[Federal Register Volume 82, Number 128 (Thursday, July 6, 2017)]
[Notices]
[Pages 31331-31333]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-14109]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS- R-138, CMS-18F5 and CMS-10651]


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 the necessity and utility of the 
proposed

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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 September 5, 2017.

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 https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
    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: William Parham at (410) 786-4669.

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-R-138 Medicare Geographic Classification Review Board Procedures 
and Criteria
CMS-18F5 Application for Hospital Insurance and Supporting Regulations
CMS-10651 CMS Tribal Long Term Services and Supports (LTSS) Program 
Survey

    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: Medicare 
Geographic Classification Review Board Procedures and Criteria; Use: 
During the first few years of IPPS, hospitals were paid strictly based 
on their physical geographic location concerning the wage index 
(Metropolitan Statistical Areas (MSAs)) and the standardized amount 
(rural, other urban, or large urban). However, a growing number of 
hospitals became concerned that their payment rates were not providing 
accurate compensation. The hospitals argued that they were not 
competing with the hospitals in their own geographic area, but instead 
that they were competing with hospitals in neighboring geographic 
areas. At that point, Congress enacted Section 1886(d)(10) of the Act 
which enabled hospitals to apply to be considered part of neighboring 
geographic areas for payment purposes based on certain criteria. The 
application and decision process is administered by the MGCRB which is 
not a part of CMS so that CMS could not be accused of any untoward 
action. However, CMS needs to remain apprised of any potential payment 
changes. Hospitals are required to provide CMS with copy of any 
applications that they made to the MGCRB. CMS also developed the 
guidelines for the MGCRB that were the interim final issue of the 
Federal Register, and must ensure that the MGCRB properly applied the 
guidelines. This check and balance process also contributes to limiting 
the number of hospitals that ultimately need to appeal their MGCRB 
decisions to the CMS Administrator. Form Number: CMS-R-138 (OMB control 
number: 0938-0573); Frequency: Occasionally; Affected Public: 
Businesses or other for-profits and Not-for-profit institutions; Number 
of Respondents: 300; Total Annual Responses: 300; Total Annual Hours: 
300. (For policy questions regarding this collection contact Noel 
Manlove at 410-786-5161.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Application for 
Hospital Insurance and Supporting Regulations; Use: Individuals who are 
already entitled to retirement or disability benefits under Social 
Security or Railroad Retirement Board (RRB) benefits are automatically 
entitled to premium-free Medicare Hospital Insurance (Part A) when they 
attain age 65 or reach the 25th month of disability benefit 
entitlement. These individuals do not file a separate application for 
Medicare Part A because their application for Social Security or RRB 
benefits is also an application for Part A. The form is for individuals 
who are not eligible for Social Security for RRB benefits, but may 
qualify for premium-free Medicare Part A based on certain requirements 
outlined in Sec.  406.11 and 406.15 or for certain disabled individuals 
who may enroll in premium Medicare Part A based on certain requirements 
outlined in Sec.  406.20. Individuals may also choose to enroll in 
Medicare Part B at the same time they apply for Medicare Part A. Form 
Number: CMS-18F5 (OMB control number: 0938-0251); Frequency: Once; 
Affected Public: Individuals or households; Number of Respondents: 
51,000; Total Annual Responses: 51,000; Total Annual Hours: 29,580. 
(For policy questions regarding this collection contact Carla Patterson 
at 410-786-8911.)
    3. Type of Information Collection Request: New collection (request 
for a new OMB control number); Title of Information Collection: CMS 
Tribal Long Term Services and Supports (LTSS) Program Survey; Use: The 
Survey will provide CMS with an inventory of LTSS programs for older 
adults or individuals with disabilities managed by American Indian and 
Alaska Native (AI/AN) tribes. Information on tribal LTSS programs has 
previously been gathered through publicly available data via online 
research. However, not all of the information, including program 
contact

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information and program focus, are regularly available online as tribal 
Web sites are not updated frequently. Therefore, the survey will enable 
the collection of the most accurate information possible.
    The respondents include 424 LTSS programs run by AI/AN tribes. Once 
the survey has been conducted, CMS will feature the survey data, 
specifically a list of AI/AN managed LTSS programs, online on CMS.gov. 
The dissemination of survey data on CMS.gov will allow tribal 
communities and the general public to access this important data. 
Documentation of these programs will support sharing of LTSS best 
practices and innovative models employed in Indian Country. CMS will 
use the survey data to generate further content on LTSS in Indian 
Country, including literature reviews and reports on best practices.
    Form Number: CMS-10651 (OMB control number: 0938-TBD); Frequency: 
Yearly; Affected Public: State, Local, or Tribal Governments; Number of 
Respondents: 425; Total Annual Responses: 425; Total Annual Hours: 106. 
(For policy questions regarding this collection contact John Johns at 
410-786-7253).

    Dated: June 29, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2017-14109 Filed 7-5-17; 8:45 am]
 BILLING CODE 4120-01-P