[Federal Register Volume 74, Number 190 (Friday, October 2, 2009)]
[Notices]
[Page 50973]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-23811]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10299]


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: New Collection; Title of 
Information Collection: State Plan Amendment Template for the Option to 
Cover Certain Children and Pregnant Women Lawfully residing in U.S.; 
Use: This new option for State Medicaid and Children Health Insurance 
Programs (CHIP) was provided by section 214 of the Children's Health 
Insurance Program Reauthorization Act of 2009, Public Law 111-3, which 
amends section 1902 of the Social Security Act. To select this option, 
a State Medicaid or CHIP agency will complete a template page and 
submit it for approval as part of their State Plan. Form Number: CMS-
10299 (OMB<greek-i>: 0938-NEW); Frequency: Reporting--Once and 
occasionally; Affected Public: State, Local, or Tribal Governments; 
Number of Respondents: 51; Total Annual Responses: 51; Total Annual 
Hours: 51. (For policy questions regarding this collection contact Bob 
Tomlinson at 410-786-5907. 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 E-
mail your request, including your address, phone number, OMB number, 
and CMS document identifier, to <a href="/cdn-cgi/l/email-protection#acfccddcc9dedbc3dec7eccfc1df82c4c4df82cbc3da"><span class="__cf_email__" data-cfemail="4d1d2c3d283f3a223f260d2e203e6325253e632a223b">[email protected]</span></a>, 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 December 1, 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: September 25, 2009.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E9-23811 Filed 10-1-09; 8:45 am]
BILLING CODE 4120-01-P


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