Federal Register / Vol. 78, No. 245 / Friday, December 20, 2013 / Notices 77135 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10239 and 

CMS–10496] 

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 

February 18, 2014. 

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–10239 Conditions of 

Participation for Critical Access 

Hospitals (CAH) and Supporting 

Regulations; CMS–10496 State Health 

Insurance Exchange Incident Report 

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 Collections 

1. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Conditions of 

Participation for Critical Access 

Hospitals (CAH) and Supporting 

Regulations; Use: At the outset of the 

CAH program, the information 

collection requirements for all CAHs 

were addressed together under CMS– 

R–48 (OCN: 0938–0328). As the CAH 

program has grown in scope of services 

and the number of providers, the burden 

associated with CAHs with distinct part 

units (DPUs) was separated from the 

CAHs without DPUs. Section 

1820(c)(2)(E)(i) of the Social Security 

Act provides that a CAH may establish 

and operate a psychiatric or 

rehabilitation DPU. Each DPU may 

maintain up to10 beds and must comply 

with the hospital requirements specified 

in 42 CFR Subparts A, B, C, and D of 

part 482. Presently, 105 CAHs have 

rehabilitation or psychiatric DPUs. The 

burden associated with CAHs that have 

DPUs continues to be reported under 

CMS–R–48, along with the burden for 

all 4,890 accredited and non-accredited 

hospitals. Form Number: CMS–10239 

(OCN: 0938–1043); Frequency: Yearly; 

Affected Public: Private sector— 

Business or other for-profit; Number of 

Respondents: 1,233; Total Annual 

Responses: 152,942; Total Annual 

Hours: 24,723. (For policy questions 

regarding this collection contact Sarah 

Fahrendorf at 410–786–3112.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: State Health 

Insurance Exchange Incident Report; 

Use: We have implemented a Computer 

Matching Agreement (CMA) with the 

State-Based Administering Entities 

(AEs). This agreement establishes the 

terms, conditions, safeguards, and 

procedures under which we will 

disclose certain information to the AEs 

in accordance with the Patient 

Protection and Affordable Care Act of 

2010 (Pub. L. 111–148), as amended by 

the Health Care and Education 

Reconciliation Act (Pub. L. 111–152), 

which are referred to collectively as the 

Affordable Care Act (ACA), 

amendments to the Social Security Act 

made by the ACA, and the 

implementing regulations. The AEs, 

which are state entities administering 

Insurance Affordability Programs, will 

use the data, accessed through the CMS 

Data Services Hub (Hub), to make 

Eligibility Determinations for Insurance 

Affordability Programs and certificates 

of exemption. 

The AEs shall report suspected or 

confirmed incidents affecting loss or 

suspected loss of PII within one hour of 

discovery to their designated Center for 

Consumer Information and Insurance 

Oversight State Officer who will then 

notify the affected Federal agency data 

sources, i.e., Internal Revenue Service, 

Department of Defense, Department of 

Homeland Security, Social Security 

Administration, Peace Corps, Office of 


emcdonald on DSK4SPTVN1PROD with NOTICES
77136 Federal Register / Vol. 78, No. 245 / Friday, December 20, 2013 / Notices 

Personnel Management and Veterans 

Health Administration. Additionally, 

AEs shall contact the office of the 

appropriate Special Agent-in-Charge, 

Treasury Inspector General for Tax 

Administration (TIGTA), and the IRS 

Office of Safeguards within 24 hours of 

discovery of any potential breach, loss, 

or misuse of Return Information. Form 

Number: CMS–10496 (OCN: 0938– 

1216); Frequency: Occasionally; 

Affected Public: State, Local or Tribal 

governments; Number of Respondents: 

18; Total Annual Responses: 936; Total 

Annual Hours: 234. (For policy 

questions regarding this collection 

contact Theodora Wills at 410–786– 

1504.) 

Dated: December 17, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–30337 Filed 12–19–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Proposed Collection: Public 

Comment Request 

AGENCY: Health Resources and Services 

Administration, HHS. 

ACTION: Notice. 

SUMMARY: In compliance with the 

requirement for opportunity for public 

comment on proposed data collection 

projects (Section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995), the 

Health Resources and Services 

Administration (HRSA) announces 

plans to submit an Information 

Collection Request (ICR), described 

below, to the Office of Management and 

Budget (OMB). Prior to submitting the 

ICR to OMB, HRSA seeks comments 

from the public regarding the burden 

estimate, below, or any other aspect of 

the ICR. 

DATES: Comments on this Information 

Collection Request must be received 

within 60 days of this notice. 

ADDRESSES: Submit your comments to 

paperwork@hrsa.gov or mail the HRSA 

Information Collection Clearance 

Officer, Room 10–29, Parklawn 

Building, 5600 Fishers Lane, Rockville, 

MD 20857. 

FOR FURTHER INFORMATION CONTACT: To 

request more information on the 

proposed project or to obtain a copy of 

the data collection plans and draft 

instruments, email paperwork@hrsa.gov 

or call the HRSA Information Collection 

Clearance Officer at (301) 443–1984. 

SUPPLEMENTARY INFORMATION: When 

submitting comments or requesting 

information, please include the 

information request collection title for 

reference. 

Information Collection Request Title: 

NURSE Corps Loan Repayment Program 

OMB No. 0915–0140—Revision 

Abstract: The NURSE Corps Loan 

Repayment Program (NURSE Corps 

LRP), formerly known as the Nursing 

Education Loan Repayment Program 

(NELRP), assists in the recruitment and 

retention of professional Registered 

Nurses (RNs), including advanced 

practice RNs (i.e., nurse practitioners, 

certified registered nurse anesthetists, 

certified nurse-midwives, clinical nurse 

specialists), dedicated to working at 

eligible health care facilities with a 

critical shortage of nurses (i.e., a Critical 

Shortage Facility) or working as nurse 

faculty in eligible, accredited schools of 

nursing, by decreasing the financial 

barriers associated with pursuing a 

nursing profession. The NURSE Corps 

LRP provides loan repayment assistance 

to these nurses to repay a portion of 

their qualifying educational loans in 

exchange for full-time service at a 

public or private nonprofit Critical 

Shortage Facility or in an eligible, 

accredited school of nursing. 

Need and Proposed Use of the 

Information: The need and purpose of 

this information collection is to obtain 

information for NURSE Corps LRP 

applicants and participants. The 

information is used to consider an 

applicant for a NURSE Corps LRP 

contract award and to monitor a 

participant’s compliance with the 

service requirements. Individuals must 

submit an application in order to 

participate in the program. The 

application asks for personal, 

professional, educational, and financial 

information required to determine the 

applicant’s eligibility to participate in 

the NURSE Corps LRP. The semi-annual 

employment verification form asks for 

personal and employment information 

to determine if a participant is in 

compliance with the service 

requirements. 

Likely Respondents: Professional RNs 

or advanced practice RNs (i.e., nurse 

practitioners, certified registered nurse 

anesthetists, certified nurse-midwives, 

clinical nurse specialists) who are 

interested in participating in the NURSE 

Corps LRP, and official representatives 

at their service sites. 

Burden Statement: Burden in this 

context means the time expended by 

persons to generate, maintain, retain, 

disclose or provide the information 

requested. This includes the time 

needed to review instructions; to 

develop, acquire, install and utilize 

technology and systems for the purpose 

of collecting, validating and verifying 

information, processing and 

maintaining information, and disclosing 

and providing information; to train 

personnel and to be able to respond to 

a collection of information; to search 

data sources; to complete and review 

the collection of information; and to 

transmit or otherwise disclose the 

information. The total annual burden 

hours estimated for this Information 

Collection Request are summarized in 

the table below. 

Total Estimated Annualized Burden 

Hours: 

The estimates of reporting burden for 

applicants are as follows: 

Instrument Number of 

respondents 

Responses/ 

respondents 

Total 

responses 

Hours per 

response 

Total burden 

hours 

NURSE Corps LRP Application * ....................................... 5,500 1 5,500 2 .0 11,000 

Authorization to Release Information Form ....................... 5,500 1 5,500 .10 550 

Authorization to Release Employment Information ........... 5,500 1 5,500 .10 550 

Total ............................................................................ 5,500 1 16,500 .733 12,100 

*Please note that the burden hours associated with this instrument account for both new and continuation applications. Additional (uploaded) 

supporting documentation is included as part of this instrument and reflected in the burden hours. 


emcdonald on DSK4SPTVN1PROD with NOTICES