57162 Federal Register / Vol. 78, No. 180 / Tuesday, September 17, 2013 / Notices 

Matters to be Discussed: cancer 

prevention and control, cardiovascular 

disease prevention and control, diabetes 

prevention and control, motor vehiclerelated injury prevention, and 

promoting physical activity. 

Meeting Accessibility: This meeting is 

open to the public, limited only by 

space availability. 

Roybal Campus Security Guidelines 

The Edward R. Roybal Campus is the 

headquarters of the U.S. Centers for 

Disease Control and Prevention and is 

located at 1600 Clifton Road NE., 

Atlanta, Georgia. The meeting is being 

held in a Federal government building; 

therefore, Federal security measures are 

applicable. 

In planning your arrival time, please 

take into account the need to park and 

clear security. All visitors must enter 

the Roybal Campus through the 

entrance on Clifton Road; the guard 

force will direct visitors to the 

designated parking area. Visitors must 

present government issued photo 

identification (e.g., a valid federal 

identification badge, state driver’s 

license, state non-driver’s identification 

card, or passport). Non-United States 

citizens must present a valid passport, 

visa, Permanent Resident Card, or other 

type of work authorization document. 

All persons entering the building must 

pass through a metal detector. Visitors 

will be issued a visitor’s ID badge at the 

entrance to Building 19 and will be 

escorted in groups of 5–10 persons to 

the meeting room. All items brought to 

HHS/CDC are subject to inspection. 

Dated: September 11, 2013. 

Tanja Popovic, 

Deputy Associate Director for Science, 

Centers for Disease Control and Prevention. 

[FR Doc. 2013–22581 Filed 9–16–13; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers CMS–1728–94, CMS– 

1763, CMS–R–267 and CMS–250–254] 

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 October 17, 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/Paperwork

ReductionActof1995. 

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: Home Health 

Agency Cost Report; Use: In accordance 

with sections 1815(a), 1833(e) and 

1861(v)(1)(A) of the Social Security Act, 

providers of service in the Medicare 

program are required to submit annual 

information to achieve reimbursement 

for health care services rendered to 

Medicare beneficiaries. In addition, 42 

CFR 413.20(b) requires that cost reports 

are required from providers on an 

annual basis. Such cost reports are 

required to be filed with the provider’s 

Medicare contractor. The Medicare 

contractor uses the cost report not only 

to make settlement with the provider for 

the fiscal period covered by the cost 

report, but also in deciding whether to 

audit the records of the provider. 

Section 413.24(a) requires providers 

receiving payment on the basis of 

reimbursable cost provide adequate cost 

data based on their financial and 

statistical records that must be capable 

of verification by qualified auditors. 

Besides determining program 

reimbursement, the data submitted on 

the cost reports supports the 

management of federal programs. The 

data is extracted from the cost report 

and used for making projections of 

Medicare Trust Fund requirements and 

for analysis to rebase home health 

agency prospective payment system. 

The data is also available to Congress, 

researchers, universities, and other 

interested parties. While the collection 

of data is a secondary function of the 

cost report, its primary function is to 

reimburse providers for services 

rendered to program beneficiaries. Form 

Number: CMS–1728–94 (OCN: 0938– 

0022); Frequency: Yearly; Affected 

Public: Business or other for-profits and 

Not-for-profit institutions; Number of 

Respondents: 11,563; Total Annual 

Responses: 11,563; Total Annual Hours: 

2,613,238. (For policy questions 

regarding this collection contact Angela 

Havrilla at 410–786–4516.) 

2. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 


tkelley on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 180 / Tuesday, September 17, 2013 / Notices 57163 

Title of Information Collection: Request 

for Termination of Premium Hospital 

and Supplementary Medical Insurance; 

Use: The CMS–1763 provides us and the 

Social Security Administration (SSA) 

with the enrollee’s request for 

termination of Part B, Part A or both 

Part B and A premium coverage. The 

form is completed by an SSA claims or 

field representative using information 

provided by the Medicare enrollee 

during an interview. The purpose of the 

form is to provide to the enrollee with 

a standardized format to request 

termination of Part B, Part A premium 

coverage or both, explain why the 

enrollee wishes to terminate such 

coverage, and to acknowledge that the 

ramifications of the decision are 

understood. Form Number: CMS–1763 

(OCN: 0938–0025); Frequency: Once; 

Affected Public: Individuals or 

households; Number of Respondents: 

14,000; Total Annual Responses: 

14,000; Total Annual Hours: 5,833. (For 

policy questions regarding this 

collection contact Lindsay Smith at 

410–786–6843.) 

3. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Medicare 

Advantage Program Requirements; Use: 

Medicare Advantage (MA) organizations 

and potential MA organizations 

(applicants) use the information to 

comply with the application 

requirements and the MA contract 

requirements. We will use this 

information to: approve contract 

applications, monitor compliance with 

contract requirements, make proper 

payment to MA organizations, 

determine compliance with the new 

prescription drug benefit requirements, 

and to ensure that correct information is 

disclosed to Medicare beneficiaries 

(both potential enrollees and enrollees). 

Form Number: CMS–R–267 (OCN: 

0938–0753); Frequency: Yearly; Affected 

Public: Individuals or households and 

Business or other for-profits; Number of 

Respondents: 18,043,776; Total Annual 

Responses: 21,935,728; Total Annual 

Hours: 8,529,541. (For policy questions 

regarding this collection contact Dana 

Burley at 410–786–4547.) 

4. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: 

Medicare Secondary Payer Information 

Collection and Supporting Regulations; 

Use: We are seeking to renew approval 

to collect information from 

beneficiaries, providers, physicians, 

insurers, and suppliers on health 

insurance coverage that is primary to 

Medicare. Collecting this information 

allows us to identify those Medicare 

beneficiaries who are in situations 

where Medicare is statutorily required 

to be a secondary payer (MSP), thereby 

safeguarding the Medicare Trust Fund. 

Specifically, we use the information to 

accurately process and pay Medicare 

claims and to make necessary recoveries 

in accordance with § 1862(b) of the Act 

(42 U.S.C.1395y(b)). If an active MSP 

situation is identified and Medicare is 

inappropriately billed as primary, the 

claim will be rejected. The hospitals, 

other providers, physicians, pharmacies, 

and suppliers use the information 

collected (and furnished to them on the 

denial) to properly bill the appropriate 

primary payer. Completing an MSP 

questionnaire and making an accurate 

MSP determination helps hospitals, 

other providers, physicians, pharmacies, 

and suppliers to bill correctly the first 

time, saving the Medicare Program 

money and affording Medicare 

beneficiaries an enhanced level of 

customer service (which, again, is 

particularly important in Part D due to 

the real-time adjudication of claims and 

the complicated nature of its benefit 

administration). Insurers, underwriters, 

third party administrators, and selfinsured/self-administered employers 

use the information to ensure 

compliance with the law by refunding 

any identified mistaken payments to 

Medicare. Form Number: CMS–250–254 

(OCN: 0938–0214); Frequency: 

Occasionally; Affected Public: 

Individuals and Households, Private 

Sector, State, Local or Tribal 

Governments; Number of Respondents: 

143,070,217; Total Annual Responses: 

143,070,217; Total Annual Hours: 

1,788,057. (For policy questions 

regarding this collection contact Ward 

Marsh at 410–786–6473.) 

Dated: September 11, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–22515 Filed 9–16–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10069] 

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 

November 18, 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 llllll, 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. 


tkelley on DSK3SPTVN1PROD with NOTICES