### 23566 Federal Register/ Vol. 78, No. 76 / Friday, April 19, 2013 / Notices

or bank holding company. The factors that are considered in acting on the notices are set forth in paragraph 7 of the Act (12 U.S.C. 1817(j)(7)).

The notices are available for immediate inspection at the Federal Reserve Bank indicated. The notices also will be available for inspection at the offices of the Board of Governors. Interested persons may express their views in writing to the Reserve Bank indicated for that notice or to the offices of the Board of Governors. Comments must be received not later than May 6,
2013.

A. Federal Reserve Bank of Minneapolis (Jacqueline G. King, Community Affairs Officer) 90 Hennepin Avenue, Minneapolis, Minnesota 55480–0291:

1. Thomas W. Armstrong, and BradleyA. Trimner, individually and as CoTrustees of the Arnold J. Stueber, Sr. Revocable Trust, and the Sadie A. Stueber Revocable Trust, and Mary Luethmers, all of Park Falls, Wisconsin, individually, to each retain voting shares of Park Falls Agency, Inc., and thereby indirectly retain voting shares of The First National Bank of Park Falls, both in Park Falls, Wisconsin.

Board of Governors of the Federal Reserve System, April 16, 2013. Margaret McCloskey Shanks, Deputy Secretary of the Board.
[FR Doc. 2013–09220 Filed 4–18–13; 8:45 am]

**BILLING CODE 6210–01–P**

**FEDERAL RESERVE SYSTEM**

**Formations of, Acquisitions by, and Mergers of Bank Holding Companies;**  **Correction**

This notice corrects a notice (FR Doc. 2013–08630) published on pages 21949– 21950 of the issue for Friday, April 12,
2013.

Under the Federal Reserve Bank of St. Louis heading, the entry for Hopfed Bancorp, Inc., Hopkinsville, Kentucky, is revised to read as follows:

A. Federal Reserve Bank of St. Louis (Yvonne Sparks, Community Development Officer) P.O. Box 442, St. Louis, Missouri 63166–2034:

1. Hopfed Bancorp, Inc., Hopkinsville, Kentucky; to become a bank holding company through the conversion of its wholly owned subsidiary, Heritage Bank, Hopkinsville, Kentucky, from a federally chartered savings bank to a state charted commercial bank.

Comments on this application must be received by May 9, 2013. Board of Governors of the Federal Reserve System, April 16, 2013. Margaret McCloskey Shanks, Deputy Secretary of the Board.
[FR Doc. 2013–09219 Filed 4–18–13; 8:45 am]

**BILLING CODE 6210–01–P**

**DEPARTMENT OF HEALTH AND HUMAN SERVICES** 

**Centers for Medicare & Medicaid Services** 

**[Document Identifiers: CMS–10108, CMS– 10268, CMS–10316, and CMS–10478]** 

**Agency Information Collection Activities: Proposed Collection;**  **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) 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: Extension of a currently approved collection; Title of Information Collection: Medicaid Managed Care Regulations; Use: Medicaid enrollees use the information collected and reported to make informed choices regarding health care, including how to access health care services and the grievance and appeal system. States use the information collected and reported as part of its contracting process with managed care entities, as well as its compliance oversight role. The CMS uses the information collected and reported in an oversight role of state Medicaid managed care programs. Form Number: CMS–10108 (OCN: 0938–0920); Frequency: Occasionally; Affected Public: Individuals or households,Private sector (business or other forprofit and not-for-profit institutions), and State, local or Tribal Government; Number of Respondents: 1,640,223; Total Annual Responses: 5,217,333; Total Annual Hours: 5,872,255. (For policy questions regarding this collection contact Amy Gentile at 410– 786–3499. For all other issues call 410– 786–1326.)

2. Type of Information Collection Request: Reinstatement of a currently approved collection; Title of Information Collection: Consolidated Renal Operations in a Web Enabled Network (CROWNWeb) Third-party Submission Authorization Form Use: The Consolidated Renal Operations in a Web Enabled Network (CROWNWeb) Third-Party Submission Authorization (CWTPSA) form is to be completed by ‘‘Facility Administrators’’ (administrators of CMS-certified dialysis facilities) if they intend to authorize a third party (a business with which the facility is associated, or an independent vendor) to submit data to CMS to comply with the recently-revised Conditions for Coverage of dialysis facilities. The CROWNWeb system is the system used as the collection point of data necessary for entitlement of ESRD patients to Medicare benefits and for Federal Government monitoring and assessing of the quality and types of care provided to renal patients. The information collected through the CWTPSA form will allow CMS and its contractors to receive data from authorized parties acting on behalf of CMS-certified dialysis facilities. Since February 2009, CMS has received 4,160 CWTPSA forms and anticipates that they will continue to receive no more than 400 new CWTPSA forms annually to address the creation of new facilities under the current participating ‘‘third party submitters.’’ Form Number: CMS– 10268 (OCN: 0938–1052); Frequency: Occasionally; Affected Public: Private Sector; Business or other for-profits and Not-for-profit institutions; Number of Respondents: 400; Total Annual Responses: 400; Total Annual Hours: 34. (For policy questions regarding this collection contact Michelle Tucker at 410–786–0736. For all other issues call 410–786–1326.)

3. Type of Information Collection Request: Revision of a currently approved collection. Title of Information Collection: Implementation of the Medicare Prescription Drug Plan (PDP) and Medicare Advantage (MA) Plan Disenrollment Reasons Survey. Use: This data collection complements the satisfaction data collected through the Medicare Consumer Assessment of Healthcare Providers and Systems survey by providing dissatisfaction data in the form of reasons for disenrollment


### 23567 Federal Register/ Vol. 78, No. 76 / Friday, April 19, 2013 / Notices

from a Prescription Drug Plan. The data collected in this survey can be used to improve the operation of Medicare Advantage (both MA and MA–PD) contracts and standalone PDPs through the identification of beneficiary disenrollment reasons. Plans can use the information to guide quality improvement efforts. The data can also be used by beneficiaries who need to choose among the different MA and PDP options. To the extent that these data identify areas for improvement at the contract level they can be used to inform CMS contract oversight. Form Number: CMS–10316 (OCN: 0938– 1113). Frequency: Yearly; Affected Public: Individuals or households; Number of Respondents: 88,492; Total Annual Responses: 88,492; Total Annual Hours: 22,887. (For policy questions regarding this collection contact Sai Ma at 410–786–1479. For all other issues call 410–786–1326.)

4. Type of Information Collection Request: New collection (request for a new OMB control number). Title of Information Collection: National Implementation of In-Center Hemodialysis CAHPS Survey. Use: Data collected in the national implementation of the In-center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey will be used for the following purposes: (1) To provide a source of information from which selected measures can be publicly reported to beneficiaries as a decision aid for dialysis facility selection; (2) to aid facilities with their internal quality improvement efforts and external benchmarking with other facilities; (3) to provide CMS with information for monitoring and public reportingpurposes; and (4) to support the endstage renal disease value-based purchasing program. Form Number: CMS–10478 (OCN: 0938–New); Frequency: Semi-annually and once; Affected Public: Individuals or households; Number of Respondents: 165,000; Total Annual Responses: 165,000; Total Annual Hours: 87,750. (For policy questions regarding this collection contact Elizabeth Goldstein at 410–786–6665. 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 June 18, 2013:

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

ll, Room C4–26–05, 7500 Security Boulevard, Baltimore, Maryland 21244–1850.

Dated: April 16, 2013. Martique Jones, Deputy Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2013–09267 Filed 4–18–13; 8:45 am]

**BILLING CODE 4120–01–P**

**DEPARTMENT OF HEALTH AND HUMAN SERVICES** 

**Centers for Medicare & Medicaid Services** 

**[Document Identifiers: CMS–576A]**

**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 of a currently approved collection; Title of Information Collection: Organ Procurement Organization’s (OPOs) Health Insurance Benefits Agreement and Supporting Regulations at 42 CFR 486.301–486.348; Use: The Medicare and Medicaid Programs final conditions for coverage for Organ Procurement Organizations (OPOs) require OPOs to sign agreements with the Center for Medicare and Medicaid Services (CMS) in order to be reimbursed and perform their services. The information provided on this form serves as a basis for continuing the agreements with CMS and the OPOs for participation in the Medicare and Medicaid programs for reimbursement of service. Form Number: CMS–576A (OCN: 0938–0512); Frequency: Occasionally; Affected Public: Private Sector: Business or other for-profit and not-for-profit institutions; Number of Respondents: 58; Total Annual Responses: 58; Total Annual
Hours: 116. (For policy questions regarding this collection contact Melissa Rice at 410–786–3270. 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 May 20, 2013.
OMB, Office of Information and

Regulatory Affairs, Attention: CMS Desk Officer, Fax Number: (202) 395– 6974, Email: OIRA

_submission@omb.eop.gov
Dated: April 16, 2013. Martique Jones, Deputy Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2013–09256 Filed 4–18–13; 8:45 am]

**BILLING CODE 4120–01–P**