Federal Register / Vol. 78, No. 91 / Friday, May 10, 2013 / Notices 27399 

laboratories that perform immunologic 

testing. 

Dated: May 2, 2013. 

Sherri A. Berger, 

Chief Operating Officer, Centers for Disease 

Control and Prevention. 

[FR Doc. 2013–11144 Filed 5–9–13; 8:45 am] 

BILLING CODE 4160–18–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–R–64, CMS– 

1957, and CMS–10169] 

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) 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: Reinstatement of a previously 

approved collection; Title of 

Information Collection: Indirect Medical 

Education (IME) and Supporting 

Regulations at 42 CFR 412.105; Direct 

Graduate Medical Education (GME) and 

Supporting Regulations at 412 CFR 

413.75 through 83; Use: Section 

1886(d)(5)(B) of the Social Security Act 

(the Act) requires additional payments 

to be made under the Medicare 

Prospective Payment System (PPS) for 

the indirect medical educational costs a 

hospital incurs in connection with 

interns and residents (IRs) in approved 

teaching programs. In addition, Title 42, 

Part 413, sections 75 through 83 

implement section 1886(d) of the Act by 

establishing the methodology for 

Medicare payment of the cost of direct 

graduate medical educational activities. 

These payments, which are adjustments 

(add-ons) to other payments made to a 

hospital under PPS, are largely 

determined by the number of full-time 

equivalent (FTE) IRs that work at a 

hospital during its cost reporting period. 

In Federal fiscal year (FY) 2011, the 

estimated Medicare program payments 

for indirect medical education (IME) 

costs amounted to $6.59 billion. 

Medicare program payments for direct 

graduate medical education (GME) are 

also based upon the number of FTE–IRs 

that work at a hospital. In FY 2011, the 

estimated Medicare program payments 

for GME costs amounted to $2.57 

billion. Form Number: CMS–R–64 

(OCN: 0938–0456); Frequency: 

Reporting—Annually; Affected Public: 

Private Sector—Business or other forprofits and Not-for-profit institutions; 

Number of Respondents: 1,075; Total 

Annual Responses: 1,075; Total Annual 

Hours: 2,150. (For policy questions 

regarding this collection contact Milton 

Jacobson at 410–786–7553. For all other 

issues call 410–786–1326.) 

2. Type of Information Collection 

Request: Reinstatement of a previously 

approved collection; Title of 

Information Collection: Social Security 

Office (SSO) Report of State Buy-in 

Problem; Use: Under Section 1843 of the 

Social Security Act, states may enter 

into an agreement with the Department 

of Health and Human Services to enroll 

eligible individuals in Medicare and pay 

their premiums. The purpose of the 

State Buy-in program is to assure that 

Medicaid is the payer of last resort by 

permitting a state to provide Medicare 

protection to certain groups of needy 

individuals, as part of the state’s total 

assistance plan. State Buy-in also has 

the effect of transferring some medical 

costs for this population from the 

Medicaid program, which is partially 

state funded to the Medicare program, 

which is funded by the federal 

government and individual premiums. 

Generally, the States Buy-in for 

individuals who meet the eligibility 

requirements for Medicare and are cash 

recipients or deemed cash recipients or 

categorically needy under Medicaid. In 

some cases, states may also include 

individuals who are not cash assistance 

recipients under the Medical Assistance 

Only group. The day-to-day operations 

of the State Buy-in program is 

accomplished through an automated 

data exchange process. The automated 

data exchange process is used to 

exchange Medicare and Buy-in 

entitlement information between the 

Social Security District Offices, 

Medicaid State Agencies and the 

Centers for Medicare & Medicaid 

Services. When problems arise however 

that cannot be resolved though the 

normal data exchange process, clerical 

actions are required. The CMS–1957, 

‘‘SSO Report of State Buy-In Problem’’ 

is used to report Buy-in problems cases. 

The CMS–1957 is the only standardized 

form available for communications 

between the aforementioned agencies 

for the resolution of beneficiary 

complaints and inquiries regarding State 

Buy-in eligibility. Form Number: CMS– 

1957 (OCN: 0938–0035); Frequency: 

Reporting—Annually; Affected Public: 

Individuals and Households; Number of 

Respondents: 3,802; Total Annual 

Responses: 3,802; Total Annual Hours: 

1,266. (For policy questions regarding 

this collection contact Lucia DiazRobinson at 410–247–6843. For all other 

issues call 410–786–1326.) 

3. Type of Information Collection 

Request: Revision of a currently 

approved collection. Title of 

Information Collection: Medicare 

Durable Medical Equipment, 

Prosthetics, Orthotics and Supplies 

(DMEPOS) Competitive Bidding 

Program. Use: Since 1989, Medicare has 

been paying for durable medical 

equipment (DME) and supplies (other 

than customized items) using fee 

schedule amounts that are calculated for 

each item or category of DME identified 

by a Healthcare Common Procedure 

Coding System code. Payments are 

based on the average supplier charges 

on Medicare claims from 1986 and 1987 

and are updated annually on a factor 

legislated by Congress. For many years, 

the Government Accountability Office 

and the Office of Inspector General of 

the U.S. Department of Health and 

Human Services have reported that 

these fees are often highly inflated and 

that Medicare has paid higher than 

market rates for several different types 

of DME. Due to reports of Medicare 

overpayment of DME and supplies, 

Congress required that CMS conduct a 

competitive bidding demonstration 

project for these items. Accordingly, 

CMS implemented a demonstration 

project for this program from 1999–2002 

which produced significant savings for 

beneficiaries and taxpayers without 

hindering access to DMEPOS and 

related services. Shortly after a 

successful demonstration of the 

competitive bidding program, Congress 

passed the Medicare Prescription Drug, 

Improvement and Modernization Act of 

2003 and mandated a phased-in 

approach to implement this program 

over the course of several years 

beginning in 2007 in 10 metropolitan 

statistical areas (MSAs). The statute 

mstockstill on DSK4VPTVN1PROD with NOTICES

27400 Federal Register / Vol. 78, No. 91 / Friday, May 10, 2013 / Notices 

specifically required the Secretary to 

establish and implement programs 

under which competitive bidding areas 

are established throughout the United 

States for contract award purposes for 

the furnishing of certain competitively 

priced items and services for which 

payment is made under Medicare Part 

B. This program is commonly known as 

the ‘‘Medicare DMEPOS Competitive 

Bidding Program.’’ 

CMS conducted its first round of 

bidding for the Medicare DMEPOS 

Competitive Bidding Program in 2007 

with the help of its contractor, the 

Competitive Bidding Implementation 

Contractor. CMS published a Request 

for Bids instructions and accompanying 

forms for suppliers to submit their bids 

to participate in the program. During 

this first round of bidding, DMEPOS 

suppliers from across the U.S. submitted 

bids identifying the MSA(s) to service 

and the competitively bid item(s) they 

wished to furnish to Medicare 

beneficiaries. CMS evaluated these bids 

and contracted with those suppliers that 

met all program requirements. The first 

round of bidding was successfully 

implemented on July 1, 2008. 

On July 15, 2008, however, Congress 

delayed this program in section 154 of 

the Medicare Improvements for Patients 

and Providers Act of 2008 (MIPPA). 

MIPPA mandated certain changes to the 

competitive bidding program which 

included, but are not limited to: a delay 

of Rounds 1 (competition began in 2009) 

and 2 of the program (competition began 

in 2011 in 70 specific MSAs); the 

exclusion of Puerto Rico and negative 

pressure wound therapy from Round 1 

and group 3 complex rehabilitative 

power wheelchairs from all rounds of 

competition; a process for providing 

feedback to suppliers regarding missing 

financial documentation; and a 

requirement for contract suppliers to 

disclose to CMS information regarding 

subcontracting relationships. Section 

154 of the MIPPA specified that the 

competition for national mail order 

items and services may be phased in 

after 2010 and established a rule 

requiring that a bidder demonstrate that 

its bid covers 50 percent (or higher) of 

the types of diabetic testing strips, based 

on volume (the ‘‘50 percent rule’’) for 

national mail order competitions. As 

required by MIPPA, CMS conducted the 

competition for the Round 1 Rebid in 

2009. The Round 1 Rebid contracts and 

prices became effective on January 1, 

2011. 

The Affordable Care Act, enacted on 

March 23, 2010, expanded the Round 2 

competition by adding an additional 21 

MSAs, bringing the total MSAs for 

Round 2 to 91. The competition for 

Round 2 began in December 2011. CMS 

also began a competition for National 

Mail Order of Diabetic Testing Supplies 

at the same time as Round 2. The Round 

2 and National Mail-Order contracts and 

prices have a target implementation date 

of July 1, 2013. 

The MMA requires the Secretary to recompete contracts not less often than 

once every 3 years. Most Round 1 Rebid 

contracts will expire on December 31, 

2013. (Round 1 Rebid contracts for mailorder diabetic testing supplies ended on 

December 31, 2012.) Consequently, we 

are currently in the process of recompeting the competitive bidding 

contracts in the Round 1 Rebid areas. 

The most recent approval for this 

information collection request (ICR) was 

issued by OMB on October 10, 2012. 

Since then, CMS has decided to 

sequentially update the paperwork 

burden necessary to administer the 

program as it expands nationally and 

cycles through multiple rounds of 

competition. Specifically, we are now 

seeking to update our burden estimates 

for certain contract maintenance forms 

for Round 2 and the national mail-order 

competitions. These include Form C 

and the Contract Supplier’s Disclosure 

of Subcontractors form. We are also 

requesting approval of two additional 

forms: the Change of Ownership 

(CHOW) Purchaser Form and the CHOW 

Contract Supplier Notification Form, 

which will be utilized in all rounds of 

competition. Finally, we are retaining 

without change Forms A, B, and D and 

their associated burden under this ICR. 

We note that the information collection 

for Forms A and B is already complete. 

We intend to continue use of the forms 

in future rounds of competition. 

Form Number: CMS–10169 (OCN: 

0938–1016). Frequency: Occasionally. 

Affected Public: Private Sector (business 

or other for-profits) and Individuals or 

households. Number of Respondents: 

19,035. Total Annual Responses: 

19,035. Total Annual Hours: 9,311. (For 

policy questions regarding this 

collection contact Michael Keane at 

410–786–4495. 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 June 10, 2013. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS 

Desk Officer. Fax Number: (202) 395– 

6974. Email: 

OIRA_submission@omb.eop.gov. 

Dated: May 6, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group,Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–11033 Filed 5–9–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–R–70, CMS–R– 

72, CMS–R–247, CMS–10287, CMS–R–43, 

CMS–855(POH), CMS–2552–10, and CMS– 

10062] 

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: Reinstatement with a change of 

a previously approved collection; Title 

of Information Collection: Information 

Collection Requirements in HSQ–110, 

Acquisition, Protection and Disclosure 

of Peer review Organization Information 

and Supporting Regulations in 42 CFR, 

Sections 480.104, 480.105, 480.116, and 

480.134; Use: The Peer Review 

Improvement Act of 1982 authorizes 

quality improvement organizations 

mstockstill on DSK4VPTVN1PROD with NOTICES