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[Federal Register Volume 76, Number 247 (Friday, December 23, 2011)]
[Notices]
[Page 80372]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-33098]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10368]

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: New collection (request 
for a new OMB control number); Title of Information Collection: Dental 
Action Plan Template for Medicaid and CHIP Programs; Use: CMS is 
responsible for administering the Federal Medicaid program and the 
Children's Health Insurance Program (CHIP). As part of the Federal 
Medicaid program, CMS oversees the Early and Periodic Screening, 
Diagnostic, and Treatment (EPSDT) benefit to assure that all 
requirements are met. The provision of dental services to EPSDT-
eligible individuals is required under section 1905(r)(3) of the Social 
Security Act. In addition, section 1902(a)(43)(D)(iii) requires that 
CMS collect information on dental services furnished to eligible 
individuals. Section 501(e) of CHIPRA imposed new data reporting 
requirements for the CHIP program by requiring certain dental data to 
be reported in 2011 on the CHIP annual report. Dental data for CHIP is 
unavailable as the requirement to report this data is new for CHIP 
programs. CMS intends to use the information provided in the template 
to help inform us of the States' activities undertaken to achieve the 
national oral health goals for Medicaid and CHIP. CMS will use the 
information to routinely follow-up with States on the achievement of 
their goals and activities and will share that information with other 
States. The template has been revised since the publication of the 60-
day notice by clarifying instructions and by making minor changes. The 
supporting documents have not been changed; Form No.: CMS-10368 (OCN 
0938-NEW); Frequency: Once; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 69; Total Annual Responses: 69; 
Total Annual Hours: 4,485. (For policy questions regarding this 
collection contact Cindy Ruff at (410) 786-5916. 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 January 23, 2012. 
OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-6974, email: OIRA_submission@omb.eop.gov.

    Dated: December 16, 2011.
Martique Jones,
Director, Regulations Development Group, Division-B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2011-33098 Filed 12-22-11; 8:45 am]
BILLING CODE 4120-01-P
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