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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 ofoutpatient 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 ofoutpatient 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,


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

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 thanksrespondents 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 ofcash 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.