[Federal Register Volume 72, Number 101 (Friday, May 25, 2007)]
[Notices]
[Pages 29322-29323]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 07-2578]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-131]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

AGENCY: Centers for Medicare & Medicaid Services, Department of Health 
and Human Services.
    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: Revision of a currently 
approved collection; Title of Information Collection: Advance 
Beneficiary Notice of Noncoverage (ABN); Use Under section 1879 of the 
Social Security Act, a physician, provider, practitioner or supplier of 
items or services participating in the Medicare Program, or taking a 
claim on assignment, may bill a Medicare beneficiary for items or 
services usually covered under Medicare, but denied in an individual 
case under specific statutory exclusions, if they inform the 
beneficiary, prior to furnishing the service, that Medicare is likely 
to deny payment. 42 CFR 411.404(b) and (c), and 411.408(d)(2) and (f), 
require written notice be provided to inform beneficiaries in advance 
of potential liability for payment; Form Number: CMS-R-131 
(OMB<greek-i>: 0938-0566); Frequency: Reporting: Weekly, Monthly, 
Yearly, Biennially and Occasionally; Affected Public: Business or other 
for-profit and Not-for-profit institutions; Number of Respondents: 
1,270,614; Total Annual Responses: 40,302,506; Total Annual Hours: 
4,701,959.
    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 <a href="/cdn-cgi/l/email-protection#fcac9d8c998e8b938e97bc9f918fd294948fd29b938a"><span class="__cf_email__" data-cfemail="603001100512170f120b20030d134e0808134e070f16">[email protected]</span></a>, or call the 
Reports Clearance Office on (410) 786-1326.
    Written comments and recommendations for the proposed information 
collections must be mailed or faxed within 30 days of this notice 
directly to the OMB desk officer: OMB Human Resources and Housing 
Branch, Attention: Carolyn Lovett, New Executive Office Building, Room 
10235, Washington, DC 20503, Fax Number: (202) 395-6974.


[[Page 29323]]


    Dated: May 16, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 07-2578 Filed 5-24-07; 8:45 am]
BILLING CODE 4120-01-P


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