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Hours: 242,376. (For policy questions regarding this collection contact Elizabeth Goldstein at 410–786–6665. For all other issues call 410–786–1326.)

3. Type of Information Collection Request: New collection; Title of Information Collection: Medicare Part C and Part D Data Validation (42 CFR 422.516g and 423.514g); Use: Organizations contracted to offer Medicare Part C and Part D benefits are required to report data to the Centers for Medicare & Medicaid Services on a variety of measures. In order for the data to be useful for monitoring and performance measurement, the data must be reliable, valid, complete, and comparable among sponsoring organizations. To meet this goal, CMS is developing reporting standards and data validation specifications with respect to the Part C and Part D reporting requirements. These standards will provide a review process for Medicare Advantage Organizations (MAOs), Cost Plans, and Part D sponsors to use to conduct data validation checks on their reported Part C and Part D data. Form Number: CMS–10305 (OMB#: 0938– NEW); Frequency: Yearly; Affected Public: Business or other for-profit; Number of Respondents: 710; Total Annual Responses: 710; Total Annual

Hours: 231,410. (For policy questions regarding this collection contact Terry Lied at 410–786–8973. For all other issues call 410–786–1326.)

4. Type of Information Collection Request: New collection; Title of Information Collection: New Quality Measures for Medicare Advantage Organizations; Use: For CMS to strengthen the oversight of quality improvement programs implemented by Medicare Advantage organizations, there is a need to collect additional data on quality and outcomes measures in order to better track plan performance. Examples of additional areas on whichCMS plans to collect data are postsurgical infections or patient falls. Collection will begin during contract year 2012. The specific data elements that will be collected are currently under development. Form Number: CMS–10313 (OMB#: 0938–NEW); Frequency: Yearly; Affected Public:Business or other for-profit and Not–forprofit institutions; Number of Respondents: 624; Total Annual Responses: 624; Total Annual Hours: 624,000. (For policy questions regarding this collection contact Sabrina Ahmed at 410–786–7499. 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.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.

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 byJune 18, 2010:

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: April 13, 2010. Michelle Shortt, Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs.

[FR Doc. 2010–8958 Filed 4–16–10; 8:45 am]

**BILLING CODE 4120–01–P**

**DEPARTMENT OF HEALTH AND HUMAN SERVICES** 

**Centers for Medicare & Medicaid Services** 

**[Document Identifier: CMS–416 and CMS– R–297]** 

**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.

1. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: Annual Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services Participation Report; Form Number: CMS–416 (OMB#: 0938–0354); Use: States are required to submit an annual report on the provision of EPSDT services pursuant to section 1902(a)(43)(D) of the Social Security Act. These reports provide CMS with data necessary to assess the effectiveness of State EPSDT programs, to determine a State’s results in achieving its participation goal and to respond to inquiries. Respondents are State Medicaid Agencies. The data is due April 1 of every year so States need to have the form and instructions as soon as possible in order to report timely. Frequency: Yearly; Affected Public: State, Tribal and Local governments; Number of Respondents:
56; Total Annual Responses: 112; Total Annual Hours: 1,568. (For policy questions regarding this collection contact Cindy Ruff at 410–786–5916. For all other issues call 410–786–1326.)

2. 1. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Request for Employment Information; Use: Section 1837(i) of the Social Security Act provides for a special enrollment period for individuals who delay enrolling in Medicare Part B because they are covered by a group health plan based on their own or a spouse’s current employment status. When these individuals apply for Medicare Part B, they must provide proof that the group health plan coverage is (or was) based on current employment status. This form is used by the Social Security Administration to obtain information from employers regarding whether a Medicare beneficiary’s coverage under a group health plan is based on current employment status. Form Number: CMS–R–297 (OMB#: 0938–0787); Frequency: Once; Affected Public:Private Sector: Business or other forprofits and Not-for-profit institutions; Number of Respondents: 5,000; Total Annual Responses: 5,000; Total Annual

Hours: 1,250. (For policy questions regarding this collection contact Kevin


### 20367 Federal Register/ Vol. 75, No. 74 / Monday, April 19, 2010 / Notices

Simpson at 410–786–0017. 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.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 18, 2010:

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: April 9, 2010. Michelle Shortt, Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs.

[FR Doc. 2010–8901 Filed 4–16–10; 8:45 am]

**BILLING CODE 4120–01–P**

**DEPARTMENT OF HEALTH AND HUMAN SERVICES** 

**[Document Identifier: CMS–10295, CMS– 10234, CMS–10303, CMS–10066 and CMS–**  **R–193]**

**Centers for Medicare & Medicaid Services** 

**Agency Information Collection Activities: Submission for OMB**  **Review; 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), 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: Recovery Act— Reporting Requirements for States Under FMAP Increase and TMA Provisions; Use: The American Recovery and Reinvestment Act of 2009 (Recovery Act), Public Law 111–5, requires that States submit quarterly reports to the Secretary of Health and Human Services in accordance with section 5001 Temporary Increase of Medicaid Federal Medical Assistance Percentage (FMAP) and section 5004(d) Extension of Transitional Medical Assistance (TMA). The reports under section 5001 are required for the period of October 1, 2008–September 30, 2011. The reports under section 5004 are required beginning on July 1, 2009 until the Federal authority for TMA coverage sunsets (now scheduled to sunset on December 31, 2010). Each State Medicaid agency will submit its quarterly reports to the appropriate Regional Office of CMS. The reports will be compiled and summarized for annual reports to Congress. Form Number: CMS–10295 (OMB#: 0938–1073); Frequency: Reporting—Quarterly; Affected Public: State, Local, or Tribal Governments; Number of Respondents:
50; Total Annual Responses: 200; Total Annual Hours: 600. (For policy questions regarding this collection contact Richard Strauss at 410–786– 2019. For all other issues call 410–786– 1326.)

2. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: State Plan Preprint implementing Section 6087 of theDeficit Reduction Act: Optional SelfDirection Personal Assistance Services (PAS) Program (Cash and Counseling); Form Number: CMS–10234 (OMB#: 0938–1024); Use: Information submitted via the State Plan Amendment (SPA) pre-print is used by CMS and Regional Offices to analyze a State’s proposal to implement Section 6087 of the Deficit Reduction Act (DRA). State MedicaidAgencies will complete the SPA preprint, and submit it to CMS for a comprehensive analysis. The pre-print contains assurances, check-off items, and areas for States to describe policies and procedures for subjects such as quality assurance, risk management, and voluntary and involuntary disenrollment; Frequency: Reporting— Once; Affected Public: State, Local, or Tribal Government; Number of Respondents: 56; Total Annual Responses: 20; Total Annual Hours: 400. (For policy questions regarding this collection contact Carrie Smith at 410– 786–4485. For all other issues call 410– 786–1326.)

3. Type of Information Collection Request: New collection; Title of Information Collection: Medicare Gainsharing Demonstration Evaluation: Physician Focus Groups; Use: The proposed physician focus groups are part of an overall evaluation of the Centers for Medicare & Medicaid Services CMS’ congressionally mandated Medicare Gainsharing Demonstration Evaluation. The Congress, under Section 5007 of the Deficit Reduction Act (DRA) of 2005, requires CMS to conduct a qualified gainsharing program to test alternative ways that hospitals and physicians can share in efficiency gains. The primary goal of the demonstration is to evaluate gainsharing as a means to align physician and hospital incentives to improve quality and efficiency. The demonstration has two mandated Reports to Congress. Results from physician focus groups will be included in both Reports to Congress. Form Number: CMS–10303 (OMB#: 0938– New); Frequency: Once; Affected Public: Private Sector, Business or other for profits; Number of Respondents: 192; Total Annual Responses: 96; Total Annual Hours: 96. (For policy questions regarding this collection contact William Buczko at 410–786–6593. For all other issues call 410–786–1326.)

4. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Detailed Notice of Discharge (DND); Use: A beneficiary/ enrollee who wishes to appeal a determination by a Medicare health plan or hospital that inpatient care is no longer necessary, may request Quality Improvement Organization (QIO) review of the determination. On the date the QIO receives the beneficiary’s/enrollee’s request, it must notify the plan and hospital that the beneficiary/enrollee has filed a request for an expedited determination. The plan (for a managed care enrollee) or hospital (for an original