37542 Federal Register / Vol. 78, No. 120 / Friday, June 21, 2013 / Notices 

collaboration and informed decision 

making with the ultimate goal of 

reaching consensus on issues. Although 

formal responsibility for the agency’s 

overall government-to-government 

consultation activities rests within the 

CDC Office of the Director (OD), other 

CDC Center, Institute, and Office (CIO) 

leadership shall actively participate in 

TAC meetings and HHS-sponsored 

regional and national tribal consultation 

sessions as frequently as possible. 

Matters to Be Discussed: The TAC 

will convene their advisory committee 

meeting with discussions and 

presentations from various CDC senior 

leaders on activities and areas identified 

by TAC members and other tribal 

leaders as priority public health issues. 

The following topics are scheduled for 

presentation and discussion during the 

TAC Meeting; however, discussion is 

not limited to these topics: Native 

specimens, direct assistance and EpiAids, success stories, and disease 

specific topics. 

The 10th Biannual Tribal 

Consultation Session will engage CDC 

senior leadership from the CDC OD and 

various CDC CIOs. Sessions that will be 

held during the Tribal Consultation 

include the following: A listening 

session with CDC’s director, roundtable 

discussions with CDC senior leadership, 

and an opportunity for tribal testimony. 

Additional opportunities will be 

provided during the Consultation 

Session for tribal testimony. Tribal 

Leaders are encouraged to submit 

written testimony by 12:00 a.m., EST on 

July 19, 2013, to Kimberly Cantrell, 

Deputy Associate Director for Tribal 

Support, OSTLTS, via mail to 4770 

Buford Highway NE., MS E–70, Atlanta, 

Georgia 30341 or email to 

tribalconsult@cdc.gov. Depending on 

the time available, it may be necessary 

to limit the time of each presenter. 

The agenda is subject to change as 

priorities dictate. 

Information about the TAC, CDC’s 

Tribal Consultation Policy, and previous 

meetings may be referenced on the 

following web link: http://www.cdc.gov/ 

tribal. 

Contact Person For More Information: 

April R. Taylor, Public Health Analyst, 

CDC/OSTLTS, via mail to 4770 Buford 

Highway NE., MS E–70, Atlanta, 

Georgia 30341 or email to 

ARTaylor@cdc.gov. 

The Director, Management Analysis 

and Services Office has been delegated 

the authority to sign Federal Register 

notices pertaining to announcements of 

meetings and other committee 

management activities, for both the 

Centers for Disease Control and 

Prevention, and the Agency for Toxic 

Substances and Disease Registry. 

Elaine L. Baker, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. 2013–14779 Filed 6–20–13; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

Disease, Disability, and Injury 

Prevention and Control Special 

Emphasis Panel (SEP): Initial Review 

The meeting announced below 

concerns NIOSH Cooperative 

Agreement Research to Aid Recovery 

from Hurricane Sandy, Request for 

Applications (RFA) OH13–002, initial 

review. 

In accordance with Section 10(a)(2) of 

the Federal Advisory Committee Act 

(Pub. L. 92–463), the Centers for Disease 

Control and Prevention (CDC) 

announces the aforementioned meeting: 

Time and Date: 1:00 p.m.–5:00 p.m., 

August 8, 2013 (Closed). 

Place: Teleconference. 

Status: The meeting will be closed to 

the public in accordance with 

provisions set forth in Section 

552b(c)(4) and (6), Title 5 U.S.C., and 

the Determination of the Director, 

Management Analysis and Services 

Office, CDC, pursuant to Public Law 92– 

463. 

Matters to Be Discussed: The meeting 

will include the initial review, 

discussion, and evaluation of 

applications received in response to 

‘‘NIOSH Cooperative Agreement 

Research to Aid Recovery from 

Hurricane Sandy RFA OH13–002.’’ 

Contact Person for More Information: 

Joan Karr, Ph.D., Scientific Review 

Officer, CDC/NIOSH 1600 Clifton Road, 

Mailstop E–74, Atlanta, Georgia 30333, 

Telephone: (404)498–2506. 

The Director, Management Analysis 

and Services Office, has been delegated 

the authority to sign Federal Register 

notices pertaining to announcements of 

meetings and other committee 

management activities, for both the 

Centers for Disease Control and 

Prevention and the Agency for Toxic 

Substances and Disease Registry. 

Elaine L. Baker, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. 2013–14782 Filed 6–20–13; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

Board of Scientific Counselors, 

National Center for Injury Prevention 

and Control, (BSC, NCIPC) 

Correction: This notice was published 

in the Federal Register on June 11, 

2013, Volume 78, Number 112, Pages 

35036–35037. The closing date for 

receipt of nominations was 

inadvertently omitted. Nominations 

must be submitted (postmarked or 

electronically received) by July 26, 

2013. 

Contact Person for More Information: 

Paul Middendorf, Senior Health 

Scientist, 1600 Clifton Rd. NE., MS: E– 

20, Atlanta, GA 30329; telephone (404) 

498–2548 (this is not a toll-free 

number); email: pmiddendorf@cdc.gov. 

The Director, Management Analysis 

and Services Office, has been delegated 

the authority to sign Federal Register 

notices pertaining to announcements of 

meetings and other committee 

management activities, for both the 

Centers for Disease Control and 

Prevention, and Agency for Toxic 

Substances and Disease Registry. 

Elaine L. Baker, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. 2013–14781 Filed 6–20–13; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10116, CMS– 

R–245, CMS–1572, CMS–250–254, CMS–379, 

CMS–4040, CMS–10174, CMS–10261, and 

CMS–R–285] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

ACTION: Notice. 

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 

(PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information (including each proposed 


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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 

August 20, 2013. 

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 lll, 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: 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–10116 Conditions for Payment 

of Power Mobility Devices, including 

Power Wheelchairs and Power-Operated 

Vehicles. 

CMS–R–245 Medicare and Medicaid 

Programs OASIS Collection 

Requirements as Part of the CoPs for 

HHAs and Supp. Regs. in 42 CFR 48.55, 

484.205, 484.245, 484.250. 

CMS–1572 Home Health Agency 

Survey and Deficiencies Report. 

CMS–250–254 Medicare Secondary 

Payer Information Collection and 

Supporting Regulations. 

CMS–379 Financial Statement of 

Debtor and Supporting Regulations. 

CMS–4040 Request for Enrollment 

in Supplementary Medical Insurance. 

CMS–10174 Collection of 

Prescription Drug Event Data from 

Contracted Part D Providers for 

Payment. 

CMS–10261 Part C Medicare 

Advantage Reporting Requirements and 

Supporting Regulations. 

CMS–R–285 Request for Retirement 

Benefit Information. 

Under the Paperwork Reduction Act 

of 1995 (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 

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 Collections 

1. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: 

Conditions for Payment of Power 

Mobility Devices, including Power 

Wheelchairs and Power-Operated 

Vehicles; Use: We are renewing our 

request for approval for the collection 

requirements associated with the final 

rule, CMS–3017–F (71 FR 17021), which 

published on April 5, 2006, and 

required a face-to-face examination of 

the beneficiary by the physician or 

treating practitioner, a written 

prescription, and receipt of pertinent 

parts of the medical record by the 

supplier within 45 days after the faceto-face examination that the durable 

medical equipment (DME) suppliers 

maintain in their records and make 

available to CMS and its agents upon 

request. Form Number: CMS–10116 

(OCN: 0938–0971); Frequency: Yearly; 

Affected Public: Private Sector— 

Business or other for-profits; Number of 

Respondents: 90,521; Number of 

Responses: 173,810; Total Annual 

Hours: 34,762. (For policy questions 

regarding this collection contact Susan 

Miller at 410–786–2118.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: OASIS 

Collection Requirements as Part of the 

CoPs for HHAs and Supporting 

Regulations; Use: The OASIS data set is 

currently mandated for use by Home 

Health Agencies (HHAs) as a condition 

of participation (CoP) in the Medicare 

program. Since 1999, the Medicare CoPs 

have mandated that HHAs use the 

OASIS data set when evaluating adult 

non-maternity patients receiving skilled 

services. The OASIS is a core standard 

assessment data set that agencies 

integrate into their own patient-specific, 

comprehensive assessment to identify 

each patient’s need for home care that 

meets the patient’s medical, nursing, 

rehabilitative, social, and discharge 

planning needs. Form Number: CMS–R– 

245 (OCN: 0938–0760); Frequency: 

Occasionally; Affected Public: Private 

Sector (Business or other for-profit and 

Not-for-profit institutions); Number of 

Respondents: 12,014; Total Annual 

Responses: 17,268,890; Total Annual 

Hours: 15,305,484. (For policy questions 

regarding this collection contact Robin 

Dowell at 410–786–0060.) 

3. Type of Information Collection 

Request: Reinstatement with change of a 

previously approved collection; Title of 

Information Collection: Home Health 

Agency Survey and Deficiencies Report; 

Use: In order to participate in the 

Medicare Program as a Home Health 

Agency (HHA) provider, the HHA must 

meet federal standards. This form is 

used to record information and patients’ 

health and provider compliance with 

requirements and to report the 

information to the federal government. 

Form Number: CMS–1572 (OCN: 0938– 

0355); Frequency: Yearly; Affected 

Public: State, Local or Tribal 

Government; Number of Respondents: 

3,830; Total Annual Responses: 3,830; 

Total Annual Hours: 958. (For policy 

questions regarding this collection 

contact Patricia Sevast at 410–786– 

8135.) 

4. Type of Information Collection 

Request: Reinstatement without change 


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of a previously approved collection; 

Title of Information Collection: 

Medicare Secondary Payer Information 

Collection and Supporting Regulations; 

Use: We are seeking to renew approval 

to collect information from 

beneficiaries, providers, physicians, 

insurers, and suppliers on health 

insurance coverage that is primary to 

Medicare. Collecting this information 

allows us to identify those Medicare 

beneficiaries who are in situations 

where Medicare is statutorily required 

to be a secondary payer (MSP), thereby 

safeguarding the Medicare Trust Fund. 

Specifically, we use the information to 

accurately process and pay Medicare 

claims and to make necessary recoveries 

in accordance with § 1862(b) of the Act 

(42 U.S.C. 1395y(b)). If an active MSP 

situation is identified and Medicare is 

inappropriately billed as primary, the 

claim will be rejected. The hospitals, 

other providers, physicians, pharmacies, 

and suppliers use the information 

collected (and furnished to them on the 

denial) to properly bill the appropriate 

primary payer. Completing an MSP 

questionnaire and making an accurate 

MSP determination helps hospitals, 

other providers, physicians, pharmacies, 

and suppliers to bill correctly the first 

time, saving the Medicare Program 

money and affording Medicare 

beneficiaries an enhanced level of 

customer service (which, again, is 

particularly important in Part D due to 

the real-time adjudication of claims and 

the complicated nature of its benefit 

administration). Insurers, underwriters, 

third party administrators, and selfinsured/self-administered employers 

use the information to ensure 

compliance with the law by refunding 

any identified mistaken payments to 

Medicare. Form Number: CMS–250–254 

(OCN: 0938–0214); Frequency: 

Occasionally; Affected Public: 

Individuals and Households, Private 

Sector, State, Local or Tribal 

Governments; Number of Respondents: 

143,070,217; Total Annual Responses: 

143,070,217; Total Annual Hours: 

1,788,057. (For policy questions 

regarding this collection contact Ward 

Marsh at 410–786–6473.) 

5. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: 

Financial Statement of Debtor and 

Supporting Regulations; Use: The form 

CMS–379 is used to collect financial 

information which is needed to evaluate 

requests from physicians and suppliers 

to pay indebtedness under an extended 

repayment schedule, or to compromise 

a debt less than the full amount. 

Normally, when a Medicare 

Administrative Contractor (MAC) 

overpays a physician or supplier, the 

overpayment is associated with a single 

claim, and the amount of the 

overpayment is moderate. In these 

cases, the physician/supplier usually 

refunds the overpaid amount in a lump 

sum. Alternatively, the MAC may 

recoup the overpaid amount against 

future payments. A recoupment is the 

recovery by Medicare of any 

outstanding Medicare debt by reducing 

present or future Medicare payments 

and applying the amount withheld to 

the indebtedness. The recoupment can 

be made only if the physician or 

supplier accepts assignment since the 

MAC makes payment to the physician 

or supplier only on assigned claims. 

Sometimes, however, an overpayment 

to a physician or supplier is 

exceptionally large, and it cannot be 

recovered in the normal fashion. The 

large overpayment usually results from 

aberrant billing practices, such as billing 

for more expensive services than were 

rendered. This could be discovered 

during routine review of a statistically 

valid sample of claims. The physician or 

supplier may be unable to refund a large 

overpaid amount in a single payment. 

The MAC cannot recover the 

overpayment by recoupment if the 

physician/supplier does not accept 

assignment of future claims, or is not 

expected to file future claims because of 

going out of business, illness or death. 

In these unusual circumstances, the 

MAC has authority to approve or deny 

extended repayment schedules up to 12 

months, or may recommend to that we 

approve up to 60 months. Before the 

MAC takes these actions, the MAC will 

require full documentation of the 

physician’s or supplier’s financial 

situation. Thus, the physician or 

supplier must complete form CMS–379. 

Form Number: CMS–379 (OCN: 0938– 

0270); Frequency: Occasionally; 

Affected Public: Private Sector— 

Business or other for-profits; Number of 

Respondents: 500; Total Annual 

Responses: 500; Total Annual Hours: 

1,000. (For policy questions regarding 

this collection contact Ronke Fabayo at 

410–786–4460.) 

6. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: Request 

for Enrollment in Supplementary 

Medical Insurance; Use: Form CMS– 

4040 (and CMS–4040SP) is used to 

establish entitlement to and enrollment 

in Medicare Part B for beneficiaries who 

file for Part B only. The collected 

information is used to determine 

entitlement for individuals who meet 

the requirements in section 1836(2) of 

the Social Security Act as well as the 

entitlement of the applicant or their 

spouses to an annuity paid by OPM for 

premium deduction purposes. Form 

Number: CMS–4040 (OCN: 0938–0245); 

Frequency: Once; Affected Public: 

Individuals or households; Number of 

Respondents: 10,000; Total Annual 

Responses: 10,000; Total Annual Hours: 

2,500. (For policy questions regarding 

this collection contact Lindsay Smith at 

410–786–6843.) 

7. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: 

Collection of Prescription Drug Event 

Data from Contracted Part D Providers 

for Payment; Use: The information users 

would include Pharmacy Benefit 

Managers, third party administrators 

and pharmacies and prescription drug 

plans, Medicare Advantage plans that 

offer integrated prescription drug and 

health care coverage, Fallbacks and 

other plans that offer coverage of 

outpatient prescription drugs under the 

Medicare Part D benefit to Medicare 

beneficiaries. The data is used primarily 

for payment, but is also used for claim 

validation as well as for other legislated 

functions such as quality monitoring, 

program integrity, and oversight. Form 

Number: CMS–10174 (OCN: 0938– 

0982); Frequency: Monthly; Affected 

Public: Private sector (business or other 

for-profits and not-for-profit 

institutions); Number of Respondents: 

747; Total Annual Responses: 

947,881,770; Total Annual Hours: 1,896. 

(For policy questions regarding this 

collection contact Ivan Iveljic at 410– 

786–3312.) 

8. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Part C Medicare 

Advantage Reporting Requirements and 

Supporting Regulations; Use: There are 

a number of information users of Part C 

reporting, including CMS central and 

regional office staff that use this 

information to monitor health plans and 

to hold them accountable for their 

performance, researchers, and other 

government agencies such as GAO. 

Health plans can use this information to 

measure and benchmark their 

performance. We intend to make some 

of these data available for public 

reporting as ‘‘display measures’’ in 

2013. Form Number: CMS–10261 (OCN: 

0938–1054); Frequency: Yearly and 

semi-annually; Affected Public: Private 

sector (business or other for-profits); 

Number of Respondents: 588; Total 

Annual Responses: 6,715; Total Annual 

Hours: 200,918. (For policy questions 


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regarding this collection contact Terry 

Lied at 410–786–8973.) 

9. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: Request 

for Retirement Benefit Information; Use: 

Section 1818(d)(5) of the Social Security 

Act provides that former state and local 

government employees (who are age 65 

or older, have been entitled to Premium 

Part A for at least 7 years, and did not 

have the premium paid for by a state, a 

political subdivision of a state, or an 

agency or instrumentality of one or 

more states or political subdivisions) 

may have the Part A premium reduced 

to zero. These individuals must also 

have 10 years of employment with the 

state or local government employer or a 

combination of 10 years of employment 

with a state or local government 

employer and a non-government 

employer. Form CMS–R–285 is an 

essential part of the process of 

determining whether an individual 

qualifies for the premium reduction. 

The Social Security Administration will 

use this information to help determine 

whether a beneficiary meets the 

requirements for reduction of the Part A 

premium. Form Number: CMS–R–285 

(OCN: 0938–0769). Frequency: Once. 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

500; Total Annual Responses: 500; Total 

Annual Hours: 125. (For policy 

questions regarding this collection 

contact Lindsay Smith at 410–786– 

6843.) 

Dated: June 18, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–14878 Filed 6–20–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–460] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

ACTION: Notice. 

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 

(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 

a second opportunity for public 

comment on the notice. Interested 

persons are invited to send comments 

regarding the 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. 

DATES: Comments on the collection(s) of 

information must be received by the 

OMB desk officer by July 22, 2013. 

ADDRESSES: When commenting on the 

proposed information collections, 

please reference the document identifier 

or OMB control number. To be assured 

consideration, comments and 

recommendations must be received by 

the OMB desk officer via one of the 

following transmissions: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–6974 or Email: 

OIRA_submission@omb.eop.gov. 

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: Under the 

Paperwork Reduction Act of 1995 (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 (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-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 that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicare 

Participating Physician or Supplier 

Agreement; Use: Section 1842(h) of the 

Social Security Act permits physicians 

and suppliers to voluntarily participate 

in Medicare Part B by agreeing to take 

assignment on all claims for services to 

Medicare beneficiaries. The law also 

requires that the Secretary provide 

specific benefits to the physicians, 

suppliers and other persons who choose 

to participate. Form CMS–460 is the 

agreement by which the physician or 

supplier elects to participate in 

Medicare. The collected information is 

used by Medicare contractors to provide 

the benefits the law provides for 

participating entities and to enable 

contractors to enforce the Medicare 

limiting charge for physicians, suppliers 

and other persons who do not 

participate. It is also used by Medicare 

beneficiaries to assist them in locating 

physicians who will accept Medicare 

assignment on claims for services and 

therefore save them money. In addition, 

we use the form to gauge the 

effectiveness of efforts to increase 

participation in Medicare. Form 

Number: CMS–460 (OCN: 0938–0373); 

Frequency: Yearly; Affected Public: 

Private sector (business or other forprofits); Number of Respondents: 

120,000; Total Annual Responses: 

120,000; Total Annual Hours: 30,000. 

(For policy questions regarding this 

collection contact April Billingsley at 

410–786–0140.) 

Dated: June 18, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–14870 Filed 6–20–13; 8:45 am] 

BILLING CODE 4120–01–P 


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