Federal Register / Vol. 78, No. 82 / Monday, April 29, 2013 / Notices 25089 

3,440 respondents × 25/60 minutes = 

1,433 hours). In total, this will be 

approximately 1,531 hours. 

There are no costs to respondents 

other than their time. 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondents Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hrs.) 

Total burden 

(in hrs.) 

Mental Health/Public Health Agency 

Staff and Community Leaders.

Community Recovery Interview 

Guide.

98 1 1 98 

General Public from Disaster affected communities.Public Health Systems, Mental 

Health and Community Recovery 

Household Survey.

3,440 1 25/60 1,433 

Total ........................................... ........................................................... ........................ ........................ ........................ 1,531 

Ron A. Otten, 

Director, Office of Scientific Integrity, Office 

of the Associate Director for Science, Office 

of the Director. Centers for Disease Control 

and Prevention. 

[FR Doc. 2013–09992 Filed 4–26–13; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–1984–14, CMS– 

10115, CMS–10130, and CMS–10479] 

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: Revision of a currently 

approved collection; Title of 

Information Collection: Hospice Facility 

Cost Report; Use: In accordance with 

sections 1815(a), 1833(e) and 

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

(the Act), providers of service in the 

Medicare program are required to 

submit annual information to achieve 

reimbursement for health care services 

rendered to Medicare beneficiaries. In 

addition, 42 CFR 413.20(b) specifies that 

cost reports are required from providers 

on an annual basis. Such cost reports 

are required to be filed with the 

provider’s Medicare contractor. The 

functions of the Medicare contractor are 

described in section 1816 of the Act. 

Section 3132 of the Affordable Care Act 

requires that CMS collect appropriate 

data and information to facilitate 

hospice payment reform. Form Number: 

CMS–1984–14 (OCN: 0938–0758); 

Frequency: Yearly; Affected Public: 

Private sector (business or other forprofit and not-for-profit institutions); 

Number of Respondents: 2,751; Total 

Annual Responses: 2,751; Total Annual 

Hours: 517,188. (For policy questions 

regarding this collection contact Gail 

Duncan at 410–786–7278. For all other 

issues call 410–786–1326.) 

2. Type of Information Collection 

Request: Reinstatement with change of a 

previously approved collection; Title of 

Information Collection: Federal 

Reimbursement of Emergency Health 

Services Furnished to Undocumented 

Aliens, Section 1011 of the Medicare 

Prescription Drug, Improvement and 

Modernization Act of 2003 (MMA). Use: 

Section 1011 of the MMA provides that 

the Secretary will establish a process 

(i.e., enrollment and claims payment) 

for eligible providers to request 

payment. The Secretary must directly 

pay hospitals, physicians and 

ambulance providers (including Indian 

Health Service, Indian Tribe and Tribal 

organizations) for their otherwise unreimbursed costs of providing services 

required by section 1867 of the Social 

Security Act and related hospital 

inpatient, outpatient and ambulance 

services. CMS will use the application 

information to administer this health 

services program and establish an audit 

process. Form Number: CMS–10115 

(OCN: 0938–0929); Frequency: Once 

and occasionally; Affected Public: 

Private sector (business or other forprofit and not-for-profit institutions); 

Number of Respondents: 10,000; Total 

Annual Responses: 10,000; Total 

Annual Hours: 5,000. (For policy 

questions regarding this collection 

contact Fred Rooke at 404–562–7502. 

For all other issues call 410–786–1326.) 

3. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: Federal 

Reimbursement of Emergency Health 

Services Furnished to Undocumented 

Aliens, Section 1011 of the Medicare 

Prescription Drug, Improvement and 

Modernization Act of 2003 (MMA): 

‘‘Section 1011 Provider Payment 

Determination’’ and ‘‘Request for 

Section 1011 Hospital On-Call Payments 

to Physicians’’ Forms. Use: Section 1011 

of the MMA requires that the Secretary 

establish a process under which eligible 

providers (certain hospitals, physicians 

and ambulance providers) may request 

payment for (claim) their otherwise unreimbursed costs of providing eligible 

services. The Secretary must make 

quarterly payments directly to such 

providers. The Secretary must also 

implement measures to ensure that 

inappropriate, excessive, or fraudulent 

payments are not made under Section 

1011, including certification by 

providers of the veracity of their 

requests for payment. Both forms have 

been established to address the statutory 

requirements outlined above. Form 

Number: CMS–10130 (OCN: 0938– 

0952); Frequency: Occasionally; 

Affected Public: Private sector (business 

or other for-profit and not-for-profit 

institutions); Number of Respondents: 


emcdonald on DSK67QTVN1PROD with NOTICES
25090 Federal Register / Vol. 78, No. 82 / Monday, April 29, 2013 / Notices 

12,037; Total Annual Responses: 

300,148; Total Annual Hours: 75,037. 

(For policy questions regarding this 

collection contact Fred Rooke at 404– 

562–7205. For all other issues call 410– 

786–1326.) 

4. Type of Information Collection 

Request: New Collection; Title of 

Information Collection: Evaluation of 

the Multi-Payer Advanced Primary Care 

Practice (MAPCP) Demonstration Focus 

Group Protocols; Use: On September 16, 

2009, the Department of Health and 

Human Services announced the 

establishment of the Multi-payer 

Advanced Primary Care Practice 

(MAPCP) Demonstration, under which 

Medicare joined Medicaid and private 

insurers as a payer participant in statesponsored patient-centered medical 

home (PCMH) initiatives. CMS selected 

eight states to participate in this 

demonstration: Maine, Vermont, Rhode 

Island, New York, Pennsylvania, North 

Carolina, Michigan, and Minnesota. 

CMS is proposing to conduct in-person 

focus groups with Medicare and 

Medicaid beneficiaries and their 

caregivers to more thoroughly 

understand patients’ experiences with 

their PCMHs and how well their PCMHs 

are serving their needs. 

The focus groups will provide CMS 

with answers to fundamental ‘‘what, 

how, and why’’ questions about 

beneficiaries’ experiences with care and 

access to and coordination of care. The 

information obtained via in-person, 

focus groups will be utilized by CMS for 

the evaluation of the MAPCP 

Demonstration. The focus group data 

will be collected to supplement other 

qualitative and quantitative analyses 

from primary and secondary data 

sources by providing data on context, 

structure, and process, as well as select 

aspects of the key outcomes. The data 

gathered from the interviews will allow 

for more complete interpretation of the 

quantitative claims and other data 

analysis by taking into account the 

unique perspectives of beneficiaries. 

Form Number: CMS–10479 (OCN: 

0938–NEW); Frequency: Annually; 

Affected Public: Individuals and 

households; Number of Respondents: 

768; Total Annual Responses: 384; Total 

Annual Hours: 1,152. (For policy 

questions regarding this collection 

contact Suzanne Goodwin at 410–786– 

0226. 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 June 28, 2013: 

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/OMB 

Control Number llll, Room C4–26– 

05, 7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: April 23, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–09948 Filed 4–26–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

Proposed Collection, 60-day Comment 

Request: Certificate of Confidentiality 

Electronic Application System 

SUMMARY: In compliance with the 

requirement of Section 3506(c)(2)(A) of 

the Paperwork Reduction Act of 1995, to 

provide the opportunity for public 

comment on proposed data collection 

projects, the Office of Extramural 

Research (OER) of the National 

Institutes of Health (NIH) is developing 

an electronic application form for the 

submission of requests to NIH for 

Certificates of Confidentiality (CoCs). 

Written comments and/or suggestions 

from the public and affected agencies 

are invited on one or more of the 

following points: (1) Whether the 

proposed collection of information is 

necessary for the proper performance of 

the function of the agency, including 

whether the information will have 

practical utility; (2) the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information, 

including the validity of the 

methodology and assumptions used; (3) 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected; and (4) ways to minimize the 

burden of the collection of information 

on those who are to respond, including 

the use of appropriate automated, 

electronic, mechanical, or other 

technological collection techniques or 

other forms of information technology. 

To Submit Comments and For Further 

Information: To obtain a copy of the 

data collection plans and instruments, 

submit comments in writing, or request 

more information on the proposed 

project, contact: Dr. Ann M. Hardy, NIH 

Extramural Human Research Protections 

Officer and Coordinator, Certificates of 

Confidentiality, Office of Extramural 

Programs, OER, NIH, 3701 Rockledge 

Drive, Room 3002, Bethesda, MD 20892; 

or call the non-toll-free number (301) 

435–2690; or email your request, 

including your address, to 

hardyan@od.nih.gov. Formal requests 

for additional plans and instruments 

must be requested in writing. 

Comment Due Date: Comments 

regarding this information collection are 

best assured of having their full effect if 

received within 60 days of the date of 

this publication. 

Proposed Collection: Certificate of 

Confidentiality Electronic Application 

System 0925–New, Office of Extramural 

Research (OER), National Institutes of 

Health (NIH). 

Need and Use of Information 

Collection: This application system will 

provide one electronic form to be used 

by all research organizations that wish 

to request a Certificate of Confidentiality 

(CoC) from NIH. As described in the 

authorizing legislation (Section 301(d) 

of the Public Health Service Act, 42 

U.S.C. 241(d)), CoCs are issued by the 

agencies of the Department of Health 

and Human Services (HHS), including 

NIH, to authorize researchers 

conducting sensitive research to protect 

the privacy of human research subjects 

by enabling them to refuse to release 

names and identifying characteristics of 

subjects to anyone not connected with 

the research. At the NIH, the issuance of 

CoCs has been delegated to the 

individual NIH Institutes and Centers 

(ICs). The NIH ICs collectively issue 

approximately 1,000 new CoCs each 

year for eligible research projects. 

However, the process for submitting a 

CoC request is not consistent across the 

ICs, which creates confusion for 

applicants. To make the application 

process consistent across the entire 

agency, the OER is proposing to use an 

electronic application system that will 

be accessed by research organizations 

that wish to request a CoC from any NIH 


emcdonald on DSK67QTVN1PROD with NOTICES