Federal Register / Vol. 72, No. 61 / Friday, March 30, 2007 / Notices 15139 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10091, CMS–

1728, CMS–10028 A, B and C, and CMS–

10099] 

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 of a currently 

approved collection; Title of 

Information Collection: Accepting New 

Patients Indicator UPIN (Unique 

Physician Identification Number) 

Participating Physicians Directory; Use: 

CMS is expanding the Participating 

Physician Directory to provide 

additional information about physicians 

who participate in Medicare. The new 

data element ‘‘accepting new Medicare 

patients’’ will provide beneficiaries and 

other users with much needed 

information about the physicians who 

participate in the Medicare program. It 

will also provide a service to physicians 

who are either seeking new Medicare 

patients or who wish to reduce the 

burden of responding to callers when 

they are no longer accepting new 

Medicare patients. Form Number: CMS–

10091 (OMB#: 0938–0905); Frequency: 

Reporting: Daily, Weekly and Yearly; 

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

Number of Respondents: 109.800; Total 

Annual Responses: 10,980; Total 

Annual Hours: 915. 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Home Health 

Agency 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, to submit annual 

information to achieve settlement of 

costs for health care services rendered to 

Medicare beneficiaries. The CMS–1728–

94 cost report is needed to determine 

the amount of reimbursable cost, based 

upon the cost limits, that is due these 

providers furnishing medical services to 

Medicare beneficiaries. Form Number: 

CMS–1728–94 (OMB#: 0938–0022); 

Frequency: Reporting: Yearly; Affected 

Public: Business or other for-profit and 

Not-for-profit institutions; Number of 

Respondents: 5069; Total Annual 

Responses: 5069; Total Annual Hours: 

892,144. 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: State Health 

Insurance Assistance Program (SHIP) 

Client Contact Form, Pubic and Media 

Activity Form, and Resource Report 

Form; Use: The information collected is 

used to fulfill the reporting 

requirements described in Section 

4360(f) of OBRA 1990. Also, the data 

will be accumulated and analyzed to 

measure State Health Insurance 

Assistance Program (SHIP) performance 

in order to determine whether and to 

what extent the SHIPs have met the 

goals of improved CMS customer 

service to beneficiaries and better 

understanding by beneficiaries of their 

health insurance options. Further, the 

information will be used in the 

administration of the grants, to measure 

performance and appropriate use of the 

funds by the State grantees, to identify 

gaps in services and technical support 

needed by SHIPs, and to identify and 

share best practices. Form Number: 

CMS–10028–A, B and C (OMB#: 0938–

0850); Frequency: Reporting: Quarterly 

and Semi-annually; Affected Public: 

State, Local, or Tribal Governments; 

Number of Respondents: 12,000; Total 

Annual Responses: 1,056,000; Total 

Annual Hours: 87,965. 

4. Type of Information Collection 

Request: Extension of a currently 

approved information collection; Title 

of Information Collection: Review of 

National Coverage Determinations and 

Local Coverage Determinations and 

Supporting Regulations in 42 CFR 

426.400 and 42 CFR 426.500; Use: 

Section 522 of the Benefits 

Improvement and Protection Act (BIPA) 

of 2000 requires the implementation of 

a process for the appeal of National 

Coverage Determinations (NCDs) and 

Local Coverage Determinations (LCDs). 

Sections 426.400 and 426.500, state that 

an aggrieved party may initiate a review 

of an LCD or NCD, respectively, by 

filing a written complaint. These 

sections also identify the information 

required in the complaint to qualify as 

an aggrieved party as defined in 

§ 426.110, as well as the process and 

information needed for an aggrieved 

party to withdraw a complaint. The 

required documentation includes a copy 

of the written authorization to represent 

the beneficiary, if the beneficiary has a 

representative, and a copy of a written 

statement from the treating physician 

that the beneficiary needs a service that 

is the subject of the LCD. Form Number: 

CMS–10099 (OMB#: 0938–0911); 

Frequency: Reporting—On occasion; 

Affected Public: Individuals or 

Households; Number of Respondents: 

1,040; Total Annual Responses: 1,040; 

Total Annual Hours: 4,160. 

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 

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 on (410) 786–

1326. 

Written comments and 

recommendations for the proposed 

information collections must be mailed 

or faxed within 30 days of this notice 

directly to the OMB desk officer: OMB 

Human Resources and Housing Branch, 

Attention: Carolyn Lovett, New 

Executive Office Building, Room 10235, 

Washington, DC 20503, Fax Number: 

(202) 395–6974. 

Dated: March 22, 2007. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E7–5754 Filed 3–29–07; 8:45 am] 

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