4726 Federal Register / Vol. 79, No. 19 / Wednesday, January 29, 2014 / Notices 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10485, CMS– 

417, CMS–10277, and CMS–10260] 

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: 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 February 28, 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) 395–5806 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 

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: New Collection (Request for a 

new OMB control number); Title of 

Information Collection: Evaluation of 

the Multi-Payer Advanced Primary Care 

Practice (MAPCP) Demonstration: 

Provider Survey; Use: On September 16, 

2009, the Department of Health and 

Human Services announced the 

establishment of the Multi-payer 

Advanced Primary Care Practice 

(MAPCP) Demonstration, under which 

Medicare joined Medicaid and private 

insurers as a payer participant in statesponsored patient-centered medical 

home (PCMH) initiatives. We selected 

eight states to participate in this 

demonstration: Maine, Vermont, Rhode 

Island, New York, Pennsylvania, North 

Carolina, Michigan, and Minnesota. 

We are proposing to conduct this 

provider survey to understand how 

participating practices’ structures and 

functions vary, particularly with respect 

to their adoption of different 

components of the PCMH model of care. 

Researchers evaluating the MAPCP 

Demonstration plan to combine these 

survey data with claims data to conduct 

statistical analyses that identify which 

particular medical home care processes 

are associated with the largest gains in 

health care quality and reductions in 

health care cost trends. Subsequent to 

the publication of the 60-day Federal 

Register notice (78 FR 41931), revisions 

have been made to the survey. There has 

been a slight increase in the annual 

burden hours. Form Number: CMS– 

10485 (OCN: 0938–NEW); Frequency: 

Annually; Affected Public: Individuals 

and households; Number of 

Respondents: 5,799; Total Annual 

Responses: 5,799; Total Annual Hours: 

1,740. (For policy questions regarding 

this collection contact Suzanne Wensky 

at 410–786–0226.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Hospice Request 

for Certification and Supporting 

Regulations; Use: The Hospice Request 

for Certification Form is the 

identification and screening form used 

to initiate the certification process and 

to determine if the provider has 

sufficient personnel to participate in the 

Medicare program. Subsequent to the 

publication of the 60-day Federal 

Register notice (78 FR 65656), minor 

changes were made to the form. Form 

Number: CMS–417 (OCN: 0938–0313); 

Frequency: Annually; Affected Public: 

Private Sector (Business or other forprofits); Number of Respondents: 3,807; 

Total Annual Responses: 3,807; Total 

Annual Hours: 952. (For policy 

questions regarding this collection 

contact Patricia Sevast at 410–786– 

8135). 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Hospice 

Conditions of Participation and 

Supporting Regulations; Use: The 

Conditions of Participation and 

accompanying requirements are used by 

Federal or State surveyors as a basis for 

determining whether a hospice qualifies 

for approval or re-approval under 

Medicare. The healthcare industry and 

CMS believe that the availability to the 

hospice of the type of records and 

general content of records, which the 

final rule (72 FR 32088) specifies, is 

standard medical practice, and is 

necessary in order to ensure the wellbeing and safety of patients and 

professional treatment accountability. 

Form Number: CMS–10277 (OCN: 

0938–1067); Frequency: Reporting and 

Recordkeeping—Yearly; Affected 

Public: Private sector (Business or other 

for-profit and Not-for-profit 

institutions); Number of Respondents: 

3,897; Total Annual Responses: 

1,535,919; Total Annual Hours: 

1,625,440. (For policy questions 

regarding this collection contact 

Danielle Shearer at 410–786–6617.) 

4. Type of Information Collection 

Request: Reinstatement with change of a 


tkelley on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 79, No. 19 / Wednesday, January 29, 2014 / Notices 4727 

previously approved collection; Title of 

Information Collection: Medicare 

Advantage and Prescription Drug 

Program: Final Marketing Provisions; 

Use: We require that Medicare 

Advantage (MA) organizations and Part 

D sponsors use standardized documents 

to satisfy disclosure requirements 

mandated by section 1851(d)(3)(A) of 

the Social Security Act (Act) and 42 

CFR 422.111(b) for MA organizations, 

and section 1860D–1(c) of the Act and 

42 CFR 423.128(a)(3) for Part D 

sponsors. The regulatory provisions 

require that MA organizations and Part 

D sponsors disclose plan information, 

including: Service area, benefits, access, 

grievance and appeals procedures, and 

quality improvement and quality 

assurance requirements by September 

30th of each year. The MA organizations 

and Part D sponsors use the information 

to comply with the disclosure 

requirements. We will use the approved 

standardized documents to ensure that 

correct information is disclosed to 

current and potential enrollees. The 

package has been revised subsequent to 

the publication of the 60-day notice (78 

FR 63208). Form Number: CMS–10260 

(OCN: 0938–1051); Frequency: Yearly; 

Affected Public: Private sector (Business 

or other for-profits); Number of 

Respondents: 770; Total Annual 

Responses: 770; Total Annual Hours: 

9,240. (For policy questions regarding 

this collection contact Timothy Roe at 

410–786–2006.) 

Dated: January 24, 2014. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2014–01775 Filed 1–28–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–3290–PN] 

Medicare and Medicaid Programs: 

Application From the Joint 

Commission for Continued Approval of 

Its Hospital Accreditation Program 

AGENCY: Centers for Medicare and 

Medicaid Services, HHS. 

ACTION: Proposed notice. 

SUMMARY: This proposed notice 

acknowledges the receipt of an 

application from the Joint Commission 

for continued recognition as a national 

accrediting organization for hospitals 

that wish to participate in the Medicare 

or Medicaid programs. Section 

1865(b)(3)(A) of the Social Security Act 

(the Act) requires that within 60 days of 

receipt of an organization’s complete 

application, CMS publish a notice that 

identifies the national accrediting body 

making the request, describes the nature 

of the request, and provides at least a 

30-day public comment period. 

DATES: To be assured consideration, 

comments must be received at one of 

the addresses provided below, no later 

than 5 p.m. on February 28, 2014. 

ADDRESSES: In commenting, please refer 

to file code CMS–3290–PN. Because of 

staff and resource limitations, we cannot 

accept comments by facsimile (FAX) 

transmission. 

You may submit comments in one of 

four ways (please choose only one of the 

ways listed): 

1. Electronically. You may submit 

electronic comments on specific issues 

in this regulation to http://

www.regulations.gov. Follow the 

‘‘Submit a comment’’ instructions. 

2. By regular mail. You may mail 

written comments (one original and two 

copies) to the following address ONLY: 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, Attention: CMS–3290– 

PN, P.O. Box 8016, Baltimore, MD 

21244–8010. 

Please allow sufficient time for mailed 

comments to be received before the 

close of the comment period. 

3. By express or overnight mail. You 

may send written comments to the 

following address ONLY: 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, Attention: CMS–3290– 

PN, Mail Stop C4–26–05, 7500 Security 

Boulevard, Baltimore, MD 21244–1850. 

4. By hand or courier. Alternatively, 

you may deliver (by hand or courier) 

your written comments to the following 

addresses: 

a. For delivery in Washington, DC— 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, Room 445–G, Hubert 

H. Humphrey Building, 200 

Independence Avenue SW., 

Washington, DC 20201 

(Because access to the interior of the 

Hubert H. Humphrey Building is not 

readily available to persons without 

Federal government identification, 

commenters are encouraged to leave 

their comments in the CMS drop slots 

located in the main lobby of the 

building. A stamp-in clock is available 

for persons wishing to retain a proof of 

filing by stamping in and retaining an 

extra copy of the comments being filed.) 

b. For delivery in Baltimore, MD— 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, 7500 Security 

Boulevard, Baltimore, MD 21244–1850. 

If you intend to deliver your 

comments to the Baltimore address, call 

telephone number (410) 786–7195 in 

advance to schedule your arrival with 

one of our staff members. 

Comments erroneously mailed to the 

addresses indicated as appropriate for 

hand or courier delivery may be delayed 

and received after the comment period. 

For information on viewing public 

comments, see the beginning of the 

SUPPLEMENTARY INFORMATION section. 

FOR FURTHER INFORMATION CONTACT: 

Monda Shaver, (410) 786–3410, Cindy 

Melanson, (410) 786–0310, or Patricia 

Chmielewski, (410) 786–6899. 

SUPPLEMENTARY INFORMATION: Inspection 

of Public Comments: All comments 

received before the close of the 

comment period are available for 

viewing by the public, including any 

personally identifiable or confidential 

business information that is included in 

a comment. We post all comments 

received before the close of the 

comment period on the following Web 

site as soon as possible after they have 

been received: http://

www.regulations.gov. Follow the search 

instructions on that Web site to view 

public comments. 

Comments received timely will also 

be available for public inspection as 

they are received, generally beginning 

approximately 3 weeks after publication 

of a document, at the headquarters of 

the Centers for Medicare & Medicaid 

Services, 7500 Security Boulevard, 

Baltimore, Maryland 21244, Monday 

through Friday of each week from 8:30 

a.m. to 4 p.m. To schedule an 

appointment to view public comments, 

phone 1–800–743–3951. 

I. Background 

Under the Medicare program, eligible 

beneficiaries may receive covered 

services from a hospital provided 

certain requirements are met. Sections 

1861(e) of the Social Security Act (the 

Act), establish distinct criteria for 

facilities seeking designation as a 

hospital. Regulations concerning 

provider agreements are at 42 CFR part 

489 and those pertaining to activities 

relating to the survey and certification 

of facilities are at 42 CFR part 488. The 

regulations at 42 CFR part 482 specify 

the minimum conditions that a hospital 

must meet to participate in the Medicare 

program. 

Generally, to enter into an agreement, 

a hospital must first be certified by a 

state survey agency as complying with 


tkelley on DSK3SPTVN1PROD with NOTICES