Federal Register / Vol. 78, No. 120 / Friday, June 21, 2013 / Notices 37545 

regarding this collection contact Terry 

Lied at 410–786–8973.) 

9. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: Request 

for Retirement Benefit Information; Use: 

Section 1818(d)(5) of the Social Security 

Act provides that former state and local 

government employees (who are age 65 

or older, have been entitled to Premium 

Part A for at least 7 years, and did not 

have the premium paid for by a state, a 

political subdivision of a state, or an 

agency or instrumentality of one or 

more states or political subdivisions) 

may have the Part A premium reduced 

to zero. These individuals must also 

have 10 years of employment with the 

state or local government employer or a 

combination of 10 years of employment 

with a state or local government 

employer and a non-government 

employer. Form CMS–R–285 is an 

essential part of the process of 

determining whether an individual 

qualifies for the premium reduction. 

The Social Security Administration will 

use this information to help determine 

whether a beneficiary meets the 

requirements for reduction of the Part A 

premium. Form Number: CMS–R–285 

(OCN: 0938–0769). Frequency: Once. 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

500; Total Annual Responses: 500; Total 

Annual Hours: 125. (For policy 

questions regarding this collection 

contact Lindsay Smith at 410–786– 

6843.) 

Dated: June 18, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–14878 Filed 6–20–13; 8:45 am] 

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DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–460] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

ACTION: Notice. 

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 

a second opportunity for public 

comment on the notice. Interested 

persons are invited to send comments 

regarding the 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. 

DATES: Comments on the collection(s) of 

information must be received by the 

OMB desk officer by July 22, 2013. 

ADDRESSES: When commenting on the 

proposed information collections, 

please reference the document identifier 

or OMB control number. To be assured 

consideration, comments and 

recommendations must be received by 

the OMB desk officer via one of the 

following transmissions: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–6974 or Email: 

OIRA_submission@omb.eop.gov. 

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’ Web site address at 

http://www.cms.hhs.gov/ 

PaperworkReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326. 

SUPPLEMENTARY INFORMATION: Under the 

Paperwork Reduction Act of 1995 (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 (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-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 that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicare 

Participating Physician or Supplier 

Agreement; Use: Section 1842(h) of the 

Social Security Act permits physicians 

and suppliers to voluntarily participate 

in Medicare Part B by agreeing to take 

assignment on all claims for services to 

Medicare beneficiaries. The law also 

requires that the Secretary provide 

specific benefits to the physicians, 

suppliers and other persons who choose 

to participate. Form CMS–460 is the 

agreement by which the physician or 

supplier elects to participate in 

Medicare. The collected information is 

used by Medicare contractors to provide 

the benefits the law provides for 

participating entities and to enable 

contractors to enforce the Medicare 

limiting charge for physicians, suppliers 

and other persons who do not 

participate. It is also used by Medicare 

beneficiaries to assist them in locating 

physicians who will accept Medicare 

assignment on claims for services and 

therefore save them money. In addition, 

we use the form to gauge the 

effectiveness of efforts to increase 

participation in Medicare. Form 

Number: CMS–460 (OCN: 0938–0373); 

Frequency: Yearly; Affected Public: 

Private sector (business or other forprofits); Number of Respondents: 

120,000; Total Annual Responses: 

120,000; Total Annual Hours: 30,000. 

(For policy questions regarding this 

collection contact April Billingsley at 

410–786–0140.) 

Dated: June 18, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–14870 Filed 6–20–13; 8:45 am] 

BILLING CODE 4120–01–P 


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