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[Federal Register Volume 79, Number 63 (Wednesday, April 2, 2014)]
[Notices]
[Pages 18555-18556]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-07405]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS-370 and CMS-377]

Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

ACTION: Notice.

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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 (the 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 60 days for public 
comment on the proposed action. Interested persons are invited to send 
comments regarding our burden estimates 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

[[Page 18556]]

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 must be received by June 2, 2014.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number (OCN). To be assured consideration, comments and 
recommendations must be submitted in any one of the following ways:
    1. Electronically. You may send 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) that are 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 ------, Room C4-26-05, 7500 Security Boulevard, 
Baltimore, Maryland 21244-1850.
    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: 

Contents

    This notice sets out a summary of the use and burden associated 
with the following information collections. More detailed information 
can be found in each collection's supporting statement and associated 
materials (see ADDRESSES).

CMS-370 and CMS-377 Health Insurance Benefits Agreement and Ambulatory 
Surgical Center Request for Certification or Update of Certification 
Information in the Medicare Program

    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 Collection

    1. Type of Information Collection Request: Revision of a currently 
approved collection; Titles of Information Collection: Health Insurance 
Benefits Agreement and Ambulatory Surgical Request for Certification or 
Update of Certification Information in the Medicare Program; Use: The 
CMS-370 is used to establish eligibility for payment. This agreement, 
upon submission by the ambulatory surgical center (ASC) and acceptance 
for filing by the Secretary of Health & Human Services, shall be 
binding on both the ASC and the Secretary. The agreement may be 
terminated by either party in accordance with regulations. In the event 
of termination, payment will not be available for ASC services 
furnished on or after the effective date of termination.
    The CMS-377 is used to collect facility-specific characteristics 
that facilitate CMS' oversight of ambulatory surgical centers (ASCs). 
The CMS-377 is submitted by ASCs when they request initial 
certification of compliance with the ASC conditions for coverage or to 
update an ASC's existing certification information. It is also used by 
State agencies who conduct certification surveys on CMS' behalf to 
maintain information on the facility's characteristics that facilitate 
conducting surveys, e.g., determining the size and the composition of 
the survey team on the basis of the number of operating and procedure 
rooms and the types of surgical procedures performed in the ASC. Form 
Numbers: CMS-370 and CMS-377 (OCN: 0938-0266); Frequency: Occasionally; 
Affected Public: Private sector--business or other for-profit and not-
for-profit institutions; Number of Respondents: 5,449; Total Annual 
Responses: 1,833; Total Annual Hours: 633. (For policy questions 
regarding this collection contact Erin McCoy at 410-786-2337.)

    Dated: March 28, 2014.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2014-07405 Filed 4-1-14; 8:45 am]
BILLING CODE 4120-01-P
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