[Federal Register Volume 89, Number 116 (Friday, June 14, 2024)]
[Notices]
[Pages 50588-50589]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-13129]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-370 and CMS-377]


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 August 13, 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.

[[Page 50589]]

    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-370 and CMS-377 ASC Forms for Medicare Program Certification

    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; Titles of Information Collection: ASC Forms for 
Medicare Program Certification; Use: The form CMS-370 titled ``Health 
Insurance Benefits Agreement'' is used for the purpose of establishing 
an ASC's eligibility for payment under title XVIII of the Social 
Security Act (the ``Act''). This agreement, upon acceptance by the 
Secretary of Health & Human Services, shall be binding on the ASC and 
the Secretary. The agreement may be terminated by either party in 
accordance with regulations. In the event of termination of this 
agreement, payment will not be available for the ASC's services 
furnished to Medicare beneficiaries on or after the effective date of 
termination.
    The CMS-377 form is used by ASCs to initiate both the initial and 
renewal survey by the State Survey Agency, which provides the 
certification required for an ASC to participate in the Medicare 
program. An ASC must complete the CMS-377 form and send it to the 
appropriate State Survey Agency prior to their scheduled accreditation 
renewal date. The CMS-377 form provides the State Survey Agency with 
information about the ASC facility's characteristics, such as, 
determining the size and the composition of the survey team on the 
basis of the number of ORs/procedure rooms and the types of surgical 
procedures performed in the ASC. Form Numbers: CMS-370 and CMS-377 (OMB 
control number: 0938-0266); Frequency: Occasionally; Affected Public: 
Private Sector--Business or other for-profit and Not-for-profit 
institutions; Number of Respondents: 1,711; Total Annual Responses: 
1,711; Total Annual Hours: 1,559. (For policy questions regarding this 
collection contact Caroline Gallaher at 410-786-8705.)

William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts, 
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2024-13129 Filed 6-13-24; 8:45 am]
BILLING CODE 4120-01-P