65656 Federal Register / Vol. 78, No. 212 / Friday, November 1, 2013 / Notices 

will be more widely disseminated to 

coal mine operators so they can 

implement similar discussion groups at 

their mines. 

There is no cost to respondents other 

than their time. The total estimated 

annualized burden hours are 798. 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondents Form name Number of 

respondents 

Number of 

responses 

per 

respondent 

Average 

burden per 

response 

(in hours) 

Mine Safety Operators .................................... Script for Phone and/or Email Mine Recruitment Script.5 1 5/60 

Individual Miners from Experimental and 

Control Groups.

Recruitment Script for Individual Miners ........ 209 1 3/60 

Experimental Groups (from five different 

mines).

Week 1 PDM Pre-Survey ............................... 109 1 15/60 

Week 2 Participant Worksheet ...................... 109 1 15/60 

Week 3–5 Participant Worksheets ................. 327 3 15/60 

Week 6 PDM Post-Survey ............................. 109 1 15/60 

Facilitator Weekly Meeting Manual ................ 109 6 30/60 

Interview Guide for Miners’ Utilization of 

PDM Feedback.

29 1 1 

Mine Safety Operators for Experimental 

Groups (from five different mines).

Daily respirable coal mine dust exposure 

data.

5 45 5/60 

Mine Safety Operators for Control Groups 

(from four different mines).

......................................................................... 4 45 5/60 

Control Groups (from four different mines) .... Week 1 PDM Pre-Survey ............................... 100 1 15/60 

Week 6 PDM Post-Survey ............................. 100 1 15/60 

Interview Guide for Miners’ Utilization of 

PDM Feedback.

20 1 1 

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. 2013–26114 Filed 10–31–13; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–1561, CMS– 

417, CMS–10433, and CMS–R–262] 

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 

December 31, 2013. 

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 l; 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–1561 Provider Agreement—CMS 

Form 1561 and 1561A and 

Supporting Regulations 

CMS–417 Hospice Request for 

Certification and Supporting 

Regulations 

CMS–10433 Initial Plan Data 

Collection to Support Qualified 


emcdonald on DSK67QTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 212 / Friday, November 1, 2013 / Notices 65657 

Health Plan (QHP) Certification and 

Other Financial Management and 

Exchange Operations 

CMS–R–262 CY 2015 Plan Benefit 

Package (PBP), Formulary, and 

Supporting Regulations 

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 Collections 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Health 

Insurance Benefit Agreement; Use: 

Applicants to the Medicare program are 

required to agree to provide services in 

accordance with Federal requirements. 

The CMS–1561 is essential in that is 

allows us to ensure that applicants are 

in compliance with the requirements. 

Applicants will be required to sign the 

completed form and provide operational 

information to us to assure that they 

continue to meet the requirements after 

approval. Form Number: CMS–1561 

(OCN: 0938–0832); Frequency: Yearly; 

Affected Public: Private Sector— 

Business or other for-profits and Notfor-profit institutions; Number of 

Respondents: 3,000; Total Annual 

Responses: 3,000; Total Annual Hours: 

500. (For policy questions regarding this 

collection contact Shonte Carter at 410– 

786–3532). 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Hospice Request 

for Certification and Supporting 

Regulations; Use: The Hospice Request 

for Certification Form is the 

identification and screening form used 

to initiate the certification process and 

to determine if the provider has 

sufficient personnel to participate in the 

Medicare program. Form Number: 

CMS–417 (OCN: 0938–0313); 

Frequency: Annually; Affected Public: 

Private Sector—Business or other forprofits; Number of Respondents: 3,807; 

Total Annual Responses: 3,807; Total 

Annual Hours: 952. (For policy 

questions regarding this collection 

contact Patricia Sevast at 410–786– 

8135). 

3. Title of Information Collection: 

Initial Plan Data Collection to Support 

Qualified Health Plan (QHP) 

Certification and Other Financial 

Management and Exchange Operations; 

Type of Information Collection Request: 

Revision of a currently approved 

collection; Use: As required by the 

CMS–9989–F, Patient Protection and 

Affordable Care Act; Establishment of 

Exchanges and Qualified Health Plans; 

Exchange Standards for Employers (77 

FR 18310) (Exchange Establishment 

Rule), published on March 27, 2012, 

each Exchange must assume 

responsibilities related to the 

certification and offering of Qualified 

Health Plans (QHPs). To offer insurance 

through an Exchange, a health insurance 

issuer must have its health plans 

certified as QHPs by the Exchange. A 

QHP must meet certain minimum 

certification standards, such as those 

pertaining to essential community 

providers, essential health benefits, and 

actuarial value. In order to meet those 

standards, the Exchange is responsible 

for collecting data and validating that 

QHPs meet these minimum 

requirements as described in the 

Exchange rule under 45 CFR parts 155 

and 156, based on the Affordable Care 

Act, as well as other requirements 

determined by the Exchange. In 

addition to data collection for the 

certification of QHPs, the reinsurance 

and risk adjustment programs outlined 

by the Affordable Care Act, detailed in 

45 CFR part 153, as established by 

CMS–9975–F, Patient Protection and 

Affordable Care Act; Standards for 

Reinsurance, Risk Corridors, and Risk 

Adjustment (77 FR 17220), published in 

March 23, 2012, have general 

information reporting requirements that 

apply to issuers, group health plans, 

third party administrators, and plan 

offerings outside of the Exchanges. 

Subsequent regulations for these 

programs including the final HHS 

Notice of Benefit and Payment 

Parameters for 2014 and the Program 

Integrity: Exchange, Premium 

Stabilization Programs, and Market 

Standards; Amendments to the HHS 

Notice of Benefit and Payment 

Parameters for 2014 provide further 

reporting requirements. The Office of 

Management and Budget (OMB) issued 

OMB Control Number 0938–1187 for 

this Paperwork Reduction Act (PRA) 

package on March 13, 2013. Based on 

experience with the first year of data 

collection, we propose revisions to data 

elements being collected and the burden 

estimates for years two and three. Form 

Number: CMS–10433 (OCN: 0938– 

1187); Frequency: Annually; Affected 

Public: States and Private Sector— 

Business or other for-profits and Notfor-profit institutions; Number of 

Respondents: 27,225; Number of 

Responses: 27,225; Total Annual Hours: 

216,028. (For questions regarding the 

collection contact Danielle Chestang at 

(410) 786–7815.) 

4. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: CY 2015 Plan 

Benefit Package (PBP), Formulary, and 

Supporting Regulations; Use: We 

require Medicare Advantage and 

Prescription Drug Plan organizations 

submit a completed plan benefit 

package (PBP) and formulary as part of 

the annual bidding process. During this 

process, organizations prepare their 

proposed plan benefit packages for the 

upcoming contract year and submit 

them to us for review and approval. We 

publish beneficiary education 

information using a variety of formats. 

Specific education initiatives that 

utilize PBP and formulary data include 

web application tools on medicare.gov 

and the plan benefit insert in the 

Medicare & You handbook. In addition, 

organizations utilize the PBP data to 

generate their Summary of Benefits 

marketing information. Form Number: 

CMS–R–262 (OCN: 0938–0763); 

Frequency: Yearly; Affected Public: 

Private sector—Business or other forprofits and Not-for-profit institutions; 

Number of Respondents: 652; Total 

Annual Responses: 6,265; Total Annual 

Hours: 57,477. (For policy questions 

regarding this collection contact Kristy 

Holtje at 410–786–2209). 

Dated: October 29, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–26083 Filed 10–31–13; 8:45 am] 

BILLING CODE 4120–01–P 


emcdonald on DSK67QTVN1PROD with NOTICES