15016 Federal Register / Vol. 78, No. 46 / Friday, March 8, 2013 / Notices 

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: Reinstatement without change 

of previously approved collection; Title: 

Durable Medical Equipment Medicare 

Administrative Contractor Certificate of 

Medical Necessity and Supporting 

Documentation Requirements; Use: The 

certificates of medical necessity (CMNs) 

collect information required to help 

determine the medical necessity of 

certain items. The 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. 

Form Numbers: CMS–846, 847, 848, 

849, 10125, 10126 (OCN: 0938–0679); 

Frequency: Occasionally; Affected 

Public: Individuals or Households; 

Number of Respondents: 462,000; Total 

Annual Responses: 462,000; Total 

Annual Hours: 92,400. (For policy 

questions regarding this collection 

contact Amanda Burd at 410–786–2074. 

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 April 8, 2013. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS 

Desk Officer, Fax Number: (202) 395– 

6974, Email: 

OIRA_submission@omb.eop.gov. 

Dated: February 26, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–05388 Filed 3–7–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10053] 

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: Paid Feeding 

Assistants in Long-Term Care Facilities 

and Supporting Regulations at 42 CFR 

483.160; Use: Pursuant to 42 CFR part 

483, long-term care facilities are 

permitted to use paid feeding assistants 

to supplement the services of certified 

nurse aides. If facilities choose this 

option, feeding assistants must complete 

a training program. Nursing home 

providers are expected to maintain a 

record of all individuals used by the 

facility as paid feeding assistants. Form 

Number: CMS–10053 (OCN: 0938– 

0916); Frequency: Occasionally; 

Affected Public: Private Sector: Business 

or other for-profit and not-for-profit 

institutions; Number of Respondents: 

4,250; Total Annual Responses: 4,250; 

Total Annual Hours: 25,500. (For policy 

questions regarding this collection 

contact Shelly Ray at 410–786–7884. 

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. 

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 May 7, 2013: 

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 lll, Room C4–26–05, 

7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: March 4, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–05389 Filed 3–7–13; 8:45 am] 

BILLING CODE 4120–01–P 

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