73546 Federal Register / Vol. 78, No. 235 / Friday, December 6, 2013 / Notices 

CMS–10346 Appeals of Quality Bonus 

Payment Determinations 

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: Extension of a currently 

approved collection; Title of 

Information Collection: Application for 

Hospital Insurance and Supporting 

Regulations; Use: Regulations at 42 CFR 

406.6 specifies the individuals who 

must file an application for Medicare 

Hospital Insurance (Part A) and those 

who need not file an application for Part 

A. Section 406.7 lists CMS–18F5 as the 

application form. The form elicits 

information that the Social Security 

Administration and CMS need to 

determine entitlement to Part A and 

Supplementary Medical Insurance (Part 

B); Form Number: CMS–18F5 (OCN: 

0938–0251); Frequency: Once; Affected 

Public: Individuals or households; 

Number of Respondents: 50,000; Total 

Annual Responses: 50,000; Total 

Annual Hours: 12,500. (For policy 

questions regarding this collection 

contact Naomi Rappaport at 410–786– 

2175). 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: 1932(a) State 

Plan Amendment Template, State Plan 

Requirements, and Supporting 

Regulations; Use: Section 1932(a)(1)(A) 

of the Social Security Act (the Act) 

grants states the authority to enroll 

Medicaid beneficiaries on a mandatory 

basis into managed care entities 

(managed care organization (MCOs) and 

primary care case managers (PCCMs)). 

Under this authority, a state can amend 

its Medicaid state plan to require certain 

categories of Medicaid beneficiaries to 

enroll in managed care entities without 

being out of compliance with provisions 

of section 1902 of the Act on 

statewideness (42 CFR 431.50), freedom 

of choice (42 CFR 431.51) or 

comparability (42 CFR 440.230). The 

template may be used by states to easily 

modify their state plans if they choose 

to implement the provisions of section 

1932(a)(1)(A); Form Number: CMS– 

10120 (OCN: 0938–0933); Frequency: 

Once and occasionally; Affected Public: 

State, Local, or Tribal Governments; 

Number of Respondents: 56; Total 

Annual Responses: 15; Total Annual 

Hours: 65. (For policy questions 

regarding this collection contact Camille 

Dobson at 410–786–7062). 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Appeals of 

Quality Bonus Payment Determinations; 

Use: The information collected from 

Medicare Advantage organizations is 

considered by the reconsideration 

official and potentially the hearing 

officer to review our determination of 

the organization’s eligibility for a 

quality bonus payment. Form Number: 

CMS–10346 (OCN: 0938–1129; 

Frequency: Yearly; Affected Public: 

Private sector—Business or other forprofits; Number of Respondents: 350; 

Total Annual Responses: 25; Total 

Annual Hours: 200. (For policy 

questions regarding this collection 

contact Sarah Gaillot at 410–786–4637). 

Dated: December 3, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–29144 Filed 12–5–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–416, CMS–R– 

26 and CMS–10487] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

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 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 on the collection(s) of 

information must be received by the 

OMB desk officer by January 6, 2014. 

ADDRESSES: When commenting on the 

proposed information collections, 

please reference the document identifier 

or OMB control number. To be assured 

consideration, comments and 

recommendations must be received by 

the OMB desk officer via one of the 

following transmissions: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–6974 OR, Email: 

OIRA_submission@omb.eop.gov. 

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: 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 


emcdonald on DSK67QTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 235 / Friday, December 6, 2013 / Notices 73547 

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: Annual Early 

and Periodic Screening, Diagnostic and 

Treatment (EPSDT) Participation 

Report; Use: The baseline data collected 

is used to assess the effectiveness of 

state early and periodic screening, 

diagnostic and treatment (EPSDT) 

programs in reaching eligible children, 

by age group and basis of Medicaid 

eligibility, who are provided initial and 

periodic child health screening services, 

referred for corrective treatment, and 

receiving dental, hearing, and vision 

services. This assessment is coupled 

with the state’s results in attaining the 

participation goals set for the state. The 

information gathered from this report, 

permits federal and state managers to 

evaluate the effectiveness of the EPSDT 

law on the basic aspects of the program. 

The associated 30-day PRA package has 

been revised subsequent to the 

publication of the 60-day notice (78 FR 

48687). Form Number: CMS–416 (OCN: 

0938–0354); Frequency: Yearly; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

56; Total Annual Responses: 56; Total 

Annual Hours: 1,568. (For policy 

questions regarding this collection 

contact Marsha Lillie-Blanton at 410– 

786–8856.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Clinical 

Laboratory Improvement Amendments 

(CLIA) Regulations; Use: The 

information is necessary to determine 

an entity’s compliance with the 

Congressionally-mandated program 

with respect to the regulation of 

laboratory testing (CLIA). In addition, 

laboratories participating in the 

Medicare program must comply with 

CLIA requirements as required by 

section 6141 of OBRA 89. Medicaid, 

under the authority of section 

1902(a)(9)(C) of the Social Security Act, 

pays for services furnished only by 

laboratories that meet Medicare (CLIA) 

requirements. Form Number: CMS–R– 

26 (OCN: 0938–0612); Frequency: 

Monthly, occasionally; Affected Public: 

Private sector—Business or other forprofits and Not-for-profit institutions, 

State, Local or Tribal Governments, and 

the Federal government; Number of 

Respondents: 79,175; Total Annual 

Responses: 88,886,364; Total Annual 

Hours: 15,613,299. (For policy questions 

regarding this collection contact Raelene 

Perfetto at 410–786–6876). 

3. Type of Information Collection 

Request: New Collection (Request for a 

new OMB control number); Title of 

Information Collection: Medicaid 

Emergency Psychiatric Demonstration 

(MEPD) Evaluation; Use: Since the 

inception of Medicaid, inpatient care 

provided to adults ages 21 to 64 in 

institutions for mental disease (IMDs) 

has been excluded from federal 

matching funds. The Emergency 

Medical Treatment and Active Labor 

Act (EMTALA), however, requires IMDs 

that participate in Medicare to provide 

treatment for psychiatric emergency 

medical conditions (EMCs), even for 

Medicaid patients for whose services 

cannot be reimbursed. Section 2707 of 

the Affordable Care Act (ACA) directs 

the Secretary of Health and Human 

Services to conduct and evaluate a 

demonstration project to determine the 

impact of providing payment under 

Medicaid for inpatient services 

provided by private IMDs to individuals 

with emergency psychiatric conditions 

between the ages of 21 and 64. We will 

use the data to evaluate the Medicaid 

Emergency Psychiatric Demonstration 

(MEPD) in accordance with the ACA 

mandates. This evaluation in turn will 

be used by Congress to determine 

whether to continue or expand the 

demonstration. If the decision is made 

to expand the demonstration, the data 

collected will help to inform us as well 

as our stakeholders about possible 

effects of contextual factors and 

important procedural issues to consider 

in the expansion, as well as the 

likelihood of various outcomes. 

Subsequent to publication of the 60-day 

Federal Register notice (78 FR 45205), 

there was an increase in the burden due 

to an increase in time assessed for 

reviewing medical records and the need 

to obtain additional informed consents 

for beneficiary interviews. There have 

also been changes made to the ‘‘Key 

Informant Interview Questions’’ for 

clarification purposes. Form Number: 

CMS–10487 (OCN: 0938–NEW); 

Frequency: Annually; Affected Public: 

Individuals and households; State, 

Local and Tribal governments; Private 

sector—Business and other for-profits 

and Not-for-profits; Number of 

Respondents: 98; Total Annual 

Responses: 2,754; Total Annual Hours: 

2,613. (For policy questions regarding 

this collection contact Negussie Tilahun 

at 410–786–2058.) 

Dated: December 3, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–29143 Filed 12–5–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–1463–N] 

Medicare Program; Semi-Annual 

Meeting of the Advisory Panel on 

Hospital Outpatient Payment (HOP 

Panel) March 10–11, 2014 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human Services (HHS). 

ACTION: Notice. 

SUMMARY: This notice announces the 

first semi-annual meeting of the 

Advisory Panel on Hospital Outpatient 

Payment (the Panel) for 2014. The 

purpose of the Panel is to advise the 

Secretary of the Department of Health 

and Human Services (the Secretary) and 

the Administrator of the Centers for 

Medicare & Medicaid Services (the 

Administrator) on the clinical integrity 

of the Ambulatory Payment 

Classification (APC) groups and their 

associated weights, and hospital 

outpatient therapeutic services 

supervision issues. 

DATES: Meeting Dates: The first semiannual meeting in 2014 is scheduled for 

the following dates and times. The times 

listed in this notice are Eastern Standard 

Time (EST) and are approximate times; 

consequently, the meetings may last 

longer than the times listed in this 

notice, but will not begin before the 

posted times: 

• Monday, March 10, 2014, 1 p.m. to 5 

p.m. EST 

• Tuesday, March 11, 2014, 9 a.m. to 5 

p.m. EST 

Meeting Information Updates: 

The actual meeting hours and days 

will be posted in the agenda. As 

information and updates regarding the 

onsite and webcasted meeting and 

agenda become available, they will be 

posted to the CMS Web site at: http:// 

cms.gov/Regulations-and-Guidance/

Guidance/FACA/AdvisoryPanel

onAmbulatoryPaymentClassification

Groups.html. 


emcdonald on DSK67QTVN1PROD with NOTICES