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[Federal Register Volume 80, Number 11 (Friday, January 16, 2015)]
[Notices]
[Pages 2430-2431]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2015-00627]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-372(S), CMS-10500, CMS-10221 and CMS-R-263]

Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

ACTION: Notice.

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SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is 
announcing an opportunity for the public to comment on CMS' intention 
to collect information from the public. Under the Paperwork Reduction 
Act of 1995 (the PRA), federal agencies are required to publish notice 
in the Federal Register concerning each proposed collection of 
information (including each proposed extension or reinstatement of an 
existing collection of information) and to allow 60 days for public 
comment on the proposed action. Interested persons are invited to send 
comments regarding our burden estimates 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.

DATES: Comments must be received by March 17, 2015.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number (OCN). To be assured consideration, comments and 
recommendations must be submitted in any one of the following ways:
    1. Electronically. You may send 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) that are 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.
    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, you may make 
your request using one of following:
    1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to Paperwork@cms.hhs.gov.
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.

SUPPLEMENTARY INFORMATION:

Contents

    This notice sets out a summary of the use and burden associated 
with the following information collections. More detailed information 
can be found in each collection's supporting statement and associated 
materials (see ADDRESSES).

CMS-372(S) Annual Report on Home and Community Based Services Waivers 
and Supporting Regulations

CMS-10500 Outpatient/Ambulatory Surgery Patient Experience of Care 
Survey (O/ASPECS)

CMS-10221 Site Investigation for Independent Diagnostic Testing 
Facilities (IDTFs)

CMS-R-263 Site Investigation for Suppliers of Durable Medical 
Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)

    Under the PRA (44 U.S.C. 3501-3520), federal agencies must obtain 
approval from the Office of Management and Budget (OMB) for each 
collection of information they conduct or sponsor. The term 
``collection of information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 
1320.3(c) and includes agency requests or requirements that members of 
the public submit reports, keep records, or provide information to a 
third party. Section 3506(c)(2)(A) of the PRA

[[Page 2431]]

requires federal agencies to publish a 60-day notice in the Federal 
Register concerning each proposed collection of information, including 
each proposed extension or reinstatement of an existing collection of 
information, before submitting the collection to OMB for approval. To 
comply with this requirement, CMS is publishing this notice.

Information Collection

    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Annual Report on 
Home and Community Based Services Waivers and Supporting Regulations; 
Use: We use this report to compare actual data to the approved waiver 
estimates. In conjunction with the waiver compliance review reports, 
the information provided will be compared to that in the Medicaid 
Statistical Information System (MSIS) (CMS-R-284; OMB control number 
0938-0345) report and FFP claimed on a state's Quarterly Expenditure 
Report (CMS-64; OMB control number 0938-1265), to determine whether to 
continue the state's home and community-based services waiver. States' 
estimates of cost and utilization for renewal purposes are based upon 
the data compiled in the CMS-372(S) reports. Form Number: CMS-372(S) 
(OMB Control Number: 0938-0272); Frequency: Yearly; Affected Public: 
State, Local, or Tribal Governments; Number of Respondents: 48; Total 
Annual Responses: 315; Total Annual Hours: 13,545. (For policy 
questions regarding this collection contact Ralph Lollar at 410-786-
0777).
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Outpatient/
Ambulatory Surgery Patient Experience of Care Survey (O/ASPECS); Use: 
The information collected in the national implementation of Outpatient/
Ambulatory Surgery Patient Experience of Care Survey (A/ASPECS) will be 
used to: (1) Provide a source of information from which selected 
measures can be publicly reported to beneficiaries to help them make 
informed decisions for outpatient surgery facility selection; (2) aid 
facilities with their internal quality improvement efforts and external 
benchmarking with other facilities; and (3) provide us with information 
for monitoring and public reporting purposes. Form Number: CMS-10500 
(OMB Control Number: 0938-1240); Frequency: Once; Affected Public: 
Individuals and households; Number of Respondents: 2,813,610; Total 
Annual Responses: 2,813,610; Total Annual Hours: 365,769. (For policy 
questions regarding this collection contact Memuna Ifedirah at 410-786-
6849).
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Site 
Investigation for Independent Diagnostic Testing Facilities (IDTFs); 
Use: We enroll Independent Diagnostic Testing Facilities (IDTFs) into 
the Medicare program via a uniform application, the CMS 855B. 
Implementation of enhanced procedures for verifying the enrollment 
information has improved the enrollment process as well as identified 
and prevented fraudulent IDTFs from entering the Medicare program. As 
part of this process, verification of compliance with IDTF performance 
standards is necessary. The primary function of the site investigation 
form for IDTFs is to provide a standardized, uniform tool to gather 
information from an IDTF that tells us whether it meets certain 
standards to be a IDTF (as found in 42 CFR 410.33(g)) and where it 
practices or renders its services. The site investigation form has been 
used in the past to aid in verifying compliance with the required 
performance standards found in 42 CFR 410.33(g). No revisions have been 
made to this form since the last submission for OMB approval. Form 
Number: CMS-10221 (OMB Control Number: 0938-1029); Frequency: 
Occasionally; Affected Public: Private Sector (Business or other for-
profits and Not-for-profit institutions); Number of Respondents: 900; 
Total Annual Responses: 900; Total Annual Hours: 1,800. (For policy 
questions regarding this collection contact Kim McPhillips at 410-786-
5374).
    4. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Site 
Investigation for Suppliers of Durable Medical Equipment, Prosthetics, 
Orthotics and Supplies (DMEPOS); Use: We enroll suppliers of durable 
medical equipment, prosthetics, orthotics, and supplies (DMEPOS) into 
the Medicare program via a uniform application, the CMS 855S. 
Implementation of enhanced procedures for verifying the enrollment 
information has improved the enrollment process as well as identified 
and prevented fraudulent DMEPOS suppliers from entering the Medicare 
program. As part of this process, verification of compliance with 
supplier standards is necessary. The primary function of the site 
investigation form is to provide a standardized, uniform tool to gather 
information from a DMEPOS supplier that tells us whether it meets 
certain qualifications to be a DMEPOS supplier (as found in 42 CFR 
424.57(c)) and where it practices or renders its services. The site 
investigation form has been used in the past to aid in verifying 
compliance with the required supplier standards found in 42 CFR 
424.57(c). No revisions have been made to this form since the last 
submission for OMB approval. Form Number: CMS-R-263 (OMB Control 
Number: 0938-0749); Frequency: Occasionally; Affected Public: Private 
Sector (Business or other for-profits and Not-for-profit institutions); 
Number of Respondents: 30,000; Total Annual Responses: 30,000; Total 
Annual Hours: 15,000. (For policy questions regarding this collection 
contact Kim McPhillips at 410-786-5374).

    Dated: January 13, 2015.
Martique Jones,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 2015-00627 Filed 1-15-15; 8:45 am]
BILLING CODE 4120-01-P
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