollment 
information has improved the enrollment process as well as identified 
and prevented fraudulent DMEPOS suppliers from entering the Medicare 
program. As part of this process, verification of compliance with 
supplier standards is necessary. The primary function of the site 
investigation form is to provide a standardized, uniform tool to gather 
information from a DMEPOS

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supplier that tells us whether it meets certain qualifications to be a 
DMEPOS supplier (as found in 42 CFR 424.57(c)) and where it practices 
or renders its services. The site investigation form has been used in 
the past to aid in verifying compliance with the required supplier 
standards found in 42 CFR 424.57(c). No revisions have been made to 
this form since the last submission for OMB approval. Form Number: CMS-
R-263 (OMB Control Number: 0938-0749); Frequency: Occasionally; 
Affected Public: Private Sector (Business or other for-profits and Not-
for-profit institutions); Number of Respondents: 30,000; Total Annual 
Responses: 30,000; Total Annual Hours: 15,000. (For policy questions 
regarding this collection contact Kim McPhillips at 410-786-5374).

    Dated: March 25, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2015-07219 Filed 3-27-15; 8:45 am]
 BILLING CODE 4120-01-P