48686 Federal Register / Vol. 78, No. 154 / Friday, August 9, 2013 / Notices 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–367, CMS– 

10265, CMS–10279 and CMS–10483] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 

(PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, and to allow 

a second opportunity for public 

comment on the notice. Interested 

persons are invited to send comments 

regarding the 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. 

DATES: Comments on the collection(s) of 

information must be received by the 

OMB desk officer by September 9, 2013. 

ADDRESSES: When commenting on the 

proposed information collections, 

please reference the document identifier 

or OMB control number. To be assured 

consideration, comments and 

recommendations must be received by 

the OMB desk officer via one of the 

following transmissions: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–6974 or, Email: 

OIRA_submission@omb.eop.gov . 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

http://www.cms.hhs.gov/ 

PaperworkReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326. 

SUPPLEMENTARY INFORMATION: Under the 

Paperwork Reduction Act of 1995 (PRA) 

(44 U.S.C. 3501–3520), federal Agencies 

must obtain approval from the Office of 

Management and Budget (OMB) for each 

collection of information they conduct 

or sponsor. The term ‘‘collection of 

information’’ is defined in 44 U.S.C. 

3502(3) and 5 CFR 1320.3(c) and 

includes agency requests or 

requirements that members of the public 

submit reports, keep records, or provide 

information to a third party. Section 

3506(c)(2)(A) of the PRA (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-day notice in the 

Federal Register concerning each 

proposed collection of information, 

including each proposed extension or 

reinstatement of an existing collection 

of information, before submitting the 

collection to OMB for approval. To 

comply with this requirement, CMS is 

publishing this notice that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Medicaid Drug 

Program Monthly and Quarterly Drug 

Reporting Format; Use: Labelers 

transmit drug data to us within 30 days 

after the end of each calendar month 

and quarter. We calculate the unit rebate 

amount (URA) for each National Drug 

Code and distributes to all state 

Medicaid agencies. States use the URA 

to invoice the labeler for rebates. The 

monthly data is used to calculate 

Federal Upper Limit prices for 

applicable drugs and for states that opt 

to use this data to establish their 

pharmacy reimbursement methodology. 

Form Number: CMS–367 (OCN: 0938– 

0578); Frequency: Monthly and 

quarterly; Affected Public: Private 

sector—Business or other for-profits; 

Number of Respondents: 590; Total 

Annual Responses: 9,440; Total Annual 

Hours: 139,712. (For policy questions 

regarding this collection contact Cindy 

Bergin at 410–786–1176.) 

2. Type of Information Collection 

Request: Reinstatement with a change of 

a previously approved collection; Title 

of Information Collection: Mandatory 

Insurer Reporting Requirements of 

Section 111 of the Medicare, Medicaid 

and SCHIP Act of 2007; Use: The 

purpose of this submission is to renew 

the information collection request (ICR) 

and the information collected in 

accordance with to Section 111 of the 

Medicare, Medicaid and SCHIP Act of 

2007 (MMSEA). The information is 

collected from applicable reporting 

entities for the purpose of coordination 

of benefits. Section 111 mandates the 

reporting of information in the form and 

manner specified by the Secretary, 

DHHS. Data the Secretary collects is 

necessary for both pre-payment and 

post-payment coordination of benefit 

purposes, including necessary recovery 

actions. 

Section 111 establishes separate 

mandatory reporting requirements for 

GHP arrangements as well as for 

liability insurance (including selfinsurance), no-fault insurance, and 

workers’ compensation; for purposes of 

this ICR these may be collectively be 

referred to as ‘‘non-GHP.’’ Both GHP 

and non-GHP entities have had and 

continue to have the responsibility for 

determining when they are primary to 

Medicare and to pay appropriately, even 

without the mandatory Section 111 

process. In order to make this 

determination, they should already and 

always be collecting most of the 

information CMS will require in 

connection with Section 111 of the 

MMSEA. Form Number: CMS–10265 

(OCN: 0938–1074); Frequency: Yearly; 

Affected Public: Private sector— 

Business or other for-profits, Not-forprofit institutions and State, Local or 

Tribal Governments; Number of 

Respondents: 22,647; Total Annual 

Responses: 22,647; Total Annual Hours: 

333,130. (For policy questions regarding 

this collection contact Cynthia Ginsburg 

at 410–786–2579.) 

3. Type of Information Collection 

Request: Reinstatement with change of a 

previously approved collection; Title of 

Information Collection: Ambulatory 

Surgical Center Conditions for Coverage; 

Use: The Ambulatory Surgical Center 

(ASC) Conditions for Coverage (CfCs) 

focus on a patient-centered, outcomeoriented, and transparent processes that 

promote quality patient care. The CfCs 

are designed to ensure that each facility 

has properly trained staff to provide the 

appropriate type and level of care for 

that facility and provide a safe physical 

environment for patients. The CfCs are 

used by Federal or state surveyors as a 

basis for determining whether an ASC 

qualifies for approval or re-approval 

under Medicare. We, along with the 

healthcare industry, believe that the 

availability to the facility of the type of 

records and general content of records, 

which this regulation specifies, is 

standard medical practice and is 

necessary in order to ensure the wellVerDate Mar<15>2010 14:54 Aug 08, 2013 Jkt 229001 PO 00000 Frm 00045 Fmt 4703 Sfmt 4703 E:\FR\FM\09AUN1.SGM 09AUN1

pmangrum on DSK3VPTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 154 / Friday, August 9, 2013 / Notices 48687 

being and safety of patients and 

professional treatment accountability. 

Form Number: CMS–10279 (OCN: 

0938–1071); Frequency: Annual; 

Affected Public: Private sector— 

Business or other for-profit and not-forprofit institutions; Number of 

Respondents: 5,300; Total Annual 

Responses: 5,300; Total Annual Hours: 

206,700. (For policy questions regarding 

this collection contact Jacqueline Leach 

at 410–786–4282.) 

4. Type of Information Collection 

Request: New Collection (Request for a 

new control number); Title of 

Information Collection: Evaluation of 

the Multi-Payer Advanced Primary Care 

Practice (MAPCP) Demonstration: 

Conduct Beneficiary Experience with 

Care Surveys; Use: On September 16, 

2009, the Department of Health and 

Human Services announced the 

establishment of the Multi-payer 

Advanced Primary Care Practice 

(MAPCP) Demonstration, under which 

Medicare joined Medicaid and private 

insurers as a payer participant in statesponsored patient-centered medical 

home (PCMH) initiatives. We selected 

eight states to participate in this 

demonstration: Maine, Vermont, Rhode 

Island, New York, Pennsylvania, North 

Carolina, Michigan, and Minnesota. We 

are conducting a survey to assess the 

care experiences of beneficiaries 

involved in the MAPCP Demonstration. 

We have chosen to measure patient 

experience using a validated, 

standardized survey questionnaire, the 

PCMH version of the Consumer 

Assessment of Healthcare Providers and 

Systems (PCMH–CAHPS). The PCMH– 

CAHPS is a validated, federally 

developed instrument that measures 

patient experience in 6 domains (access 

to care, provider communication, office 

staff interactions, attention to medical, 

emotional, or both medical and 

emotional health, health care support, 

and medication decisions). Form 

Number: CMS–10483 (OCN: 0938– 

NEW); Frequency: Annually; Affected 

Public: Individuals and households; 

Number of Respondents: 10,038; Total 

Annual Responses: 10,038; Total 

Annual Hours: 3,313. (For policy 

questions regarding this collection 

contact Suzanne Wensky at 410–786– 

0226.) 

Dated: August 6, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–19379 Filed 8–8–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–416, CMS–R–71, 

and CMS–10150] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 (the 

PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information (including each proposed 

extension or reinstatement of an existing 

collection of information) and to allow 

60 days for public comment on the 

proposed action. Interested persons are 

invited to send comments regarding our 

burden estimates 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. 

DATES: Comments must be received by 

October 8, 2013. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number (OCN). To be 

assured consideration, comments and 

recommendations must be submitted in 

any one of the following ways: 

1. Electronically. You may send 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) that are 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 ll, Room C4–26–05, 

7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

http://www.cms.hhs.gov/ 

PaperworkReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326 

SUPPLEMENTARY INFORMATION: 

Contents 

This notice sets out a summary of the 

use and burden associated with the 

following information collections. More 

detailed information can be found in 

each collection’s supporting statement 

and associated materials (see 

ADDRESSES). 

CMS–416 Annual Early and Periodic 

Screening, Diagnostic and Treatment 

(EPSDT) Participation Report 

CMS–R–71 Quality Improvement 

Organization (QIO) Assumption of 

Responsibilities and Supporting 

Regulations 

CMS–10150 Collection of Drug 

Pricing and Network Pharmacy Data 

from Medicare Prescription Drug Plans 

(PDPs and MA–PDs) and Supporting 

Regulations 

Under the PRA (44 U.S.C. 3501– 

3520), federal agencies must obtain 

approval from the Office of Management 

and Budget (OMB) for each collection of 

information they conduct or sponsor. 

The term ‘‘collection of information’’ is 

defined in 44 U.S.C. 3502(3) and 5 CFR 

1320.3(c) and includes agency requests 

or requirements that members of the 

public submit reports, keep records, or 

provide information to a third party. 

Section 3506(c)(2)(A) of the PRA 

requires federal agencies to publish a 

60-day notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, before 

submitting the collection to OMB for 

approval. To comply with this 

requirement, CMS is publishing this 

notice. 

Information Collections 

1. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 


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