63482 Federal Register / Vol. 75, No. 199 / Friday, October 15, 2010 / Notices 

justification for an FMAP adjustment, 

we cannot predetermine how much time 

will be required to verify the 

information, but will review and verify 

a State’s submission and request for an 

adjustment to its FMAP as expeditiously 

as possible. 

D. Methodology Utilized in the 

Calculation of the Adjustment to the 

Medicaid FMAP 

This Final Notice announces the 

methodology that the U.S. Department 

of Health and Human Services (HHS) 

will use in implementing the employer 

contribution disregard required by 

Section 614 of CHIPRA. The approach 

reflects the absence of a Federal source 

of reliable and timely data on pension 

and insurance contributions by 

individual employer and State. 

We will use the BEA definition of 

pension and insurance contributions: 

contributions consisting of employer 

payments (including payments-in-kind) 

to private pension and profit-sharing 

plans, publicly administered 

government employee retirement plans, 

private group health and life insurance 

plans, privately administered workers’ 

compensation plans, and supplemental 

unemployment benefit plans, formerly 

called ‘‘other labor income’’. 

We will identify significantly 

disproportionate employer pension or 

insurance contributions for a State by 

reviewing contributions identified by 

the State. We believe that States may 

have greater access to timely and 

relevant data on such contributions than 

is available from Federal data sources. 

We would request that any State that 

believes an individual employer has 

made a significantly disproportionate 

employer or insurance contribution 

provide data on that individual 

employer contribution to HHS. The 

State may submit official audited 

financial statements for the employer for 

the year of the contribution (starting 

with the year 2003) and the prior year. 

If the State does not submit official 

audited financial statements for the 

employer, the State may submit other 

evidence that the increase in the 

employer’s contribution is likely to 

exceed 25 percent of the increase in the 

State’s personal income in that year. 

After a State submits written 

notification that such a contribution 

occurred, HHS will verify the State’s 

data. As part of this verification process, 

HHS will search the Security Exchange 

Commission (SEC) filings or the Internal 

Revenue Service (IRS) 5500 Annual 

Return/Report of Employee Benefit Plan 

database to find the employer’s 

contributions for the relevant two-year 

period. If HHS is unable to verify the 

State’s submitted data, no FMAP 

adjustment will be made. 

After the State’s data for an employer 

is verified, HHS will allocate employer 

contributions in both years to the State 

according to the methodology used by 

the BEA. Under that methodology, 

employer contributions to pension and 

insurance funds are distributed 

according to State wages and salaries by 

the employer’s industry subsector. 

Then, HHS will determine whether the 

State increase in the employer 

contribution exceeds the trigger of 25 

percent of the increase in total State 

personal income. 

If the employer contribution is 

significantly disproportionate, HHS will 

disregard the State-allocated 

contribution, i.e., subtract it from the 

State’s personal income in that year. 

HHS will calculate the FMAP 

adjustment for the State using the 

revised State per capita income based 

on the newly calculated State personal 

income. Since the FMAP calculation 

involves the average per capita income 

for three years, the FMAP adjustment 

will be calculated for each fiscal year 

affected by the State’s revised per capita 

income. For instance, a significantly 

disproportionate employer contribution 

in 2003 would affect the FMAPs for 

FY06 (based on State per capita income 

for calendar years 2001, 2002, and 

2003), FY07 (based on State per capita 

income for calendar years 2002, 2003, 

and 2004), and FY08 (based on State per 

capita income for calendar years 2003, 

2004, and 2005). 

States may submit data on 

disproportionate employer 

contributions made between 2003 and 

2008 to HHS by the end of FY 2011. The 

deadline for 2009 and beyond will be 

the end of the second fiscal year 

following the year end of the employer’s 

annual financial statement that includes 

the disproportionate employer 

contribution. 

To summarize this methodology, after 

receipt of a State submission, HHS will 

verify the employer contributions from 

SEC filings or IRS 5500 reports for the 

year of the contribution and the prior 

year. If the employer contributions are 

verified, HHS will allocate the employer 

contributions for the State for both years 

and determine whether the State 

increase in the employer contribution 

exceeds the trigger of 25 percent of the 

increase in the State’s personal income. 

If the employer contribution meets the 

definition of significantly 

disproportionate by exceeding the 

trigger, HHS will recalculate the FMAP 

rates for the corresponding fiscal years. 

The Centers for Medicare & Medicaid 

Services (CMS) will then calculate the 

changes in Federal medical assistance 

payments resulting from the adjusted 

FMAP rates for the State’s applicable 

fiscal years. If HHS is unable to verify 

the State’s submitted data, then no 

FMAP adjustment will be made. 

DATES: Effective Dates: This final notice 

is effective 30 days after publication and 

sets forth a methodology for adjusted 

percentages applicable under title XIX 

of the Social Security Act for fiscal years 

2006 and beyond, beginning October 1, 

2005. 

FOR FURTHER INFORMATION CONTACT: Rose 

Chu or Thomas Musco, Office of Health 

Policy, Office of the Assistant Secretary 

for Planning and Evaluation, Room 

447D—Hubert H. Humphrey Building, 

200 Independence Avenue, SW., 

Washington, DC 20201, (202) 690–6870. 

Dated: September 10, 2010 . 

Kathleen Sebelius, 

Secretary. 

[FR Doc. 2010–25977 Filed 10–14–10; 8:45 am] 

BILLING CODE 4210–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10304 and CMS– 

10315] 

Agency Information Collection 

Activities: Submission for OMB 

Review; 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), 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: New collection; Title of 

Information Collection: Information 

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Federal Register / Vol. 75, No. 199 / Friday, October 15, 2010 / Notices 63483 

Collection Requirements and 

Supporting Information for Chronic 

Kidney Disease Surveys under the 9th 

Scope of Work; Form Number: CMS– 

10304 (OMB #: 0938–New); Use: The 

Centers for Medicare & Medicaid 

Services (CMS) and the U.S. Department 

of Health and Human Services (DHHS) 

are requesting OMB clearance for the 

Chronic Kidney Disease (CKD) Partner 

Survey and the Chronic Kidney Disease 

(CKD) Provider Survey. The Prevention 

CKD Theme is a component of the 

Prevention Theme of the Quality 

Improvement Organization (QIO) 

Program’s 9th Scope of Work (SOW). 

The statutory authority for this scope of 

work is found in Part B of Title XI of 

the Social Security Act (the Act) as 

amended by the Peer Review 

Improvement Act of 1982. The Act 

established the Utilization and Quality 

Control Peer Review Organization 

Program, now known as the Quality 

Improvement Organization (QIO) 

Program. 

The goal of the Prevention CKD 

Theme is to detect the incidence, 

decrease the progression of CKD, and 

improve care among Medicare 

beneficiaries through provider adoption 

of timely and effective quality of care 

interventions; participation in quality 

incentive initiatives; beneficiary 

education; and key linkages and 

collaborations for system change at the 

state and local level. In addition to 

improving the quality of care for the 

elderly and frail-elderly, this Theme 

aims to reduce the rate of Medicare 

entitlement by disability through the 

delay and prevention of end-stage renal 

disease (ESRD); thus resulting in higher 

quality care and significant savings to 

the Medicare Trust Fund. 

The CKD Partner Survey constitutes a 

new information collection to be used 

by CMS to obtain information on how 

QIO collaboration with partners 

facilitates systems change within the 

QIO’s respective state. The CKD Partner 

Survey will be a census administered to 

350 collaborative partners in the 9th 

SOW. The CKD Partner Survey will be 

administered via telephone. Responses 

will be entered into a pre-programmed 

Computer-Assisted Telephone 

Interviewing (CATI) interface. The 

results of the survey shall be used for 

inpatient quality indicators (IQI) by the 

QIO. CMS will also use the results to 

assess how partner organizations and 

their perspective of the QIO’s role are 

implementing system change. 

Similarly, the CKD Provider Survey 

constitutes a new information collection 

to be used by CMS to obtain information 

on how QIO collaboration with 

physician practices facilitates systems 

change within the QIO’s respective 

state. The CKD Provider Survey will be 

administered via telephone and the 

Web. Responses collected by phone will 

be entered into a pre-programmed 

Computer-Assisted Telephone 

Interviewing (CATI) interface. 

Responses collected by Web will be 

housed on a secure server and database. 

The results of the survey shall be used 

for inpatient quality indicators (IQI) by 

the QIO. CMS will also use the results 

to assess how physicians’ practices and 

their perspective of the QIO’s role are 

implementing system change. 

Frequency: Yearly; Affected Public: 

Private Sector—Business or other forprofits and Not-for profit institutions; 

Number of Respondents: 1,350; Total 

Annual Responses: 1,350; Total Annual 

Hours: 337.5. (For policy questions 

regarding this collection contact Robert 

Kambic at 410–786–1515. For all other 

issues call 410–786–1326.) 

2. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Patient Safety 

Survey Under the 9th Scope of Work: 

Nursing Home in Need (NHIN) Use: The 

Centers for Medicare & Medicaid 

Services (CMS) is requesting OMB 

clearance for the Nursing Homes in 

Need (NHIN) Survey. The NHIN is a 

component of the Patient Safety Theme 

of the Quality Improvement 

Organization (QIO) Program’s 9th Scope 

of Work (SOW). The statutory authority 

for this scope of work is found in Part 

B of Title XI of the Social Security Act 

(the Act) as amended by the Peer 

Review Improvement Act of 1982. The 

Act established the Utilization and 

Quality Control Peer Review 

Organization Program, now known as 

the Quality Improvement Organization 

(QIO) Program. 

The QIO in each State will provide 

special technical assistance to a small 

number of nursing homes in need of 

assistance with quality improvement 

efforts. This special technical assistance 

will be for the QIO to conduct a root 

cause analysis (RCA) with one nursing 

home in its state per year (three over 

three years). Under this component, it is 

expected that within the first quarter of 

the contract period, CMS will assign one 

nursing home to each QIO. The 

determination of which nursing homes 

are eligible under this component will 

be made by CMS. Some of these 

facilities may meet criteria for Special 

Focus Facilities (SFF). The intent of this 

component is that each State QIO will 

work with three nursing homes over the 

three-year contract period; these 

assignments are expected to be spaced 

out so that each State QIO will get one 

nursing home assigned approximately 

every 12 months. 

The NHIN Survey is a new 

information collection to be used by 

CMS to obtain information on nursing 

home satisfaction with technical 

assistance strategies delivered as a 

component of the NHIN. The NHIN 

Survey will be a census of 53 nursing 

homes working with their respective 

QIOs. The survey will be conducted one 

time for each of the nursing homes 

assisted in the first two years under the 

9th SOW and it will be conducted twice 

with nursing homes assisted in the third 

year. The information collected through 

this survey will allow CMS to help 

focus the NHIN task to maximize the 

benefit to participating nursing homes. 

The NHIN Survey will be administered 

via telephone by trained and 

experienced interviewers. Responses 

will be entered into a pre-programmed 

Computer-Assisted Telephone 

Interviewing (CATI) interface. 

The NHIN Survey will include 

questions to determine if the QIO has 

conducted a root cause analysis and 

developed an action plan. These will be 

followed by questions about their 

satisfaction with the QIO and their 

perceived value of the QIO’s assistance. 

The NHIN Survey will address the 

following: 

• Background information; 

• Current work—information and 

assessment; 

• Satisfaction with QIOs; 

• Value of QIO assistance; 

• Sources of information; and 

• Respondent comments. 

All survey protocol and 

correspondence will be translated into 

Spanish and bi-lingual telephone 

interviewers will be used as needed. 

Form Number: CMS–10315 (OMB #: 

0938–New); Frequency: Occasionally; 

Affected Public: Businesses and other 

for-profit and not-for-profit institutions; 

Number of Respondents: 53; Total 

Annual Responses: 106; Total Annual 

Hours: 17.5 hours (years 1 and 2), 35 

hours (year 3). (For policy questions 

regarding this collection contact Bob 

Kambic 410–786–1515. 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. 

mstockstill on DSKH9S0YB1PROD with NOTICES

63484 Federal Register / Vol. 75, No. 199 / Friday, October 15, 2010 / Notices 

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 November 15, 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: October 8, 2010. 

Martique Jones, 

Director, Regulations Development Division— 

B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2010–25943 Filed 10–14–10; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–R–153 and 

CMS–10152] 

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, 

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: Reinstatement with change of a 

previously approved collection; Title of 

Information Collection: Medicaid Drug 

Utilization Review (DUR) Annual 

Report; Use: The DUR program is 

required to assure that prescriptions are 

appropriate, medically necessary and 

are not likely to result in adverse 

medical results. Each State DUR 

program must consist of prospective 

drug use review, retrospective drug use 

review, data assessment of drug use 

against predetermined standards, and 

ongoing educational outreach activities. 

In addition, States are required to 

submit an annual DUR program report 

that includes a description of the nature 

and scope of State DUR activities as 

outlined in the statute and regulations. 

Over the years, technology has changed 

as has the practice of the pharmacy. 

Therefore, CMS has revised the old 

survey vehicle to more fully address the 

current practices and areas of concern 

with the Medicaid Pharmacy Programs. 

Form Number: CMS–R–153 (OMB#: 

0938–0659); Frequency: Annually; 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

51; Total Annual Responses: 51; Total 

Annual Hours: 20,298. (For policy 

questions regarding this collection 

contact Madlyn Kruh at 410–786–3239. 

For all other issues call 410–786–1326.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Data Collection 

for Medicare Beneficiaries Using 

NaF–18 Positron Emission Tomography 

(PET) to Identify Bone Metastasis in 

Cancer; Use: In Decision Memorandum 

# CAG–00065R, issued on February 26, 

2010, the Centers for Medicare and 

Medicaid Services (CMS) determined 

that the evidence is sufficient to 

conclude that for Medicare beneficiaries 

receiving NaF–18 PET scan to identify 

bone metastasis in cancer is reasonable 

and necessary only when the provider is 

participating in and patients are 

enrolled in a clinical study designed to 

information at the time of the scan to 

assist in initial antitumor treatment 

planning or to guide subsequent 

treatment strategy by the identification, 

location and quantification of bone 

metastases in beneficiaries in whom 

bone metastases are strongly suspected 

based on clinical symptoms or the 

results of other diagnostic studies. 

Qualifying clinical studies must ensure 

that specific hypotheses are addressed; 

appropriate data elements are collected; 

hospitals and providers are qualified to 

provide the PET scan and interpret the 

results; participating hospitals and 

providers accurately report data on all 

Medicare enrolled patients; and all 

patient confidentiality, privacy, and 

other Federal laws must be followed. 

Consistent with section 1142 of the 

Social Security Act, the Agency for 

Healthcare Research and Quality 

(AHRQ) supports clinical research 

studies that the CMS determines meet 

specified standards and address the 

specified research questions. 

To qualify for payment, providers 

must prescribe certain NaF–18 PET 

scans for beneficiaries with a set of 

clinical criteria specific to each solid 

tumor. The statuary authority for this 

policy is section 1862(a)(1)(E) of the 

Social Security Act. The need to 

prospectively collect information at the 

time of the scan is to assist the provider 

in decision making for patient 

management. To qualify for payment, 

providers must prescribe certain 

NaF–18 PET scans for beneficiaries with 

a set of clinical criteria specific to each 

solid tumor. Data elements will be 

transmitted to CMS for evaluation of the 

short and long-term benefits of NaF–18 

PET to beneficiaries and for use in 

future clinical decision making. Form 

Number: CMS–10152 (OMB#: 0938– 

0968); Frequency: Annually; Affected 

Public: Individuals or Households; 

Number of Respondents: 25,000; Total 

Annual Responses: 25,000; Total 

Annual Hours: 2,084. (For policy 

questions regarding this collection 

contact Stuart Caplan at 410–786–9564. 

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.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. 

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 December 14, 2010: 

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: October 8, 2010. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2010–25934 Filed 10–14–10; 8:45 am] 

BILLING CODE 4120–01–P 

mstockstill on DSKH9S0YB1PROD with NOTICES