[Federal Register Volume 76, Number 46 (Wednesday, March 9, 2011)]
[Notices]
[Pages 12965-12966]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-5365]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10232 and CMS-R-211]


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: Revision of currently 
approved collection; Title of Information Collection: State Plan 
Template to Implement Section 6062 of the Deficit Reduction Act; Form 
No.: CMS-10232 (OMB<greek-i>: 0938-1045); Use: The Deficit Reduction 
Act (DRA) provides States with numerous flexibilities in operating 
their State Medicaid Programs. Section 6062 of the DRA (Opportunity for 
families of Disabled Children to Purchase Medicaid Coverage for Such 
Children) provides States the opportunity to provide Medicaid benefits 
to disabled children who would otherwise be ineligible because of 
family income that is above the State's highest Medicaid eligibility 
standards for children. States must establish a State Plan for medical 
assistance to implement this provision. To do this,

[[Page 12966]]

State Medicaid Agencies will complete the template. CMS will review the 
information to determine if the State has met all the requirements of 
the DRA provision; Frequency: Once; Affected Public: State, Federal, or 
Tribal Governments; Number of Respondents: 56; Total Annual Responses: 
10; Total Annual Hours: 60. (For policy questions regarding this 
collection contact Barbara Washington at 410-786-9964. For all other 
issues call 410-786-1326.)
    2. Type of Information Collection Request: Revision of currently 
approved collection; Title of Information Collection: Model Application 
Template and Instructions for State Child Health Plan Under Title XXI 
of the Social Security Act, State Children's Health Insurance Program; 
Form No.: CMS-R-211 (OMB<greek-i>: 0938-0707); Use: The information 
will be used to assess State plan performance and health outcomes and 
to evaluate the amount of substitute private coverage and the effect of 
subsidies on access to coverage; Frequency: Yearly, occasionally; 
Affected Public: State, Federal, or Tribal Governments; Number of 
Respondents: 40; Total Annual Responses: 40; Total Annual Hours: 3,200. 
(For policy questions regarding this collection contact Nancy 
Goetschius at 410-786-0707. 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#c797a6b7a2b5b0a8b5ac87a4aab4e9afafb4e9a0a8b1"><span class="__cf_email__" data-cfemail="025263726770756d706942616f712c6a6a712c656d74">[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 May 9, 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.

    Dated: February 28, 2011.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 2011-5365 Filed 3-4-11; 4:15 pm]
BILLING CODE 4120-01-P


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