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

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


### 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**