77496 Federal Register / Vol. 79, No. 247 / Wednesday, December 24, 2014 / Notices 

States. Ambulatory services are 

rendered in a wide variety of settings, 

including physicians’ offices and 

hospital outpatient and emergency 

departments, and ambulatory surgery 

centers. 

The target universe of the NHAMCS is 

in-person visits made to outpatient 

departments (OPDs), emergency 

departments (EDs), and ambulatory 

surgery locations (ASLs) of non-Federal, 

short-stay hospitals (hospitals with an 

average length of stay of less than 30 

days) or those whose specialty is general 

(medical or surgical) or children’s 

general. 

The objective of this revision is to 

make slight modifications to survey 

questions. 

Users of NHAMCS data include, but 

are not limited to, congressional offices, 

Federal agencies, state and local 

governments, schools of public health, 

colleges and universities, private 

industry, nonprofit foundations, 

professional associations, clinicians, 

researchers, administrators, and health 

planners. There are no costs to the 

respondents other than their time. 

The total estimated annualized 

burden hours are 4,412. 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondents Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hrs.) 

Hospital Chief Executive Officer ..................... Hospital Induction (NHAMCS–101) ............... 458 1 90/60 

Ancillary Service Executive ............................. Ambulatory Unit Induction (NHAMCS–101U) 1,750 1 15/60 

Physician/Registered Nurse/Medical Record 

Clerk.

ED Patient Record form ................................. 33 100 7/60 

Physician/Registered Nurse/Medical Record 

Clerk.

OPD Patient Record form .............................. 23 200 14/60 

Physician/Registered Nurse/Medical Record 

Clerk.

ASC Patient Record Form ............................. 23 100 7/60 

Medical Record Clerk ..................................... Pulling and re-filing Patient Records (ED, 

OPD, and ASC).

696 133 1/60 

Ancillary Service Executive—Reabstraction ... Reabstraction Telephone Call ........................ 72 1 5/60 

Medical Record Clerk—Reabstraction ............ Pulling and re-filing Patient Records (ED, 

OPD, and AS).

72 10 1/60 

Leroy A. Richardson, 

Chief, Information Collection Review Office, 

Office of Scientific Integrity, Office of the 

Associate Director for Science, Office of the 

Director, Centers for Disease Control and 

Prevention. 

[FR Doc. 2014–30083 Filed 12–23–14; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10142] 

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 January 23, 2015. 

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) 395–5806 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/Paperwork

ReductionActof1995. 

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 

mstockstill on DSK4VPTVN1PROD with NOTICES

Federal Register / Vol. 79, No. 247 / Wednesday, December 24, 2014 / Notices 77497 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Bid Pricing Tool 

(BPT) for Medicare Advantage (MA) 

Plans and Prescription Drug Plans 

(PDP); Use: We require that Medicare 

Advantage organizations and 

Prescription Drug Plans complete the 

Bid Pricing Tool (BPT) as part of the 

annual bidding process. During this 

process, organizations prepare their 

proposed actuarial bid pricing for the 

upcoming contract year and submit 

them to us for review and approval. The 

purpose of the BPT is to collect the 

actuarial pricing information for each 

plan. The BPT calculates the plan’s bid, 

enrollee premiums, and payment rates. 

We publish beneficiary premium 

information using a variety of formats 

(www.medicare.gov, the Medicare & You 

handbook, Summary of Benefits 

marketing information) for the purpose 

of beneficiary education and 

enrollment. Form Number: CMS–10142 

(OMB control number 0938–0944); 

Frequency: Yearly; Affected Public: 

Private sector (Business or other forprofits and Not-for-profit institutions); 

Number of Respondents: 555; Total 

Annual Responses: 4,995; Total Annual 

Hours: 149,850. (For policy questions 

regarding this collection contact Rachel 

Shevland at 410–786–3026). 

Dated: December 18, 2014. 

Martique Jones, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2014–30026 Filed 12–23–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers CMS–1557] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services. 

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 (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 

February 23, 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 Numberll, 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/Paperwork

ReductionActof1995. 

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–1557 Survey Report Form for 

Clinical Laboratory Improvement 

Amendments (CLIA) and Supporting 

Regulations 

Under the Paperwork Reduction Act 

(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 Collection 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection. Title of 

Information Collection: Survey Report 

Form for Clinical Laboratory 

Improvement Amendments (CLIA) and 

Supporting Regulations. Use: The form 

is used to report surveyor findings 

during a CLIA survey. For each type of 

survey conducted (i.e., initial 

certification, recertification, validation, 

complaint, addition/deletion of 

specialty/subspecialty, transfusion 

fatality investigation, or revisit 

inspections) the Survey Report Form 

incorporates the requirements specified 

in the CLIA regulations. Form Number: 

CMS–1557 (OMB control number: 

0938–0544). Frequency: Biennially. 

Affected Public: Business or other forprofit, not-for-profit institutions, State, 

Local or Tribal Governments and 

Federal Government. Number of 

Respondents: 19,051. Total Annual 

Responses: 9,526. Total Annual Hours: 

4,763. (For policy questions regarding 

this collection contact Kathleen Todd at 

410–786–3385). 

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