Federal Register / Vol. 77, No. 44 / Tuesday, March 6, 2012 / Notices 13337 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration on Aging 

Agency Information Collection 

Activities; Proposed Collection; 

Comment Request; Annual Reporting 

Requirements for the Older American 

Act Title VI Grant Program 

AGENCY: Administration on Aging, HHS. 

ACTION: Notice. 

SUMMARY: The Administration on Aging 

(AoA) is announcing that the proposed 

collection of information listed below 

has been submitted to the Office of 

Management and Budget (OMB) for 

review and clearance under the 

Paperwork Reduction Act of 1995. 

DATES: Submit written or electronic 

comments on the collection of 

information by April 5, 2012. 

ADDRESSES: Submit electronic 

comments on the collection of 

information to: 

Cynthia.LaCounte@aoa.hhs.gov. Submit 

written comments on the collection of 

information to Cynthia LaCounte, 

Administration on Aging, Washington, 

DC 20201 or by fax at 202–357–3560. 

FOR FURTHER INFORMATION CONTACT: 

Margaret Graves at (202) 357–0148 or 

Cynthia.LaCounte@aoa.hhs.gov. 

SUPPLEMENTARY INFORMATION: In 

compliance with 44 U.S.C 3507, AoA 

has submitted the following proposed 

collection of information to OMB for 

review and clearance. 

Describe Collection of Information 

AoA estimates the burden of this 

collection of information as follows: 

Annual submission of the Program 

Performance Reports are due 90 days 

after the end of the budget period and 

final project period. 

Respondents: Federally Recognized 

Tribes, Tribal and Native Hawaiian 

Organizations receiving grants under 

Title VI, Part A, Grants for Native 

Americans; Title VI, Part B, Native 

Hawaiian Program and Title VI, Part C, 

Native American Caregiver Support 

Program. 

Estimated Number of Responses: 256. 

Total Estimated Burden Hours: 640. 

Dated: February 28, 2012. 

Kathy Greenlee, 

Assistant Secretary for Aging. 

[FR Doc. 2012–5437 Filed 3–5–12; 8:45 am] 

BILLING CODE 4154–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10136, CMS– 

10116, CMS–10426 and CMS–10406] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services. 

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: Reinstatement of a previously 

approved collection; Title of 

Information Collection: Physician Group 

Practice Transition Demonstration 

(PGP–TD) Performance Assessment Tool 

(‘‘PAT’’); Use: The Physician Group 

Practice (PGP) Demonstration was 

mandated by section 412 of the 

Medicare, Medicaid, and SCHIP 

Benefits Improvement and Protection 

Act of 2000 and is the precursor to the 

Medicare Shared Savings Program. 

Section 1899(k) of the Social Security 

Act, as added by section 10307(k) of the 

Affordable Care Act (as amended by 

section 10307 of the Health Care and 

Education Reconciliation Act of 2010), 

states ‘‘the Secretary may enter into an 

agreement with an ACO under the 

Demonstration under section 1866A, 

subject to rebasing and other 

modifications deemed appropriate by 

the Secretary.’’ The Demonstration 

extension is entitled the PGP Transition 

Demonstration (PGP–TD). 

We are seeking reinstatement of the 

collection of information as it was 

erroneously discontinued. Only a 

portion of the information collection 

requirements previously approved 

under 0938–0941 should have been 

discontinued. The collection of 

information is strictly voluntary in 

nature and was developed in 

conjunction with the industry and 

Demonstration participants. Only 

organizations that voluntarily respond 

and elect to participate in the 

Demonstration will be reporting the 

measures. Moreover, CMS will not be 

using this information to regulate or 

sanction but rather to provide financial 

incentives for improving the quality of 

care. The collection of information to be 

used under this extension is being used 

to test quality data collection systems 

and determine incentive payment levels 

to participating physician group 

practices participating in the PGP–TD. 

In addition, this data will be used to 

evaluate the effectiveness of these 

payment models and provide insight 

into the most appropriate way for the 

agency to collect clinical information. 

Form Number: CMS–10136 (OCN: 

0938–0941); Frequency: Yearly; Affected 

Public: Private Sector—Business or 

other for-profits and not-for-profit 

institutions. Number of Respondents: 

10. Number of Responses: 10. Total 

Annual Hours: 790. (For policy 

questions regarding this collection 

contact Heather Grimsley at 410–786– 

1048. For all other issues call 410–786– 

1326.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; 

Title of Information Collection: 

Conditions for Payment of Power 

Mobility Devices, including Power 

Wheelchairs and Power-Operated 

Vehicles; Use: CMS is renewing our 

request for approval for the collection 

requirements associated with the final 

rule, CMS–3017–F (71 FR 17021), which 

was published on April 5, 2006 and 

became effective on June 5, 2006. The 

regulation CMS–3017–F finalized 

provisions set forth in the interim final 

regulation (70 FR 50940) published on 

August 26, 2005. This final rule 

conforms our regulations to section 

302(a)(2)(E)(iv) of the Medicare 

Prescription Drug, Improvement, and 

Modernization Act of 2003. This rule 

defines the term power mobility devices 

(PMDs) as power wheelchairs and 

power operated vehicles (POVs or 

scooters). It sets forth revised conditions 

for Medicare payment of PMDs and 

defines who may prescribe PMDs. This 

rule also requires a face-to-face 

examination of the beneficiary by the 

physician or treating practitioner, a 

written prescription, and receipt of 

pertinent parts of the medical record by 

the supplier within 45 days after the 

face-to-face examination that the 

durable medical equipment (DME) 


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13338 Federal Register / Vol. 77, No. 44 / Tuesday, March 6, 2012 / Notices 

suppliers maintain in their records and 

make available to CMS and its agents 

upon request. Finally, this rule 

discusses CMS’ policy on 

documentation that may be requested by 

CMS and its agents to support a 

Medicare claim for payment. Form 

Number: CMS–10116 (OCN: 0938– 

0971); Frequency: Yearly; Affected 

Public: Private Sector—Business or 

other for-profits. Number of 

Respondents: 90,521. Number of 

Responses: 173,810. Total Annual 

Hours: 34,762. (For policy questions 

regarding this collection contact Susan 

Miller at 410–786–2118. For all other 

issues call 410–786–1326.) 

3. Type of Information Collection 

Request: New collection; Title of 

Information Collection: End Stage Renal 

Disease (ESRD) System Access Request 

Form; Use: Within CMS, the Office of 

Clinical Standards and Quality is 

developing a new suite of systems to 

support the End Stage Renal Disease 

(ESRD) program. Due to the sensitivity 

of the data being collected and reported, 

CMS must ensure that only authorized 

personnel have access to data. Personnel 

are given access to the ESRD systems 

through the creation of user IDs and 

passwords within the QualityNet 

Identity Management System (QIMS); 

however, once within the system, the 

system determines the rights and 

privileges the personnel has over the 

data within the system. 

The sole purpose the End Stage Renal 

Disease System (ESRD) System Access 

Request Form is to identify the 

individual’s data access rights once 

within the ESRD system. This function 

and the associated data collection is 

currently being accomplished under 

‘‘Part B’’ of the QualityNet Identity 

Management System Account Form 

(CMS–10267; OCN: 0938–1050). Once 

the ESRD System Access Form is 

approved, the QualityNet Identity 

Management System (QIMS) Account 

Form will be revised to remove Part B 

from the QIMS data collection. Form 

Number: CMS–10426 (OCN: 0938– 

New); Frequency: Yearly; Affected 

Public: Private Sector—Business or 

other for-profits. Number of 

Respondents: 25,000. Number of 

Responses: 25,000. Total Annual Hours: 

6,250. (For policy questions regarding 

this collection contact Michelle Tucker 

at 410–786–0736. For all other issues 

call 410–786–1326.) 

4. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Probable Fraud 

Measurement Pilot; Use: The Centers for 

Medicare & Medicaid Services (CMS) is 

seeking Office of Management and 

Budget (OMB) approval of the 

collections required for a probable fraud 

measurement pilot. The probable fraud 

measurement pilot would establish a 

baseline estimate of probable fraud in 

payments for home health care services 

in the fee-for-service Medicare program. 

CMS and its agents will collect 

information from home health agencies, 

the referring physicians and Medicare 

beneficiaries selected in a national 

random sample of home health claims. 

The pilot will rely on the information 

collected along with a summary of the 

service history of the HHA, the referring 

provider, and the beneficiary to estimate 

the percentage of total payments that are 

associated with probable fraud and the 

percentage of all claims that are 

associated with probable fraud for 

Medicare fee-for-service home health. 

Form Number: CMS–10406 (OCN: 

0938–New); Frequency: Yearly; Affected 

Public: Individual and Private Sector— 

Business or other for-profits. Number of 

Respondents: 6,000. Number of 

Responses: 6,000. Total Annual Hours: 

10,500. (For policy questions regarding 

this collection contact Kelly Gent at 

410–786–0918. 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 

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

PaperworkReductionActof1995, or Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office on (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 7, 2012: 

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 lll, Room C4–26– 

05, 7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: March 1, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–5439 Filed 3–5–12; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Tribal Consultation Meetings 

AGENCY: Office of Head Start (OHS), 

Administration for Children and 

Families, HHS. 

ACTION: Notice of meetings. 

SUMMARY: Pursuant to the Improving 

Head Start for School Readiness Act of 

2007, Public Law 110–134, notice is 

hereby given of one-day Tribal 

Consultation Sessions to be held 

between the Department of Health and 

Human Services, Administration for 

Children and Families, Office of Head 

Start leadership and the leadership of 

Tribal Governments operating Head 

Start (including Early Head Start) 

programs. The purpose of these 

Consultation Sessions is to discuss ways 

to better meet the needs of American 

Indian and Alaska Native children and 

their families, taking into consideration 

funding allocations, distribution 

formulas, and other issues affecting the 

delivery of Head Start services in their 

geographic locations [42 U.S.C. 9835, 

Section 640(l)(4)]. 

DATES: March 22 and April 3, 2012. 

ADDRESSES: 2012 Office of Head Start 

Tribal Consultation Sessions will be 

held at the following locations: 

Thursday, March 22, 2012—Phoenix, 

Arizona—Sheraton Crescent Hotel, 2620 

West Dunlap Avenue Phoenix, AZ 

85021; Tuesday, April 3, 2012—Billings, 

Montana—Holiday Inn Grand Montana 

5500 Midland Road, Billings, MT 59101. 

FOR FURTHER INFORMATION CONTACT: 

Camille Loya, Acting Regional Program 

Manager Region XI, email 

Camille.Loya@acf.hhs.gov or phone 

(202) 401–5964. Additional information 

and online meeting registration is 

available at http:// 

www.headstartresourcecenter.org. 

SUPPLEMENTARY INFORMATION: The 

Department of Health and Human 

Services (HHS) announces Office of 

Head Start (OHS) Tribal Consultations 

with leaders of Tribal Governments 

operating Head Start (including Early 

Head Start) programs for each of the 

nine geographic regions of Head Start 


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