34076 Federal Register / Vol. 76, No. 112 / Friday, June 10, 2011 / Notices 

and (CMS–378) Ambulatory Surgical 

Center (ASC) Survey Report Form; Use: 

CMS–370 has not been revised and will 

continue to be used to establish 

eligibility for payment under Title XVIII 

of the Social Security Act (the ‘‘Act’’). As 

revised, CMS–377 will be used to 

collect facility-specific characteristics 

that facilitate CMS’ oversight of ASCs. 

The data also enables CMS to respond 

to inquiries from the Congress, GAO, 

and the OIG concerning the 

characteristics of Medicare-participating 

ASCs. The data base that supports 

survey and certification activities will 

be revised to reflect changes in the data 

fields on this revised form, such as the 

data on the types of surgical procedures 

performed in the ASC. CMS–378 will be 

discontinued since it duplicates 

information collected by other means; 

Form Numbers: CMS–370, –377 and 

–378 (OCN: 0938–0266); Frequency: 

Occasionally; Affected Public: Private 

Sector: Business or other for-profit and 

Not-for-profit institutions; Number of 

Respondents: 7,213; Total Annual 

Responses: 1,795; Total Annual Hours: 

648. (For policy questions regarding this 

collection contact Gail Vong at 410– 

786–0787. For all other issues call 410– 

786–1326.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Identification of 

Extension Units of Medicare Approved 

Outpatient Physical Therapy/Outpatient 

Speech Pathology (OPT/OSP) Providers 

and Supporting Regulations in 42 CFR 

485.701–485.729; Use: The collected 

information is used in conjunction with 

42 CFR 485.701 through 485.729 

governing the operation of providers of 

outpatient physical therapy and speechlanguage pathology services. The 

provider uses the form to report to the 

State survey agency extension locations 

that it has added since the date of last 

report. The form is used by the State 

survey agencies and by the CMS 

regional offices to identify and monitor 

extension locations to ensure their 

compliance with the Federal 

requirements for the providers of 

outpatient physical therapy and speechlanguage pathology services; Form 

Number: CMS–381 (OMB #: 0938– 

0273); Frequency: Annually; Affected 

Public: Private Sector; Business or other 

for-profit and not-for-profit institutions; 

Number of Respondents: 2,960; Total 

Annual Responses: 2,960; Total Annual 

Hours: 740. (For policy questions 

regarding this collection contact Georgia 

Johnson at 410–786–6859. For all other 

issues call 410–786–1326.) 

3. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Medicare Part B 

Drug and Biological Competitive 

Acquisition Program (CAP) and 

Supporting Regulations in 42 CFR 

Sections 414.906, 414.908, 414.910, 

414.914, 414.916, and 414.917; Use: 

Section 303(d) of the Medicare 

Prescription Drug, Improvement, and 

Modernization Act of 2003 (MMA) 

provides an alternative payment 

methodology for Part B covered drugs 

that are not paid on a cost or 

prospective payment basis. In 

particular, Section 303(d) of the MMA 

amends Title XVIII of the Social 

Security Act by adding a new section 

1847B, which establishes a competitive 

acquisition program for the acquisition 

of and payment for Part B covered drugs 

and biologicals furnished on or after 

January 1, 2006. Since its inception, 

additional legislation has augmented the 

CAP. Section 108 of the Medicare 

Improvements and Extension Act under 

Division B, Title I of the Tax Relief 

Health Care Act of 2006 (MIEA–TRHCA) 

amended Section 1847b(a)(3) of the 

Social Security Act and requires that 

CAP implement a post payment review 

process. This procedure is done to 

assure that payment is made for a drug 

or biological under this section only if 

the drug or biological has been 

administered to a beneficiary. Form 

Number: CMS–10145 (OCN: 0938– 

0945); Frequency: Weekly, quarterly and 

occasionally; Affected Public: Private 

sector—Business or other for-profit and 

Not-for-profit institutions; Number of 

Respondents: 3000; Total Annual 

Responses: 156,020; Total Annual 

Hours: 31,208. (For policy questions 

regarding this collection contact Karen 

Hill at 410–786–5607. For all other 

issues call 410–786–1326.) 

4. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Autism 

Spectrum Disorders (ASD): State of the 

States Services and Supports for People 

with ASD; Use: The information that is 

collected in the interviews will be used 

to communicate additional information 

about services available to people with 

ASD and the public policy issues that 

affect people with ASD to key 

stakeholder audiences. The format of 

the report will include data tables from 

various State programs and narrative 

about the data being presented based on 

the interviews with State agency staff. 

We propose interviewing multiple staff 

in each State because several State 

agencies have an impact on services and 

supports for people with ASD; Form 

Number: CMS–10362 (OCN: 0938– 

New); Frequency: Once; Affected Public: 

State, local, or Tribal Governments; 

Number of Respondents: 459; Total 

Annual Responses: 459; Total Annual 

Hours: 803. (For policy questions 

regarding this collection contact Ellen 

Blackwell at 410–786–4498. 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 

e-mail 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 July 11, 2011. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS Desk 

Officer, Fax Number: (202) 395–6974, Email: oira_submission@omb.eop.gov. 

Dated: June 3, 2011. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2011–14226 Filed 6–9–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10393] 

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, 

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Federal Register / Vol. 76, No. 112 / Friday, June 10, 2011 / Notices 34077 

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: Existing collection in use 

without an OMB control number; Title 

of Information Collection: Medicare 

Beneficiary and Family-Centered 

Satisfaction Survey; Use: The data 

collection methodology used to 

determine Beneficiary Satisfaction flows 

from the proposed sampling approach. 

While it was feasible to conduct the 9th 

SOW via telephone data collection only, 

with a quarterly sample size for the 10th 

SOW estimated to be 2,664, it does not 

seem efficient to maintain a telephone 

only data collection approach. Based on 

recent literature on survey methodology 

and response rates by mode, we 

recommend using a data collection that 

is done primarily by mail. A mail-based 

methodology will achieve the goals of 

being efficient, effective, and minimally 

burdensome for beneficiary 

respondents. 

As previously described, we 

anticipate that a mail-based 

methodology could yield a response rate 

of approximately 60 percent. In order to 

achieve this response rate, we would 

recommend a 3 staged approach to data 

collection: 

(1) Mailout of a covering letter, the 

paper survey questionnaire, and a 

postage-paid return envelope. 

(2) Mailout of a post card that thanks 

respondents and reminds the nonrespondents to please return their 

survey. 

(3) Mailout of a follow-up covering 

letter, the paper survey questionnaire, 

and a postage-paid return envelope. 

Through the pilot test, we will 

determine the response rate that can be 

achieved using this approach. If it is 

deemed necessary, additional mailout 

reminders can be added to the protocol, 

or a telephone non-response step can be 

added to the protocol. 

Using the 3-step mail approach 

described above, we anticipate that data 

collection would occur over an 8 to 10 

weeks. This is to say, if the first survey 

mailing were dropped on January 1, we 

would anticipate completing data 

collection at the end of February or 

early March. Data would then be 

cleaned, scores would be generated, and 

data would be delivered to CMS. 

Through the pilot test, we will 

determine the precise timing required to 

achieve an acceptable response rate, but 

we are aiming to complete sampling, 

data collection, and scoring within a 12- 

week period. Form Number: CMS– 

10393 (OCN: 0938–New) Frequency: 

Once; Affected Public: Individuals or 

households; Number of Respondents: 

16,010; Number of Responses: 16,010; 

Total Annual Hours: 4002. (For policy 

questions regarding this collection, 

contact Coles Mercier at 410–786–2112. 

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 

at http://www.cms.gov/ 

PaperworkReductionActof1995/PRAL/ 

list.asp#TopOfPage 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 at 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 August 9, 2011: 

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, Room C4–26–05, 7500 

Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: June 7, 2011. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2011–14435 Filed 6–9–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Title: Pre-testing of Evaluation 

Surveys. 

OMB No.: 0970–0355. 

Description: The Office of Planning, 

Research and Evaluation (OPRE), 

Administration for Children and 

Families (ACF), U.S. Department of 

Health and Human Services (HHS), 

intends to request approval from the 

Office of Management and Budget 

(OMB) for a generic clearance that a will 

allow OPRE to conduct a variety of data 

gathering activities aimed at identifying 

questionnaire and procedural problems 

in survey administration. Over the next 

three years, OPRE anticipates 

undertaking a variety of new surveys as 

part of research projects in the fields of 

cash welfare, employment and selfsufficiency, Head Start, child care, 

healthy marriage and responsible 

fatherhood, and child welfare, among 

others. In order to improve the 

development of its research and 

evaluation surveys, OPRE envisions 

using a variety of techniques including 

field tests, respondent debriefing 

questionnaires, cognitive interviews and 

focus groups in order to identify 

questionnaire and procedural problems, 

suggest solutions, and measure the 

relative effectiveness of alternative 

survey solutions. 

Following standard OMB 

requirements, OPRE will submit a 

change request to OMB individually for 

every data collection activity 

undertaken under this generic 

clearance. OPRE will provide OMB with 

a copy of the individual instrument or 

questionnaire, as well as other materials 

describing the project and specific 

survey pre-test. 

Respondents: The respondents will be 

identified at the time that each change 

request is submitted to OMB. Generally 

they will be individuals who are 

representative of the target groups for 

the public assistance research or 

evaluation project in question. 

WReier-Aviles on DSKGBLS3C1PROD with NOTICES