Federal Register / Vol. 74, No. 156 / Friday, August 14, 2009 / Notices 41141 

ESTIMATED ANNUALIZED BURDEN HOURS—Continued 

Type of respondent Form name Number of 

respondents 

Number of 

responses per 

respondent 

Avg. burden 

per response 

(in hours) 

Total burden 

(in hours) 

Consumer Focus Group Discussion 

Guide.

Comparison Organization Staff 

(Telephone Interviews).

10 ..................................................... 1 1 10 Advance 

Letter for 

Comparison 

Organizations 

Comparison Organization Interview 

Protocol.

Total ........................................... ........................................................... ........................ ........................ ........................ 335 

Seleda Perryman, 

Office of the Secretary, Paperwork Reduction 

Act Reports Clearance Officer. 

[FR Doc. E9–19515 Filed 8–13–09; 8:45 am] 

BILLING CODE 4150–33–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10050, CMS– 

1450(UB–04), CMS–276 and CMS–R–254] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Centers for Medicare & Medicaid 

Services (CMS), Department of Health 

and Human Services, is publishing the 

following summary of proposed 

collections for public comment. 

Interested persons are invited to send 

comments regarding this 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 function; 

(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. 

1. Type of Information Collection 

Request: Revision of the currently 

approved collection; Title of 

Information Collection: New Enrollee 

Survey; Use: The New Enrollee survey 

was developed to gather information 

from newly enrolled Medicare 

beneficiaries about their Medicare 

knowledge and needs. CMS is seeking 

understanding about what types of 

information new enrollees need and 

what they know about Medicare. 

Included in the survey are questions 

regarding how well informed new 

enrollees are about Medicare and what 

information they have received about 

the Medicare program. Information 

gathered in this survey will be used 

only for purposes of targeting and 

improving communications with newly 

eligible Medicare beneficiaries. Form 

Number: CMS–10050 (OMB#: 0938– 

0869); Frequency: Reporting—Quarterly; 

Affected Public: Individuals or 

Households; Number of Respondents: 

1200; Total Annual Responses: 1200; 

Total Annual Hours: 300. (For policy 

questions regarding this collection 

contact Renee Clarke at 410–786–0006. 

For all other issues call 410–786–1326.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicare 

Uniform Institutional Provider Bill and 

Supporting Regulations in 42 CFR 

424.5; Use: Section 42 CFR 424.5(a)(5) 

requires providers of services to submit 

a claim for payment prior to any 

Medicare reimbursement. Charges billed 

are coded by revenue codes. The bill 

specifies diagnoses according to the 

International Classification of Diseases, 

Ninth Edition (ICD–9–CM) code. 

Inpatient procedures are identified by 

ICD–9–CM codes, and outpatient 

procedures are described using the CMS 

Common Procedure Coding System 

(HCPCS). These are standard systems of 

identification for all major health 

insurance claims payers. Submission of 

information on the CMS–1450 permits 

Medicare intermediaries to receive 

consistent data for proper payment. 

Form Numbers: CMS–1450 (UB– 

04)(OMB#: 0938–0997); Frequency: 

Reporting—On occasion; Affected 

Public: Not-for-profit institutions, 

Business or other for-profit; Number of 

Respondents: 53,111; Total Annual 

Responses: 181,909,654; Total Annual 

Hours: 1,567,455. (For policy questions 

regarding this collection contact Matt 

Klischer at 410–786–7488. For all other 

issues call 410–786–1326.) 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Prepaid Health 

Plan Cost Report; Use: Health 

Maintenance Organizations and 

Competitive Medical Plans (HMO/ 

CMPs) contracting with the Secretary 

under Section 1876 of the Social 

Security Act are required to submit a 

budget and enrollment forecast, four 

quarterly reports and a final certified 

cost report. Health Care Prepayment 

Plans (HCPPs) contracting with the 

Secretary under Section 1833 of the 

Social Security Act are required to 

submit a budget and enrollment 

forecast, mid-year report, and final cost 

report. An HMO/CMP is a health care 

delivery system that furnishes directly 

or arranges for the delivery of the full 

spectrum of health services to an 

enrolled population. A HCPP is a health 

care delivery system that furnishes 

directly or arranges for the delivery of 

certain physician and diagnostics 

services up to the full spectrum of nonprovider Part B health services to an 

enrolled population. These reports will 

be used to establish the reasonable cost 

of delivering covered services furnished 

to Medicare enrollees by an HMO/CMP 

or HCPP.; Form Numbers: CMS–276 

(OMB#: 0938–0165); Frequency: 

Recordkeeping, Reporting—Quarterly 

and Annually; Affected Public: Business 

or other for-profit; Number of 

Respondents: 35; Total Annual 

Responses: 128; Total Annual Hours: 

5,285. (For policy questions regarding 

this collection contact Temeshia 

Johnson at 410–786–8692. For all other 

issues call 410–786–1326.) 

4. Type of Information Collection 

Request: Reinstatement of a currently 

approved collection; Title of 

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41142 Federal Register / Vol. 74, No. 156 / Friday, August 14, 2009 / Notices 

Information Collection: National 

Medicare & You Education Program 

(NMEP) Survey of Medicare 

Beneficiaries Use: The Centers for 

Medicare and Medicaid Services is 

requesting a reinstatement of this 

information collection request to 

continue to collect information from 

Medicare beneficiaries, caregivers, 

health care providers, and health 

information providers. The collection of 

information was inadvertently 

discontinued in December 2008; 

however, as stated earlier, we are 

currently seeking a reinstatement with 

change as we have revised the collection 

instrument. It is critical for this agency 

to obtain feedback from the 

aforementioned groups so that the 

agency can accurately assess the needs 

of the Medicare audience. Using random 

digit dial and/or an administrative 

sample, members of the Medicare 

audience will be called and asked to 

complete the survey via telephone. The 

results of this survey will be compiled 

and studied so that communication may 

be amended to benefit Medicare’s 

audience. The survey has the following 

objectives: to assess satisfaction with 

and knowledge of the Medicare 

program; to gather information on 

health behaviors and quality of health 

care; to determine the most used source 

for Medicare information; and to gather 

information from health care provider 

and health information providers. Form 

Number: CMS–R–254 (OMB# 0938– 

0738); Frequency: Once; Affected 

Public: Individuals and Households, 

Private Sector—Business or other forprofits; Number of Respondents: 7,000; 

Total Annual Responses: 7,000; Total 

Annual Hours: 1,750. 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS Web Site 

address at http://www.cms.hhs.gov/

PaperworkReductionActof1995, or Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office on (410) 786– 

1326. 

To be assured consideration, 

comments and recommendations for the 

proposed information collections must 

be received by the OMB desk officer at 

the address below, no later than 5 p.m. 

on September 14, 2009: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–6974, E-mail: 

OIRA_submission@omb.eop.gov. 

Dated: August 7, 2009. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E9–19537 Filed 8–13–09; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–R–284 and 

CMS–10190] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Centers for Medicare & Medicaid 

Services (CMS) is publishing the 

following summary of proposed 

collections for public comment. 

Interested persons are invited to send 

comments regarding this 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. 

1. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Medicaid 

Statistical Information System; Use: 

State data are reported by the Federally 

mandated electronic process, known as 

(MSIS) Medical Statistical Information 

System. These data are the basis of 

actuarial forecasts for Medicaid service 

utilization and costs; of analysis and 

cost savings estimates required for 

legislative initiatives relating to 

Medicaid and for responding to requests 

for information from CMS components, 

the Department, Congress and other 

customers. 

Form Number: CMS–R–284 (OMB#: 

0938–0345); Frequency: Reporting— 

Quarterly; Affected Public: State, Local, 

or Tribal Governments; Number of 

Respondents: 51; Total Annual 

Responses: 204; Total Annual Hours: 

2,040. (For policy questions regarding 

this collection contact Denise Franz 

410–786–6117. For all other issues call 

410–786–1326.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Section 1901 of 

the Act (42 U.S.C. 1396) requires that 

States must establish a State plan for 

medical assistance that are approved by 

the Secretary to carry out the purposes 

of title XIX. The DRA provides States 

with numerous flexibilities in operating 

their State Medicaid programs. The 

intent of these flexibilities is to provide 

States with program alternatives that 

allow them to provide the most 

appropriate health care coverage that 

meets beneficiary needs, while at the 

same time curtailing State and Federal 

spending. Except for the documentation 

of citizenship requirements, States can 

submit SPAs to CMS to effectuate these 

changes to their Medicaid programs. 

CMS provided State Medicaid Directors 

letters providing guidance on these 

provisions and the implementation of 

the DRA and associated SPA templates 

for use by States to modify their 

Medicaid State plans if they choose to 

implement these flexibilities. Under this 

process, the end result is the State 

burden will be reduced significantly. To 

implement these flexibilities, a 

collection of information to effectuate 

these changes is required. Therefore, 

State Medicaid agencies will complete 

the templates to effectuate the changes. 

CMS will review the information to 

determine if the State has met all of the 

requirements of the DRA provisions the 

States choose to implement. If the 

requirements are met, CMS will approve 

the amendments to the State’s Title XIX 

plan giving the State the authority to 

implement the flexibilities. For a State 

to receive Medicaid Title XIX funding, 

there must be an approved Title XIX 

State plan. Five templates were created 

to assist States in effectuating these 

flexibilities through modifications to the 

State plan. The Children’s Health 

Insurance Program Reauthorization Act 

(CHIPRA) of 2009, enacted on February 

4, 2009, corrected language in section 

6044 (Alternative Benefit Packages) of 

the DRA as if these amendments were 

included in the DRA, and subsequently 

amended section 1937 ‘‘State Flexibility 

for Medicaid Benefit Packages.’’ We 

have modified the preprints to reflect 

these statutory changes. Form Number: 

CMS–10190 (OMB#: 0938–0993); 

Frequency: Reporting—Yearly; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

56; Total Annual Responses: 16; Total 

mstockstill on DSKH9S0YB1PROD with NOTICES