[Federal Register Volume 85, Number 234 (Friday, December 4, 2020)]
[Notices]
[Pages 78333-78334]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-26756]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-18F5]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, Health and Human 
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 the necessity and utility of the 
proposed information collection for the proper performance of the 
agency's functions, the accuracy of the estimated burden, ways to 
enhance the quality, utility, and clarity of the information to be 
collected, and 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 2, 2021.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number. 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, 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' website address at website address at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
    2. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: William N. Parham at (410) 786-4669.

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-18F5 Application for Enrollment in Medicare Part A internet 
Claim (iClaim) Application Screen Modernized Claims System and 
Consolidated Claim Experience Screens.
    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 Collection

    1. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Application for 
Enrollment in Medicare Part A internet Claim (iClaim) Application 
Screen Modernized Claims System and Consolidated Claim Experience 
Screens; Use: Individuals who are already entitled to retirement or 
disability benefits under Social Security or Railroad Retirement Board 
(RRB) benefits are automatically entitled to premium-free Medicare 
Hospital Insurance (Part A) when they attain age

[[Page 78334]]

65 or reach the 25th month of disability benefit entitlement. These 
individuals do not file a separate application for Medicare Part A 
because their application for Social Security or RRB benefits is also 
an application for Part A. The form is for individuals who are not 
eligible for Social Security for RRB benefits, but may qualify for 
premium-free Medicare Part A based on certain requirements outlined in 
Sec.  406.11 and 406.15 or for certain disabled individuals who may 
enroll in premium Medicare Part A based on certain requirements 
outlined in Sec.  406.20. Individuals may also choose to enroll in 
Medicare Part B at the same time they apply for Medicare Part A.
    The Application for Enrollment in Medicare Part A (CMS-18F5 and 
CMS-18F5-SP) was designed to capture all the information needed to make 
a determination of an individual's entitlement to Part A. This 
Information Collection Request (ICR) adds the collection instruments 
SSA uses to collect information from individuals who are filing an 
Application for Hospital Insurance, updates the burden information. CMS 
will begin reporting for additional collection instruments, including 
the internet Claim System (iClaim), Modernized Claims System (MCS), and 
the Consolidated Claims Experience (CCE). Form Number: CMS-18F5 (OMB 
control number: 0938-0251); Frequency: Annually; Affected Public: 
State, Local, or Tribal Governments; Number of Respondents: 1,394,264; 
Total Annual Responses: 1,394,264; Total Annual Hours: 348,566. (For 
policy questions regarding this collection contact Carla Patterson at 
410-786-1000.)

    Dated: December 1, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2020-26756 Filed 12-3-20; 8:45 am]
BILLING CODE 4120-01-P