Federal Register / Vol. 75, No. 218 / Friday, November 12, 2010 / Notices 69445 

of Central Bancshares, Inc., and thereby 

indirectly acquire voting shares of 

Central Bank, both of Little Rock, 

Arkansas. 

3. Carlson Bancshares, Inc., West 

Memphis, Arkansas; to acquire no more 

than 9.99 percent of the voting shares of 

Central Bancshares, Inc., and thereby 

indirectly acquire voting shares of 

Central Bank, both of Little Rock, 

Arkansas. 

B. Federal Reserve Bank of Kansas 

City (Dennis Denney, Assistant Vice 

President), 1 Memorial Drive, Kansas 

City, Missouri 64198–0001: 

1. Northern Missouri Bancshares, Inc., 

Unionville, Missouri; to acquire at least 

51 percent of the voting shares of 

Exchange Bancorp of Missouri, Inc., and 

thereby indirectly acquire voting shares 

of Exchange Bank of Missouri, both of 

Fayette, Missouri. 

Board of Governors of the Federal Reserve 

System, November 8, 2010. 

Robert deV. Frierson, 

Deputy Secretary of the Board. 

[FR Doc. 2010–28465 Filed 11–10–10; 8:45 am] 

BILLING CODE 6210–01–P 

FEDERAL RESERVE SYSTEM 

Formations of, Acquisitions by, and 

Mergers of Bank Holding Companies; 

Correction 

This notice corrects a notice (FR Doc. 

2010–28126) published on page 68608 

of the issue for Monday, November 8, 

2010. 

Under the Federal Reserve Bank of 

New York heading, the entry for First 

Niagara Financial Group, Inc., Buffalo, 

New York, is revised to read as follows: 

A. Federal Reserve Bank of New York 

(Ivan Hurwitz, Vice President) 33 

Liberty Street, New York, New York 

10045–0001: 

1. First Niagara Financial Group, Inc., 

Buffalo, New York; to acquire 100 

percent of the voting shares of, and 

thereby merge with NewAlliance 

Bancshares, Inc., and thereby indirectly 

acquire voting shares of, and merge with 

NewAlliance Bank, both of New Haven, 

Connecticut. 

Comments on this application must 

be received by December 3, 2010. 

Board of Governors of the Federal Reserve 

System, November 8, 2010. 

Robert deV. Frierson, 

Deputy Secretary of the Board. 

[FR Doc. 2010–28464 Filed 11–10–10; 8:45 am] 

BILLING CODE 6210–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10052, CMS– 

10351 and CMS–R–216] 

Agency Information Collection 

Activities: Submission for OMB 

Review; 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), Department of Health 

and Human Services, 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 function; 

(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: Extension of a currently 

approved collection; Title of 

Information Collection: Recognition of 

pass-through payment for additional 

(new) categories of devices under the 

Outpatient Prospective Payment System 

and Supporting Regulations in 42 CFR, 

Part 419; Form Number: CMS–10052 

(OMB#: 0938–0857); Use: Section 201(b) 

of the Balanced Budget Act of 1999 

amended section 1833(t) of the Social 

Security Act (the Act) by adding new 

section 1833(t)(6). This provision 

requires the Secretary to make 

additional payments to hospitals for a 

period of 2 to 3 years for certain drugs, 

radiopharmaceuticals, biological agents, 

medical devices and brachytherapy 

devices. Section 402 of the Benefits 

Improvement and Protection Act of 

2000 made changes to the transitional 

pass-through provision for medical 

devices. The most significant change is 

the required use of categories as the 

basis for determining transitional passthrough eligibility for medical devices, 

through the addition of section 

1833(t)(6)(B) of the Act. This 

information collection is necessary to 

determine eligibility of medical devices 

for establishment of additional device 

categories for payment under 

transitional pass-through payment 

provisions as required by section 

1833(t)(6) of the Act. Frequency: Once; 

Affected Public: Private Sector: Business 

or other for-profits; Number of 

Respondents: 10; Total Annual 

Responses: 10; Total Annual Hours: 

160. (For policy questions regarding this 

collection contact Christina S. Ritter at 

410–786–4636. For all other issues call 

410–786–1326.) 

2. Type of Information Collection 

Request: New collection; Title of 

Information Collection: ESRD PPS 

Transition Election and attestations of 

Low-Volume; Form Number: CMS– 

10351 (OMB#: 0938–New); Use: The 

Medicare Improvement for Patients and 

Providers Act (MIPPA) requires 

implementation of an End Stage Rental 

Disease (ESRD) bundled prospective 

payment system (PPS) effective January 

1, 2011. Once implemented, the ESRD 

PPS will replace the current basic casemix adjusted composite payment system 

and the methodologies for the 

reimbursement of separately billable 

outpatient ESRD related items and 

services. The ESRD PPS will provide a 

single payment to the ESRD facilities 

that will cover all the resources used in 

providing an outpatient dialysis 

treatment. Also, as required my MIPPA, 

ESRD facilities are eligible to receive a 

low-volume adjustment when the 

facility furnished less than 4000 

treatments in each of the three years 

pre-ceding the payment year. 

In order for an ESRD facility to 

receive the low-volume adjustment, 

CMS will require that an ESRD facility 

must provide an attestation to the fiscal 

intermediary or the Medicare 

administrative contractor (FI/MAC) that 

it has met the criteria to qualify as a 

low-volume facility. The FI or MAC 

would verify the ESRD facility’s 

attestation of their low-volume status 

using the ESRD facility’s final-settled 

cost reports. Also, an ESRD facility may 

make a one-time election to be excluded 

from the four-year transition to the 

ESRD PPS. A facility may elect to be 

paid entirely based on the ESRD PPS 

beginning January 1, 2011. If the ESRD 

facility fails to submit an election, or the 

ESRD facility’s election is not received 

by their MAC by November 1, 2010, 

payments to the ESRD facility for items 

and services provided during the 

transition will be paid under the basic 

case-mix adjusted composite payment 

system. Frequency: Annually; Affected 

Public: Private Sector: Business or other 

for-profits and Not-for-profit 

institutions; Number of Respondents: 

5,808; Total Annual Responses: 2,520; 

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69446 Federal Register / Vol. 75, No. 218 / Friday, November 12, 2010 / Notices 

Total Annual Hours: 563.2. (For policy 

questions regarding this collection 

contact Janet Samen at 410–786–4533. 

For all other issues call 410–786–1326.) 

3. Title of Information Collection: 

Issuance of Advisory Opinions 

Concerning Physicians’ Referrals; Type 

of Information Collection Request: 

Extension of a currently approved 

collection; Form Number: CMS–R–216 

(OMB#: 0938–0714); Use: Section 

1877(g)(6) of the Social Security Act 

requires that the Department of Health 

and Human Services accept requests for 

advisory opinions made after November 

3, 1997 and before August 21, 2000. 

Section 543 of the Benefits 

Improvement and Protection Act of 

2001, Public Law 106–554, extended 

indefinitely the period during which the 

Department of Health and Human 

Services accepts requests for these 

advisory opinions. CMS promulgated 42 

CFR 411.370 through 411.389 to comply 

with this statutory mandate. The 

collection of information contained in 

42 CFR 411.372 and 411.373 is 

necessary to allow CMS to consider 

requests for advisory opinions and 

provide accurate and useful opinions. ; 

Frequency: Occasionally; Affected 

Public: Private Sector: Business or other 

for-profits and not- for profit 

institutions; Number of Respondents: 

25; Total Annual Responses: 25; Total 

Annual Hours: 500. (For policy 

questions regarding this collection 

contact John Davis at 410–786–0008. 

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. 

To be assured consideration, 

comments and recommendations for the 

proposed information collections must 

be received by the OMB desk officer at 

the address below, no later than 5 p.m. 

on December 13, 2010. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS 

Desk Officer, Fax Number: (202) 395– 

6974, E-mail: 

OIRA_submission@omb.eop.gov. 

Dated: November 4, 2010. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2010–28332 Filed 11–10–10; 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 

Proposed Projects 

Title: Child and Family Services Plan 

(CFSP), Annual Progress and Services 

Review (APSR), and Annual Budget 

Expenses Request and Estimated 

Expenditures (CFS–101). 

OMB No.: 0980–0047. 

Description: Under title IV–B, 

subparts 1 and 2, of the Social Security 

Act (the Act), States, Territories, and 

Tribes are required to submit a Child 

and Family Services Plan (CFSP). The 

CFSP lays the groundwork for a system 

of coordinated, integrated, and 

culturally relevant family services for 

the subsequent five years (45 CFR 

1357.15(a)(1)). The CFSP outlines 

initiatives and activities the State, Tribe 

or territory will carry out in 

administering programs and services to 

promote the safety, permanency, and 

well-being of children and families. By 

June 30 of each year, States, Territories, 

and Tribes are also required to submit 

an Annual Progress and Services Report 

(APSR) and a financial report called the 

CFS–101. The APSR is a Yearly report 

that discusses progress made by a State, 

Territory or Tribe in accomplishing the 

goals and objectives cited in its CFSP 

(45 CFR 1357.16(a)). The APSR contains 

new and updated information about 

service needs and organizational 

capacities throughout the five-year plan 

period. The CFS–101 has three parts. 

Part I is an annual budget request for the 

upcoming fiscal year. Part II includes a 

summary of planned expenditures by 

program area for the upcoming fiscal 

year, the estimated number of 

individuals or families to be served, and 

the geographical service area. Part III 

includes actual expenditures by 

program area, numbers of families and 

individuals served by program area, and 

the geographic areas served for the last 

complete fiscal year. 

The Child and Family Services 

Improvement Act of 2006 amended Title 

IV–B, subparts 1 and 2, adding a 

number of requirements that affect 

reporting through the APSR and the 

CFS–101. Of particular note, the law 

added a provision requiring States 

(including Puerto Rico and the District 

of Columbia) to report data on 

caseworker visits (section 424(e) of the 

Act). States must provide annual data 

on (1) the percentage of children in 

foster care under the responsibility of 

the State who were visited on a monthly 

basis by the caseworker handling the 

case of the child; and (2) the percentage 

of the visits that occurred in the 

residence of the child. In addition, by 

June 30, 2008, States must set target 

percentages and establish strategies to 

meet the goal that; by October 1, 2011; 

at least 90 percent of the children in 

foster care are visited by their 

caseworkers on a monthly basis and that 

the majority of these visits occur in the 

residence of the child (section 

424(e)(2)(A) of the Act). 

Respondents: States, Territories, and 

Tribes must complete the CFSP, APSR, 

and CFS–101. Tribes and territories are 

exempted from the monthly caseworker 

visits reporting requirement of the 

APSR. There are approximately 180 

Tribal entities that are eligible for IV–B 

funding. There are 52 States (including 

Puerto Rico and the District of 

Columbia) that must complete the CFSP, 

APSR, and CFS–101. There are a total of 

232 possible respondents. 

ANNUAL BURDEN ESTIMATES

Instrument Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden hours 

per response 

Total burden 

hours 

APSR ............................................................................................................. 232 1 76.58 17,766 .56 

CFSP ............................................................................................................. 232 1 120.25 27,898 

CFS–101, Parts I, II, and III .......................................................................... 232 1 4.38 1,016 .16 

Caseworker Visits .......................................................................................... 52 1 99.33 5,165 .16 

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