[Federal Register Volume 84, Number 101 (Friday, May 24, 2019)]
[Notices]
[Pages 24153-24154]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-10963]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS-1957]


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 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 July 23, 2019.

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,

[[Page 24154]]

 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' website address at website 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 N. 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-1957 Social Security Office Report of State Buy-in Problem

    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 without change 
of a currently approved collection; Title of Information Collection: 
Social Security Office Report of State Buy-in Problem; Use: The 
statutory authority for the State Buy-in program is Section 1843 of the 
Social Security Act, amended through 1989. Under Section 1843, a State 
can enter into an agreement to provide Medicare protection to 
individuals who are members of a Buy-in coverage group, as specified in 
the State's Buy-in agreement. The Code of Federal Regulations at 42 CFR 
Section 407.40 provides for States to enroll in Medicare and pay the 
premiums for all eligible members covered under a Buy-in coverage 
group. Individuals enrolled in Medicare through the Buy-in program must 
be eligible for Medicare and be an eligible member of a Buy-in coverage 
group. The day to day operations of the State Buy-in program is 
accomplished through an automated data exchange process. The automated 
data exchange process is used to exchange Medicare and Buy-in 
entitlement information between the Social Security District Offices, 
State Medicaid Agencies and the Centers for Medicare & Medicaid 
Services (CMS). When problems arise that cannot be resolved though the 
normal data exchange process, clerical actions are required. The CMS-
1957, ``SSO Report of State Buy-In Problem'' is used to report Buy-in 
problems cases. The CMS-1957 is the only standardized form available 
for communications between the aforementioned agencies for the 
resolution of beneficiary complaints and inquiries regarding State Buy-
in eligibility. Form Number: CMS-1957 (OMB control number: 0938-0035); 
Frequency: Yearly; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 5,854; Total Annual Responses: 
5,854; Total Annual Hours: 1,951. (For policy questions regarding this 
collection contact Keith Johnson at 410-786-1148.)

    Dated: May 21, 2019.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2019-10963 Filed 5-23-19; 8:45 am]
 BILLING CODE 4120-01-P