Federal Register / Vol. 78, No. 230 / Friday, November 29, 2013 / Notices 71617 

Leroy Richardson, 

Chief, Information Collection Review Office, 

Office of Scientific Integrity, Office of the 

Associate Director for Science, Office of the 

Director, Centers for Disease Control and 

Prevention. 

[FR Doc. 2013–28592 Filed 11–27–13; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–R–194] 

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 December 30, 2013: 

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 

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: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: 

Medicare Disproportionate Share 

Adjustment (DSH) Procedures and 

Criteria and Supporting Regulations; 

Use: Section 1886(d)(5)(F) of the Social 

Security Act provides for additional 

payment to hospitals that serve a 

disproportionate share of the indigent 

patient population. This payment is an 

add-on to the set amount per case that 

we pay to hospitals under the Medicare 

Inpatient Prospective Payment System. 

To meet the qualifying criteria for this 

additional DSH payment, a hospital 

must prove that a disproportionate 

percentage of its patients are low 

income using Supplemental Security 

Income and Medicaid as proxies for this 

determination. Once a hospital qualifies 

for the DSH payment, we also determine 

the hospital’s payment adjustment. 

Form Number: CMS–R–194 (OCN: 

0938–0691); Frequency: Occasionally; 

Affected Public: Private sector (business 

or other for-profits and not-for-profit 

institutions); Number of Respondents: 

800; Total Annual Responses: 800; Total 

Annual Hours: 400. (For policy 

questions regarding this collection 

contact JoAnne Cerne at 410–786–4530.) 

Dated: November 22, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–28524 Filed 11–27–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10512, CMS–R– 

153 and CMS–10277] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

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 (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 

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 

January 28, 2014. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number (OCN). To be 

assured consideration, comments and 


sroberts on DSK5SPTVN1PROD with NOTICES
71618 Federal Register / Vol. 78, No. 230 / Friday, November 29, 2013 / Notices 

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 llllll, 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–10512 Direct Service Workforce 

Resource Center CC Survey Instrument 

CMS–R–153 Medicaid Drug Use 

Review Program 

CMS–10277 Hospice Conditions of 

Participation and Supporting 

Regulations 

Under the Paperwork Reduction Act 

(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: New collection (request for 

new OMB control number); Title of 

Information Collection: Direct Service 

Workforce (DSW) Resource Center (RC) 

Core Competencies (CC) Survey 

Instrument; Use: This survey is part of 

Phase IIIB of the Direct Service 

Workforce Resource Center’s Road Map 

of Core Competencies for the Direct 

Service Workforce, a multi-phased 

research project implemented to 

identify a common set of core 

competencies across community-based 

long-term services and supports (LTSS) 

population sectors: Aging, behavioral 

health (including mental health and 

substance use), intellectual and 

developmental disabilities, and physical 

disabilities. Phase IIIB includes (1) Field 

testing and a national study to validate 

the core competency set among the 

workforce; (2) establishing the core 

competency set in the public domain; 

and (3) providing technical assistance to 

promote the development of 

specializations within each sector. The 

survey serves as item 1 of Phase IIIB. 

No data that validates cross-sector 

core competencies in the direct service 

workforce has been previously 

collected. The data collected in the 

survey will be used by the DSW RC, 

states, direct service agencies and other 

partners interested in implementing the 

core competencies. The target 

populations for the surveys include 

DSW professionals, front line 

supervisors and managers, agency 

administrators and directors, 

participants and families/guardians, and 

self-advocates. 

The overall purpose of this survey is 

to confirm and validate that the DSW 

RC’s set of core competencies are 

relevant and applicable to actual direct 

service workers, their employers and 

their participants. Information gained 

from the survey will lend credibility to 

the set of core competencies. As the 

population of older adults with longterm services and supports needs grow, 

more emphasis will be placed on the 

DSW and a universally accepted set of 

core competencies such as that 

produced by the DSW RC would 

increase retention, agility and capacity 

of the workforce. 

Collecting these data from a broad 

range of stakeholders in the direct 

service workforce industry will provide 

critical information about the relevance 

and validity of the set of core 

competencies. The surveys will collect 

the data in a manner that is consistent 

across all population sectors, service 

populations and states. 

We, in collaboration with the DSW 

RC, will use the resources and tools 

developed and refined through this 

project to develop a Direct Service 

Workforce set of Core Competencies 

web-based toolkit that will be made 

available to all states and territories. It 

will also establish the core competency 

set in the public domain and provide 

technical assistance to promote the 

development of specializations within 

each sector. Form Number: CMS–10512 

(OCN: 0938—New); Frequency: Once; 

Affected Public: Individuals and 

households, Private sector (business or 

other for-profits and not-for-profit 

institutions) and State, Local, or Tribal 

Governments; Number of Respondents: 

4,800; Total Annual Responses: 4,800; 

Total Annual Hours: 2,400. (For policy 

questions regarding this collection 

contact Kathryn King at 410–786–1283). 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicaid Drug 

Use Review Program; Use: This 

information collection is necessary to: 

Establish patient profiles in pharmacies, 

identify problems in prescribing, 

dispensing, or both prescribing and 

dispensing; determine each program’s 

ability to meet minimum standards 

required for federal financial 

participation; and ensure quality 

pharmaceutical care for Medicaid 

patients. State Medicaid agencies that 

have prescription drug programs are 

required to perform prospective and 

retrospective drug use review in order to 

identify aberrations in prescribing, 

dispensing, and patient behavior. Form 

Number: CMS–R–153 (OCN: 0938– 

0659); Frequency: Yearly, quarterly, and 

occasionally; Affected Public: State, 

Local, or Tribal Governments; Number 

of Respondents: 51; Total Annual 

Responses: 510; Total Annual Hours: 

20,298. (For policy questions regarding 

this collection contact Madlyn Kruh at 

410–786–3239). 

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 


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Federal Register / Vol. 78, No. 230 / Friday, November 29, 2013 / Notices 71619 

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. We 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 

well-being and safety of patients and 

professional treatment accountability. 

There are no program changes to this 

information collection request, meaning 

there are no new requirements; 

however, we are currently adjusting the 

numbers of respondents and responses. 

The final numbers will be present in the 

30-day notice. Form Number: CMS– 

10277 (OCN: 0938–1067); Frequency: 

Yearly; Affected Public: Private sector— 

Business or other for-profit and Not-forprofit institutions; Number of 

Respondents: 2,872; Total Annual 

Responses: 1,808,345; Total Annual 

Hours: 2,152,396. (For policy questions 

regarding this collection contact 

Danielle Shearer at 410–786–6617.) 

Dated: November 22, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–28537 Filed 11–27–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–3285–FN] 

Medicare and Medicaid Programs; 

Continued Approval of American 

Osteopathic Association/Healthcare 

Facilities Accreditation Program’s 

Critical Access Hospital Accreditation 

Program 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

ACTION: Final notice. 

SUMMARY: This final notice announces 

our decision to approve the American 

Osteopathic Association/Healthcare 

Facilities Accreditation Program (AOA/ 

HFAP) for continued recognition as a 

national accrediting organization (AO) 

for critical access hospitals (CAH) that 

wish to participate in the Medicare or 

Medicaid programs. 

DATES: This final notice is effective 

December 27, 2013 through December 

27, 2019. 

FOR FURTHER INFORMATION CONTACT: 

James Cowher, (410) 786–41948, 

Cindy Melanson, (410) 786–0310, or 

Patricia Chmielewski, (410) 786–6899. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Under the Medicare program, eligible 

beneficiaries may receive covered 

services in a CAH provided certain 

requirements are met. Sections 

1820(c)(2)(B), 1820(e), and 1861(mm)(1) 

of the Social Security Act (the Act) 

establish distinct criteria for facilities 

seeking designation as a CAH. 

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 485, subpart F specify the 

conditions that a CAH must meet to 

participate in the Medicare program, the 

scope of covered services, and the 

conditions for Medicare payment for 

CAHs. 

Generally, to enter into an agreement, 

a CAH must first be certified by a state 

survey agency as complying with the 

conditions or requirements set forth in 

part 485, subpart F. Thereafter, the CAH 

is subject to regular surveys by a state 

survey agency to determine whether it 

continues to meet these requirements. 

However, there is an alternative to 

surveys by state agencies. Certification 

by a nationally recognized accreditation 

program can substitute for ongoing state 

review. 

Section 1865(a)(1) of the Act provides 

that, if a provider entity demonstrates 

through accreditation by an approved 

national AO that all applicable 

Medicare conditions are met or 

exceeded, we will deem those provider 

entities as having met the requirements. 

Accreditation by an AO is voluntary and 

is not required for Medicare 

participation. A national AO applying 

for approval of its accreditation program 

under part 488, subpart A, must provide 

CMS with reasonable assurance that the 

AO requires the accredited provider 

entities to meet requirements that are at 

least as stringent as the Medicare 

conditions. 

Our regulations concerning the 

approval of AOs are set forth at § 488.4 

and § 488.8(d)(3). The regulations at 

§ 488.8(d)(3) require AOs to reapply for 

continued approval of its accreditation 

program every 6 years or sooner as 

determined by CMS. The AOA/HFAP’s 

current term of approval for their CAH 

accreditation program expires December 

27, 2013. 

II. Application Approval Process 

Section 1865(a)(3)(A) of the Act 

provides a statutory timetable to ensure 

that our review of applications for CMSapproval of an accreditation program is 

conducted in a timely manner. The Act 

provides us 210 days after the date of 

receipt of a complete application, with 

any documentation necessary to make 

the determination, to complete our 

survey activities and application 

process. Within 60 days after receiving 

a complete application, we must 

publish a notice in the Federal Register 

that identifies the national accrediting 

body making the request, describes the 

request, and provides no less than a 30- 

day public comment period. At the end 

of the 210-day period, we must publish 

a notice in the Federal Register 

approving or denying the application. 

III. Provisions of the Proposed Notice 

On June 25, 2013, we published a 

proposed notice in the Federal Register 

(78 FR 38043) announcing AOA/HFAP’s 

request for approval of its CAH 

accreditation program. In the proposed 

notice, we detailed our evaluation 

criteria. Under section 1865(a)(2) of the 

Act and in our regulations at § 488.4 and 

§ 488.8, we conducted a review of AOA/ 

HFAP’s application in accordance with 

the criteria specified by our regulations, 

which include, but are not limited to the 

following: 

• An onsite administrative review of 

AOA/HFAP’s: (1) Corporate policies; (2) 

financial and human resources available 

to accomplish the proposed surveys; (3) 

procedures for training, monitoring, and 

evaluation of its surveyors; (4) ability to 

investigate and respond appropriately to 

complaints against accredited facilities; 

and (5) survey review and 

decisionmaking process for 

accreditation. 

• The comparison of AOA/HFAP’s 

accreditation to our current Medicare 

CAH conditions of participation (CoPs). 

• A documentation review of AOA/

HFAP’s survey process to: 

++ Determine the composition of the 

survey team, surveyor qualifications, 

and AOA/HFAP’s ability to provide 

continuing surveyor training. 

++ Compare AOA/HFAP’s processes 

to those of state survey agencies, 

including survey frequency, and the 

ability to investigate and respond 

appropriately to complaints against 

accredited facilities. 

++ Evaluate AOA/HFAP’s procedures 

for monitoring CAHs out of compliance 

with AOA/HFAP’s program 

requirements. The monitoring 

procedures are used only when AOA/

HFAP identifies noncompliance. If 

noncompliance is identified through 

validation reviews, the state survey 

agency monitors corrections as specified 

at § 488.7(d). 


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