Federal Register / Vol. 75, No. 180 / Friday, September 17, 2010 / Notices 57035 

formula grant program. The purpose of 

this program is to educate adolescents 

on both abstinence and contraception to 

prevent pregnancy and sexually 

transmitted infections (STIs); and at 

least three adulthood preparation 

subjects. The Personal Responsibility 

Education grant program funding is 

available for fiscal years 2010 through 

2014. 

An emergency request is being made 

to solicit comments from the public on 

paperwork reduction as it relates to 

ACYF’s receipt of the following 

documents from applicants and 

awardees: Application for Mandatory 

Formula Grant State Plan; Performance 

Progress Report. 

Respondents: 50 States and 9 

Territories, to include, District of 

Columbia, Puerto Rico, Virgin Islands, 

Guam, American Samoa, Northern 

Mariana Islands, the Federated States of 

Micronesia, the Marshall Islands and 

Palau 

ANNUAL BURDEN ESTIMATES

Instrument Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden hours 

per response 

Total burden 

hours 

Application, to include program narrative ........................................................ 59 1 24 1,416 

State Plan ........................................................................................................ 59 1 40 2,360

Performance Progress Reports ....................................................................... 59 5 16 4,720 

Estimated Total Annual Burden 

Hours: 8,496 

In compliance with the requirements 

of Section 506(c)(2)(A) of the Paperwork 

Reduction Act of 1995, the 

Administration for Children and 

Families is soliciting public comment 

on the specific aspects of the 

information collection described above. 

Copies of the proposed collection of 

information can be obtained and 

comments may be forwarded by writing 

to the Administration for Children and 

Families, Office of Administration, 

Office of Information Services, 370 

L’Enfant Promenade, SW., Washington, 

DC 20447, Attn: ACF Reports Clearance 

Officer. E-mail address: 

infocollection@acf.hhs.gov. All requests 

should be identified by the title of the 

information collection. 

The Department specifically requests 

comments on: (a) Whether the proposed 

collection of information is necessary 

for the proper performance of the 

functions of the agency, including 

whether the information shall have 

practical utility; (b) the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information; (c) 

the quality, utility, and clarity of the 

information to be collected; and (d) 

ways to minimize the burden of the 

collection of information on 

respondents, including through the use 

of automated collection techniques or 

other forms of information technology. 

Consideration will be given to 

comments and suggestions submitted 

within 60 days of this publication. 

Dated: September 14, 2010 

Robert Sargis, 

Reports Clearance Officer. 

[FR Doc. 2010–23200 Filed 9–16–10; 8:45 am] 

BILLING CODE 4184–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10267, CMS– 

10137, CMS–10237, CMS–R–240, CMS– 

10316 and CMS–10305] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services. 

In compliance with the requirement 

of section 3506I(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: Revision of a currently 

approved collection; Title of 

Information Collection: QualityNet 

Identity Management System (QIMS) 

Account Form; Use: The QualityNet 

Identity Management System (QIMS) 

account registration form must be 

completed by any new persons needing 

access to Consolidated Renal Operations 

in a Web Enabled Network 

(CROWNWeb.) The 8,561 existing 

accounts owners will not have to 

reregister for new user accounts. The 

CROWNWeb user community is 

composed of CMS employees, ESRD 

Network Organization staff and dialysis 

facilities staff. The CROWNWeb system 

is the system used as the collection 

point of data necessary for entitlement 

of ESRD patients to Medicare benefits 

and Federal Government monitoring 

and assessing of quality and type of care 

provided to renal patients. The data 

collected in QIMS will provide the 

necessary security measures for creating 

and maintaining active CROWNWeb 

user accounts and collection of audit 

trail information required by the CMS 

Information Security Officers (ISSO). 

Form Number: CMS–10267 (OMB#: 

0938–1050); Frequency: Occasionally; 

Affected Public: Business or other forprofits and Not-for-profit institutions; 

Number of Respondents: 7,439; Total 

Annual Responses: 7,439; Total Annual 

Hours: 3,720. (For policy questions 

regarding this collection contact 

Michelle Tucker at 410–786–0376. For 

all other issues call 410–786–1326. 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Application for 

Prescription Drug Plans (PDP); 

Application for Medicare Advantage 

Prescription Drug (MA–PD); 

Application for Cost Plans to Offer 

Qualified Prescription Drug Coverage; 

Application for Employer Group Waiver 

Plans to Offer Prescription Drug 

Coverage; Service Area Expansion 

Application for Prescription Drug 

Coverage; Use: The Applications for Part 

D sponsors to offer qualified 

prescription drug coverage are 

completed by entities seeking approval 

to offer Part D benefits under the 

Medicare Prescription Drug Benefit 


wwoods2 on DSK1DXX6B1PROD with NOTICES_PART 1
57036 Federal Register / Vol. 75, No. 180 / Friday, September 17, 2010 / Notices 

program established by section 101 of 

the Medicare Prescription Drug, 

Improvement, and Modernization Act of 

2003 (MMA) and is codified in section 

1860D of the Social Security Act. 

Effective January 1, 2006, the Part D 

program established an optional 

prescription drug benefit for individuals 

who are entitled to Medicare Part A or 

enrolled in Part B. In general, coverage 

for the prescription drug benefit is 

provided through PDPs that offer drugonly coverage, or through MA 

organizations that offer integrated 

prescription drug and health care 

coverage (MA–PD plans). PDPs must 

offer a basic drug benefit. Medicare 

Advantage Coordinated Care Plans 

(MA–CCPs) must offer either a basic 

benefit or may offer broader coverage for 

no additional cost. Medicare Advantage 

Private Fee for Service Plans (MA– 

PFFS) may choose to offer a Part D 

benefit. Cost Plans that are regulated 

under Section 1876 of the Social 

Security Act, and Employer Group Plans 

may also provide a Part D benefit. If any 

of the contracting organizations meet 

basic requirements, they may also offer 

supplemental benefits through 

enhanced alternative coverage for an 

additional premium. 

The information will be collected 

under the solicitation of proposals from 

PDP, MA–PD, Cost Plan, PACE, and 

EGWP applicants. The collected 

information will be used by CMS to: (1) 

ensure that applicants meet CMS 

requirements, (2) support the 

determination of contract awards. Form 

Number: CMS–10137 (OMB#: 0938– 

0936); Frequency: Once; Affected 

Public: Business or other for-profits and 

Not-for-profit institutions; Number of 

Respondents: 295; Total Annual 

Responses: 295; Total Annual Hours: 

3,576. (For policy questions regarding 

this collection contact Linda Anders at 

410–786–0459. For all other issues call 

410–786–1326.) 

3. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Part C Medicare 

Advantage Application and 1876 Cost 

Plan Expansion Application; Use: The 

Balanced Budget Act of 1997 (BBA) 

established a new ‘‘Part C’’ in the 

Medicare statute (sections 1851 through 

1859 of the Social Security Act (the Act) 

which provided for a Medicare+Choice 

(M+C) program. Under section 

1851(a)(1) of the Act, every individual 

entitled to Medicare Part A and enrolled 

under Part B, except for most 

individuals with end-stage renal disease 

(ESRD), could elect to receive benefits 

either through the Original Medicare 

Program or an M+C plan, if one was 

offered where he or she lived. The 

Medicare Prescription Drug, 

Improvement, and Modernization Act of 

2003 (MMA), established the Medicare 

Prescription Drug Benefit Program (Part 

D) and made revisions to the provisions 

of Medicare Part C, governing what is 

now called the Medicare Advantage 

(MA) program (formerly 

Medicare+Choice) Organizations 

wishing to provide healthcare services 

under MA and/or MA–PD plans must 

complete an application, file a bid, and 

receive final approval from CMS. 

Existing MA plans may expand their 

contracted area by completing the 

Service Area Expansion (SAE) 

application. Any current Cost Plan 

Contractor that wants to expand its 

Medicare cost-based contract with CMS 

under Section 1876 of the Act, as 

amended by the Tax Equity and Fiscal 

Responsibility Act of 1982 (TEFRA) and 

subsequent legislation can complete the 

application. Form Number: CMS–10237 

(OMB#: 0938–0935); Frequency: Yearly; 

Affected Public: Business or other forprofits and Not-for-profit institutions; 

Number of Respondents: 870; Total 

Annual Responses: 870; Total Annual 

Hours: 15,696. (For policy questions 

regarding this collection contact Letticia 

Ramsey at 410–786–5262. For all other 

issues call 410–786–1326.) 

4. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Prospective 

Payments for Hospital Outpatient 

Service and Supporting Regulations is 

42 CFR 413.65; Use: Section 1833(t) of 

the Social Security Act (the Act) 

requires the Secretary to establish a 

prospective payment system (PPS) for 

hospital outpatient services. Successful 

implementation of an outpatient PPS 

requires that CMS distinguish facilities 

or organizations that function as 

departments of hospitals from those that 

are freestanding, so that CMS can 

determine which services should be 

paid under the outpatient prospective 

payment system (OPPS), the clinical 

laboratory fee schedule, or other 

payment provisions applicable to 

services furnished to hospital 

outpatients. 

CMS will use the information from 

sections 413.65(b)(3) and (c) to 

determine whether a facility or 

organization acquired by a main 

provider should be treated as providerbased for Medicare certification, 

coverage, and payment purposes or 

whether a main provider has had a 

material change in its relationship to a 

provider-based facility or organization 

that affects the provider-based status of 

the facility or organization. In addition, 

section 1866(b)(2) of the Act authorizes 

hospitals and other providers to impose 

deductible and coinsurance charges for 

facility services, but does not allow such 

charges by facilities or organizations 

which are not provider-based. 

Implementation of this provision 

requires that CMS have information 

from the required reports, so it can 

determine which facilities are providerbased. Form Number: CMS–R–240 

(OMB#: 0938–0798); Frequency: 

Occasionally; Affected Public: Business 

or other for-profits and Not-for-profit 

institutions; Number of Respondents: 

905; Total Annual Responses: 500,405; 

Total Annual Hours: 26,563 (For policy 

questions regarding this collection 

contact Daniel Schroder at 410–786– 

7452. For all other issues call 410–786– 

1326.) 

5. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Medicare 

Prescription Drug Plan (PDP) and 

Medicare Advantage Prescription Drug 

Plan (MA–PD) Disenrollment Reasons 

Survey; Use: The Medicare Prescription 

Drug, Improvement, and Modernization 

Act of 2003 (MMA) requires the 

collection and reporting performance 

data for Part D prescription drug plans. 

Specifically, the MMA under section 

1860D–4 (Beneficiary Protections for 

Qualified Prescription Drug Coverage) 

requires CMS to conduct consumer 

satisfaction surveys regarding PDPs and 

MA–PDs. CMS will use the survey to 

obtain information regarding 

beneficiaries’ reasons for disenrolling 

from their chosen Part D plan, and their 

expectations relative to provided 

benefits and services. Determining the 

reasons for disenrollment from Part D 

plans will provide important 

information regarding potential 

dissatisfaction with some aspect of the 

plan, such as access, service, cost, 

quality of care, or the benefits provided. 

This information can be used by CMS to 

improve the design and functioning of 

the Part D program. Form Number: 

CMS–10316 (OMB#: 0938–New); 

Frequency: Yearly; Affected Public: 

Individuals and households; Number of 

Respondents: 120,000; Total Annual 

Responses: 120,000; Total Annual 

Hours: 34,800. (For policy questions 

regarding this collection contact Phyllis 

Nagy at 410–786–6646. For all other 

issues call 410–786–1326.) 

6. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Medicare Part C 

and Part D Data Validation (42 CFR 

422.516g and 423.514g); Use: 

Organizations contracted to offer 

Medicare Part C and Part D benefits are 

required to report data to the Centers for 


wwoods2 on DSK1DXX6B1PROD with NOTICES_PART 1
Federal Register / Vol. 75, No. 180 / Friday, September 17, 2010 / Notices 57037 

Medicare & Medicaid Services on a 

variety of measures. In order for the data 

to be useful for monitoring and 

performance measurement, the data 

must be reliable, valid, complete, and 

comparable among sponsoring 

organizations. To meet this goal, CMS is 

developing reporting standards and data 

validation specifications with respect to 

the Part C and Part D reporting 

requirements. These standards will 

provide a review process for Medicare 

Advantage Organizations (MAOs), Cost 

Plans, and Part D sponsors to use to 

conduct data validation checks on their 

reported Part C and Part D data. Form 

Number: CMS–10305 (OMB#: 0938– 

NEW); Frequency: Yearly; Affected 

Public: Business or other for-profit; 

Number of Respondents: 634; Total 

Annual Responses: 634; Total Annual 

Hours: 237,127. (For policy questions 

regarding this collection contact Terry 

Lied at 410–786–8973. 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 October 18, 2010. OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–6974, E-mail: 

OIRA_submission@omb.eop.gov. 

Dated: September 13, 2010. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2010–23160 Filed 9–16–10; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

Periodically, the Health Resources 

and Services Administration (HRSA) 

publishes abstracts of information 

collection requests under review by the 

Office of Management and Budget 

(OMB), in compliance with the 

Paperwork Reduction Act of 1995 (44 

U.S.C. Chapter 35). To request a copy of 

the clearance requests submitted to 

OMB for review, e-mail 

paperwork@hrsa.gov or call the HRSA 

Reports Clearance Office on (301) 443– 

1129. 

The following request has been 

submitted to the Office of Management 

and Budget for review under the 

Paperwork Reduction Act of 1995: 

Proposed Project: Black Lung Clinics 

Program Database (OMB No. 0915– 

0292)—Revision 

The Office of Rural Health Policy 

(ORHP), Health Resources and Services 

Administration, conducts an annual 

data collection of user information for 

the Black Lung Program. This has been 

ongoing with OMB approval since 2004. 

The purpose of the Black Lung Clinic 

Program is to improve the health status 

of coal workers by providing services to 

minimize the effects of respiratory and 

pulmonary impairments of coal miners, 

treatment procedures required in the 

management of problems associated 

with black lung disease which improves 

the quality of life or the miner and 

reduces economic costs associated with 

morbidity and mortality arising from 

pulmonary diseases. The purpose of 

collecting this data is to provide HRSA 

with information on how well each 

grantee is meeting the needs of active 

and retired miners in the funded 

communities. 

Data from the annual report will 

provide quantitative information about 

the programs, specifically: (a) The 

characteristics of the patients they serve 

(gender, age, disability level, occupation 

type); (b) the characteristics of services 

provided (medical encounters, nonmedical encounters, benefits 

counseling, or outreach); and (c) the 

number of patients served. The annual 

report will be updated to include a 

qualitative measure on the percent of 

patients that show improvement in 

pulmonary function. This assessment 

will provide data useful to the program 

and will enable HRSA to provide data 

required by Congress under the 

Government Performance and Results 

Act of 1993. It will also ensure that 

funds are being effectively used to 

provide services to meet the needs of 

the target population. 

There has been a modification to a 

long term Black Lung performance 

measures. The new measure will be the 

evaluation of the quality of spirometry 

performed by the clinic. The evaluation 

of coal miners for the presence of 

disabling pneumoconiosis depends on 

well performed, valid and accurate lung 

function testing. There is no additional 

burden on the grantee to collect this 

information since the grantees are 

currently collecting this data. 

The annual estimate of burden is as 

follows: 

Instrument Number of 

respondents 

Responses 

per 

respondent 

Total 

responses 

Hours per 

response 

Total burden 

hours 

Database .............................................................................. 15 1 1 10 150 

Written comments and 

recommendations concerning the 

proposed information collection should 

be sent within 30 days of this notice to 

the desk officer for HRSA, either by email to OIRA_submission@omb.eop.gov 

or by fax to 202–395–6974. Please direct 

all correspondence to the ‘‘attention of 

the desk officer for HRSA.’’ 

Dated: September 13, 2010. 

Sahira Rafiullah, 

Director, Division of Policy and Information 

Coordination. 

[FR Doc. 2010–23260 Filed 9–16–10; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Submission for OMB Review; 

Comment Request 

Title: New Runaway and Homeless 

Youth Management Information System 

(NEORHYMIS) 

OMB No.: 0970–0123. 


wwoods2 on DSK1DXX6B1PROD with NOTICES_PART 1