25132 Federal Register / Vol. 79, No. 85 / Friday, May 2, 2014 / Notices 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–304/CMS–304a 

and CMS–368/CMS–R–144] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services. 

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 

July 1, 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 lll, 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–304 and–304a Reconciliation of 

State Invoice and Prior Quarter 

Adjustment Statement 

CMS–368 and–R–144 Medicaid Drug 

Rebate Program Forms 

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: Extension of a currently 

approved collection; Title of 

Information Collection: Reconciliation 

of State Invoice and Prior Quarter 

Adjustment Statement; Use: Form CMS– 

304 (Reconciliation of State Invoice) is 

used by manufacturers to respond to the 

state’s rebate invoice for current quarter 

utilization. Form CMS–304a (Prior 

Quarter Adjustment Statement) is 

required only in those instances where 

a change to the original rebate data 

submittal is necessary. Form Number: 

CMS–304 and -304a (OCN: 0938–0676); 

Frequency: Quarterly; Affected Public: 

Private sector (business or other forprofits); Number of Respondents: 1,037; 

Total Annual Responses: 4,148; Total 

Annual Hours: 187,880. (For policy 

questions regarding this collection 

contact Andrea Wellington at 410–786– 

3490). 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicaid Drug 

Rebate Program Forms; Use: We develop 

the rebate amount per drug unit from 

information supplied by the drug 

manufacturers and distributes these data 

to the states. States then must report 

quarterly to the drug manufacturers and 

report to us the total number of units of 

each dosage form/strength of their 

covered outpatient drugs reimbursed 

during a quarter and the rebate amount 

to be refunded. This report is due 

within 60 days of the end of each 

calendar quarter. The information in the 

report is based on claims paid by the 

state Medicaid agency during a calendar 

quarter. CMS–R–144 (Quarterly Report 

Data) is required from states quarterly to 

report utilization for any drugs paid for 

during that quarter. Form CMS–368 

(Administrative Data) is required only 

in those instances where a change to the 

original data submittal is necessary. 

Form Number: CMS–368 and -R–144 

(OCN: 0938–0582); Frequency: 

Quarterly; Affected Public: State, Local, 

or Tribal Governments; Number of 

Respondents: 56; Total Annual 

Responses: 224; Total Annual Hours: 

12,101. (For policy questions regarding 

this collection contact Andrea 

Wellington at 410–786–3490). 

Dated: April 29, 2014. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2014–10128 Filed 5–1–14; 8:45 am] 

BILLING CODE 4120–01–P 

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