14806 Federal Register / Vol. 77, No. 49 / Tuesday, March 13, 2012 / Notices 

Advisory Committee, 1600 Clifton Road 

NE., Mailstop E–94, Atlanta, Georgia 

30333, telephone 404/498–6400 or fax 

404/498–6410. 

The Director, Management Analysis 

and Services Office, has been delegated 

the authority to sign Federal Register 

notices pertaining to announcements of 

meetings and other committee 

management activities, for both the 

Centers for Disease Control and 

Prevention and the Agency for Toxic 

Substances and Disease Registry. 

Dated: March 6, 2012. 

Elaine L. Baker, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. 2012–6080 Filed 3–12–12; 8:45 am] 

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DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

Disease, Disability, and Injury 

Prevention and Control Special 

Emphasis Panel (SEP): Initial Review 

The meeting announced below 

concerns Epidemiology, Prevention and 

Treatment of Influenza and Other 

Respiratory Infections in Ghana, Studies 

at the Animal-Human Interface of 

Influenza and Other Zoonotic Diseases 

in Vietnam, The Incidence of 

Community Associated Influenza and 

Other Respiratory Infections in the 

United States, and Epidemiology, 

Prevention and Treatment of Influenza 

and Other Respiratory Infections in 

Panama and Central America Region, 

Funding Opportunity Announcements 

(FOAs) IP12–001, IP12–002,IP12–003, 

and IP12–006, initial review. 

Correction: The notice was published 

in the Federal Register on January 26, 

2012, Volume 77, Number 17, Page 

4047. The place should read as follows: 

Place: Crowne Plaza Hotel AtlantaAirport, 1325 Virginia Avenue, Atlanta, 

GA 30344, Telephone: (404) 768–6660. 

Contact Person for More Information: 

Gregory Anderson, MPH, MS, Scientific 

Review Officer, CDC, 1600 Clifton Road, 

NE., Mailstop E60, Atlanta, Georgia 

30333, Telephone: (404) 718–8833. 

The Director, Management Analysis 

and Services Office, has been delegated 

the authority to sign Federal Register 

notices pertaining to announcements of 

meetings and other committee 

management activities, for both the 

Centers for Disease Control and 

Prevention and the Agency for Toxic 

Substances and Disease Registry. 

Dated: March 6, 2012. 

Elaine L. Baker, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. 2012–6075 Filed 3–12–12; 8:45 am] 

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DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–1880 and –1882; 

CMS–10393; and CMS–R–245] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

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), Department of Health 

and Human Services, 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 function; 

(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: Extension without change of a 

currently approved collection. Title of 

Information Collection: Certification as 

a Supplier of Portable X-Ray and 

Portable X-Ray Survey Report Form and 

Supporting Regulations at 42 CFR Part 

486.100–486.110. Use: CMS–1880 is 

initially completed by suppliers of 

portable X-ray services, expressing an 

interest in and requesting participation 

in the Medicare program. This form 

initiates the process of obtaining a 

decision as to whether the conditions of 

coverage are met as a portable X-ray 

supplier. It also promotes data reduction 

or introduction to, and retrieval from, 

the Certification and Survey Provider 

Enhanced Reporting (CASPER) by the 

CMS Regional Offices (ROs). 

CMS–1882 is used by the State survey 

agency to provide data collected during 

an on-site survey of a supplier of 

portable X-ray services to determine 

compliance with the applicable 

conditions of participation and to report 

this information to the Federal 

Government. The form is primarily a 

coding worksheet designed to facilitate 

data reduction and retrieval into the 

ASPEN system at the CMS ROs. The 

form includes basic information on 

compliance (i.e., met, not met, 

explanatory statements) and does not 

require any descriptive information 

regarding the survey activity itself. CMS 

has the responsibility and authority for 

certification decisions which are based 

on supplier compliance with the 

applicable conditions of participation. 

The information needed to make these 

decisions is available to CMS only 

through the use of information 

abstracted from the survey report form. 

Subsequent to the publication of the 

60-day Federal Register notice 

(December 23, 2011; 76 FR 80372), the 

Supporting Statement has been revised 

by making editorial changes and by 

adding clarifying language. The 

requirements and burden estimates have 

not changed. Form Numbers: CMS–1880 

(Request for Certification as a Supplier 

of Portable X-Ray Services), CMS–1882 

(Medicare/Medicaid Portable X-Ray 

Survey Report), and OCN 0938–0027. 

Frequency: Occasionally. Affected 

Public: State, Local, or Tribal 

Governments. Number of Respondents: 

579. Total Annual Responses: 86. Total 

Annual Hours: 151. (For policy 

questions regarding this collection 

contact Georgia Johnson at 410–786– 

6859. For all other issues call 410–786– 

1326.) 

2. Type of Information Collection 

Request: Existing collection in use 

without an OMB control number; Title 

of Information Collection: Medicare 

Beneficiary and Family-Centered 

Satisfaction Survey; Use: The data 

collection methodology used to 

determine Beneficiary Satisfaction flows 

from the proposed sampling approach. 

While it was feasible to conduct the 9th 

SOW via telephone data collection only, 

with a quarterly sample size for the 10th 

SOW estimated to be 2,664, it does not 

seem efficient to maintain a telephone 

only data collection approach. Based on 

recent literature on survey methodology 

and response rates by mode, we 

recommend using a data collection that 

is done primarily by mail. A mail-based 

methodology will achieve the goals of 

being efficient, effective, and minimally 

burdensome for beneficiary 

respondents. 

As previously described, we 

anticipate that a mail-based 

methodology could yield a response rate 

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Federal Register / Vol. 77, No. 49 / Tuesday, March 13, 2012 / Notices 14807 

of approximately 60 percent. In order to 

achieve this response rate, we would 

recommend a 3-staged approach to data 

collection: 

(1) Mailout of a covering letter, the 

paper survey questionnaire, and a 

postage-paid return envelope. 

(2) Mailout of a postcard that thanks 

respondents and reminds the nonrespondents to please return their 

survey. 

(3) Mailout of a follow-up covering 

letter, the paper survey questionnaire, 

and a postage-paid return envelope. 

Through the pilot test, we will 

determine the response rate that can be 

achieved using this approach. If it is 

deemed necessary, additional mailout 

reminders can be added to the protocol, 

or a telephone non-response step can be 

added to the protocol. 

Using the 3-step mail approach 

described above, we anticipate that data 

collection would occur over an 8 to 10 

weeks. This is to say, if the first survey 

mailing were dropped on May 1, we 

would anticipate completing data 

collection at the end of June or early 

July. Data would then be cleaned, scores 

would be generated, and data would be 

delivered to CMS. Through the pilot 

test, we will determine the precise 

timing required to achieve an acceptable 

response rate, but we are aiming to 

complete sampling, data collection, and 

scoring within a 12-week period. 

Subsequent to the publication of the 

60-day Federal Register notice (June 10, 

2011; 76 FR 34076), the survey 

instrument has been separated into two 

surveys. Prior to this action, there was 

one survey proposed for the Quality of 

Care and Appeals review types. Once 

approved by OMB, there will be two 

survey instruments that will request 

similar information: one for Quality of 

Care and one for Appeals. Form 

Number: CMS–10393 (OCN 0938–New); 

Frequency: Once; Affected Public: 

Individuals or households; Number of 

Respondents: 16,010; Number of 

Responses: 16,010; Total Annual Hours: 

4,002. (For policy questions regarding 

this collection, contact Coles Mercier at 

410–786–2112. For all other issues call 

(410) 786–1326.) 

3. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Medicare and 

Medicaid Programs OASIS Collection 

Requirements as Part of the CoPs for 

HHAs and Supp. Regs. in 42 CFR 48.55, 

484.205, 484.245, 484.250; Use: This 

data set is currently mandated for use by 

Home Health Agencies (HHAs) as a 

condition of participation (CoP) in the 

Medicare program. Since 1999, the 

Medicare CoPs have mandated that 

HHAs use the OASIS data set when 

evaluating adult non-maternity patients 

receiving skilled services. The OASIS is 

a core standard assessment data set that 

agencies integrate into their own 

patient-specific, comprehensive 

assessment to identify each patient’s 

need for home care that meets the 

patient’s medical, nursing, 

rehabilitative, social, and discharge 

planning needs. There have not been 

any changes to the PRA package that is 

associated with the 60-day Federal 

Register notice that published on 

December 16, 2011 (76 FR 78264); Form 

Number: CMS–R–245 (OCN 0938–0760); 

Frequency: Occasionally; Affected 

Public: Private Sector (Business or other 

for-profit and Not-for-profit 

institutions); Number of Respondents: 

11,495; Total Annual Responses: 

16,476,008; Total Annual Hours: 

16,567,968. (For policy questions 

regarding this collection contact Robin 

Dowell at 410–786–0060. 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. 

To be assured consideration, 

comments and recommendations for the 

proposed information collections must 

be received by the OMB desk officer at 

the address below, no later than 5 p.m. 

on April 12, 2012. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS 

Desk Officer, Fax Number: (202) 395– 

6974, Email: 

OIRA_submission@omb.eop.gov. 

Dated: March 6, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division-B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–6036 Filed 3–12–12; 8:45 am] 

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DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare and Medicaid 

Services 

[Document Identifier: CMS–10428] 

Emergency Clearance: Public 

Information Collection Requirements 

Submitted to the Office of Management 

and Budget (OMB) 

AGENCY: Centers for Medicare and 

Medicaid Services, HHS. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Centers for Medicare and Medicaid 

Services (CMS), Department of Health 

and Human Services, 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. 

We are, however, requesting an 

emergency review of the information 

collection referenced below. In 

compliance with the requirement of 

section 3506(c)(2)(A) of the Paperwork 

Reduction Act of 1995, we have 

submitted to the Office of Management 

and Budget (OMB) the following 

requirements for emergency review. We 

are requesting an emergency review to 

ensure compliance with section 

1862(a)(1)(A) of the Social Security Act. 

We cannot reasonably comply with the 

normal clearance procedures in that 

public harm is reasonably likely to 

result if normal clearance procedures 

are followed as stated in 5 CFR 

1320.13(a)(2)(i). 

1. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Pre-Existing 

Condition Insurance Plan (PCIP) HIPAA 

Authorization Form; Use: Unless 

permitted or required by law, the Health 

Insurance Portability and 

Accountability Act (HIPAA) privacy 

regulation at 45 CFR 164.508 prohibits 

CMS’ Pre-Existing Condition Insurance 

Plan (PCIP) program (a HIPAA covered 

entity) from disclosing an individual’s 

protected health information without a 

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