83966 Federal Register / Vol. 85, No. 247 / Wednesday, December 23, 2020 / Notices 

including cases involving, Oak Ridge 

Gaseous Diffusion Plant (K25), Y–12 

Plant, and Savannah River Site (SRS) 

facilities; Dose reconstruction cases 

under review from Sets 18 and 21, 

possibly including cases involving, 

Uranium Mill in Monticello and GE 

Vallecitos; and Tracking of decision 

points requiring professional judgement 

(time permitting). Agenda items are 

subject to change as priorities dictate. 

The Director, Strategic Business 

Initiatives Unit, Office of the Chief 

Operating Officer, Centers for Disease 

Control and Prevention, 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. 

Kalwant Smagh, 

Director, Strategic Business Initiatives Unit, 

Office of the Chief Operating Officer, Centers 

for Disease Control and Prevention. 

[FR Doc. 2020–28379 Filed 12–22–20; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–40B, CMS–R– 

285, CMS–10142 and CMS–10123/10124] 

Agency Information Collection 

Activities: Submission for OMB 

Review; 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 

(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 

a second opportunity for public 

comment on the notice. Interested 

persons are invited to send comments 

regarding the burden estimate 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 on the collection(s) of 

information must be received by the 

OMB desk officer by January 22, 2021. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. 

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/PRAListing.html. 

2. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

William Parham at (410) 786–4669. 

SUPPLEMENTARY INFORMATION: Under the 

Paperwork Reduction Act of 1995 (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 (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-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 that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Application for 

Enrollment in Medicare the Medical 

Insurance Program; Use: Section 1836 of 

the Act, and regulations at 42 CFR 

407.10, provide the eligibility 

requirements for enrollment in Part B. 

Section 407.11 lists the CMS–40B as the 

application to be used by individuals 

who wish to apply for Part B if they 

already have initial entitlement to 

premium-free Part A. Under the 

regulations, individuals may also enroll 

in Medicare Part B by signing a 

statement requesting Part B, if eligible 

for enrollment at that time. Individuals 

use the standardized Form CMS–40B to 

request enrollment. 

The CMS–40B provides the necessary 

information to determine eligibility and 

to process the beneficiary’s request for 

enrollment for Medicare Part B 

coverage. This form is only used for 

enrollment by beneficiaries who already 

have Part A, but not Part B. Form CMS– 

40B is completed by the person with 

Medicare or occasionally by an SSA 

representative using information 

provided by the Medicare enrollee 

during an in-person interview. The form 

is owned by CMS, but not completed by 

CMS staff. SSA processes Medicare 

enrollments on behalf of CMS. Form 

Number: CMS–40B (OMB control 

number: 0938–1230); Frequency: Yearly; 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

400,000; Total Annual Responses: 

400,000; Total Annual Hours: 100,000. 

(For policy questions regarding this 

collection contact Carla Patterson at 

410–786–1000.) 

2. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Request for 

Retirement Benefit Information; Use: 

Section 1818(d)(5) of the Social Security 

Act (the Act) provides that certain 

former State and local government 

employees (and their current or former 

spouses) may have the Part A premium 

reduced to zero. 

Form CMS–R–285, ‘‘Request for 

Retirement Benefit Information,’’ is used 

to obtain information regarding whether 

a beneficiary currently purchasing 

Medicare premium Part A coverage, is 

receiving retirement payments based on 

State or local government employment, 

how long the claimant worked for the 

State or local government employer, and 

whether the former employer or pension 

plan is subsidizing the individual’s Part 

A premium. 

Form CMS–R–285 provides the 

necessary information regarding the 

prior state or local government 

employment to process the individual’s 

request for premium Part A reduction 

based on their employment by a state or 

local government. 

The form is completed by the state or 

local government employer on behalf of 

the individual seeking the Medicare 

premium reduction. The SSA—CMS’ 


jbell on DSKJLSW7X2PROD with NOTICES
Federal Register / Vol. 85, No. 247 / Wednesday, December 23, 2020 / Notices 83967 

agent for processing Medicare 

enrollments and premium amount 

determinations will use this information 

to help determine whether a beneficiary 

meets the requirements for reduction of 

the Part A premium. The form is owned 

by CMS but not completed by CMS staff. 

Form Number: CMS–R–285 (OMB 

control number: 0938–0769); Frequency: 

Yearly; Affected Public: State, Local, or 

Tribal Governments; Number of 

Respondents: 500; Total Annual 

Responses: 500; Total Annual Hours: 

125. (For policy questions regarding this 

collection contact Carla Patterson at 

410–786–1000.) 

3. Type of Information Collection 

Request: Revision with change of a 

currently approved collection; Title of 

Information Collection: Bid Pricing Tool 

(BPT) for Medicare Advantage (MA) 

Plans and Prescription Drug Plans 

(PDP); Use: This collection dates back to 

2005. Under the Medicare Prescription 

Drug, Improvement, and Modernization 

Act of 2003 (MMA), and implementing 

regulations at 42 CFR, Medicare 

Advantage organizations (MAO) and 

Prescription Drug Plans (PDP) are 

required to submit an actuarial pricing 

‘‘bid’’ for each plan offered to Medicare 

beneficiaries for approval by the Centers 

for Medicare & Medicaid Services 

(CMS). MAOs and PDPs use the Bid 

Pricing Tool (BPT) software to develop 

their actuarial pricing bid. The 

competitive bidding process defined by 

the ‘‘The Medicare Prescription Drug, 

Improvement, and Modernization Act’’ 

(MMA) applies to both the MA and Part 

D programs. It is an annual process that 

encompasses the release of the MA rate 

book in April, the bid’s that plans 

submit to CMS in June, and the release 

of the Part D and RPPO benchmarks, 

which typically occurs in August. Form 

Number: CMS–10142 (OMB control 

number: 0938–0944); Frequency: Yearly; 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

555; Total Annual Responses: 4,995; 

Total Annual Hours: 149,850. (For 

policy questions regarding this 

collection contact Rachel Shevland at 

410–786–3026.) 

4. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Fast Track 

Appeals Notices: NOMNC/DENC; Use: 

The purpose of the NOMNC is to help 

a beneficiary/enrollee decide whether to 

pursue a fast appeal by a Quality 

Improvement Organization (QIO) and 

how to file that request. Consistent with 

§§ 405.1200 and 422.624, SNFs, HHAs, 

CORFs, and hospices must provide 

notice to all beneficiaries/enrollees 

whose Medicare-covered services are 

ending, no later than two days in 

advance of the proposed termination of 

service. This information is conveyed to 

the beneficiary/enrollee via the 

NOMNC. 

If a beneficiary/enrollee appeals the 

termination decision, the beneficiary/ 

enrollee and the QIO, consistent with 

§§ 405.1200(b) and 405.1202(f) for 

Original Medicare, and §§ 422.624(b) 

and 422.626(e)(1)–(5) for Medicare 

health plans, will receive a detailed 

explanation of the reasons services 

should end. This detailed explanation is 

provided to the beneficiary/enrollee 

using the DENC, the second notice 

included in this renewal package. Form 

Number: CMS–10123/10124 (OMB 

control number: 0938–0953); Frequency: 

Yearly; Affected Public: State, Local, or 

Tribal Governments; Number of 

Respondents: 24,915; Total Annual 

Responses: 5,314,194; Total Annual 

Hours: 1,142,749. (For policy questions 

regarding this collection contact Janet 

Miller at Janet.Miller@cms.hhs.gov.) 

Dated: December 18, 2020. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2020–28369 Filed 12–22–20; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10549] 

Agency Information Collection 

Activities: Submission for OMB 

Review; 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 

(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 

a second opportunity for public 

comment on the notice. Interested 

persons are invited to send comments 

regarding the burden estimate 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 on the collection(s) of 

information must be received by the 

OMB desk officer by January 22, 2021. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. 

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 

https://www.cms.gov/Regulations-andGuidance/Legislation/ 

PaperworkReductionActof1995/PRAListing.html 

2. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

William Parham at (410) 786–4669. 

SUPPLEMENTARY INFORMATION: Under the 

Paperwork Reduction Act of 1995 (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 (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-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 that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Generic 

Clearance: Questionnaire Testing and 


jbell on DSKJLSW7X2PROD with NOTICES