[Federal Register Volume 89, Number 66 (Thursday, April 4, 2024)]
[Notices]
[Pages 23598-23599]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-07162]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-18F5 and CMS-10537]


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 (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 3, 2024.

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, please access 
the CMS PRA website by copying and pasting the following web address 
into your web browser: https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.

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-18F5 Application for Enrollment in Medicare Part A internet Claim 
(iClaim) Application Screen Modernized Claims System and Consolidated 
Claim Experience Screens Survey Form
CMS-10537 CAHPS Hospice 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.

[[Page 23599]]

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: 
Application for Enrollment in Medicare Part A Internet Claim (iClaim) 
Application Screen Modernized Claims System and Consolidated Claim 
Experience Screens; Use: The Centers for Medicare and Medicaid Services 
(CMS) Form ``Application for Hospital Insurance'' supports sections 
1818 and 1818A of the Social Security Act (the Act) and corresponding 
regulations at 42 CFR 406.6 and 406.7.
    The CMS-18-F5 is used to establish entitlement to Part A and 
enrollment in Part B for claimants who must file an application. The 
application follows the questions and requirements used by SSA on the 
electronic application. This is done not only for consistency purposes 
but because certain requirements under titles II and XVIII of the act 
must be met in order to qualify for Part A and Part B; including 
insured status, relationship and residency. The form is owned by CMS 
but is not utilized by CMS staff. SSA uses the form to collect 
information and make Part A and Part B entitlement determinations on 
behalf of CMS. Form Number: CMS-18F5 (OMB control number: 0938-0251); 
Frequency: Once; Affected Public: Individuals and Households; Number of 
Respondents: 1,042,263; Total Annual Responses: 1,042,263; Total Annual 
Hours: 260,566. (For policy questions regarding this collection contact 
Carla Patterson at 410-786-8911 or [email protected]).
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: CAHPS Hospice 
Survey; Use: CMS launched the development of the CAHPS Hospice Survey 
in 2012. Public reporting of the results on Hospice Compare started in 
2018. The goal of the survey is to measure the experiences of patients 
and their caregivers with hospice care. The survey was developed to:
     Provide a source of information from which selected 
measures could be publicly reported to beneficiaries and their family 
members as a decision aid for selection of a hospice program;
     Aid hospices with their internal quality improvement 
efforts and external benchmarking with other facilities; and
     Provide CMS with information for monitoring the care 
provided.
    Surveys focusing on patients' experience of care with their health 
care providers are an important part of the NQS. In addition to 
publicly reporting clinical quality measures, CMS is currently 
reporting measures from patient experience of care surveys in a variety 
of settings, including in-center hemodialysis (ICH) centers, hospitals, 
home health agencies, and hospices on the Medicare Care Compare 
website. (https://www.medicare.gov/care-compare). Form Number: CMS-
10537 (OMB control number: 0938-1257); Frequency: Once; Affected 
Public: Individuals and Households; Number of Respondents: 1,159,420; 
Total Annual Responses: 1,159,420; Total Annual Hours: 168,115.90. (For 
policy questions regarding this collection contact Lauren Fuentes at 
410-786-2290 or 443-618-2123).

William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts, 
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2024-07162 Filed 4-3-24; 8:45 am]
BILLING CODE 4120-01-P