[Federal Register Volume 81, Number 136 (Friday, July 15, 2016)]
[Notices]
[Pages 46080-46081]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-16797]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-339 and CMS-460]


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: (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 September 13, 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

[[Page 46081]]

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 the 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-339 Provider Cost Report Reimbursement Questionnaire

CMS-460 Medicare Participation Agreement for Physicians and Suppliers

    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.

Information Collection

    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Provider Cost 
Report Reimbursement Questionnaire; Use: The information collected in 
this form (Exhibits 1 and 2) is authorized under Sections 1815(a) and 
1833(e) of the Social Security Act, 42 U.S.C. 1395g. Regulations at 42 
CFR 413.20 and 413.24 require providers to submit financial and 
statistical records to verify the cost data disclosed on their annual 
Medicare cost report. Providers participating in the Medicare program 
are reimbursed for furnishing covered services to eligible 
beneficiaries on the basis of an annual cost report (filed with the 
provider's MAC) in which the proper reimbursement is computed. 
Consequently, it is necessary to collect this documentation of 
providers' costs and activities that supports the Medicare cost report 
data in order to ensure proper Medicare reimbursement to providers. 
Form Number: CMS-339 (OMB control number: 0938-0301); Frequency: 
Yearly; Affected Public: Private sector (Business or other For-
profits); Number of Respondents: 2,273; Total Annual Responses: 2,273; 
Total Annual Hours: 15,911. (For policy questions regarding this 
collection contact Christine Dobrzycki at 410-786-3389.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare 
Participation Agreement for Physicians and Suppliers; Use: Section 
1842(h) of the Social Security Act permits physicians and suppliers to 
voluntarily participate in Medicare Part B by agreeing to take 
assignment on all claims for services to Medicare beneficiaries. The 
law also requires that the Secretary provide specific benefits to the 
physicians, suppliers and other persons who choose to participate. The 
CMS-460 is the agreement by which the physician or supplier elects to 
participate in Medicare. Form Number: CMS-460 (OMB control number: 
0938-0373); Frequency: Yearly; Affected Public: Private sector 
(Business or other For-profits); Number of Respondents: 120,000; Total 
Annual Responses: 120,000; Total Annual Hours: 30,000. (For policy 
questions regarding this collection contact Mark Baldwin at 410-786-
8139.)

    Dated: July 12, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2016-16797 Filed 7-14-16; 8:45 am]
 BILLING CODE 4120-01-P