[Federal Register Volume 80, Number 238 (Friday, December 11, 2015)]
[Notices]
[Pages 76994-76995]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-31302]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-855O, CMS-10438 and CMS-10439]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

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 (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: the 
necessity and utility of the proposed information collection for the 
proper performance of the agency's functions; the accuracy of the 
estimated burden; ways to enhance the quality, utility, and clarity of 
the information to be collected; and the use of automated collection 
techniques or other forms of information technology to minimize the 
information collection burden.

DATES: Comments must be received by February 9, 2016.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number. 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-855O Medicare Registration Application

CMS-10438 Data Collection To Support Eligibility Determinations and 
Enrollment for Employees in the Small Business Health Options Program

CMS-10439 Data Collection To Support Eligibility Determinations and 
Enrollment for Employers in the Small Business Health Options Program

    Under the 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.
    1. Type of Information Collection Request: Revision of a currently 
approved information collection; Title of Information Collection: 
Medicare Registration Application; Use: The primary function of the 
CMS-8550 is to gather information from a physician or other eligible 
professional to help CMS determine whether he or she meets certain 
qualifications to be enrolled in the Medicare program for the sole 
purpose of ordering or certifying certain Medicare items or services 
and/or prescribing Medicare Part D drugs for Medicare beneficiaries. 
The application allows a physician or other eligible professional to 
enroll in Medicare without being approved for billing privileges. The 
required information is submitted when the applicant requests 
enrollment in Medicare for the sole purpose of ordering and certifying 
certain Medicare items and services or for prescribing Medicare Part D 
drugs. The application is used by Medicare contractors to collect data 
to help ensure

[[Page 76995]]

that the applicant has the necessary credentials to order and certify 
certain Medicare items and services or to prescribe Medicare Part D 
drugs. This includes ensuring that the physician is not excluded 
debarred from the Medicare program. Form Number: CMS-855O (OMB Control 
Number: 0938-1135); Frequency: Occasionally; Affected Public: Private 
Sector (Business or other for-profits), State, Local, or Tribal 
Governments; Number of Respondents: 448,000; Number of Responses: 
24,000; Total Annual Hours: 243,600. (For questions regarding this 
collection contact Kimberly McPhillips (410) 786-8438.)
    2. Type of Information Collection Request: Revision of a currently 
approved information collection; Title of Information Collection: Data 
Collection to Support Eligibility Determinations and Enrollment for 
Employees in the Small Business Health Options Program; Use: Section 
1311(b)(1)(B) of the Affordable Care Act directs that the SHOP assist 
qualified small employers in facilitating the enrollment of their 
employees in QHPs offered in the small group market. Section 
1311(c)(1)(F) of the Affordable Care Act directs HHS to establish 
criteria for certification of health plans as QHPs and plans to utilize 
a uniform enrollment form for qualified employers. Further, section 
1311(c)(5)(B) directs HHS to develop a Web site that assists employers 
in determining if they are eligible to participate in SHOP. Form 
Number: CMS-10438 (OMB Control Number: 0938-1194); Frequency: Annually; 
Affected Public: Private Sector; Number of Respondents: 60,000; Number 
of Responses: 60,000; Total Annual Hours: 60,000. (For questions 
regarding this collection contact Christelle Jang at (410) 786-8438.)
    3. Type of Information Collection Request: Revision of a currently 
approved information collection; Title of Information Collection: Data 
Collection to Support Eligibility Determinations and Enrollment for 
Employers in the Small Business Health Options Program; Use: Section 
1311(b)(1)(B) of the Affordable Care Act directs that the SHOP assist 
qualified small employers in facilitating the enrollment of their 
employees in QHPs offered in the small group market. Section 
1311(c)(1)(F) of the Affordable Care Act directs HHS to establish 
criteria for certification of health plans as QHPs and plans to utilize 
a uniform enrollment form for qualified employers. Further, section 
1311(c)(5)(B) directs HHS to develop a Web site that assists employers 
in determining if they are eligible to participate in SHOP. Form 
Number: CMS-10439 (OMB Control Number: 0938-1139); Frequency: Annually; 
Affected Public: Private Sector; Number of Respondents: 6,000; Number 
of Responses: 6,000; Total Annual Hours: 12,000. (For questions 
regarding this collection contact Christelle Jang at (410) 786-8438.)

    Dated: December 8, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2015-31302 Filed 12-10-15; 8:45 am]
 BILLING CODE 4120-01-P