Federal Register / Vol. 75, No. 15 / Monday, January 25, 2010 / Notices 3907 

‘‘Customer Satisfaction Surveys,’’ will 

provide the information needed to 

complete these goals. With the 

information collected from Tribal 

homeowners, Tribal leaders, and Tribal 

operation and maintenance operators, 

the Sanitation facilities programs will 

make improvements that will result in 

improved quality of services. 

Voluntary customer satisfaction 

surveys will be conducted through 

phone calls, mail, and the Internet. The 

information gathered will be used by 

agency management and staff to identify 

strengths and weaknesses in current 

service provision, to plan and redirect 

resources, to make improvements that 

are practical and feasible, and to 

provide vital feedback to partner 

agencies, Tribal leaders, system 

operators, health boards, and 

community members regarding 

customer satisfaction or dissatisfaction 

with the SFCP. 

Affected Public: Individuals. Type of 

Respondents: Tribal homeowners, 

Tribal leaders, and Tribal operation and 

maintenance operators. 

The table below provides: Types of 

data collection instruments, Estimated 

number of respondents, Number of 

responses per respondent, Annual 

number of responses, Average burden 

minutes per response, and Total annual 

burden hour(s). 

Data collection instrument(s) 

Number 

of 

respondents 

Responses 

per 

respondent 

Total 

annual 

response 

Burden 

minutes per 

response 

Annual 

burden 

hours 

Tribal Homeowner Survey ................................................... 1,300 1 1,300 10 217 

Tribal Partner Survey ........................................................... 175 1 175 10 29 

Annual Operator O&M Survey ............................................. 125 1 125 10 21 

Post Construction O&M Survey ........................................... 200 1 200 10 33 

Total .............................................................................. 1,800 ........................ ........................ ........................ 300 

There are no Capital Costs, Operating 

Costs, and/or Maintenance Costs to 

report. 

Request for Comments: Your written 

comments and/or suggestions are 

invited on one or more of the following 

points: (a) Whether the information 

collection activity is necessary to carry 

out an agency function; (b) whether the 

agency processes the information 

collected in a useful and timely fashion; 

(c) the accuracy of the public burden 

estimate (the estimated amount of time 

needed for individual respondents to 

provide the requested information); (d) 

whether the methodology and 

assumptions used to determine the 

estimates are logical; (e) ways to 

enhance the quality, utility, and clarity 

of the information being collected; and 

(f) ways to minimize the public burden 

through the use of automated, 

electronic, mechanical, or other 

technological collection techniques or 

other forms of information technology. 

Direct Comments to OMB: Send your 

written comments and suggestions 

regarding the proposed information 

collection contained in this notice, 

especially regarding the estimated 

public burden and associated response 

time to: Office of Management and 

Budget, Office of Regulatory Affairs, 

Attention: Desk Officer for IHS, New 

Executive Office Building, Room 10235, 

Washington, DC 20503. 

Send Comments and Requests for 

Further Information: To request more 

information on the proposed collection 

or to obtain a copy of the data collection 

instrument(s) and/or instruction(s) 

contact: Ms. Betty Gould, Reports 

Clearance Officer, 801 Thompson 

Avenue, TMP, Suite 450, Rockville, MD 

20852–1627; call non-toll free (301) 

443–7899; send via facsimile to (301) 

443–9879; or send your e-mail requests, 

comments, and return address to: 

Betty.Gould@ihs.gov. 

Comment Due Date: Comments 

regarding this information collection are 

best assured of having full effect if 

received within 30 days of the date of 

this publication. 

Dated: January 14, 2010. 

Yvette Roubideaux, 

Director, Indian Health Service. 

[FR Doc. 2010–1233 Filed 1–22–10; 8:45 am] 

BILLING CODE 4165–16–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10066, CMS–R– 

193, CMS–10295 and CMS–10234] 

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 of a currently 

approved collection; Title of 

Information Collection: Detailed Notice 

of Discharge (DND); Use: A beneficiary/ 

enrollee who wishes to appeal a 

determination by a Medicare health 

plan or hospital that inpatient care is no 

longer necessary, may request Quality 

Improvement Organization (QIO) review 

of the determination. On the date the 

QIO receives the beneficiary’s/enrollee’s 

request, it must notify the plan and 

hospital that the beneficiary/enrollee 

has filed a request for an expedited 

determination. The plan (for a managed 

care enrollee) or hospital (for an original 

Medicare beneficiary), in turn, must 

deliver a detailed notice to the enrollee/ 

beneficiary. Form Number: CMS–10066 

(OMB#: 0938–1019); Frequency: 

Reporting—Yearly; Affected Public: 

Business or other for-profits and Notfor-profit institutions; Number of 

Respondents: 6163; Total Annual 

Responses: 13,218; Total Annual Hours: 

13,218. (For policy questions regarding 

this collection contact Evelyn Blaemire 

at 410–786–1803. For all other issues 

call 410–786–1326.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Important 


jlentini on DSKJ8SOYB1PROD with NOTICES
3908 Federal Register / Vol. 75, No. 15 / Monday, January 25, 2010 / Notices 

Message from Medicare (IM); Use: 

Requirements that hospitals notify 

beneficiaries in inpatient hospital 

settings of their rights as a hospital 

patient including their discharge appeal 

rights are referenced in Section 1866 of 

the Social Security Act (The Act). The 

authority for the right to an expedited 

determination is set forth at Sections 

1869 and 1154 of the Act. The hospital 

must deliver valid, written notice (the 

IM) of a patient’s rights as a hospital 

patient including the discharge appeal 

rights, within 2 calendar days of 

admission. A follow-up copy of the 

signed IM is given again as far as 

possible in advance of discharge, but no 

more than 2 calendar days before. 

Follow-up notice is not required if 

provision of the admission IM falls 

within 2 calendar days of discharge. The 

collection has been revised to include 

documentation of the time when the 

beneficiary signs the document when it 

is delivered initially and as a follow up 

copy. Form Number: CMS–R–193 

(OMB#: 0938–1019); Frequency: 

Reporting—Yearly; Affected Public: 

Business or other for-profits and Notfor-profit institutions; Number of 

Respondents: 3193; Total Annual 

Responses: 13,218; Total Annual Hours: 

19,680,000. (For policy questions 

regarding this collection contact Evelyn 

Blaemire at 410–786–1803. For all other 

issues call 410–786–1326.) 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Recovery Act— 

Reporting Requirements for States 

Under FMAP Increase and TMA 

Provisions; Use: The American 

Recovery and Reinvestment Act of 2009 

(Recovery Act), Public Law 111–5, 

requires that States submit quarterly 

reports to the Secretary of Health and 

Human Services in accordance with 

section 5001 Temporary Increase of 

Medicaid Federal Medical Assistance 

Percentage (FMAP) and section 5004(d) 

Extension of Transitional Medical 

Assistance (TMA). The reports under 

section 5001 are required for the period 

of October 1, 2008—September 30, 

2011. The reports under section 5004 

are required beginning on July 1, 2009 

until the Federal authority for TMA 

coverage sunsets (now scheduled to 

sunset on December 31, 2010). Each 

State Medicaid agency will submit its 

quarterly reports to the appropriate 

Regional Office of CMS. The reports will 

be compiled and summarized for annual 

reports to Congress. Form Number: 

CMS–10295 (OMB#: 0938–1073); 

Frequency: Reporting—Quarterly; 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

50; Total Annual Responses: 200; Total 

Annual Hours: 600. (For policy 

questions regarding this collection 

contact Richard Strauss at 410–786– 

2019. For all other issues call 410–786– 

1326.) 

4. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: State Plan Preprint implementing Section 6087 of the 

Deficit Reduction Act: Optional SelfDirection Personal Assistance Services 

(PAS) Program (Cash and Counseling); 

Form Number: CMS–10234 (OMB#: 

0938–1024); Use: Information submitted 

via the State Plan Amendment (SPA) 

pre-print is used by CMS and Regional 

Offices to analyze a State’s proposal to 

implement Section 6087 of the Deficit 

Reduction Act (DRA). State Medicaid 

Agencies will complete the SPA preprint, and submit it to CMS for a 

comprehensive analysis. The pre-print 

contains assurances, check-off items, 

and areas for States to describe policies 

and procedures for subjects such as 

quality assurance, risk management, and 

voluntary and involuntary 

disenrollment; Frequency: Reporting— 

Once; Affected Public: State, Local, or 

Tribal Government; Number of 

Respondents: 56; Total Annual 

Responses: 20; Total Annual Hours: 

400. (For policy questions regarding this 

collection contact Carrie Smith at 410– 

786–4485. 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 March 26, 2010: 

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: January 15, 2010. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2010–1341 Filed 1–22–10; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

that the Office of Management and 

Budget (OMB) approve the proposed 

information collection project: 

‘‘Collection of Information for Agency 

for Healthcare Research and Quality’s 

(AHRQ) Consumer Assessment of 

Healthcare Providers and Systems 

(CAHPS) Health Plan Survey 

Comparative Database.’’ In accordance 

with the Paperwork Reduction Act, 44 

U.S.C. 3501–3520, AHRQ invites the 

public to comment on this proposed 

information collection. 

DATES: Comments on this notice must be 

received by March 26, 2010. 

ADDRESSES: Written comments should 

be submitted to: Doris Lefkowitz, 

Reports Clearance Officer, AHRQ, by email at doris.lefkowitz@AHRQ.hhs.gov. 

Copies of the proposed collection 

plans, data collection instruments, and 

specific details on the estimated burden 

can be obtained from the AHRQ Reports 

Clearance Officer. 

FOR FURTHER INFORMATION CONTACT: 

Doris Lefkowitz, AHRQ Reports 

Clearance Officer, (301) 427–1477, or by 

e-mail at 

doris.lefkowitz@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Collection of Information for Agency 

for Healthcare Research and Quality’s 

(AHRQ) Consumer Assessment of 

Healthcare Providers and Systems 

(CAHPS) Health Plan Survey 

Comparative Database. 


jlentini on DSKJ8SOYB1PROD with NOTICES