### 20323 Federal Register/ Vol. 78, No. 65 / Thursday, April 4, 2013 / Notices

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.

Dated: March 29, 2013. Martique Jones, Deputy Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs.

[FR Doc. 2013–07798 Filed 4–3–13; 8:45 am]

**BILLING CODE 4120–01–P**

**DEPARTMENT OF HEALTH AND HUMAN SERVICES** 

**Centers for Medicare & Medicaid Services** 

**[Document Identifiers: CMS–10309, CMS– 10475, CMS–R–5, CMS–R–234, and CMS–**  **R–297]**

**Agency Information Collection Activities: Proposed Collection;**  **Comment Request**

**AGENCY :**  Centers for Medicare & 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 & Medicaid Services (CMS) 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: Reinstatement with change of a previously approved collection. Title of Information Collection: Grandfathering Provisions of the Medicare DMEPOS Competitive Bidding Program. Use: Section 1847(a)(4) of the Social Security Act (the Act) requires that (in the case of covered durable medical equipment (DME) items for which payment is made on a rental basis under section 1834(a) of the Act and in the case of oxygen for which payment is made under section 1834(a)(5) of the Act) the Secretary shall establish a grandfathering process by which covered items and supplies that were rented by suppliers before the implementation of a competitive bidding program may be continued.

We established the grandfathering process in the April 10, 2007 final rule for competitive bidding (72 FR 17992) for rented DME and oxygen and oxygen equipment when these items are included under the Medicare DMEPOS Competitive Bidding Program. This process only applies to suppliers that rented DME and oxygen and oxygen equipment to beneficiaries who maintain a permanent residence in a competitive bidding area (CBA) before the implementation of the competitive bidding program.

The competitive bidding program will require some beneficiaries to change their suppliers. In order to avoid a beneficiary being without medically necessary equipment we felt it necessary to establish this notification

process.

The notification to the beneficiaries is a beneficiary protection that will keep them informed of whether or not they can continue to rent an item from their current supplier or go to a contract supplier. The notification will also provide information to the beneficiary as to how to find a contract supplier in their CBA. In the event that the beneficiary must go to a contract supplier, the notification will identify the procedure for the pick-up of their current equipment and delivery of new equipment.

Form Number: CMS–10309 (OCN 0938–1079). Frequency: Once. Affected Public: Private sector (business or other for-profits). Number of Respondents: 2,697 (or 8,091/3). Total Annual Responses: 536,667 (or 1,610,000/3). Total Annual Hours: 65 (or 196/3). (For policy questions regarding this collection contact Michael Keane at 410–786–4495. For all other issues call 410–786–1326.)

2. Type of Information Collection Request: New collection (request for a new OMB control number). Title of Information Collection: Hospice Experience of Care Survey. Use: This survey supports the National Quality Strategy that was called for under the Affordable Care Act to create national aims and priorities to guide local, state, and national efforts to improve the quality of health care. This strategy has established six priorities that support a three-part aim focusing on better care, better health, and lower costs through improvement. Because the hospice survey focuses on experiences of care, implementation of the survey supports the following national priorities for improving care: engaging patients and families in care and promoting effective communication and coordination. In addition, upon national implementation and public reporting of hospice survey results, the survey will provide data on experiences with hospice care that enable consumers to make meaningful comparisons between hospices across the nation. Form Number: CMS–10475 (OCN 0938–New). Frequency: Once. Affected Public: Individuals and households. Number of Respondents:

730. Total Annual Responses: 730. Total Annual Hours: 185. (For policy questions regarding this collection contact Lori Teichman at 410–786– 6684. For all other issues call 410–786– 1326.)

3. Type of Information Collection Request: Reinstatement without change of a previously approved collection. Title of Information Collection: Physician Certification/Recertification in Skilled Nursing Facilities (SNFs) Manual Instructions and Supporting Regulation in 42 CFR 424.20. Use: The Medicare program requires, as a condition for Medicare Part A payment for posthospital SNF services that a physician must certify and periodically recertify that a beneficiary requires an SNF level of care. The physician certification and recertification is intended to ensure that the beneficiary’s need for services has been established and then reviewed and updated at appropriate intervals. The documentation is a condition forMedicare Part A payment for posthospital SNF care. Form Number: CMS– R–5 (OCN 0938–0454). Frequency: Occasionally. Affected Public: Private sector (business or other for-profit and not-for-profit institutions). Number of Respondents: 1,796,502. Total Annual Responses: 1,796,502. Total Annual
Hours: 559,713. (For policy questions regarding this collection contact Kia Sidbury at 410–786–7816. For all other issues call 410–786–1326.)

4. Type of Information Collection Request: Extension without change of a currently approved collection. Title of Information Collection: Subpart D— Private Contracts and Supporting Regulations contained in 42 CFR 405.410, 405.430, 405.435, 405.440, 405.445, and 405.455. Use: Section 4507 of Balancing Budget Act (BBA) 1997 amended section 1802 of the Social Security Act to permit certain physicians and practitioners to opt-out of Medicare and to provide (through private contracts) services that would otherwise be covered by Medicare. Under such contracts the mandatory claims submission and limiting charge


### 20324 Federal Register/ Vol. 78, No. 65 / Thursday, April 4, 2013 / Notices

rules of section 1848(g) of the Act would not apply. Subpart D and the supporting regulations counter the effect of certain provisions of Medicare law that, absent section 4507 of BBA 1997, preclude physicians and practitioners from contracting privately with Medicare beneficiaries to pay without regard to Medicare limits. Physicians and/or practitioners use these information collection requirements to comply with the law. In addition, Medicare carriers use this information to determine if benefits should be paid or continued. Form Number: CMS–R–234 (OCN 0938– 0730). Frequency: Biennially. Affected Public: Private sector (business or other for-profits). Number of Respondents: 26,820. Total Annual Responses: 26,820. Total Annual Hours: 7,197. (For policy questions regarding this collection contact Fred Grabau at 410– 786–0206. For all other issues call 410– 786–1326.)

5. Type of Information Collection Request: Extension without change of a currently approved collection. Title of Information Collection: Request for Employment Information. Use: This form is used by the Social Security Administration to obtain information from employers regarding whether a Medicare beneficiary’s coverage under a group health plan is based on current employment status. Form Number: CMS–R–297 (OCN 0938–0787). Frequency: Once. Affected Public:Private sector (business or other forprofit and not-for-profit institutions). Number of Respondents: 15,000. Total Annual Responses: 15,000. Total Annual Hours: 3,750. (For policy questions regarding this collection contact Lindsay Smith at 410–786–6843. For all other issues call 410–786–1326.)

To obtain copies of the supporting statement and any related forms for the proposed paperwork collections referenced above, access CMS’ Web site address at http://www.cms.hhs.gov/ PaperworkReductionActof1995, or Email your request, including your address, phone number, OMB number, and CMS document identifier, to Paperwork@cms.hhs.gov, or call the Reports Clearance Office on (410) 786–

1326. In commenting on the proposed information collections please reference the document identifier or OMB control number. To be assured consideration, comments and recommendations must be submitted in one of the following ways by June 3, 2013:

1. Electronically. You may submit 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) 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

llllllll, Room C4–26–05, 7500 Security Boulevard, Baltimore, Maryland 21244–

1850.

Dated: March 29, 2013. Martique Jones, Deputy Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs.

[FR Doc. 2013–07800 Filed 4–3–13; 8:45 am]

**BILLING CODE 4120–01–P**

**DEPARTMENT OF HEALTH AND HUMAN SERVICES** 

**Administration for Children and Families** 

**Proposed Information Collection Activity: Comment Request** 

Title: Innovative Strategies for Increasing Self-Sufficiency: Follow-Up Data Collection.

OMB No.: 0970–0397. Description: The Administration for Children and Families (ACF), U.S. Department of Health and Human Services (HHS), is proposing a data collection activity as part of theInnovative Strategies for Increasing SelfSufficiency (ISIS) demonstration and evaluation. The ISIS project will test a range of promising career pathways strategies to promote education, employment, and self-sufficiency. The major goals of the ISIS project include increasing the empirical knowledge about the effectiveness of a variety of programs for low-income individuals and families to achieve educational credentials, attain employment andadvance to positions that enable selfsufficiency, as well as producing useful findings for both policymakers and program administrators.

This proposed information collection activity focuses on collecting follow-up data elements approximately fifteen months after program enrollment. Baseline data collection instruments were previously approved under OMB
No. 0970–0397.

The purpose of this information collection effort is to follow-up with study participants, document the experiences of program participants, examine differences in service receipt and educational experiences between program and control group members, describe the intervention as it was implemented in each site and assess the extent to which it was implemented as intended, and assess the implications for intervention scalability and sustainability.

Specifically, this data will be collected using the following instruments: (a) A follow-up survey which will be administered to all study participants approximately 15 months following enrollment in the study; (b) a modification to the Baseline Information Form requesting some basic information about all of the study participant’s children (if applicable); (c) interview guides for the in-person visits to the intervention sites to structure discussions with program leadership/ managers, instructional staff, case managers/advisors, partners and employers; (d) a brief survey for instructional staff; (e) a brief survey for case managers/advisors; (f) a brief studyparticipant check-in call; and (g) indepth interviews with a sample of study participants. Respondents: Individuals enrolled in the ISIS demonstration programs, control group members, ISIS program/partner staff (including program leadership, case managers and instructional staff), and other local informants.



### ANNUAL 

### BURDEN 

### ESTIMATES

Instrument Total number of respondents Number of responses per respondent Average burden hours per

response Total burden hours Average annual burden hours

#1 Basic Information Form Modification .............................. 5,645 1 0.05 282 94 #2 15 Month Follow-up Survey, no child roster .................. 6,998 1 0.833 5,829 1943 #2 15 Month Follow-up Survey, with child roster ................ 1,562 1 1 1,562 521#2 15 Month Follow-Up Survey, Additional HPOG Questions .................................................................................. 2,974 1 0.083 247 82