53202 Federal Register / Vol. 77, No. 170 / Friday, August 31, 2012 / Notices 

By order of the Federal Open Market 

Committee, August 22, 2012. 

William B. English, 

Secretary, Federal Open Market Committee. 

[FR Doc. 2012–21557 Filed 8–30–12; 8:45 am] 

BILLING CODE 6210–01–P 

FEDERAL RESERVE SYSTEM 

Formations of, Acquisitions by, and 

Mergers of Bank Holding Companies 

The companies listed in this notice 

have applied to the Board for approval, 

pursuant to the Bank Holding Company 

Act of 1956 (12 U.S.C. 1841 et seq.) 

(BHC Act), Regulation Y (12 CFR part 

225), and all other applicable statutes 

and regulations to become a bank 

holding company and/or to acquire the 

assets or the ownership of, control of, or 

the power to vote shares of a bank or 

bank holding company and all of the 

banks and nonbanking companies 

owned by the bank holding company, 

including the companies listed below. 

The applications listed below, as well 

as other related filings required by the 

Board, are available for immediate 

inspection at the Federal Reserve Bank 

indicated. The applications will also be 

available for inspection at the offices of 

the Board of Governors. Interested 

persons may express their views in 

writing on the standards enumerated in 

the BHC Act (12 U.S.C. 1842(c)). If the 

proposal also involves the acquisition of 

a nonbanking company, the review also 

includes whether the acquisition of the 

nonbanking company complies with the 

standards in section 4 of the BHC Act 

(12 U.S.C. 1843). Unless otherwise 

noted, nonbanking activities will be 

conducted throughout the United States. 

Unless otherwise noted, comments 

regarding each of these applications 

must be received at the Reserve Bank 

indicated or the offices of the Board of 

Governors not later than September 26, 

2012. 

A. Federal Reserve Bank of New York 

(Ivan Hurwitz, Vice President) 33 

Liberty Street, New York, New York 

10045–0001: 

1. RSB Bancorp, MHC and RSB 

Bancorp, Inc., both of Roselle, New 

Jersey, to become bank holding 

companies by acquiring 100 percent of 

Roselle Savings Bank, Roselle, New 

Jersey. 

B. Federal Reserve Bank of 

Philadelphia (William Lang, Senior Vice 

President) 100 North 6th Street, 

Philadelphia, Pennsylvania 19105– 

1521: 

1. First Priority Financial Corp, 

Malvern, Philadelphia, to acquire 100 

percent of Affinity Bancorp, Inc., 

Wyomissing, Philadelphia, and thereby 

indirectly acquire Affinity Bank of 

Pennsylvania, Wyomissing, 

Philadelphia. 

Board of Governors of the Federal Reserve 

System, August 28, 2012. 

Margaret McCloskey Shanks, 

Associate Secretary of the Board. 

[FR Doc. 2012–21543 Filed 8–30–12; 8:45 am] 

BILLING CODE 6210–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10443 and CMS– 

10149] 

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: New collection. Title of 

Information Collection: Transcatheter 

Valve Therapy Registry and KCCQ–10. 

Use: The data collection is required by 

the Centers for Medicare and Medicaid 

Services (CMS) National Coverage 

Determination (NCD) entitled, 

‘‘Transcatheter Aortic Valve 

Replacement (TAVR)’’. The TAVR 

device is only covered when specific 

conditions are met including that the 

heart team and hospital are submitting 

data in a prospective, national, audited 

registry. The data includes patient, 

practitioner and facility level variables 

that predict outcomes such as all cause 

mortality and quality of life. CMS finds 

that the Society of Thoracic Surgery/ 

American College of Cardiology 

Transcatheter Valve Therapy (STS/ACC 

TVT) Registry, one registry overseen by 

the National Cardiovascular Data 

Registry, meets the requirements 

specified in the NCD on TAVR. The 

TVT Registry will support a national 

surveillance system to monitor the 

safety and efficacy of the TAVR 

technologies for the treatment of aortic 

stenosis. 

The data will also include the 

variables on the eight item Kansas City 

Cardiomyopathy Questionnaire (KCCQ– 

10) to assess heath status, functioning 

and quality of life. In the KCCQ, an 

overall summary score can be derived 

from the physical function, symptoms 

(frequency and severity), social function 

and quality of life domains. For each 

domain, the validity, reproducibility, 

responsiveness and interpretability have 

been independently established. Scores 

are transformed to a range of 0–100, in 

which higher scores reflect better health 

status. 

The conduct of the STS/ACC TVT 

Registry and the KCCQ–10 is in 

accordance with Section 1142 of the 

Social Security Act (the Act) that 

describes the authority of the Agency for 

Healthcare Research and Quality 

(AHRQ). Under section 1142, research 

may be conducted and supported on the 

outcomes, effectiveness, and 

appropriateness of health care services 

and procedures to identify the manner 

in which disease, disorders, and other 

health conditions can be prevented, 

diagnosed, treated, and managed 

clinically. Section 1862(a)(1)(E) of the 

Act allows Medicare to cover under 

coverage with evidence development 

(CED) certain items or services for 

which the evidence is not adequate to 

support coverage under section 

1862(a)(1)(A) and where additional data 

gathered in the context of a clinical 

setting would further clarify the impact 

of these items and services on the health 

of beneficiaries. 

The data collected and analyzed in 

the TVT Registry will be used by CMS 

to determine if the TAVR is reasonable 

and necessary (e.g., improves health 

outcomes) for Medicare beneficiaries 

under Section 1862(a)(1)(A) of the Act. 

Furthermore, data from the Registry will 

assist the medical device industry and 

the Food and Drug Administration 

(FDA) in surveillance of the quality, 

safety and efficacy of new medical 

devices to treat aortic stenosis. For 

purposes of the TAVR NCD, The TVT 

Registry has contracted with the Data 

Analytic Centers to conduct the 

analyses. In addition, data will be made 

available for research purposes under 

the terms of a data use agreement that 


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Federal Register / Vol. 77, No. 170 / Friday, August 31, 2012 / Notices 53203 

only provides de-identified datasets. 

Form Number: CMS–10443 (OCN: 0938- 

New); Frequency: Annual; Affected 

Public: Individuals, Households and 

Private Sector; Number of Respondents: 

12,000; Total Annual Responses: 

24,000; Total Annual Hours: 7,000. (For 

policy questions regarding this 

collection contact JoAnna Baldwin at 

410–786–7205. For all other issues call 

410–786–1326.) 

2. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: Health 

Insurance Reform: Electronic Security 

Standards; Use: This information 

collection corresponds to existing 

regulations establishing standards for 

the security of electronic protected 

health information to be implemented 

by health plans, health care 

clearinghouses and certain health care 

providers, as required under title II, 

subtitle F, sections 261 through 264 of 

the Health Insurance Portability and 

Accountability Act of 1996 (HIPAA), 

Public Law 104–191. The use of the 

security standards improves Federal 

health programs, private health 

programs, and the effectiveness and 

efficiency of the health care industry in 

general by establishing a level of 

protection for certain electronic health 

information. This information collection 

request does not propose any changes to 

this information collection related to 

future modifications of the underlying 

HIPAA security standards. Form 

Number: CMS–10149 (OCN: 0938– 

0949); Frequency: Occasionally; 

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

Federal Government, and State, Local or 

Tribal Government; Number of 

Respondents: 135,560; Total Annual 

Responses: 285,560; Total Annual 

Hours: 536,743. (For policy questions 

regarding this collection contact 

William Parham at 410–786–4669. 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. 

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 October 30, 2012: 

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: CMS–R–284 (OCN 0938– 

0345), Room C4–26–05, 7500 Security 

Boulevard, Baltimore, Maryland 21244– 

1850. 

Dated: August 28, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–21594 Filed 8–30–12; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–359 and CMS– 

360] 

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: Extension without change of a 

currently approved collection. Title of 

Information Collection: Comprehensive 

Outpatient Rehabilitation Facility 

(CORF) Eligibility and Survey Forms. 

Use: CMS–359 serves as the application 

for facilities wishing to participate in 

the Medicare/Medicaid program as 

CORFs. The form initiates the process 

for obtaining a decision as to whether 

the conditions of participation are met. 

It also promotes data reduction (key 

punching) or introduction to and 

retrieval from the Medicare/Medicaid 

Automated Certification System, 

ASPEN, by the CMS Regional Offices. 

Should any question arise regarding the 

structure of the organization, this 

information is readily available without 

going through the process of completing 

the form again. 

CMS–360 is used by the State survey 

agency to record data collected to 

determine provider compliance with 

individual conditions of participation 

and to report it to the federal 

government. CMS has the responsibility 

and authority for certification decisions 

which are based on provider 

compliance with the conditions of 

participation. The information needed 

to make these decisions is available to 

CMS only through the information 

abstracted from the survey checklists. 

The form is primarily a worksheet 

designed to facilitate key punching into 

ASPEN by the state agency after the 

survey is completed. Form Number: 

CMS–359 (CORF Eligibility Form) and 

CMS–360 (CORF Survey Report Form); 

(OCN 0938–0267); Frequency: 

Occasionally. Affected Public: Private 

Sector (Business or other for-profits). 

Number of Respondents: 295. Total 

Annual Responses: 42. Total Annual 

Hours: 137. (For policy questions 

regarding this collection contact Georgia 

Johnson at 410–786–6859. 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 October 1, 2012. OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–6974, Email: OIRA_

submission@omb.eop.gov. 


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