21932 Federal Register / Vol. 79, No. 75 / Friday, April 18, 2014 / Notices 

data quality, (2) increase our response 

rates, (3) decrease the breakoff rates, (4) 

reduce the average amount of time it 

takes to complete the survey, (5) and 

ultimately reduce the burden on the 

respondent. 

In this data collection period, 85,000 

households will be screened. After 

determining eligibility and consent, 

12,500 respondents will complete the 

survey. The average burden per 

screened respondent remains at 3 

minutes, while the average burden per 

surveyed respondent is 25 minutes. The 

survey will be conducted among English 

or Spanish speaking male and female 

adults (18 years and older) living in the 

United States. 

There are no costs to respondents 

other than their time. 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of 

respondent Form name Number of responses 

Number of 

responses 

per 

respondent 

Average 

burden per 

response 

(in hours) 

Total 

burden 

(in hours) 

Households .......... NISVSS 2013 Test Instrument (screened) ................... 28,333 1 3/60 1,417 

NISVSS 2013 Test Instrument (surveyed) ................... 4,167 1 25/60 1,736 

Total .............. ................................................................................... ........................ ........................ ........................ 3,153 

LeRoy Richardson, 

Chief, Information Collection Review Office, 

Office of Scientific Integrity, Office of the 

Associate Director for Science, Office of the 

Director, Centers for Disease Control and 

Prevention. 

[FR Doc. 2014–08784 Filed 4–17–14; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10510, CMS– 

10169 and CMS–287–05] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

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 (the 

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 

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 must be received by 

June 17, 2014. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number (OCN). 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, 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: 

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–10510 Basic Health Program 

Report for Health Insurance Exchange 

Premium 

CMS–10169 Durable Medical 

Equipment, Prosthetics, Orthotics and 

Supplies (DMEPOS) Competitive 

Bidding Program 

CMS–287–05 Home Office Cost 

Statement Form 

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; Title of 

Information Collection: Basic Health 

Program Report for Health Insurance 

Exchange Premium; Use: The Basic 

Health Program (BHP) is federally 

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Federal Register / Vol. 79, No. 75 / Friday, April 18, 2014 / Notices 21933 

funded by determining the amount of 

payments that the federal government 

would have made through the premium 

tax credit (PTC) and cost sharing 

reductions (CSR) for people enrolled in 

BHP had they instead been enrolled in 

an Exchange. To calculate the amounts 

for each state, we need the reference 

premiums for the second lowest cost 

silver plans (SLCSP) in each geographic 

area in a state, as SLCSPs are a basic 

unit in the calculation of PTC and CSRs 

under the Exchanges. To estimate what 

PTC and CSRs would have been paid, 

the reference premiums for these 

SLCSPs are critical components in the 

BHP payment methodology. Similarly, 

we also need to collect reference 

premiums for the lowest cost bronze 

plans to appropriately account for CSR 

calculations for American Indians and 

Alaskan Natives. Reference premiums 

are foundational inputs into the BHP 

payment methodology. We have the 

necessary information to determine 

these reference premiums for states 

whose Exchanges are operated by the 

Federally Facilitated Exchange (FFE) or 

are operated in partnership with the 

FFE. Consequently, this collection only 

pertains to the 17 states that are 

operating State Based Exchanges. Form 

Number: CMS–10510 (OCN: 0938– 

1218); Frequency: Yearly; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

17; Total Annual Responses: 17; Total 

Annual Hours: 68. (For policy questions 

regarding this collection contact Jessica 

Schubel at 410–786–3032.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Durable Medical 

Equipment, Prosthetics, Orthotics and 

Supplies (DMEPOS) Competitive 

Bidding Program; Use: Section 302 of 

the MMA amended section 1847 of the 

Social Security Act (the Act) to require 

the implementation of the DMEPOS 

competitive bidding program. The Act 

provided the program requirements for 

the submission of bids in establishing 

payment rates and the awarding of 

contracts; provided the requirements for 

mergers and acquisitions; and a 

requirement for the Secretary to recompete contracts not less often than 

once every 3 years. The MMA also 

requires the Secretary to recompete 

contracts not less often than once every 

3 years. The Round 1 Rebid contract 

period for all product categories except 

mail-order diabetic supplies expired on 

December 31, 2013. (Round 1 Rebid 

contracts for mail-order diabetic testing 

supplies ended on December 31, 2012.) 

The competition for the Round 1 

Recompete began in August of 2012. 

The Round 1 Recompete contracts and 

prices became effective on January 1, 

2014 and will expire on December 31, 

2016. Round 2 and National Mail-Order 

contracts and prices will expire on June 

30, 2016. 

The most recent approval for this 

information collection request (ICR) was 

issued by OMB on June 10, 2013. That 

ICR included the estimated burden to 

collect the information in bidding 

Forms A and B for the Round 1 

Recompete. We are now seeking 

approval to collect the information in 

Forms A and B for competitions that 

will occur before 2017. For these 

upcoming competitions CMS will 

publish a slightly modified version of 

the RFB instructions and accompanying 

Forms A and B so that suppliers will be 

better able to identify and understand 

the requirements of the program. We 

decided to modify the Request for Bids 

(RFB) instructions and forms based on 

our experience from the last round of 

competition. The end result is expected 

to produce more complete and accurate 

information to evaluate suppliers. No 

new collection requirements have been 

added to the modified RFB instructions 

or Form A or B. Finally, we are retaining 

without change the Change of 

Ownership (CHOW) Purchaser Form 

and the CHOW Contract Supplier 

Notification Form, the Subcontracting 

Disclosure Form, and Forms C, and D 

and their associated burden under this 

ICR. We intend to continue use of these 

Forms on an ongoing basis. Form 

Number: CMS–10169 (OCN: 0938– 

1016); Frequency: Occasionally; 

Affected Public: Private Sector— 

Business or other for-profits and 

Individuals or Households; Number of 

Respondents: 49,625; Total Annual 

Responses: 39,380; Total Annual Hours: 

235,024. (For policy questions regarding 

this collection contact Michael Keane at 

410–786–4495.) 

3. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Home Office 

Cost Statement Form; Use: Providers of 

services participating in the Medicare 

program are required under sections 

1815(a) and 1861(v)(1)(A) of the Social 

Security Act (42 U.S.C. 1395g) to submit 

annual information to achieve 

settlement of costs for health care 

services rendered to Medicare 

beneficiaries. In addition, regulations at 

42 CFR 413.17, 413.20 and 413.24 

require adequate cost data and cost 

reports from providers on an annual 

basis. The home office cost statement 

form is filed annually by chain 

organizations to report costs directly 

related to services furnished to 

individual providers that are related to 

patient care plus an appropriate share of 

indirect costs. Form Number: CMS– 

287–05 (OCN: 0938–0202); Frequency: 

Yearly; Affected Public: Business or 

other for-profit and Not-for-profit 

institutions; Number of Respondents: 

1,686; Total Annual Responses: 1,686; 

Total Annual Hours: 785,676. (For 

policy questions regarding this 

collection contact Yaakov Feinstein at 

410–786–5834.) 

Dated: April 15, 2014. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2014–08898 Filed 4–17–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10509] 

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 May 19, 2014. 

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