[Federal Register Volume 76, Number 34 (Friday, February 18, 2011)]
[Notices]
[Page 9579]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-3749]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10251]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid 
Services (CMS) is publishing the following summary of proposed 
collections for public comment. Interested persons are invited to send 
comments regarding this burden estimate or any other aspect of this 
collection of information, including any of the following subjects: (1) 
The necessity and utility of the proposed information collection for 
the proper performance of the agency's functions; (2) the accuracy of 
the estimated burden; (3) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (4) the use of 
automated collection techniques or other forms of information 
technology to minimize the information collection burden.
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Integrated 
Medicare and Medicaid State Plan Preprint; Form No.: CMS-10251 
(OMB<greek-i>: 0938-1047); Use: The Integrated Care Preprint is an 
optional tool for use by States to highlight the arrangements provided 
between the State and Medicare Advantage Special Needs Plans that are 
also providing Medicaid services. The preprint also provides the 
opportunity for States to confirm that their integrated care model 
complies with Federal statutory and regulatory requirements. State 
Medicaid Agencies may complete the preprint and CMS will review the 
information provided to determine if the State has properly completed 
and explained their integrated care arrangements and that the 
appropriate assurances have been met; Frequency: Once; Affected Public: 
State, Local, or Tribal Governments; Number of Respondents: 56; Total 
Annual Responses: 10; Total Annual Hours: 200. (For policy questions 
regarding this collection contact Mary Pat Farkas at 410-786-5731. For 
all other issues call 410-786-1326.)
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS' 
Web site at http://www.cms.hhs.gov/PaperworkReductionActof1995, or e-
mail your request, including your address, phone number, OMB number, 
and CMS document identifier, to <a href="/cdn-cgi/l/email-protection#045465746176736b766f446769772a6c6c772a636b72"><span class="__cf_email__" data-cfemail="c797a6b7a2b5b0a8b5ac87a4aab4e9afafb4e9a0a8b1">[email protected]</span></a>, or call the 
Reports Clearance Office at 410-786-1326.
    In commenting on the proposed information collections please 
reference the document identifier or OMB control number. To be assured 
consideration, comments and recommendations must be submitted in one of 
the following ways by April 19, 2011:
    1. Electronically. You may submit 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) 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.

Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2011-3749 Filed 2-17-11; 8:45 am]
BILLING CODE 4120-01-P


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