44368 Federal Register / Vol. 74, No. 166 / Friday, August 28, 2009 / Notices 

The results of this voluntary testing 

process will enable CMS to assess the 

feasibility of collecting data elements 

via electronic health records as a future 

alternative to submission of manually 

abstracted chart data elements by 

hospitals, thereby potentially reducing 

the administrative burden associated 

with submission of quality measures for 

the RHQDAPU program. Form Number: 

CMS–10296 (OMB#: 0938–New); 

Frequency: Reporting—Once; Affected 

Public: Private Sector—Business or 

other for-profits and Not-for-profit 

institutions; Number of Respondents: 

55; Total Annual Responses: 55; Total 

Annual Hours: 28,655. (For policy 

questions regarding this collection 

contact Shaheen Halim at 410–786– 

0641. For all other issues call 410–786– 

1326.) 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS’ Web Site 

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. 

In commenting on the proposed 

information collections please reference 

the document identifier or OMB control 

number. To be assured consideration, 

comments and recommendations must 

be submitted in one of the following 

ways by October 27, 2009: 

1. Electronically. You may submit 

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) 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, Room C4–26–05, 7500 

Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: August 21, 2009. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E9–20845 Filed 8–27–09; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10080, CMS–R– 

70, CMS–R–38 and CMS–846–849, 854, 

10125, 10126, 10269] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services. 

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 a currently 

approved collection; Title of 

Information Collection: Publication 

Usage Survey; Use: The Publication 

Usage survey was developed to gather 

information from people who request or 

access Medicare publications, to ensure 

comprehension, usability, and use of the 

publications. CMS is seeking 

understanding about whether 

publications have been effective in 

informing members of the Medicare 

audience regarding policy and benefits. 

Included in the survey are questions 

regarding the satisfaction of publication 

users with specific publications and 

whether the information they received 

informed them about the Medicare 

program. Information gathered in this 

survey will be used only for purposes of 

targeting and improving 

communications with Medicare 

beneficiaries, caregivers, partners, and 

community organizations. Form 

Number: CMS–10080 (OMB#: 0938– 

0892); Frequency: Reporting—On 

occasion; Affected Public: Individuals or 

Households; Number of Respondents: 

3,800; Total Annual Responses: 3,800; 

Total Annual Hours: 950. (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: Information 

Collection Requirements in HSQ–110, 

Acquisition, Protection and Disclosure 

of Peer review Organization Information 

and Supporting Regulations in 42 CFR, 

Sections 480.104, 480.105, 480.116, and 

480.134; Use: The Peer Review 

Improvement Act of 1982 authorizes 

quality improvement organizations 

(QIOs), formally known as peer review 

organizations (PROs), to acquire 

information necessary to fulfill their 

duties and functions and places limits 

on disclosure of the information. The 

QIOs are required to provide notices to 

the affected parties when disclosing 

information about them. These 

requirements serve to protect the rights 

of the affected parties. The information 

provided in these notices is used by the 

patients, practitioners and providers to: 

obtain access to the data maintained and 

collected on them by the QIOs; add 

additional data or make changes to 

existing QIO data; and reflect in the 

QIO’s record the reasons for the QIO’s 

disagreeing with an individual’s or 

provider’s request for amendment.: 

Form Number: CMS–R–70 (OMB#: 

0938–0426); Frequency: Reporting—On 

occasion; Affected Public: Business or 

other for-profits; Number of 

Respondents: 362; Total Annual 

Responses: 3729; Total Annual Hours: 

60,919. (For policy questions regarding 

this collection contact Tom Kessler at 

410–786–1991. For all other issues call 

410–786–1326.) 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Conditions of 

Certification for Rural Health Clinics 

and Supporting Regulations in 42 CFR 

491.9, 491.10, 491.11; Use: The Rural 

Health Clinic (RHC) conditions of 

certification are based on criteria 

prescribed in law and are designed to 

ensure that each facility has a properly 

trained staff to provide appropriate care 

and to assure a safe physical 

environment for patients. The Centers 

for Medicare and Medicaid Services 

(CMS) uses these conditions of 

participation to certify RHCs wishing to 

participate in the Medicare program. 

These requirements are similar in intent 

to standards developed by industry 

organizations such as the Joint 

Commission on Accreditation of 

Hospitals, and the National League of 

Nursing/American Public Association 


hsrobinson on DSK69SOYB1PROD with NOTICES
Federal Register / Vol. 74, No. 166 / Friday, August 28, 2009 / Notices 44369 

and merely reflect accepted standards of 

management and care to which rural 

health clinics must adhere. Form 

Number: CMS–R–38 (OMB#: 0938– 

0334); Frequency: Recordkeeping and 

Reporting—Annually and upon initial 

application for Medicare approval; 

Affected Public: Business or other forprofits; Number of Respondents: 3,937; 

Total Annual Responses: 3,937; Total 

Annual Hours: 18,932. (For policy 

questions regarding this collection 

contact Mary Collins at 410–786–3189. 

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

4. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Durable Medical 

Equipment Medicare Administrative 

Contractors (MAC), Certificates of 

Medical Necessity; Use: The certificate 

of medical necessity (CMN) collects 

information required to help determine 

the medical necessity of certain items. 

CMS requires CMNs where there may be 

a vulnerability to the Medicare program. 

Each initial claim for these items must 

have an associated CMN for the 

beneficiary. Suppliers (those who bill 

for the items) complete the 

administrative information (e.g., 

patient’s name and address, items 

ordered, etc.) on each CMN. The 1994 

Amendments to the Social Security Act 

require that the supplier also provide a 

narrative description of the items 

ordered and all related accessories, their 

charge for each of these items, and the 

Medicare fee schedule allowance (where 

applicable). The supplier then sends the 

CMN to the treating physician or other 

clinicians (e.g., physician assistant, 

LPN, etc.) who completes questions 

pertaining to the beneficiary’s medical 

condition and signs the CMN. The 

physician or other clinician returns the 

CMN to the supplier who has the option 

to maintain a copy and then submits the 

CMN (paper or electronic) to CMS, 

along with a claim for reimbursement. 

Due to a technical oversight on the 

part of CMS, an important question on 

CMN Form 10269 was omitted from the 

last OMB submission that would allow 

claims with an apnea-hypopnea index 

(AHI) or respiratory disturbance index 

(RDI) greater than or equal to 5 without 

symptoms for Criterion 2 be paid for by 

the Medicare program. The omission of 

the following question ‘‘Does the patient 

have documented evidence of at least 

one of the following: Excessive daytime 

sleepiness, impaired cognition, mood 

disorders, insomnia, hypertension, 

ischemic heart disease or history of 

stroke’’ could cause improper payment 

of claims without regards as to whether 

the patient has signs or symptoms in 

support of meeting the applicable 

coverage criteria for PAP devices. We 

are resubmitting this information 

collection request to have the revised 

CMN Form 10269 approved. None of the 

other CMN forms have changed. Form 

Number: CMS–846–849, 854, 10125, 

10126, 10269 (OMB# 0938–0679); 

Frequency: Occasionally; Affected 

Public: Business or other for-profit and 

Not-for-profit institutions; Number of 

Respondents: 59,200; Total Annual 

Responses: 6,480,000; Total Annual 

Hours: 1,296,000. (For policy questions 

regarding this collection contact Doris 

Jackson at 410–786–4459. For all other 

issues call 410–786–1326.) 

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 28, 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 21, 2009. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E9–20839 Filed 8–27–09; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Notice of Availability of Draft Policy 

Document for Comment 

AGENCY: Health Resources and Services 

Administration (HRSA), HHS. 

ACTION: This Policy Information Notice 

(PIN) describes the documentation that 

will be considered by the Health 

Resources and Services Administration 

(HRSA) to establish whether an 

organization can qualify as a ‘‘public 

agency’’ (also referred to in previous 

PINs as ‘‘public entities’’ or ‘‘public 

applicants’’) for the purpose of 

determining eligibility for a Health 

Center Program grant under Section 330 

of the Public Health Service (PHS) Act 

(‘‘Section 330’’) and/or Federally 

Qualified Health Center (FQHC) LookAlike designation. This draft PIN is 

available on the Internet at http:// 

bphc.hrsa.gov/draftsforcomment/ 

publiccenter. 

DATES: Comments must be received by 

October 13, 2009. 

ADDRESSES: Comments should be 

submitted to OPPDGeneral@hrsa.gov by 

close of business October 13, 2009. 

SUMMARY: HRSA believes that 

community input is valuable to the 

development of policies and policy 

documents related to the 

implementation of HRSA programs, 

including the Health Center Program. 

Therefore, we are requesting comments 

on the PIN referenced above. Comments 

will be reviewed and analyzed, and a 

summary and general response will be 

published as soon as possible after the 

deadline for receipt of comments. 

Background: HRSA administers the 

Health Center Program, which supports 

more than 1,100 organizations operating 

more than 7,500 health care delivery 

sites, including community health 

centers, migrant health centers, health 

care for the homeless centers, and 

public housing primary care centers. 

Health centers serve medically 

underserved communities delivering 

preventive and primary care services to 

patients regardless of their ability to 

pay. The Health Center Program’s 

authorizing statute and implementing 

regulations (Section 330 of the PHS Act 

and 42 CFR Part 51c) state that any 

public or non-profit private entity is 

eligible to apply for a grant under the 

Health Center Program. The term 

‘‘public agency’’ is not explicitly 

defined in Section 330 or in the Health 

Center Program’s regulations; however, 

reference is made in Section 330 to 

these types of organizations within the 

definition of a public center as ‘‘a health 

center funded (or to be funded) through 

a grant under this section to a public 

agency’’ (Section 330(k)(3)(M) of the 

PHS Act). HRSA is issuing this PIN to 

describe the documentation that will be 

considered to establish whether an 

organization can qualify as a ‘‘public 

agency’’ (also referred to in previous 

PINs as ‘‘public entities’’ or ‘‘public 

applicants’’) for purposes of 

determining eligibility for a Health 

Center Program grant under Section 330 

of the PHS Act and/or FQHC Look-Alike 

designation. 

FOR FURTHER INFORMATION CONTACT: For 

questions regarding this notice, please 

contact the Office of Policy and Program 


hsrobinson on DSK69SOYB1PROD with NOTICES