[Federal Register Volume 69, Number 26 (Monday, February 9, 2004)]
[Notices]
[Page 5991]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-2705]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-R-308]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

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) (formerly known as the Health Care Financing 
Administration (HCFA)), 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.
    1. Type of Information Collection Request: New Collection; Title of 
Information Collection: Instrument/Tool for Refinement of a Prospective 
Payment System for Patients in Inpatient Psychiatric Hospitals, and 
units: A pilot test; Form No.: CMS-10107 (OMB<greek-i> 0938-NEW); Use: 
This is a request to pilot test an instrument to refine the PPS for 
inpatient psychiatric facilities. This testing will include assessing 
the feasibility of administering this instrument, and testing the 
reliability, validity, time and process of administration.; Frequency: 
Other: Per stay per diem; Affected Public: Business or other for-
profit, Not-for-profit institutions, and State, Local or Tribal 
Government; Number of Respondents: 1,120; Total Annual Responses: 
1,120; Total Annual Hours: 2,464.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: The State 
Children's Health Insurance Program and Supporting Regulations in 42 
CFR 431.636, 457.50, 457.60, 457.70, 457.340, 457.350, 457.431, 
457.440, 457.525, 457.560, 457.570, 457.740, 457.750, 457.810, 457.940, 
457.945, 457.965, 457.985, 457.1005, 457.1015, and 457.1180; Form No.: 
CMS-R-308 (OMB<greek-i> 0938-0841); Use: States are required to submit 
title XXI plans and amendments for approval by the Secretary pursuant 
to section 2102 of the Social Security Act in order to receive funds 
for initiating and expanding health insurance coverage for uninsured 
children. States are also required to submit State expenditure and 
statistical reports, annual reports and State evaluations to the 
Secretary as outlined in title XXI of the Social Security Act and 
furnish assorted notices to recipients; Frequency: Annually; Affected 
Public: State, Local, or Tribal Government; Number of Respondents: 88; 
Total Annual Responses: 12,187,482; Total Annual Hours: 838,714.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS's 
Web Site address at http://cms.hhs.gov/regulations/pra/default.asp, or 
E-mail your request, including your address, phone number, OMB number, 
and CMS document identifier, to <a href="/cdn-cgi/l/email-protection#792918091c0b0e160b1239111a1f18571e160f"><span class="__cf_email__" data-cfemail="f9a998899c8b8e968b92b9919a9f98d79e968f">[email protected]</span></a>, or call the Reports 
Clearance Office on (410) 786-1326. Written comments and 
recommendations for the proposed information collections must be mailed 
within 60 days of this notice directly to the CMS Paperwork Clearance 
Officer designated at the following address: CMS, Office of Strategic 
Operations and Regulatory Affairs, Division of Regulations Development 
and Issuances, Attention: Melissa Musotto, Room C5-14-03, 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850.

    Dated: January 29, 2004.
Melissa Musotto,
Acting, Paperwork Reduction Act Team Leader, Office of Strategic 
Operations and Strategic Affairs, Division of Regulations Development 
and Issuances.
[FR Doc. 04-2705 Filed 2-6-04; 8:45 am]
BILLING CODE 4120-03-P


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