Federal Register / Vol. 76, No. 127 / Friday, July 1, 2011 / Notices 38655 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

Office for State, Tribal, Local, and 

Territorial Support 

In accordance with Presidential 

Executive Order No. 13175, November 

6, 2000, and the Presidential 

Memorandum of November 5, 2009 and 

September 23, 2004, Consultation and 

Coordination with Indian Tribal 

Governments, CDC, OSTLTS announces 

the following meeting and Tribal 

Consultation Session: 

Name: Tribal Advisory Committee (TAC) 

Meeting and 7th Biannual Tribal 

Consultation Session. 

Times and Dates: 

8:30 a.m.–5 p.m., August 22–23, 2011 (TAC 

Meeting). 

8:30 a.m.–4 p.m., August 24, 2011 (7th 

Biannual Tribal Consultation Session). 

Place: Suquamish Clearwater Casino 

Resort, 15347 Suquamish Way, NE., 

Suquamish, Washington 98392. 

Status: All meetings are being hosted by 

the Northwest Portland Area Indian Health 

Board and are open to the public. August 23, 

2011, has been reserved as a day to tour and 

interact with local Tribes. A special 

invitation has been extended to the 

Washington and Oregon American Indian 

Tribal Leaders, Washington and Oregon State 

Health Department Officials, and all 

American Indian/Alaska Native (AI/AN) 

Tribal leaders from across the nation. 

Purpose: CDC released its Tribal 

Consultation Policy in October of 2005 with 

the primary purpose of providing guidance 

across the agency to work effectively with AI/ 

AN tribes, communities, and organizations to 

enhance AI/AN access to CDC resources and 

programs. In November of 2006, an Agency 

Advisory Committee (the CDC/Agency for 

Toxic Substances and Disease Registry Tribal 

Advisory Committee—TAC) was established 

to provide a complementary venue wherein 

tribal representatives and CDC staff could 

exchange information about public health 

issues in Indian Country, identifying urgent 

public health needs in AI/AN communities, 

and discuss collaborative approaches to these 

issues and needs. Within the CDC 

Consultation Policy, it is stated that CDC will 

conduct government-to-government 

consultation with elected tribal officials or 

their designated representatives and confer 

with tribal and American Native 

organizations and AI/AN urban and rural 

communities before taking actions and or 

making decisions that affect them. 

Consultation is an enhanced form of 

communication that emphasizes trust, 

respect, and shared responsibility. It is an 

open and free exchange of information and 

opinion among parties that leads to mutual 

understanding and comprehension. CDC 

believes that consultation is integral to a 

deliberative process that results in effective 

collaboration and informed decision making 

with the ultimate goal of reaching consensus 

on issues. Although formal responsibility for 

the agency’s overall government-togovernment consultation activities rests 

within the CDC Office of the Director (OD), 

other CDC Centers, Institutes, and Offices, 

leadership shall actively participate in TAC 

meetings and HHS-sponsored regional and 

national tribal consultation sessions as 

frequently as possible. 

Matters to be Discussed: The TAC will 

convene their advisory committee meeting 

with discussions and presentations from 

various CDC senior leaderships on activities 

and areas identified by TAC members and 

other tribal leaders as priority public health 

issues. The Biannual Tribal Consultation 

Session will engage CDC Senior leadership 

from the CDC OD and various CDC Centers, 

Institutes and Offices, including the 

Financial Management Office, the Office of 

the Associate Director of Communications, 

OSTLTS, the National Center for 

Environmental Health and the Agency for 

Toxic Substances and Disease Registry, the 

National Center for Chronic Disease 

Prevention and Health Promotion, as well as 

others. Opportunities will be provided 

during the consultation session for tribal 

testimony. Tribal Leaders are encouraged to 

submit written testimony by close of business 

on August 5, 2011, to the contact person 

listed below. 

It may be necessary to limit the time of 

each presenter due to the availability of time. 

The agenda is subject to change as 

priorities dictate. 

Information about TAC and CDC’s Tribal 

Consultation Policy and previous meetings 

may be referenced on the following Web link: 

http://www.cdc.gov/ostlts/ 

tribal_public_health/announcements.html. 

Contact Person for more Information: 

Kimberly Cantrell, Public Health Advisor, 

Tribal Support, OSTLTS, CDC, 1600 Clifton 

Road, NE., MS K–70, Atlanta, Georgia 30333, 

telephone (404) 498–0411, e-mail: 

KLW6@cdc.gov. 

The Director, Management Analysis and 

Services Office has been delegated the 

authority to sign Federal Register notices 

pertaining to announcements of meetings and 

other committee management activities, for 

both the Centers for Disease Control and 

Prevention, and the Agency for Toxic 

Substances and Disease Registry. 

Dated: June 24, 2011. 

Elaine L. Baker, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. 2011–16558 Filed 6–30–11; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10398, CMS– 

10399, CMS–10137, and CMS–10237] 

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: Generic 

Clearance for Medicaid and CHIP State 

Plan, Waiver, and Program Submissions; 

Use: CMS is requesting a generic PRA 

clearance for a body of forms necessary 

to conduct ongoing business with State 

partners in the implementation of 

Medicaid and the Children’s Health 

Insurance Program (CHIP). The specific 

forms have not yet been developed but 

will be developed over the 3-year 

approval period. The types of forms to 

be produced in this collection include 

State plan amendment templates, 

waiver and demonstration templates, 

and reporting templates. The 

development of streamlined submission 

forms is critical for States to implement 

timely health reform initiatives in 

Medicaid and CHIP state plans, 

demonstrations, and waivers, including 

legislative requirements enacted by the 

Affordable Care Act. The development 

of streamlined submissions forms 

enhances the collaboration and 

partnership between States and CMS by 

documenting CMS policy for States to 

use as they are developing program 

changes. Streamlined forms improve 

efficiency of administration by creating 

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38656 Federal Register / Vol. 76, No. 127 / Friday, July 1, 2011 / Notices 

a common and user-friendly 

understanding of the information 

needed by CMS to quickly process 

requests for State plan amendments, 

waivers, and demonstration, as well as 

ongoing reporting; Form Number: CMS– 

10398 (OMB # 0938–NEW); Frequency: 

Occasionally; Affected Public: State, 

Local, or Tribal Governments; Number 

of Respondents: 56; Total Annual 

Responses: 1120; Total Annual Hours: 

28,747. (For policy questions regarding 

this collection contact Candice Payne at 

410–786–4453. For all other issues call 

410–786–1326.) 

2. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Analysis of 

Transportation Barriers to Utilization of 

Medicare Services by American Indian 

and Alaska Native Medicare 

Beneficiaries; Use: The purpose of the 

proposed study is to identify and 

analyze transportation barriers 

associated with the utilization of 

Medicare services by American Indian 

and Alaska Native (AI/AN) 

beneficiaries, to identify and analyze the 

health outcomes resulting from those 

barriers, and ultimately to identify 

potential solutions that could help 

mitigate the problem and produce 

meaningful improvements in health care 

use and health outcomes for this 

population. Specifically, the 

information that will be collected 

through the use of instruments and the 

study developed under the Analysis of 

Transportation Barriers to Utilization of 

Medicare Services by American Indian 

and Alaska Native Medicare 

Beneficiaries Project has not been 

collected or evaluated previously by any 

agency or individual, so data on the 

extent of transportation barriers for rural 

AI/AN beneficiaries to Medicare 

services by AI/AN Medicare 

beneficiaries are not available except 

from the proposed data collection 

activity. 

The information gathered as part of 

the project—through the use of survey, 

interview, and focus group 

instruments—will be used by CMS to 

identify transportation barriers to 

Medicare services for AI/AN Medicare 

beneficiaries. It will provide the first 

ever complete evaluation of 

transportation barriers to health care for 

this population.; Form Number: CMS– 

10399 (OMB # 0938–NEW); Frequency: 

Occasionally; Affected Public: 

Individuals and Households, Private 

Sector; Number of Respondents: 3,418; 

Total Annual Responses: 3,418; Total 

Annual Hours: 2,544. (For policy 

questions regarding this collection 

contact Roger Goodacre at 410–786– 

3209. For all other issues call 410–786– 

1326.) 

3. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Application for 

Prescription Drug Plans (PDP); 

Application for Medicare Advantage 

Prescription Drug (MA–PD); 

Application for Cost Plans to Offer 

Qualified Prescription Drug Coverage; 

Application for Employer Group Waiver 

Plans to Offer Prescription Drug 

Coverage; Service Area Expansion 

Application for Prescription Drug 

Coverage; Use: The Medicare 

Prescription Drug Benefit program was 

established by section 101 of the 

Medicare Prescription Drug, 

Improvement, and Modernization Act of 

2003 (MMA) and is codified in section 

1860D of the Social Security Act (the 

Act). Section 101 of the MMA amended 

Title XVIII of the Social Security Act by 

redesignating Part D as Part E and 

inserting a new Part D, which 

establishes the voluntary Prescription 

Drug Benefit Program (‘‘Part D’’). The 

MMA was amended on July 15, 2008 by 

the enactment of the Medicare 

Improvements for Patients and 

Providers Act of 2008 (MIPPA), on 

March 23, 2010 by the enactment of the 

Patient Protection and Affordable Care 

Act and on March 30, 2010 by the 

enactment the Health Care and 

Education Reconciliation Act of 2010 

(collectively the Affordable Care Act). 

Coverage for the prescription drug 

benefit is provided through contracted 

prescription drug plans (PDPs) or 

through Medicare Advantage (MA) 

plans that offer integrated prescription 

drug and health care coverage (MA–PD 

plans). Cost Plans that are regulated 

under Section 1876 of the Social 

Security Act, and Employer Group 

Waiver Plans (EGWP) may also provide 

a Part D benefit. Organizations wishing 

to provide services under the 

Prescription Drug Benefit Program must 

complete an application, negotiate rates, 

and receive final approval from CMS. 

Existing Part D Sponsors may also 

expand their contracted service area by 

completing the Service Area Expansion 

(SAE) application. 

Effective January 1, 2006, the Part D 

program established an optional 

prescription drug benefit for individuals 

who are entitled to Medicare Part A or 

enrolled in Part B. In general, coverage 

for the prescription drug benefit is 

provided through PDPs that offer drugonly coverage, or through MA 

organizations that offer integrated 

prescription drug and health care 

coverage (MA–PD plans). PDPs must 

offer a basic drug benefit. Medicare 

Advantage Coordinated Care Plans 

(MA–CCPs) must offer either a basic 

benefit or may offer broader coverage for 

no additional cost. Medicare Advantage 

Private Fee for Service Plans (MA– 

PFFS) may choose to offer a Part D 

benefit. Cost Plans that are regulated 

under Section 1876 of the Social 

Security Act, and Employer Group Plans 

may also provide a Part D benefit. If any 

of the contracting organizations meet 

basic requirements, they may also offer 

supplemental benefits through 

enhanced alternative coverage for an 

additional premium. 

Applicants may offer either a PDP or 

MA–PD plan with a service area 

covering the nation (i.e., offering a plan 

in every region) or covering a limited 

number of regions. MA–PD and Cost 

Plan applicants may offer local plans. 

There are 34 PDP regions and 26 MA 

regions in which PDPs or regional MA– 

PDs may be offered respectively. The 

MMA requires that each region have at 

least two Medicare prescription drug 

plans from which to choose, and at least 

one of those must be a PDP. 

Requirements for contracting with Part 

D Sponsors are defined in Part 423 of 42 

CFR. 

This clearance request is for the 

information collected to ensure 

applicant compliance with CMS 

requirements and to gather data used to 

support determination of contract 

awards; Form Number: CMS–10137 

(OMB # 0938–0936); Frequency: Yearly; 

Affected Public: Privates Sector; 

Number of Respondents: 178; Total 

Annual Responses: 178; Total Annual 

Hours: 2,322. (For policy questions 

regarding this collection contact Linda 

Anders at 410–786–0459. For all other 

issues call 410–786–1326.) 

4. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Part C Medicare 

Advantage and 1876 Cost Plan 

Expansion Application; Use: Collection 

of this information is mandated in Part 

C of the Medicare Prescription Drug, 

Improvement and Modernization Act of 

2003 (MMA) in Subpart K of 42 CRF 422 

entitled ‘‘Contracts with Medicare 

Advantage Organizations.’’ In addition, 

the Medicare Improvements for Patients 

and Providers Act of 2008 (MIPPA) 

amended titles XVII and XIX of the 

Social Security Act to improve the 

Medicare program. 

In general, coverage for the 

prescription drug benefit is provided 

through prescription drug plans (PDPs) 

that offer drug-only coverage or through 

Medicare Advantage (MA) organizations 

that offer integrated prescription drug 

and health care products (MA–PD 

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Federal Register / Vol. 76, No. 127 / Friday, July 1, 2011 / Notices 38657 

plans). PDPs must offer a basic drug 

benefit. Medicare Advantage 

Coordinated Care Plans (MA–CCPs) 

either must offer a basic benefit or may 

offer broader coverage for no additional 

cost. Medicare Advantage Private Fee 

for Service Plans (MA–PFFS) may 

choose to offer enrollees a Part D 

benefit. Employer Group Plans may also 

provide Part D benefits. If any of the 

contracting organizations meet basic 

requirements, they may also offer 

supplemental benefits through 

enhanced alternative coverage for an 

additional premium. 

Organizations wishing to provide 

healthcare services under MA and/or 

MA–PD plans must complete an 

application, file a bid, and receive final 

approval from CMS. Existing MA plans 

may request to expand their contracted 

service area by completing the Service 

Area Expansion (SAE) application. 

Applicants may offer a local MA plan in 

a county, a portion of a county (i.e., a 

partial county) or multiple counties. 

Applicants may offer a MA regional 

plan in one or more of the 26 MA 

regions. 

This clearance request is for the 

information collected to ensure 

applicant compliance with CMS 

requirements and to gather data used to 

support determination of contract 

awards. The information will be 

collected under the solicitation of Part 

C application from MA, EGWP Plan, 

and Cost Plan applicants. The collection 

information will be used by CMS to: 

(1) Ensure that applicants meet CMS 

requirements, (2) support the 

determination of contract awards. 

Participation in all Programs is 

voluntary in nature. Only organizations 

that are interested in participating in the 

program will respond to the solicitation. 

MA–PDs that voluntarily participate in 

the Part C program must submit a Part 

D application and successful bid. Form 

Number: CMS–10237 (OMB # 0938– 

0935); Frequency: Yearly; Affected 

Public: Private Sector; Number of 

Respondents: 378; Total Annual 

Responses: 378; Total Annual Hours: 

13,296. (For policy questions regarding 

this collection contact Letticia Ramsey 

at 410–786–5262. 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.gov/ 

PaperworkReductionActof1995/PRAL/ 

list.asp#TopOfPage or e-mail your 

request, including your address, phone 

number, OMB number, and CMS 

document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office at 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 August 30, 2011: 

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, Room C4–26–05, 7500 

Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: June 28, 2011. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2011–16600 Filed 6–30–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–2540–10 and 

CMS–10385] 

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: Revision of a currently 

approved collection; Title of 

Information Collection: Skilled Nursing 

Facility and Skilled Nursing Facility 

Health Care Complex Cost Report. Use: 

Form CMS 2540–10 is used by Skilled 

Nursing Facilities (SNFs) and Skilled 

Nursing Facility Complexes 

participating in the Medicare program to 

report the health care costs to determine 

the amount of reimbursable costs for 

services rendered to Medicare 

beneficiaries. It is required under 

sections 1815(a), 1833(e) 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. The revision is 

due to new reporting requirements as 

mandated by the Patient Protection and 

Affordability Act section 6104. Section 

6104(1) of Public Law 111–148 

amended § 1888(f) of the Social Security 

Act (‘‘Reporting of Direct Care 

Expenditures’’), by requiring that SNFs 

separately report expenditures for wages 

and benefits for direct care staff 

(registered nurses, licensed professional 

nurses, certified nurse assistants, and 

other medical and therapy staff). In 

implementing these changes Worksheet 

S–3, part V, was added. With the 

addition of this worksheet the average 

recordkeeping time for each provider 

will be increased by 5 hours and the 

average reporting time by 1 hour. Form 

Number: CMS–2540–10 (OMB#: 0938– 

0463); Frequency: Yearly; Affected 

Public: Private Sector; Business or other 

for-profit and not-for-profit institutions; 

Number of Respondents: 15,071; Total 

Annual Responses: 15,071; Total 

Annual Hours: 3,171,602 (For policy 

questions regarding this collection 

contact Amelia Citerone. at 410–786– 

3901. For all other issues call 410–786– 

1326.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Expedited 

Checklist: Medicaid Eligibility & 

Enrollment Systems—Advance Planning 

Document (E&E–APD); Use: Under 

sections 1903(a)(3)(A)(i) and 

1903(a)(3)(B) of the Social Security Act, 

CMS has issued new standards and 

conditions that must be met by States 

for Medicaid technology investments 

(including traditional claims processing 

systems, as well as eligibility systems) 

to be eligible for enhanced match 

funding. The Checklist will be 

submitted by States to the E&E APD 

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