Federal Register / Vol. 75, No. 10 / Friday, January 15, 2010 / Notices 2547 

3rd and 4th lines in the ADDRESSES and 

3rd line in the FOR FURTHER INFORMATION

CONTACT captions to read: 

ADDRESSES: Proposals for cosponsorship should be sent to Jane 

Wargo, Program Analyst, Office of the 

President’s Council on Physical Fitness 

and Sports, 1101 Wootton Parkway, 

Suite 560, Rockville, MD 20852; Ph: 

(240) 276–9847, Fax: (240) 276–9860. 

Proposals may also be submitted by 

electronic mail to jane.wargo@hhs.gov. 

FOR FURTHER INFORMATION CONTACT: Jane 

Wargo, Program Analyst, Office of the 

President’s Council on Physical Fitness 

and Sports, Ph: (240) 276–9847, e-mail: 

jane.wargo@hhs.gov. 

Dated: January 12, 2010. 

Jane Wargo, 

Program Analyst, President’s Council on 

Physical Fitness and Sports, U.S. Department 

of Health and Human Services. 

[FR Doc. 2010–760 Filed 1–14–10; 8:45 am] 

BILLING CODE 4150–35–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–718–721, CMS– 

10303 and CMS–685] 

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: Business 

Proposal Forms for Quality 

Improvement Organizations (QIOs); Use: 

The submission of proposal information 

by current quality improvement 

associations (QIOs) and other bidders, 

on the appropriate forms, will satisfy 

CMS’s need for meaningful, consistent, 

and verifiable data with which to 

evaluate contract proposals. The data 

collected on the forms associated with 

this information collection request is 

used by CMS to negotiate QIO contracts. 

The revised business proposal forms 

will be useful in a number of important 

ways. The Government will be able to 

compare the costs reported by the QIOs 

on the cost reports to the proposed costs 

noted on the business proposal forms. 

Subsequent contract and modification 

negotiations will be based on historic 

cost data. The business proposal forms 

will be one element of the historical cost 

data from which we can analyze future 

proposed costs. In addition, the 

business proposal format will 

standardize the cost proposing and 

pricing process among all QIOs. With 

well-defined cost centers and line items, 

proposals can be compared among QIOs 

for reasonableness and appropriateness. 

Form Number: CMS–718–721 (OMB#: 

0938–0579); Frequency: Reporting— 

Triennially; Affected Public: Business or 

other for-profits and Not-for-profit 

institutions; Number of Respondents: 

21; Total Annual Responses: 21; Total 

Annual Hours: 1,785. (For policy 

questions regarding this collection 

contact Clarissa Whatley at 410–786– 

7154. For all other issues call 410–786– 

1326.) 

2. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Medicare 

Gainsharing Demonstration Evaluation: 

Physician Focus Groups; Use: The 

proposed physician focus groups are 

part of an overall evaluation of the 

Centers for Medicare & Medicaid 

Services CMS’ congressionally 

mandated Medicare Gainsharing 

Demonstration Evaluation. The 

Congress, under Section 5007 of the 

Deficit Reduction Act (DRA) of 2005, 

requires CMS to conduct a qualified 

gainsharing program to test alternative 

ways that hospitals and physicians can 

share in efficiency gains. The primary 

goal of the demonstration is to evaluate 

gainsharing as a means to align 

physician and hospital incentives to 

improve quality and efficiency. The 

demonstration has two mandated 

Reports to Congress. Results from 

physician focus groups will be included 

in both Reports to Congress. Form 

Number: CMS–10303 (OMB#: 0938– 

New); Frequency: Once; Affected Public: 

Private Sector, Business or other for 

profits; Number of Respondents: 192; 

Total Annual Responses: 96; Total 

Annual Hours: 96. (For policy questions 

regarding this collection contact 

William Buczko at 410–786–6593. For 

all other issues call 410–786–1326.) 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: End Stage Renal 

Disease (ESRD) Network Semi-Annual 

Cost Report Forms and Supporting 

Regulations in 42 CFR section 405.2110 

and 42 CFR 405.2112; Use: Section 

1881(c) of the Social Security Act 

establishes End Stage Renal Disease 

(ESRD) Network contracts. The 

regulations found at 42 CFR 405.2110 

and 405.2112 designated 18 ESRD 

Networks which are funded by 

renewable contracts. These contracts are 

on 3-year cycles. To better administer 

the program, CMS is requiring 

contractors to submit semi-annual cost 

reports. The purpose of the cost reports 

is to enable the ESRD Networks to 

report costs in a standardized manner. 

This will allow CMS to review, compare 

and project ESRD Network costs during 

the life of the contract. Form Number: 

CMS–685 (OMB#: 0938–0657); 

Frequency: Reporting—Semi-annually; 

Affected Public: Not-for-profit 

institutions; Number of Respondents: 

18; Total Annual Responses: 36; Total 

Annual Hours: 108. (For policy 

questions regarding this collection 

contact Victoria Morgan at 410–786– 

7232. 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 March 16, 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 


jlentini on DSKJ8SOYB1PROD with NOTICES
2548 Federal Register / Vol. 75, No. 10 / Friday, January 15, 2010 / Notices 

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: January 8, 2010. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2010–743 Filed 1–14–10; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–588, CMS–10079 

and CMS–10311] 

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: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: 

Electronic Funds Transfer Authorization 

Agreement; Use: Section 1815(a) of the 

Social Security Act provides the 

authority for the Secretary of Health and 

Human Services to pay providers/ 

suppliers of Medicare services at such 

time or times as the Secretary 

determines appropriate (but no less 

frequently than monthly). Under 

Medicare, CMS, acting for the Secretary, 

contracts with Fiscal Intermediaries and 

Carriers to pay claims submitted by 

providers/suppliers who furnish 

services to Medicare beneficiaries. 

Under CMS’ payment policy, Medicare 

providers/suppliers have the option of 

receiving payments electronically. Form 

number CMS–588 authorizes the use of 

electronic fund transfers (EFTs). Form 

Number: CMS–588 (OMB#: 0938–0626); 

Frequency: Reporting—On occasion; 

Affected Public: Business or other forprofit and Not-for-profit institutions; 

Number of Respondents: 100,000; Total 

Annual Responses: 100,000; Total 

Annual Hours: 100,000. (For policy 

questions regarding this collection 

contact Kim McPhillips at 410–786– 

5374. For all other issues call 410–786– 

1326.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Hospital Wage 

Index Occupational Mix Survey and 

Supporting Regulations in 42 CFR, 

Section 412.64; Use: Section 304(c) of 

Public Law 106–554 amended section 

1886(d) (3) (E) of the Social Security Act 

to require CMS to collect data every 3 

years on the occupational mix of 

employees for each short-term, acute 

care hospital participating in the 

Medicare program, in order to construct 

an occupational mix adjustment to the 

wage index, for application beginning 

October 1, 2004 (the FY 2005 wage 

index). The purpose of the occupational 

mix adjustment is to control for the 

effect of hospitals’ employment choices 

on the wage index. Refer to the 

summary of changes document for a list 

of current changes. Form Number: 

CMS–10079 (OMB#: 0938–0907); 

Frequency: Reporting—Yearly, 

Biennially and Occasionally ; Affected 

Public: Private Sector—Business or 

other for-profits and Not-for-profit 

institutions; Number of Respondents: 

3,522; Total Annual Responses: 3,522; 

Total Annual Hours: 1,690,560. (For 

policy questions regarding this 

collection contact Taimyra Jones at 410– 

786–1562. For all other issues call 410– 

786–1326.) 

3. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Medicare 

Program/Home Health Prospective 

Payment System Rate Update for 

Calendar Year 2010: Physician Narrative 

Requirement and Supporting Regulation 

in 42 CFR 424.22; Use: The Centers for 

Medicare and Medicaid Services (CMS) 

require that a physician sign every 

patient’s individual plan of care 

certifying or recertifying that the patient 

is homebound and the planned services 

are medically necessary in order for the 

home health agency to be reimbursed 

for Medicare covered services as 

stipulated in 42 CFR 424.22. CMS is 

relying on physicians to fulfill a role 

that is sometimes thought of as a 

‘‘gatekeeper’’ by requiring the physician 

to provide a narrative located within the 

home health certification or 

recertification when skilled nursing 

management & evaluation of the plan of 

care, (PoC) is ordered. The physician’s 

narrative is required when a patient’s 

underlying condition or complication 

requires a registered nurse to ensure that 

essential non-skilled care is achieving 

its purpose, The narrative must be 

located immediately prior to the 

physician’s signature. If the narrative 

exists as an addendum to the 

certification or recertification form, in 

addition to the physician’s signature on 

the certification or recertification form, 

the physician must sign immediately 

following the narrative in the 

addendum. This change supports 

Medicare’s home health coverage 

criteria for skilled services as stipulated 

in the CFR, (see 42 CFR 409.42). Form 

Number: CMS–10311 (OMB#: 0938– 

New); Frequency: Annually; Affected 

Public: Business or other for-profit and 

Not-for-profit institutions; Number of 

Respondents: 345,600; Total Annual 

Responses: 345,600; Total Annual 

Hours: 28,800. (For policy questions 

regarding this collection contact Randy 

Throndset at 410–786–0131. 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 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. 

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 February 16, 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: January 8, 2010. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2010–712 Filed 1–14–10; 8:45 am] 

BILLING CODE 4120–01–P 


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