16686 Federal Register / Vol. 80, No. 60 / Monday, March 30, 2015 / Notices 

Dated: March 24, 2015. 

Sylvia M. Burwell, 

Secretary of Health and Human Services. 

[FR Doc. 2015–07235 Filed 3–27–15; 8:45 am] 

BILLING CODE 4150–28–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–29, CMS–10221 

and CMS–R–263] 

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 April 29, 2015. 

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) 395–5806 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/Paperwork

ReductionActof1995. 

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: Verification of 

Clinic Data—Rural Health Clinic Form 

and Supporting Regulations; Use: The 

form is utilized as an application to be 

completed by suppliers of Rural Health 

Clinic (RHC) services requesting 

participation in the Medicare program. 

This form initiates the process of 

obtaining a decision as to whether the 

conditions for certification are met as a 

supplier of RHC services. It also 

promotes data reduction or introduction 

to and retrieval from the Automated 

Survey Process Environment (ASPEN) 

and related survey and certification 

databases by the CMS Regional Offices. 

Should any question arise regarding the 

structure of the organization, this 

information is readily available. Form 

Number: CMS–29 (OMB control number 

0938–0074); Frequency: Occasionally 

(initially and then every six years); 

Affected Public: Private Sector (Business 

or other for-profit and Not-for-profit 

institutions); Number of Respondents: 

900; Total Annual Responses: 900; Total 

Annual Hours: 150. (For policy 

questions regarding this collection 

contact Shonte ́ Carter at 410–786–3532.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Site 

Investigation for Independent 

Diagnostic Testing Facilities (IDTFs); 

Use: We enroll Independent Diagnostic 

Testing Facilities (IDTFs) into the 

Medicare program via a uniform 

application, the CMS 855B. 

Implementation of enhanced procedures 

for verifying the enrollment information 

has improved the enrollment process as 

well as identified and prevented 

fraudulent IDTFs from entering the 

Medicare program. As part of this 

process, verification of compliance with 

IDTF performance standards is 

necessary. The primary function of the 

site investigation form for IDTFs is to 

provide a standardized, uniform tool to 

gather information from an IDTF that 

tells us whether it meets certain 

standards to be a IDTF (as found in 42 

CFR 410.33(g)) and where it practices or 

renders its services. The site 

investigation form has been used in the 

past to aid in verifying compliance with 

the required performance standards 

found in 42 CFR 410.33(g). No revisions 

have been made to this form since the 

last submission for OMB approval. Form 

Number: CMS–10221 (OMB Control 

Number: 0938–1029); Frequency: 

Occasionally; Affected Public: Private 

Sector (Business or other for-profits and 

Not-for-profit institutions); Number of 

Respondents: 900; Total Annual 

Responses: 900; Total Annual Hours: 

1,800. (For policy questions regarding 

this collection contact Kim McPhillips 

at 410–786–5374). 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Site 

Investigation for Suppliers of Durable 

Medical Equipment, Prosthetics, 

Orthotics and Supplies (DMEPOS); Use: 

We enroll suppliers of durable medical 

equipment, prosthetics, orthotics, and 

supplies (DMEPOS) into the Medicare 

program via a uniform application, the 

CMS 855S. Implementation of enhanced 

procedures for verifying the enrollment 

information has improved the 

enrollment process as well as identified 

and prevented fraudulent DMEPOS 

suppliers from entering the Medicare 

program. As part of this process, 

verification of compliance with supplier 

standards is necessary. The primary 

function of the site investigation form is 

to provide a standardized, uniform tool 

to gather information from a DMEPOS 

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Federal Register / Vol. 80, No. 60 / Monday, March 30, 2015 / Notices 16687 

supplier that tells us whether it meets 

certain qualifications to be a DMEPOS 

supplier (as found in 42 CFR 424.57(c)) 

and where it practices or renders its 

services. The site investigation form has 

been used in the past to aid in verifying 

compliance with the required supplier 

standards found in 42 CFR 424.57(c). No 

revisions have been made to this form 

since the last submission for OMB 

approval. Form Number: CMS–R–263 

(OMB Control Number: 0938–0749); 

Frequency: Occasionally; Affected 

Public: Private Sector (Business or other 

for-profits and Not-for-profit 

institutions); Number of Respondents: 

30,000; Total Annual Responses: 

30,000; Total Annual Hours: 15,000. 

(For policy questions regarding this 

collection contact Kim McPhillips at 

410–786–5374). 

Dated: March 25, 2015. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2015–07219 Filed 3–27–15; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10558 and CMS– 

10463] 

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 

May 29, 2015. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number. 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 lll, 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–10558 Information Collection for 

Machine Readable Data for Provider 

Network and Prescription 

Formulary Content for FFM QHPs 

CMS–10463 Cooperative Agreement to 

Support Navigators in FederallyFacilitated and State Partnership 

Exchanges 

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. Title of Information Collection: 

Information Collection for Machine 

Readable Data for Provider Network and 

Prescription Formulary Content for FFM 

QHPs; Type of Information Collection 

Request: New collection (Request for a 

new OMB control number); Use: For 

plan years beginning on or after January 

1, 2016, qualified health plan (QHP) 

issuers must make available provider 

and formulary data in a machinereadable format. As required by the final 

rule Patient Protection and Affordable 

Care Act; HHS Notice of Benefit and 

Payment Parameters for 2016 (CMS– 

9944–F), 80 Federal Register 10750 

February 27, 2015, QHP issuers in the 

Federally-facilitated Marketplaces 

(FFMs) are required to publish 

information regarding their formulary 

drug lists and provider directories on its 

Web site in an HHS-specified format, in 

a format and at times determined by 

HHS. Form Number: CMS–10558 (0938- 

New); Frequency: Monthly; Affected 

Public: Private Sector (Business or other 

For-profits and Not-for-Profit 

institutions); Number of Respondents: 

475; Number of Responses: 36; Total 

Annual Hours: 79,800. (For questions 

regarding this collection, contact LisaAnn Bailey at (301) 492- 4169.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved information collection; Title 

of Information Collection: Cooperative 

Agreement to Support Navigators in 

Federally-facilitated and State 

Partnership Exchanges; Use: Section 

1311(i) of the Affordable Care Act 

requires Exchanges to establish a 

Navigator grant program as part of its 

function to provide consumers with 

assistance when they need it. Navigators 

will assist consumers by providing 

education about and facilitating 

selection of qualified health plans 

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