21370 Federal Register / Vol. 76, No. 73 / Friday, April 15, 2011 / Notices 

Medicare beneficiaries. The legislation 

provides $500,000,000 for the program. 

The goals of the CCTP are to improve 

transitions of beneficiaries from the 

inpatient hospital setting to other care 

settings, to improve quality of care, to 

reduce readmissions for high risk 

beneficiaries, and to document 

measureable savings to the Medicare 

program. Form Number: CMS–10369 

(OMB#: 0938–NEW); Frequency: Once; 

Affected Public: State, Local, or Tribal 

Governments; Private Sector—Business 

or other for-profits and not-for-profit 

institutions; Number of Respondents: 

1,000; Total Annual Responses: 1,000; 

Total Annual Hours: 80,000. (For policy 

questions regarding this collection 

contact Juliana Tiongson at 410–786– 

0342. 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.gov/ 

PaperworkReductionActof1995/PRAL/ 

list.asp#TopOfPage or e-mail your 

request, including your address, phone 

number, OMB number, and CMS 

document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office at 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 June 14, 2011: 

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: April 6, 2011. 

Martique Jones, 

Director, Regulations Development Group— 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2011–9125 Filed 4–12–11; 11:15 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–216–94 and 

CMS–10112] 

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: Extension of a currently 

approved collection; Title of 

Information Collection: Organ 

Procurement Organization/ 

Histocompatibility Laboratory 

Statement of Reimbursable Costs, 

manual instructions and supporting 

regulations contained in 42 CFR 413.20 

and 413.24; Use: This form is required 

by statue and regulation for 

participation in the Medicare program. 

The information is used to determine 

payment for Medicare. Organ 

Procurement Organizations and 

Histocompatibility Laboratories are the 

users. Form Number: CMS–216–94 

(OMB# 0938–0102); Frequency: Yearly; 

Affected Public: Business or other forprofit, Not-for-profit institutions; 

Number of Respondents: 115; Total 

Annual Responses: 115; Total Annual 

Hours: 5175. (For policy questions 

regarding this collection contact Angela 

Havrilla at 410–786–4516 or Amelia 

Citerone at 410–786–3901. For all other 

issues call 410–786–1326.) 

2. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Phone Surveys 

of Products and Services for Medicare 

Payment Validation and Supporting 

Regulations in 42 CFR 405.502. Use: 

The phone surveys of products and 

services for Medicare payment 

validation and supporting regulations in 

42 CFR 405.502 will be used to identify 

specific products/services provided to 

Medicare beneficiaries and the costs 

associated with the provision of those 

products/services. The information 

collected will be used to validate the 

Medicare payment amounts for those 

products/services and institute revisions 

of payment amounts where necessary. 

The respondents will be the companies 

that have provided the product/service 

under review to Medicare beneficiaries. 

Form Number: CMS–10112 (OMB# 

0938–0939); Frequency: Occasionally; 

Affected Public: Private sector— 

Business or other for-profit; Number of 

Respondents: 4,000; Total Annual 

Responses: 4,000; Total Annual Hours: 

16,000. (For policy questions regarding 

this collection contact Michael Rich at 

410–786–6856. For all other issues call 

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 May 16, 2011. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS Desk 

Officer, Fax Number: (202) 395–6974, Email: OIRA_submission@omb.eop.gov. 

Dated: April 8, 2011. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2011–9024 Filed 4–14–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–304 and CMS– 

304a; and CMS–368 and CMS–R–144] 

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. 


srobinson on DSKHWCL6B1PROD with NOTICES
Federal Register / Vol. 76, No. 73 / Friday, April 15, 2011 / Notices 21371 

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: Revision of a currently 

approved collection; Title of 

Information Collection: Medicaid Drug 

Rebate Program—Labelers 

Reconciliation of State Invoice (CMS– 

304) and Prior Quarter Adjustment 

Statement (CMS–304a); Use: Section 

1927(b)(2) of the Social Security Act 

establishes manufacturer requirements 

for paying quarterly rebates to States as 

part of the Medicaid Drug Rebate 

Program. Specifically, in order to 

receive a rebate on drugs dispensed to 

Medicaid recipients, States are required 

to submit quarterly utilization data to 

drug manufacturers that have national 

rebate agreements with the Federal 

Government. Form CMS–304 is used by 

manufacturers for both unit adjustments 

and disputes in response to the State’s 

invoice for current quarter utilization. 

The form CMS–304a is required only in 

those instances where a manufacturer 

discovers unit adjustments and/or 

disputes from a previous quarter’s State 

invoice. Both forms are used to 

reconcile drug rebate payments made by 

manufacturers with the State invoices of 

rebates due; Form Numbers: CMS–304 

and CMS–304a (OMB#: 0938–0676); 

Frequency: Quarterly; Affected Public: 

Private Sector: Business or other forprofits; Number of Respondents: 1,011; 

Total Annual Responses: 4,044; Total 

Annual Hours: 183,120. (For policy 

questions regarding this collection 

contact Andrea Wellington at 410–786– 

3490. For all other issues call 410–786– 

1326.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: State Medicaid 

Drug Rebate Forms: CMS–R–144 

(Quarterly Report Data) and CMS–368 

(Administrative Data); Use: Section 

1927(b)(2) of the Social Security Act 

establishes State requirements for 

reporting drug utilization data to CMS 

and to drug manufacturers participating 

in the Medicaid Drug Rebate Program. 

Specifically, in order to receive a rebate 

on drugs dispensed to Medicaid 

recipients, States are required to submit 

quarterly utilization data reports to drug 

manufacturers that have national rebate 

agreements with the Federal 

Government. In addition, a copy of 

these reports must also be submitted to 

CMS. Form CMS–R–144 is used by the 

States to submit this utilization 

information to both manufacturers and 

CMS. Form CMS–368 is a report of 

contact for the State to name the 

individuals involved in the drug rebate 

program and is required only in those 

instances where a change to the original 

data submittal is necessary. The ability 

to require the reporting of any changes 

to these data is necessary to the efficient 

operation of the rebate program; Form 

Numbers: CMS–R–144 and CMS–368 

(OMB#: 0938–0852); 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. 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.gov/ 

PaperworkReductionActof1995/PRAL/ 

list.asp#TopOfPage or e-mail your 

request, including your address, phone 

number, OMB number, and CMS 

document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office at 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 June 14, 2011: 

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: April 8, 2011. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2011–9025 Filed 4–14–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10337] 

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: Revision of a currently 

approved collection; Title of 

Information Collection: Limited 

Competition for State Planning and 

Establishment Grants for the Affordable 

Care Act’s Exchanges; Use: On March 

23, 2010, the President signed into law 

the Patient Protection and Affordable 

Care Act. On March 30, 2010, the Health 

Care and Education Reconciliation Act 

of 2010 was signed into law. The two 

laws are collectively referred to as the 

Affordable Care Act. The Affordable 

Care Act includes a wide variety of 

provisions designed to expand coverage, 

provide more health care choices, 

enhance the quality of health care for all 

Americans, hold insurance companies 

more accountable, and lower health care 

costs. 

The Affordable Care Act provides 

each State with the option to set up a 

State-operated Health Benefits 


srobinson on DSKHWCL6B1PROD with NOTICES