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[Federal Register Volume 77, Number 155 (Friday, August 10, 2012)]
[Notices]
[Page 47851]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-19606]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10444]

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: New collection; Title of 
Information Collection: Minimum Data Set for Medicaid Incentives for 
Prevention of Chronic Diseases Program Grantees; Use: The Medicaid 
Incentives for Prevention of Chronic Diseases (MIPCD), demonstration 
program provides grants to states to implement programs that provide 
incentives to Medicaid beneficiaries of all ages who participate in 
prevention programs and demonstrate changes in health risk and 
outcomes, including the adoption of healthy behaviors. The prevention 
programs address at least one of the following prevention goals: 
tobacco cessation, controlling or reducing weight, lowering 
cholesterol, lowering blood pressure, and avoiding the onset of 
diabetes or in the case of a diabetic, improving the management of the 
condition. The programs are also comprehensive, widely available, 
easily accessible, and based on relevant evidence-based research and 
resources, including: the Guide to Community Preventive Services; the 
Guide to Clinical Preventive Services; and the National Registry of 
Evidence-Based Programs.
    The proposed information collection, the MIPCD Minimum Data Set 
(MDS), is intended to collect data for program performance monitoring 
and evaluation. The MDS is a secondary data collection that assembles 
information already collected by grantees in the course of tracking 
beneficiary participation and outcomes and performing their own 
evaluation activities. Data collected through the MDS will be used to 
report on program implementation and evaluation to CMS and Congress. 
Form Number: CMS-10444 (OCN: 0938-New); Frequency: Quarterly; Affected 
Public: State, Local, or Tribal Governments; Number of Respondents: 10; 
Total Annual Responses: 40; Total Annual Hours: 3,467. (For policy 
questions regarding this collection contact Sherrie Fried at 410-786-
6619. 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.
    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 October 9, 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, Room C4-26-05, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.

    Dated: August 6, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-19606 Filed 8-9-12; 8:45 am]
BILLING CODE 4120-01-P
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