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

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


### 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 thepopulation 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


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

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).