44776 Federal Register / Vol. 79, No. 148 / Friday, August 1, 2014 / Notices 

technology to minimize the information 

collection burden. 

DATES: Comments on the collection(s) of 

information must be received by the 

OMB desk officer by September 2, 2014. 

ADDRESSES: When commenting on the 

proposed information collections, 

please reference the document identifier 

or OMB control number. To be assured 

consideration, comments and 

recommendations must be received by 

the OMB desk officer via one of the 

following transmissions: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–5806 OR, Email: 

OIRA_submission@omb.eop.gov. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

http://www.cms.hhs.gov/

PaperworkReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326. 

SUPPLEMENTARY INFORMATION: Under the 

Paperwork Reduction Act of 1995 (PRA) 

(44 U.S.C. 3501–3520), federal agencies 

must obtain approval from the Office of 

Management and Budget (OMB) for each 

collection of information they conduct 

or sponsor. The term ‘‘collection of 

information’’ is defined in 44 U.S.C. 

3502(3) and 5 CFR 1320.3(c) and 

includes agency requests or 

requirements that members of the public 

submit reports, keep records, or provide 

information to a third party. Section 

3506(c)(2)(A) of the PRA (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-day notice in the 

Federal Register concerning each 

proposed collection of information, 

including each proposed extension or 

reinstatement of an existing collection 

of information, before submitting the 

collection to OMB for approval. To 

comply with this requirement, CMS is 

publishing this notice that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Independent 

Rural Health Clinic/Freestanding 

Federally Qualified Health Center Cost 

Report; Use: Providers of services 

participating in the Medicare program 

are required under sections 1815(a) and 

1861(v)(1)(A) of the Social Security Act 

(42 U.S.C. 1395g) to submit annual 

information to achieve settlement of 

costs for health care services rendered to 

Medicare beneficiaries. In addition, 

regulations at 42 CFR 413.20 and 413.24 

require adequate cost data and cost 

reports from providers on an annual 

basis. The Form CMS–222–92 cost 

report is needed to determine the 

provider’s reasonable costs incurred in 

furnishing medical services to Medicare 

beneficiaries and reimbursement due to 

or due from the provider. Form Number: 

CMS–222–92 (OMB control number: 

0938–0107); Frequency: Annually; 

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

Number of Respondents: 3,264; Total 

Annual Responses: 3,264; Total Annual 

Hours: 163,200. (For policy questions 

regarding this collection contact 

Leonard Fisher at 410–786–4574.) 

Dated: July 28, 2014. 

Martique Jones, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2014–18040 Filed 7–31–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10292 and CMS– 

10357] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 (the 

PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information (including each proposed 

extension or reinstatement of an existing 

collection of information) and to allow 

60 days for public comment on the 

proposed action. Interested persons are 

invited to send comments regarding our 

burden estimates 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. 

DATES: Comments must be received by 

September 30, 2014. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number (OCN). To be 

assured consideration, comments and 

recommendations must be submitted in 

any one of the following ways: 

1. Electronically. You may send 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) that are 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/OMB 

Control Numberlll, Room C4–26– 

05, 7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

http://www.cms.hhs.gov/

PaperworkReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326. 

SUPPLEMENTARY INFORMATION: 

Contents 

This notice sets out a summary of the 

use and burden associated with the 

following information collections. More 

detailed information can be found in 

each collection’s supporting statement 

and associated materials (see 

ADDRESSES). 

CMS–10292 State Medicaid HIT Plan, 

Planning Advance Planning 

Document, and Implementation 

Advance Planning Document for 

Section 4201 of the Recovery Act 


tkelley on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 79, No. 148 / Friday, August 1, 2014 / Notices 44777 

CMS–10357 Letter Requesting Waiver 

of Medicare/Medicaid Enrollment 

Application Fee; Submission of 

Fingerprints; Submission of 

Medicaid Identifying Information; 

Medicaid Site Visit and Rescreening 

Under the Paperwork Reduction Act 

(PRA)(44 U.S.C. 3501–3520), federal 

agencies must obtain approval from the 

Office of Management and Budget 

(OMB) for each collection of 

information they conduct or sponsor. 

The term ‘‘collection of information’’ is 

defined in 44 U.S.C. 3502(3) and 5 CFR 

1320.3(c) and includes agency requests 

or requirements that members of the 

public submit reports, keep records, or 

provide information to a third party. 

Section 3506(c)(2)(A) of the PRA 

requires federal agencies to publish a 

60-day notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, before 

submitting the collection to OMB for 

approval. To comply with this 

requirement, CMS is publishing this 

notice. 

Information Collection 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: State Medicaid 

HIT Plan, Planning Advance Planning 

Document, and Implementation 

Advance Planning Document for 

Section 4201 of the Recovery Act; Use: 

To assess the appropriateness of state 

requests for the administrative Federal 

financial participation for expenditures 

under their Medicaid Electronic Health 

Record Incentive Program related to 

health information exchange, our staff 

will review the submitted information 

and documentation to make an approval 

determination of the state advance 

planning document. Form Number: 

CMS–10292 (OMB control number 

0938–1088); Frequency: Once and 

occasionally; Affected Public: State, 

Local, and Tribal Governments; Number 

of Respondents: 56; Total Annual 

Responses: 56; Total Annual Hours: 

896. (For policy questions regarding this 

collection contact Thomas Romano at 

410–786–0465). 

2. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection: 

Title of Information Collection: Letter 

Requesting Waiver of Medicare/

Medicaid Enrollment Application Fee; 

Submission of Fingerprints; Submission 

of Medicaid Identifying Information; 

Medicaid Site Visit and Rescreening; 

Use: Section 6401 of the Affordable Care 

Act (ACA) establishes a number of 

important payment safeguard 

provisions. The provisions are designed 

to improve the integrity of the Medicare, 

Medicaid, and Children’s Health 

Insurance Programs (CHIP) so as to 

reduce fraud, waste and abuse. The 

provisions include the following: 

• Medicare Enrollment Application 

Fee Waiver Request: Certain providers 

and suppliers enrolling in Medicare will 

be required to submit a fee with their 

application. Under 42 CFR 424.514, if 

the applicant believes it has a hardship 

that justifies a waiver of the application 

fee, it may submit a letter describing 

said hardship. 

• Fingerprints: Certain providers and 

suppliers enrolling in Medicare, 

Medicaid, and CHIP will be required to 

submit fingerprints—either digitally or 

via the FD–258 standard fingerprint 

card—of their owners. 

• Suspension of Medicaid Payments: 

A State Medicaid agency shall suspend 

all Medicaid payments to a provider 

when there is a pending investigation of 

a credible allegation of Medicaid fraud 

against an individual or entity, unless it 

has good cause not to suspend payments 

or to suspend payment only in part. The 

State Medicaid agency may suspend 

payments without first notifying the 

provider of its intention to suspend 

such payments. A provider may request, 

and must be granted, administrative 

review where State law so requires. 

• Collection of Social Security 

Numbers (SSNs) and Dates of Birth 

(DOBs) for Medicaid and CHIP 

Providers: The State Medicaid agency or 

CHIP agency must require that all 

persons with an ownership or control 

interest in a Medicaid or CHIP provider 

submit their SSNs and DOBs. 

• Site Visits for Medicaid-only or 

CHIP-only providers: A State Medicaid 

agency or CHIP agency must conduct 

on-site visits for providers it determines 

to be ‘‘moderate’’ or ‘‘high’’ categorical 

risk. 

• Rescreening of Medicaid and CHIP 

Providers Every 5 Years: A State 

Medicaid agency or CHIP agency must 

screen all providers at least every 5 

years. This is consistent with the 

Medicare requirement in current 42 CFR 

424.515 that providers and suppliers 

revalidate their enrollment information 

at least every 5 years. 

Form Number: CMS–10357 (OMB 

control number: 0938–1137); Frequency: 

On occasion; Affected Public: Private 

sector—Business or for-profit and Notfor-profit institutions and State, Local, 

or Tribal Governments; Number of 

Respondents: 960,981; Total Annual 

Responses: 960,981; Total Annual 

Hours: 1,248,082. (For policy questions 

regarding this collection contact Frank 

Whelan at 410–786–1302). 

Dated: July 28, 2014. 

Martique Jones, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2014–18042 Filed 7–31–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Proposed Projects: 

Title: State Plan for the Temporary 

Assistance for Needy Families (TANF). 

OMB No.: 0970–0145. 

Description: The State plan is a 

mandatory statement submitted to the 

Secretary of the Department of Health 

and Human Services by the State. It 

consists of an outline specifying how 

the state’s TANF program will be 

administered and operated and certain 

required certifications by the State’s 

Chief Executive Officer. It is used to 

provide the public with information 

about the program. 

Authority to require States to submit 

a State TANF plan is contained in 

section 402 of the Social Security Act, 

as amended by Public Law 104–193, the 

Personal Responsibility and Work 

Opportunity Reconciliation Act of 1996. 

States are required to submit new plans 

periodically (i.e., within a 27-month 

period). 

We are proposing to continue the 

information collection without change. 

Respondents: The 50 States of the 

United States, the District of Columbia, 

Guam, Puerto Rico, and the Virgin 

Islands. 


tkelley on DSK3SPTVN1PROD with NOTICES