[Federal Register Volume 81, Number 40 (Tuesday, March 1, 2016)]
[Notices]
[Pages 10625-10627]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-04463]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-685, CMS-576A, CMS-10601, and CMS-R-199]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services.

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 require; 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

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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 minimize the information collection 
burden.

DATES: Comments must be received by May 2, 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-685 End Stage Renal Disease (ESRD) Network Semi-Annual Cost 
Report Forms and Supporting Regulations
CMS-576A Organ Procurement Organization's (OPOs) Health Insurance 
Benefits Agreement and Supporting Regulations
CMS-10601 CMS Innovation Partners Program Applications and Surveys
CMS-R-199 Medicaid Report on Payables and Receivables

    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 previously 
approved collection; Title of Information Collection: End Stage Renal 
Disease (ESRD) Network Semi-Annual Cost Report Forms and Supporting 
Regulations; Use: Section 1881(c) of the Social Security Act 
establishes End Stage Renal Disease (ESRD) Network contracts. The 
regulations found at 42 CFR 405.2110 and 405.2112 designated 18 ESRD 
Networks which are funded by renewable contracts. These contracts are 
on 3-year cycles. To better administer the program, CMS is requiring 
contractors to submit semi-annual cost reports. The purpose of the cost 
reports is to enable the ESRD Networks to report costs in a 
standardized manner. This will allow CMS to review, compare and project 
ESRD Network costs during the life of the contract. Form Number: CMS-
685 (OMB Control Number: 0938-0657); Frequency: Reporting--Semi-
annually; Affected Public: Not-for-profit institutions; Number of 
Respondents: 18; Total Annual Responses: 36; Total Annual Hours: 144. 
(For policy questions regarding this collection contact Etleva Davis at 
410-786-4013)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Organ Procurement 
Organization's (OPOs) Health Insurance Benefits Agreement and 
Supporting Regulations; Use: The Medicare and Medicaid Programs final 
conditions for coverage for Organ Procurement Organizations (OPOs) 
require OPOs to sign agreements with the Center for Medicare and 
Medicaid Services (CMS) in order to be reimbursed and perform their 
services. The information provided on this form serves as a basis for 
continuing the agreements with CMS and the OPOs for participation in 
the Medicare and Medicaid programs for reimbursement of service. Form 
Number: CMS-576A (OMB Control Number: 0938-0512); Frequency: 
Occasionally; Affected Public: Private Sector: Business or other for-
profit and not-for-profit institutions; Number of Respondents: 58; 
Total Annual Responses: 58; Total Annual Hours: 116. (For policy 
questions regarding this collection contact Melissa Rice at 410-786-
3270.)
    3. Type of Information Collection Request: New collection (Request 
for a new OMB control number); Title of Information Collection: CMS 
Innovation Partners Program Applications and Surveys; Use: The CMS 
Innovation Center (CMMI) has a significant role in supporting the goals 
set by the Secretary of Health and Human Services to move 30 percent of 
Medicare fee-for-service payments to alternate payment models by the 
end of 2016 and ultimately 50 percent by the end of 2018. A multi-
pronged approach is necessary to achieve these ambitious goals and 
includes the testing of innovative models around design of both payment 
and care delivery, the Health Care Payment and Learning Action Network 
(HCPLAN) and value and quality based initiatives through the Medicare 
Access and CHIP Reauthorization Act of 2015 (MACRA) and Merit-based 
Incentive Payment System (MIPS). In addition to these key strategies, 
CMS seeks to engage individuals from the front lines of health care, 
who are actively supporting delivery system transformation at local and 
regional levels, in order to support and accelerate adoption of 
alternate payment models developed through the Innovation Center. This 
will be accomplished through the Innovation Partners Program (IPP).
    The IPP will provide an opportunity for 100 selected individuals 
from around the country who are already leading and participating in 
delivery reform initiatives with local and regional networks to engage 
in a deeper way with CMS to enhance these efforts. During the course of 
one year, the IPP will immerse individuals in the strategy

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and innovation work of CMS through intensive webinars and small group 
discussions. Program participants will engage with CMS staff in the 
Innovation Center and Regional Offices to inform and support regional 
activities supporting innovation models. In collaboration with CMS and 
fellow program participants, they will create partnerships regionally 
and across the United States.
    An application process is necessary to select the individuals who 
will participate in IPP and is the first component of this data 
collection. Applicants shall likely include physicians, nurses and 
other clinical staff in leadership roles from various health care 
delivery, public health and community health organizations. The second 
data collection component is a set surveys and the respondents shall be 
only those who are participating in the program. Data from these 
surveys will be used to design program activities and to identify 
opportunities for improvement to both activities and the program 
overall. This data collection is necessary in order to launch and 
implement the IPP--a key initiative in the efforts of CMS to support 
the Secretary's goals. Form Number: CMS-10601 (OMB control number: 
0938--NEW); Frequency: Annually; Affected Public: Individuals and 
Households; Number of Respondents: 850; Total Annual Responses: 850; 
Total Annual Hours: 1,700. (For policy questions regarding this 
collection contact Fran Griffin at 212-616-2370).
    4. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicaid Report 
on Payables and Receivables; Use: The Government Management and Reform 
Act of 1994 requires that all offices, bureaus and associated 
activities of the 24 CFO Act agencies must be covered in an agency-
wide, audited financial statement. Collection of Medicaid data and the 
calculation of the Medicaid Incurred But Not Reported (IBNR) estimate 
are pertinent to CMS' financial audit. The Medicaid Report on Payables 
and Receivables will provide the information needed to calculate the 
Medicaid IBNR. Failure to collect this information could result in non-
compliance with the law. Form Number: CMS-R-199 (OMB Control Number: 
0938-0697); Frequency: Yearly; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 56; Total Annual Responses: 56; 
Total Annual Hours: 392. (For policy questions regarding this 
collection contact Beverly Boher at 410-786-7806.)

    Dated: February 25, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2016-04463 Filed 2-29-16; 8:45 am]
 BILLING CODE 4120-01-P