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[Federal Register Volume 76, Number 48 (Friday, March 11, 2011)]
[Notices]
[Page 13415]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-5685]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10367]

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: 
Medicaid State Plan Preprint for Use by States When Implementing 
Section 6505 of the [Patient Protection and] Affordable Care Act; Use: 
CMS has developed a Medicaid State Plan Preprint for use by States and 
specifically to support the January 1, 2011, mandate of the prohibition 
on payments outside of the United States. The preprint follows the 
format and requested information from prior preprints provided to the 
States by CMS and provides a placeholder and assurance of compliance 
with section 1902(a) of the Social Security Act; Form Number: CMS-10367 
(OMB: 0938-NEW); Frequency: Occasionally; Affected Public: 
State, Local, or Tribal Governments; Number of Respondents: 56; Total 
Annual Responses: 56; Total Annual Hours: 5. (For policy questions 
regarding this collection contact Carla Ausby at 410-786-2153. 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 
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.
    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 April 11, 2011: 
OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-6974, E-mail: OIRA_submission@omb.eop.gov.

    Dated: March 4, 2011.
Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2011-5685 Filed 3-10-11; 8:45 am]
BILLING CODE 4120-01-P
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