Federal Register / Vol. 75, No. 74 / Monday, April 19, 2010 / Notices 20367 

Simpson at 410–786–0017. 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 

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 June 18, 2010: 

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: April 9, 2010. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2010–8901 Filed 4–16–10; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

[Document Identifier: CMS–10295, CMS– 

10234, CMS–10303, CMS–10066 and CMS– 

R–193] 

Centers for Medicare & Medicaid 

Services 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services. 

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: Extension of a currently 

approved collection; Title of 

Information Collection: Recovery Act— 

Reporting Requirements for States 

Under FMAP Increase and TMA 

Provisions; Use: The American 

Recovery and Reinvestment Act of 2009 

(Recovery Act), Public Law 111–5, 

requires that States submit quarterly 

reports to the Secretary of Health and 

Human Services in accordance with 

section 5001 Temporary Increase of 

Medicaid Federal Medical Assistance 

Percentage (FMAP) and section 5004(d) 

Extension of Transitional Medical 

Assistance (TMA). The reports under 

section 5001 are required for the period 

of October 1, 2008–September 30, 2011. 

The reports under section 5004 are 

required beginning on July 1, 2009 until 

the Federal authority for TMA coverage 

sunsets (now scheduled to sunset on 

December 31, 2010). Each State 

Medicaid agency will submit its 

quarterly reports to the appropriate 

Regional Office of CMS. The reports will 

be compiled and summarized for annual 

reports to Congress. Form Number: 

CMS–10295 (OMB#: 0938–1073); 

Frequency: Reporting—Quarterly; 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

50; Total Annual Responses: 200; Total 

Annual Hours: 600. (For policy 

questions regarding this collection 

contact Richard Strauss at 410–786– 

2019. For all other issues call 410–786– 

1326.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: State Plan Preprint implementing Section 6087 of the 

Deficit Reduction Act: Optional SelfDirection Personal Assistance Services 

(PAS) Program (Cash and Counseling); 

Form Number: CMS–10234 (OMB#: 

0938–1024); Use: Information submitted 

via the State Plan Amendment (SPA) 

pre-print is used by CMS and Regional 

Offices to analyze a State’s proposal to 

implement Section 6087 of the Deficit 

Reduction Act (DRA). State Medicaid 

Agencies will complete the SPA preprint, and submit it to CMS for a 

comprehensive analysis. The pre-print 

contains assurances, check-off items, 

and areas for States to describe policies 

and procedures for subjects such as 

quality assurance, risk management, and 

voluntary and involuntary 

disenrollment; Frequency: Reporting— 

Once; Affected Public: State, Local, or 

Tribal Government; Number of 

Respondents: 56; Total Annual 

Responses: 20; Total Annual Hours: 

400. (For policy questions regarding this 

collection contact Carrie Smith at 410– 

786–4485. For all other issues call 410– 

786–1326.) 

3. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Medicare 

Gainsharing Demonstration Evaluation: 

Physician Focus Groups; Use: The 

proposed physician focus groups are 

part of an overall evaluation of the 

Centers for Medicare & Medicaid 

Services CMS’ congressionally 

mandated Medicare Gainsharing 

Demonstration Evaluation. The 

Congress, under Section 5007 of the 

Deficit Reduction Act (DRA) of 2005, 

requires CMS to conduct a qualified 

gainsharing program to test alternative 

ways that hospitals and physicians can 

share in efficiency gains. The primary 

goal of the demonstration is to evaluate 

gainsharing as a means to align 

physician and hospital incentives to 

improve quality and efficiency. The 

demonstration has two mandated 

Reports to Congress. Results from 

physician focus groups will be included 

in both Reports to Congress. Form 

Number: CMS–10303 (OMB#: 0938– 

New); Frequency: Once; Affected Public: 

Private Sector, Business or other for 

profits; Number of Respondents: 192; 

Total Annual Responses: 96; Total 

Annual Hours: 96. (For policy questions 

regarding this collection contact 

William Buczko at 410–786–6593. For 

all other issues call 410–786–1326.) 

4. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Detailed Notice 

of Discharge (DND); Use: A beneficiary/ 

enrollee who wishes to appeal a 

determination by a Medicare health 

plan or hospital that inpatient care is no 

longer necessary, may request Quality 

Improvement Organization (QIO) review 

of the determination. On the date the 

QIO receives the beneficiary’s/enrollee’s 

request, it must notify the plan and 

hospital that the beneficiary/enrollee 

has filed a request for an expedited 

determination. The plan (for a managed 

care enrollee) or hospital (for an original 


wwoods2 on DSK1DXX6B1PROD with NOTICES_PART 1
20368 Federal Register / Vol. 75, No. 74 / Monday, April 19, 2010 / Notices 

Medicare beneficiary), in turn, must 

deliver a detailed notice to the enrollee/ 

beneficiary. Form Number: CMS–10066 

(OMB#: 0938–1019); Frequency: 

Reporting—Yearly; Affected Public: 

Business or other for-profits and Notfor-profit institutions; Number of 

Respondents: 6,163; Total Annual 

Responses: 13,218; Total Annual Hours: 

13,218. (For policy questions regarding 

this collection contact Evelyn Blaemire 

at 410–786–1803. For all other issues 

call 410–786–1326.) 

5. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Important 

Message from Medicare (IM); Use: 

Requirements that hospitals notify 

beneficiaries in inpatient hospital 

settings of their rights as a hospital 

patient including their discharge appeal 

rights are referenced in Section 1866 of 

the Social Security Act (the Act). The 

authority for the right to an expedited 

determination is set forth at Sections 

1869 and 1154 of the Act. 

The hospital must deliver valid, 

written notice (the IM) of a patient’s 

rights as a hospital patient including the 

discharge appeal rights, within 2 

calendar days of admission. A follow-up 

copy of the signed IM is given again as 

far as possible in advance of discharge, 

but no more than 2 calendar days 

before. Follow-up notice is not required 

if provision of the admission IM falls 

within 2 calendar days of discharge. The 

collection has been revised to include 

documentation of the time when the 

beneficiary signs the document when it 

is delivered initially and as a follow-up 

copy. Form Number: CMS–R–193 

(OMB#: 0938–1019); Frequency: 

Reporting—Yearly; Affected Public: 

Business or other for-profits and Notfor-profit institutions; Number of 

Respondents: 3,193; Total Annual 

Responses: 13,218; Total Annual Hours: 

19,680,000. (For policy questions 

regarding this collection contact Evelyn 

Blaemire at 410–786–1803. 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 May 19, 2010: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–6974, E-mail: 

OIRA_submission@omb.eop.gov. 

Dated: April 9, 2010. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2010–8900 Filed 4–16–10; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Substance Abuse and Mental Health 

Services Administration 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

In compliance with section 

3506(c)(2)(A) of the Paperwork 

Reduction Act of 1995 concerning 

opportunity for public comment on 

proposed collections of information, the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

will publish periodic summaries of 

proposed projects. To request more 

information on the proposed projects or 

to obtain a copy of the information 

collection plans, call the SAMHSA 

Reports Clearance Officer on (240) 276– 

1243. 

Comments are invited on: (a) Whether 

the proposed collections of information 

are necessary for the proper 

performance of the functions of the 

agency, including whether the 

information shall have practical utility; 

(b) the accuracy of the agency’s estimate 

of the burden of the proposed collection 

of information; (c) ways to enhance the 

quality, utility, and clarity of the 

information to be collected; and (d) 

ways to minimize the burden of the 

collection of information on 

respondents, including through the use 

of automated collection techniques or 

other forms of information technology. 

Proposed Project: Confidentiality of 

Alcohol and Drug Abuse Patient 

Records—(OMB No. 0930–0092)— 

Revision 

Statute (42 U.S.C. 290dd–2) and 

regulations (42 CFR part 2) require 

federally conducted, regulated, or 

directly or indirectly assisted alcohol 

and drug abuse programs to keep 

alcohol and drug abuse patient records 

confidential. Information requirements 

are (1) written disclosure to patients 

about Federal laws and regulations that 

protect the confidentiality of each 

patient, and (2) documenting ‘‘medical 

personnel’’ status of recipients of a 

disclosure to meet a medical emergency. 

Annual burden estimates for these 

requirements are summarized in the 

table below: 

ANNUALIZED BURDEN ESTIMATES

Annual number 

of respondents 1

Responses per 

respondent Total responses Hours per response 

Total hour 

burden 

Disclosure 

42 CFR 2.22 .................................................... 10,064 185 1,865,503 2 .20 373,101 

Recordkeeping 

42 CFR 2.51 .................................................... 10,064 2 20,128 .167 3,361 

Total .......................................................... 10,064 ............................ 1,885,631 ............................ 376,462 

1The number of publicly funded alcohol and drug facilities from SAMHSA’s 2007 National Survey of Substance Abuse Treatment Services (N– 

SSATS). 2The average number of annual treatment admissions from SAMHSA’s 2005–2007 Treatment Episode Data Set (TEDS). 

Send comments to Summer King, 

SAMHSA Reports Clearance Officer, 

Room 7–1044, One Choke Cherry Road, 

Rockville, MD 20857. Written comments 

should be received within 60 days of 

this notice. 


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