Federal Register / Vol. 76, No. 229 / Tuesday, November 29, 2011 / Notices 73649 

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 January 30, 2012: 

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 lll_l, Room C4– 

26–05, 7500 Security Boulevard, 

Baltimore, Maryland 21244–1850. 

Dated: November 21, 2011. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2011–30729 Filed 11–28–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10411, CMS– 

10114 and CMS–10390] 

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: State Balancing 

Incentive Payments Program (BIPP); 

Use: The Balancing Incentive Program 

requires that States undertake three 

structural changes to their long-term 

services and supports (LTSS) systems to 

increase nursing home diversions and 

access to community-based care: 

implementation of a No Wrong Door/ 

Single Entry Point System, conflict-free 

case management, and the use of a core 

standardized assessment for supporting 

eligibility determination and service 

planning. In addition, grantee States 

must increase their community-based 

LTSS expenditures relative to their 

overall expenditures on LTSS to a 

minimum of 25% or 50%. State 

Medicaid agencies are responsible for 

developing the submissions to CMS in 

order to participate in this opportunity. 

If the statutory requirements are met, 

CMS will approve the State’s 

submission, giving the State the 

authority to implement the changes in 

the program and to draw down the 

increased FMAP funds. Form Number: 

CMS–10411 (OCN 0938–1145); 

Frequency: Once; Affected Public: State, 

Local, or Tribal Government; Number of 

Respondents: 56; Total Annual 

Responses: 56; Total Annual Hours: 

2,240. (For policy questions regarding 

this collection contact Effie George at 

(410) 786–8639. For all other issues call 

(410) 786–1326.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: National 

Provider Identifier (NPI) Application 

and Update Form and Supporting 

Regulations in 45 CFR 142.408, 45 CFR 

162.406, 45 CFR 162.408; Use: The 

National Provider Identifier (NPI) 

Application and Update Form is used 

by health care providers to apply for 

NPIs and furnish updates to the 

information they supplied on their 

initial applications. The form is also 

used to deactivate their NPIs if 

necessary. The NPI Application/Update 

form has been revised to provide 

additional guidance on how to 

accurately complete the form. This 

collection includes clarification on 

information that is required on initial 

applications. Minor changes include 

adding a ‘delete’ check box for removal 

of information. This collection also 

includes revisions to the instructions. In 

addition, we have adjusted the burden 

downward from the estimate provided 

in the 60-day Federal Register notice to 

correct an arithmetic error. Form 

Number: CMS–10114 (OCN: 0938– 

0931); Frequency: Reporting—On 

occasion; Affected Public: Business or 

other for-profit, Not-for-profit 

institutions, and Federal government; 

Number of Respondents: 481,440; Total 

Annual Responses: 481,440; Total 

Annual Hours: 89,080. (For policy 

questions regarding this collection 

contact Leslie Jones at (410) 786–6599. 

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

3. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Hospice 

Voluntary Quality Data Reporting 

Program; Use: Section 1814(i)(5) of the 

Social Security Act (Act) added by 

section 3004 of Patient Protection and 

Affordable Care Act, Public Law 111– 

148, enacted on March 23, 2010 

(Affordable Care Act), authorizes the 

Secretary to establish a quality reporting 

program for hospices. Section 

1814(i)(5)(A)(i) of the Act requires that 

the Secretary, beginning with FY 2014, 

reduce the market basket update by 2 

percentage points for any hospice that 

does not comply with the quality data 

submission requirements with respect to 

that fiscal year. 

To meet the quality reporting 

requirements for hospices, as set forth in 

the proposed Hospice Wage Index for 

Fiscal Year 2012 rule, we propose that 

there shall be a voluntary hospice 

quality reporting cycle which will 

consist of data collection cycle 

beginning on October 1, 2011 and 

continuing through December 31, 2011. 

This data shall be reported to CMS by 

no later than January 31, 2012. There 

shall be a mandatory hospice quality 

reporting cycle which will consist of 

data collected from October 1, 2012 

through December 31, 2012. This data 

shall be reported to CMS by no later 

than April 1, 2013. Thereafter, it is 

proposed that all subsequent hospice 

quality reporting cycles will be based on 

the calendar-year basis (that is, January 

1, 2013 through December 31, 2013 for 

determination of the Hospice market 

basket increase factor for each Hospice 

in FY 2015, etc.). 

We are requesting an initial approval 

of a data collection instrument entitled 

‘‘Quality Data Submission Form’’ that 

hospice providers will use to submit 

quality measures data to CMS during 

the proposed voluntary reporting period 

of 10/01/2011 through 12/31/2011. This 

form shall be used by hospices to report 

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73650 Federal Register / Vol. 76, No. 229 / Tuesday, November 29, 2011 / Notices 

quality data pertaining to one structural 

measure, which is entitled: Participation 

in a Quality Assessment and 

Performance Improvement (QAPI) 

Program that Includes at Least Three 

Quality Indicators Related to Patient 

Care. 

Since the publication of the 60-day 

Federal Register notice, there have been 

some revision made to the Supporting 

Statement A and B of this PRA package. 

These revisions have been made in 

order to: (1) Correct several very minor 

errors; (2) make the content of the 

document more descriptive; and (3) to 

add additional information about the 

program that has become available since 

publication of the 60-day notice. The 

operational details of the program have 

progressed and been finalized. 

Therefore, these changes will reflect 

information pertaining to operational 

details of the program that was not 

available at the time that the PRA 

package documents were published. 

There have been no changes to the 

Information Collection Request that is 

the subject of this PRA package. There 

has been no change in the estimated 

burden that will be required of 

providers. Form Number: CMS–10390 

(OCN: 0938–New); Frequency: 

Occasionally; Affected Public: Private 

Sector: Business or other for-profit and 

not-for-profit institutions; Number of 

Respondents: 3,531; Total Annual 

Responses: 3,531; Total Annual Hours: 

883. (For policy questions regarding this 

collection contact Robin Dowell at (410) 

786–0060. 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. 

To be assured consideration, 

comments and recommendations for the 

proposed information collections must 

be received by the OMB desk officer at 

the address below, no later than 5 p.m. 

on December 29, 2011. 

OMB, Office of Information and 

Regulatory Affairs, 

Attention: CMS Desk Officer. 

Fax Number: (202) 395–6974. 

Email: 

OIRA_submission@omb.eop.gov. 

Dated: November 21, 2011. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2011–30732 Filed 11–28–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Proposed Collection: 

Comment Request 

In compliance with the requirement 

for opportunity for public comment on 

proposed data collection projects 

(section 3506(c)(2)(A) of Title 44, United 

States Code, as amended by the 

Paperwork Reduction Act of 1995, Pub. 

L. 104–13), the Health Resources and 

Services Administration (HRSA) 

publishes periodic summaries of 

proposed projects being developed for 

submission to the Office of Management 

and Budget (OMB) under the Paperwork 

Reduction Act of 1995. To request more 

information on the proposed project or 

to obtain a copy of the data collection 

plans and draft instruments, email 

paperwork@hrsa.gov or call the HRSA 

Reports Clearance Officer at (301) 443– 

1129. 

Comments are invited on: (a) The 

proposed collection of information for 

the proper performance of the functions 

of the Agency; (b) the accuracy of the 

Agency’s estimate of the burden of the 

proposed collection of information; (c) 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected; and (d) ways to minimize the 

burden of the collection of information 

on respondents, including through the 

use of automated collection techniques 

or other forms of information 

technology. 

Proposed Project: Organ Procurement 

and Transplantation Network and 

Scientific Registry of Transplant 

Recipients Data System (OMB No. 

0915–0157)—[Revision] 

Section 372 of the Public Health 

Service (PHS) Act requires that the 

Secretary, by contract, provide for the 

establishment and operation of an Organ 

Procurement and Transplantation 

Network (OPTN). The OPTN, among 

other responsibilities, operates and 

maintains a national waiting list of 

individuals requiring organ transplants, 

maintains a computerized system for 

matching donor organs with transplant 

candidates on the waiting list, and 

operates a 24-hour system to facilitate 

matching organs with individuals 

included in the list. 

Data for the OPTN data system are 

collected from transplant hospitals, 

organ procurement organizations, and 

tissue-typing laboratories. The 

information is used to indicate the 

disease severity of transplant 

candidates, to monitor compliance of 

member organizations with OPTN rules 

and requirements, and to report 

periodically on the clinical and 

scientific status of organ donation and 

transplantation in this country. Data are 

used to develop transplant, donation 

and allocation policies, to determine if 

institutional members are complying 

with policy, to determine member 

specific performance, to ensure patient 

safety and to fulfill the requirements of 

the OPTN Final Rule. The practical 

utility of the data collection is further 

enhanced by requirements that the 

OPTN data must be made available, 

consistent with applicable laws, for use 

by OPTN members, the Scientific 

Registry of Transplant Recipients, the 

Department of Health and Human 

Services, and others for evaluation, 

research, patient information, and other 

important purposes. 

The OPTN is recommending addition 

of a new Liver Explant Pathology form 

to the OPTN data system. This new form 

was developed by the OPTN Liver and 

Intestinal Organ Transplantation 

Committee and will be used to collect 

pathology data on liver transplant 

recipients who received waitlist 

exception points as a result of a 

diagnosis of hepatocellular carcinoma. 

Existing OPTN policy requires 

submission of post-transplant pathology 

reports by fax transmission, and the 

proposed form will provide 

standardized collection of this alreadyrequired information. 

There are also minor revisions to the 

existing data collection forms; the added 

fields were inadvertently left off of the 

forms at the time of the initial 

submission. Several of these fields are 

‘‘read only’’ and are included on the 

forms for information purposes only. 

One field is proposed to be removed as 

it represented duplicative information. 

The annual estimate of burden is as 

follows: 

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