[Federal Register Volume 86, Number 62 (Friday, April 2, 2021)]
[Notices]
[Pages 17392-17393]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-06873]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-417 and CMS-209]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, Health and Human 
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 June 1, 2021.

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: CMS-P-0015A, 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 https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.

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-417 Hospice Request for Certification and Supporting Regulations
CMS-209 Laboratory Personnel Report (CLIA) and Supporting Regulations

    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: Hospice Request 
for Certification and Supporting Regulations; Use: The Hospice Request 
for Certification Form is the identification and screening form used to 
initiate the certification process and to determine if the provider has 
sufficient personnel to participate in the Medicare program. The CMS-
417 form is completed by existing hospices at the time of their 
recertification surveys, to update their certification information. 
Form Number: CMS-417 (OMB Control number: 0938-0313); Frequency: 
Annually; Affected Public: Private Sector--Business or other for-
profits; Number of Respondents: 2,059; Total Annual Responses: 2,059; 
Total Annual Hours: 1,544 (For policy questions regarding this 
collection contact Caroline Gallaher at 410-786-8705.)
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Laboratory 
Personnel Report (CLIA) and Supporting Regulations; Use: The 
information collected on this survey form is used in the administrative 
pursuit of the Congressionally-mandated program with regard to 
regulation of laboratories participating in CLIA. The surveyor will 
provide the laboratory with the CMS-209 form. While the surveyor 
performs other aspects of the survey, the laboratory will complete the 
CMS-209 by recording the personnel data needed to support their 
compliance with the personnel requirements of CLIA. The surveyor will 
then use this information in choosing a sample of personnel to verify 
compliance with the personnel requirements. Information on personnel 
qualifications of all technical personnel is needed to ensure the 
sample is representative of the entire laboratory. Form Number: CMS-209 
(OMB control number 0938-0151); Frequency: Biennially; Affected Public: 
Private Sector--State, Local, or Tribal Governments; and Federal 
Government; Number of Respondents: 19,163; Total Annual Responses: 
9,582; Total Annual Hours: 4,791. (For policy questions

[[Page 17393]]

regarding this collection contact Kathleen Todd at 410-786-3385.)

    Dated: March 30, 2021.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2021-06873 Filed 4-1-21; 8:45 am]
BILLING CODE 4120-01-P