Federal Register / Vol. 77, No. 130 / Friday, July 6, 2012 / Notices 40063 

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. 

Section 1413 of the Affordable Care 

Act directs the Secretary of Health and 

Human Services to develop and provide 

to each State a single, streamlined form 

that may be used to apply for coverage 

through the Exchange and Insurance 

Affordability Programs, including 

Medicaid, the Children’s Health 

Insurance Program (CHIP), and the Basic 

Health Program, as applicable. The 

application must be structured to 

maximize an applicant’s ability to 

complete the form satisfactorily, taking 

into account the characteristics of 

individuals who qualify for the 

programs. A State may develop and use 

its own single streamlined application if 

approved by the Secretary in accordance 

with section 1413 and if it meets the 

standards established by the Secretary. 

Section 155.405(a) of the Exchange 

Final Rule (77 FR 18310) provides more 

detail about the application that must be 

used by the Exchange to determine 

eligibility and to collect information 

necessary for enrollment. The 

regulations in § 435.907 and § 457.330 

establish the requirements for State 

Medicaid and CHIP agencies related to 

the use of the single streamlined 

application. CMS is designing the single 

streamlined application to be a dynamic 

online application that will tailor the 

amount of data required from an 

applicant based on the applicant’s 

circumstances and responses to 

particular questions. The paper version 

of the application will not be able to be 

tailored in the same way but is being 

designed to collect only the data 

required to determine eligibility. 

Individuals will be able to submit an 

application online, through the mail, 

over the phone through a call center, or 

in person, per § 155.405(c)(2) of the 

Exchange Final Rule, as well as through 

other commonly available electronic 

means as noted in § 435.907(a) and 

§ 457.330 of the Medicaid Final Rule. 

The application may be submitted to an 

Exchange, Medicaid or CHIP agency. 

The online application process will 

vary depending on each applicant’s 

circumstances, their experience with 

health insurance applications and 

online capabilities. The goal is to solicit 

sufficient information so that in most 

cases no further inquiry will be needed. 

We estimate that on average it will take 

approximately .50 hours (30 minutes) to 

complete for people applying for 

Insurance Affordability Programs. It will 

take an estimated .25 hours (15 minutes) 

to complete without consideration for 

Insurance Affordability Programs. We 

expect approximately 7,700,260 

applications to be submitted for 

Insurance Affordability Programs 

between 2014 and 2016. The total 

burden is estimated to be 2,264,329 

hours for 2014, and 605,920 hours and 

979,881 hours for years 2015 and 2016, 

respectively. We estimate 1,139, 240 

applications to be submitted online 

without consideration for Insurance 

Affordability Programs between 2014 

and 2016, resulting in 71,203 hours of 

burden each year in 2014 and in 2015, 

and 142,405 burden hours in 2016. The 

paper application process will take 

approximately .75 hours (45 minutes) to 

complete for those applying for 

Insurance Affordability Programs and 

.33 hours (20 minutes) for those 

applying without consideration for 

Insurance Affordability Programs. We 

expect approximately 855,584 

applications to be submitted for 

Insurance Affordability Programs on 

paper in 2014 through 2016 for a total 

of 377,388 estimated burden hours in 

2014. The burden hours are projected to 

be 100,987 hours and 163,314 hours in 

2015 and 2016, respectively. We 

estimate 126,581 applications will be 

submitted without consideration for 

Insurance Affordability Programs from 

2014 through 2016. Total burden hours 

are expected to be 10,443 hours in 2014 

and 2015, and 20,886, in 2016. Form 

Number: CMS–10440 (OCN: 0938– 

NEW); Frequency: Once per year; 

Affected Public: Individuals and 

households; Number of Respondents: 

3,273,889; Total Annual Responses: 

3,273,889; Total Annual Hours: 

1,669,683 hours. (For policy questions 

regarding this collection contact Hannah 

Moore at 301–492–4232. 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 September 4, 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: Document Identifier (lll), 

Room C4–26–05, 7500 Security 

Boulevard, Baltimore, Maryland 21244– 

1850. 

Dated: June 29, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–16508 Filed 7–2–12; 11:15 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10427 and CMS– 

10437] 

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. 


TKELLEY on DSK3SPTVN1PROD with NOTICES
40064 Federal Register / Vol. 77, No. 130 / Friday, July 6, 2012 / Notices 

1. Type of Information Collection 

Request: New collection; Title of 

Information Collection: For-Profit PACE 

Study; Use: The Program of All 

Inclusive Care of the Elderly (PACE) 

aims to provide integrated care and 

services to the frail elderly at risk of 

institutionalization to enable them to 

remain in the community. Under the 

Balanced Budget Act of 1997 (BBA), the 

not-for-profit PACE plans were 

established as permanent providers 

under the Medicare and Medicaid 

programs. The BBA also mandated a 

demonstration of for-profit PACE plans. 

This study will estimate the differences 

in quality and access to care between 

the for-profit and not-for-profit PACE 

plans. The data collected in the survey 

will be used to measure the outcomes of 

interest-differences in access to and 

quality of care delivered to PACE 

enrollees. To measure these key 

outcomes, the survey will collect data 

on access to and satisfaction with 

healthcare, personal care, and 

transportation assistance provided by 

the plans. Form Number: CMS–10427 

(OCN: 0938–New); Frequency: Yearly; 

Affected Public: Individuals. Number of 

Respondents: 813. Number of 

Responses: 813. Total Annual Hours: 

447. (For policy questions regarding this 

collection contact Julia Zucco at 410– 

786–6670. For all other issues call 410– 

786–1326.) 

2. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Generic Social 

Marketing & Consumer Testing 

Research; Use: The purpose of this 

submission is to request an Information 

Collection Request (ICR) generic 

clearance for a program of consumer 

research aimed at a broad audience of 

those affected by CMS programs 

including Medicare, Medicaid, 

Children’s Health Insurance Program 

(CHIP), and health insurance exchanges. 

This program extends strategic efforts to 

reach and tailor communications to 

beneficiaries, caregivers, providers, 

stakeholders, and any other audiences 

that would support the Agency in 

improving the functioning of the health 

care system, improve patient care and 

outcomes, and reduce costs without 

sacrificing quality of care. With the 

clearance, CMS will create a fast track, 

streamlined, proactive process for 

collection of data and utilizing the 

feedback on service delivery for 

continuous improvement of 

communication activities aimed at 

diverse CMS audiences. 

The generic clearance will allow rapid 

response to inform CMS initiatives 

using a mixture of qualitative and 

quantitative consumer research 

strategies (including formative research 

studies and methodological tests) to 

improve communication with key CMS 

audiences. As new information 

resources and persuasive technologies 

are developed, they can be tested and 

evaluated for beneficiary response to the 

materials and delivery channels. Results 

will inform communication 

development and information 

architecture as well as allow for 

continuous quality improvement. The 

overall goal is to maximize the extent to 

which consumers have access to useful 

sources of CMS program information in 

a form that can help them make the 

most of their benefits and options. 

The activities under this clearance 

involve social marketing and consumer 

research using samples of self-selected 

customers, as well as convenience 

samples, and quota samples, with 

respondents selected either to cover a 

broad range of customers or to include 

specific characteristics related to certain 

products or services. All collection of 

information under this clearance will 

utilize a subset of items drawn from a 

core collection of customizable items 

referred to as the Social Marketing and 

Consumer Testing Item Bank. This item 

bank is designed to establish a set of 

pre-approved generic question that can 

be drawn upon to allow for the rapid 

turn-around consumer testing required 

for CMS to communicate more 

effectively with its audiences. The 

questions in the item bank are divided 

into two major categories. One set 

focuses on characteristics of individuals 

and is intended primarily for participant 

screening and for use in structured 

quantitative on-line or telephone 

surveys. The other set is less structured 

and is designed for use in qualitative 

one-on-one and small group discussions 

or collecting information related to 

subjective impressions of test materials. 

A Study Initiation Request Form 

detailing each specific study 

(description, methodology, estimated 

burden) conducted under this clearance 

will be submitted before any testing is 

initialed. Results will be compiled and 

disseminated so that future 

communication can be informed by the 

testing results. We will use the findings 

to create the greatest possible public 

benefit. Form Number: CMS–10427 

(OCN: 0938–New); Frequency: Yearly; 

Affected Public: Individuals. Number of 

Respondents: 41,592. Number of 

Responses: 28,800. Total Annual Hours: 

21,488. (For policy questions regarding 

this collection contact Neal Hickson at 

410–786–6737. 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 August 6, 2012. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS Desk 

Officer, Fax Number: (202) 395–6974, 

Email: OIRA_submission@omb.eop.gov. 

Dated: June 29, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–16526 Filed 7–5–12; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–R–218, CMS– 

10428, CMS–10441, CMS–10261, CMS– 

10338, CMS–10137, CMS–10237 and CMS– 

10003] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid 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) 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. 


TKELLEY on DSK3SPTVN1PROD with NOTICES