2430 Federal Register / Vol. 80, No. 11 / Friday, January 16, 2015 / Notices 

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: 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; 

Title of Information Collection: 

National Provider Identifier (NPI) 

Application and Update Form and 

Supporting Regulations in 45 CFR 

142.408, 45 CFR 162.406, 45 CFR 

162.408; Use: The National Provider 

Identifier (NPI) Application and Update 

Form is used by health care providers to 

apply for NPIs and furnish updates to 

the information they supplied on their 

initial applications. The form is also 

used to deactivate their NPIs if 

necessary. The NPI Application/Update 

form has been revised to provide 

additional guidance on how to 

accurately complete the form. The NPI 

Application/Update form has been 

revised to provide additional guidance 

on how to accurately complete the form. 

This collection includes clarification on 

information that is required on 

applications/changes. Minor changes on 

the application/update form include 

adding a ‘Subpart’ check box in the 

Other Name section and a revision 

within the PRA Disclosure Statement. 

This collection also includes changes to 

the instructions. Form Number: CMS– 

10114 (OMB control number: 0938– 

0931); Frequency: Reporting—On 

occasion; Affected Public: Business or 

other for-profit, Not-for-profit 

institutions, and Federal government; 

Number of Respondents: 608,880; Total 

Annual Responses: 608,880; Total 

Annual Hours: 112,660. (For policy 

questions regarding this collection 

contact Kim McPhillips at 410–786– 

5374.) 

Dated: January 13, 2015. 

Martique Jones, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2015–00626 Filed 1–15–15; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–372(S), CMS– 

10500, CMS–10221 and CMS–R–263] 

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 

March 17, 2015. 

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 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–372(S) Annual Report on Home 

and Community Based Services 

Waivers and Supporting Regulations 

CMS–10500 Outpatient/Ambulatory 

Surgery Patient Experience of Care 

Survey (O/ASPECS) 

CMS–10221 Site Investigation for 

Independent Diagnostic Testing 

Facilities (IDTFs) 

CMS–R–263 Site Investigation for 

Suppliers of Durable Medical 

Equipment, Prosthetics, Orthotics and 

Supplies (DMEPOS) 

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 


asabaliauskas on DSK5VPTVN1PROD with NOTICES
Federal Register / Vol. 80, No. 11 / Friday, January 16, 2015 / Notices 2431 

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: Annual Report 

on Home and Community Based 

Services Waivers and Supporting 

Regulations; Use: We use this report to 

compare actual data to the approved 

waiver estimates. In conjunction with 

the waiver compliance review reports, 

the information provided will be 

compared to that in the Medicaid 

Statistical Information System (MSIS) 

(CMS–R–284; OMB control number 

0938–0345) report and FFP claimed on 

a state’s Quarterly Expenditure Report 

(CMS–64; OMB control number 0938– 

1265), to determine whether to continue 

the state’s home and community-based 

services waiver. States’ estimates of cost 

and utilization for renewal purposes are 

based upon the data compiled in the 

CMS–372(S) reports. Form Number: 

CMS–372(S) (OMB Control Number: 

0938–0272); Frequency: Yearly; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

48; Total Annual Responses: 315; Total 

Annual Hours: 13,545. (For policy 

questions regarding this collection 

contact Ralph Lollar at 410–786–0777). 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Outpatient/

Ambulatory Surgery Patient Experience 

of Care Survey (O/ASPECS); Use: The 

information collected in the national 

implementation of Outpatient/

Ambulatory Surgery Patient Experience 

of Care Survey (A/ASPECS) will be used 

to: (1) Provide a source of information 

from which selected measures can be 

publicly reported to beneficiaries to 

help them make informed decisions for 

outpatient surgery facility selection; (2) 

aid facilities with their internal quality 

improvement efforts and external 

benchmarking with other facilities; and 

(3) provide us with information for 

monitoring and public reporting 

purposes. Form Number: CMS–10500 

(OMB Control Number: 0938–1240); 

Frequency: Once; Affected Public: 

Individuals and households; Number of 

Respondents: 2,813,610; Total Annual 

Responses: 2,813,610; Total Annual 

Hours: 365,769. (For policy questions 

regarding this collection contact 

Memuna Ifedirah at 410–786–6849). 

3. 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). 

4. 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 

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: January 13, 2015. 

Martique Jones, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2015–00627 Filed 1–15–15; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

[OMB No.: 0970–0167] 

Submission for OMB Review; 

Comment Request: Child Care 

Quarterly Case Record Report—ACF– 

801 

Description: Section 658K of the 

Child Care and Development Block 

Grant Act (42 U.S.C. 9858) requires that 

States and Territories submit monthly 

case-level data on the children and 

families receiving direct services under 

the Child Care and Development Fund 

(CCDF). The implementing regulations 

for the statutorily required reporting are 

at 45 CFR 98.70. Case-level reports, 

submitted quarterly or monthly (at 

grantee option), include monthly 

sample or full population case-level 

data. The data elements to be included 

in these reports are represented in the 

ACF–801. ACF uses disaggregate data to 

determine program and participant 

characteristics as well as costs and 

levels of child care services provided. 

This provides ACF with the information 

necessary to make reports to Congress, 

address national child care needs, offer 

technical assistance to grantees, meet 

performance measures, and conduct 

research. On November 19, 2014, the 

President signed the Child Care and 

Development Block Grant Act of 2014 


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