43288 Federal Register / Vol. 77, No. 142 / Tuesday, July 24, 2012 / Notices 

ESTIMATED ANNUALIZED BURDEN HOURS—Continued 

Type of 

respondent Form Number of respondents 

Number of 

responses per 

respondent 

Average 

burden per 

respondent 

(in hours) 

Total burden 

hours 

Community Leaders ............................................. On-line survey .............. 600 1 1 600 

Total Burden Hours ....................................... ....................................... ........................ ........................ ........................ 1,800 

Kimberly S. Lane, 

Deputy Director, Office of Scientific Integrity, 

Office of the Associate Director for Science, 

Office of the Director, Centers for Disease 

Control and Prevention. 

[FR Doc. 2012–17984 Filed 7–23–12; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10389, CMS– 

855S and CMS–855(A,B,I,R)] 

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: New collection (request for a 

new OMB control number). Title of 

Information Collection: The Home and 

Community-Based Service (HCBS) 

Experience Survey. Use: This study is a 

one-time pilot field test involving 

individuals who receive HCBS from 

Medicaid programs. The field test will 

be conducted for the following 

purposes: (a) To assess survey 

methodology—to determine how well a 

face-to-face survey and telephone 

survey performs with individuals who 

receive HCBS services; (b) Psychometric 

Analysis—to provide information for 

the revision and shortening of the 

survey based on the assessment of the 

reliability and construct validity of 

survey items and composites; and (c) 

Case mix adjustment analysis—to assess 

the variables that may be considered as 

case mix adjusters. These preliminary 

research activities are not required by 

regulation, and will not be used by CMS 

to regulate or sanction its customers. 

They will be entirely voluntary and the 

confidentiality of respondents and their 

responses will be preserved. 

The information collected will be 

used to revise and test the survey 

instrument described in the Background 

section of the PRA package’s Supporting 

Statement. Within the PRA package, 

Attachment B includes two versions of 

the survey (one modified for 

accessibility) and Attachment C has the 

introductory information. The end 

result will be an improvement in 

information collection instruments and 

in the quality of data collected, a 

reduction or minimization of 

respondent burden, increased agency 

efficiency, and improved 

responsiveness to the public. Following 

the field test, CMS will seek approval 

from the CAHPS consortium for the 

HCBS Experience Survey to be a new 

addition to the CAHPS® family of 

surveys. Form Number: CMS–10389 

(OCN 0938–New). Frequency: Once. 

Affected Public: Individuals and 

Households. Number of Respondents: 

18,000. Total Annual Responses: 

18,000. Total Annual Hours: 9,000. (For 

policy questions regarding this 

collection contact Anita Yuskauskas at 

410–786–0268. For all other issues call 

410–786–1326.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Medicare 

Enrollment Application—Durable 

Medical Equipment, Prosthetics, 

Orthotics and Supplies (DMEPOS) 

Suppliers Use: The primary function of 

the CMS 855S Durable Medical 

Equipment, Prosthetics, Orthotics and 

Supplies (DMEPOS) supplier 

enrollment application is to gather 

information from a supplier that tells us 

who it is, whether it meets certain 

qualifications to be a health care 

supplier, where it renders its services or 

supplies, the identity of the owners of 

the enrolling entity, and information 

necessary to establish the correct claims 

payment. The goal of evaluating and 

revising the CMS 855S DMEPOS 

supplier enrollment application is to 

simplify and clarify the information 

collection without jeopardizing our 

need to collect specific information. The 

majority of the revisions contained in 

this submission are non-substantive in 

nature such as spelling and formatting 

corrections; however, we also removed 

duplicate fields and obsolete questions 

and provided clarification and 

simplified the instructions for the 

completing the application. Form 

Number: CMS–855(S) (OCN: 0938– 

1056); Frequency: Yearly; Affected 

Public: Private Sector; Business or other 

for-profit and not-for-profit institutions; 

Number of Respondents: 43,350; Total 

Annual Responses: 43,350; Total 

Annual Hours: 113,550 (For policy 

questions regarding this contact Kim 

McPhillips at 410–786–5374. For all 

other issues call 410–786–1326.) 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicare 

Enrollment Application Use: The 

primary function of the CMS–855 

Medicare enrollment application is to 

gather information from a provider or 

supplier that tells us who it is, whether 

it meets certain qualifications to be a 

health care provider or supplier, where 

it practices or renders its services, the 

identity of the owners of the enrolling 

entity, and other information necessary 

to establish correct claims payments. 

Form Number: CMS–855(A, B, I, R) 

(OCN: 0938–0685); Frequency: Yearly; 

Affected Public: Private Sector; Business 

or other for-profit and not-for-profit 

institutions; Number of Respondents: 

440,450; Total Annual Responses: 

440,450; Total Annual Hours: 856,395 

(For policy questions regarding this 


sroberts on DSK5SPTVN1PROD with NOTICES
Federal Register / Vol. 77, No. 142 / Tuesday, July 24, 2012 / Notices 43289 

1CMS determines annually which Medicare Part 

C and Part D measures are included in the data 

validation program. 

contact Kim McPhillips at 410–786– 

5374. 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 August 23, 2012. 

OMB, Office of Information and 

Regulatory Affairs, 

Attention: CMS Desk Officer, 

Fax Number: (202) 395–6974, 

Email: OIRA_submission@omb.eop.gov. 

Dated: July 18, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–17924 Filed 7–23–12; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10305] 

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: Medicare 

Part C and Part D Data Validation (42 

CFR 422.516g and 423.514g); Use: The 

Centers for Medicare and Medicaid 

Services (CMS) established reporting 

requirements for Medicare Part C and 

Part D sponsoring organizations 

(Medicare Advantage Organizations 

[MAOs], Cost Plans, and Medicare Part 

D sponsors) under the authority 

described in 42 CFR 422.516(a) and 

423.514(a), respectively. Under these 

reporting requirements, each sponsoring 

organization must submit Medicare Part 

C, Medicare Part D, or Medicare Part C 

and Part D data (depending on the type 

of contracts they have in place with 

CMS). In order for the reported data to 

be useful for monitoring and 

performance measurement, it must be 

reliable, valid, complete, and 

comparable among sponsoring 

organizations. In 2009, CMS developed 

the data validation program as a 

mechanism to verify the data reported 

are accurate, valid, and reliable. To 

maintain the independence of the 

validation process, sponsoring 

organizations do not use their own staff 

to conduct the data validation. Instead, 

sponsoring organizations are 

responsible for hiring external, 

independent data validation contractors 

(DVCs) who meet a minimum set of 

qualifications and credentials. 

CMS developed standards and data 

validation criteria for specific Medicare 

Part C and Part D reporting 

requirements that the DVCs use in 

validating the sponsoring organizations’ 

data.1 These standards and criteria are 

described in Appendix 1 ‘‘Data 

Validation Standards.’’ The data 

validation standards for each measure 

include standard instructions relating to 

the types of information that should be 

reviewed, and measure-specific criteria 

(MSC) that are aligned with the 

‘‘Medicare Part C and Part D Reporting 

Requirement Technical Specifications.’’ 

Furthermore, the standards and criteria 

describe how the DVCs should validate 

the sponsoring organizations’ 

compilations of reported data, taking 

into account appropriate data 

exclusions, and verifying calculations, 

source code, and algorithms. The data 

validation reviews are conducted at the 

contract level given that the Medicare 

Part C and Part D data are generally 

available at the contract level and the 

contract is the basis of any legal and 

accountability issues concerning the 

rendering of services. 

The review is conducted over a threemonth period following the final 

submission of data by the sponsoring 

organizations. In addition to the ’’Data 

Validation Standards’’ described in 

Appendix 1, the DVCs employ a set of 

information collection tools when 

performing their reviews, which are 

included in the appendices described 

below: 

Appendix 2: Organizational Assessment 

Instrument 

Appendix 3: Data Extraction and 

Sampling Instructions 

Appendix 4: Instructions for the 

Findings Data Collection Form 

Appendix 5: Findings Data Collection 

Form (FDCF) 

Data collected via ‘‘Medicare Part C 

and Part D Reporting Requirements’’ is 

an integral resource for oversight, 

monitoring, compliance and auditing 

activities necessary to ensure quality 

provision of the Medicare benefits to 

beneficiaries. CMS uses the data 

collected through the Medicare data 

validation program to substantiate the 

data collected via Medicare Part C and 

Part D Reporting Requirements. If CMS 

detects data anomalies, the CMS 

division with primary responsibility for 

the applicable reporting requirement 

assists with determining a resolution. 

The hour burden on industry is 

estimated at 179,301 total hours, or 879 

hours for one contract within one 

organization reporting both Part C and 

Part D measures. The validation would 

require 378 hours from the sponsoring 

organization and 501 from the data 

validation contractors. The estimates are 

based on the total number of Part C and/ 

or Part D measures, the average number 

of sponsors, and the average number of 

contracts by type (Part C, Part D, Part C/ 

D) being validated as well as a level of 

effort associated with the individual 

activities associated with the data 

validation process. Form Number: 

CMS–10305 (OCN: 0938–1115); 

Frequency: Reporting—Annually; 

Affected Public: Private sector— 

Business or other for-profits; Number of 

Respondents: 135; Total Annual 

Responses: 657; Total Annual Hours: 

179,301. (For policy questions regarding 

this collection contact Terry Lied at 

410–786–8973. 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/ 


sroberts on DSK5SPTVN1PROD with NOTICES