41932 Federal Register / Vol. 78, No. 134 / Friday, July 12, 2013 / Notices 

Number: CMS–2728 (OCN#: 0938– 

0046); Frequency: Occasionally; 

Affected Public: Individuals or 

households; Number of Respondents: 

130,000; Total Annual Responses: 

130,000; Total Annual Hours: 97,500. 

(For policy questions regarding this 

collection contact Michelle Tucker at 

410–786–0736.) 

3. Type of Information Collection 

Request: Reinstatement with change of a 

currently approved collection; Title of 

Information Collection: Home Health 

Conditions of Participation (CoP) and 

Supporting Regulations; Use: The 

information collection requirements 

contained in this request are part of the 

requirements classified as the 

conditions of participation (CoPs) which 

are based on criteria prescribed in law 

and are standards designed to ensure 

that each facility has properly trained 

staff to provide the appropriate safe 

physical environment for patients. 

These particular standards reflect 

comparable standards developed by 

industry organizations such as the Joint 

Commission on Accreditation of 

Healthcare Organizations, and the 

Community Health Accreditation 

Program. The primary users of this 

information will be state agency 

surveyors, the regional home health 

intermediaries, CMS and home health 

agencies (HHAs) for the purpose of 

ensuring compliance with Medicare 

CoPs as well as ensuring the quality of 

care provided by HHA patients. Form 

Numbers: CMS–R–39 (OCN: 0938– 

0365); Frequency: Occasionally; 

Affected Public: Business or for-profits, 

not-for-profit institutions, and State, 

Local or Tribal governments; Number of 

Respondents: 13,577; Total Annual 

Responses: 20,202,576; Total Annual 

Hours: 6,422,694. (For policy questions 

regarding this collection contact 

Danielle Shearer at 410–786–6617.) 

4. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: Retiree 

Drug Subsidy (RDS) Payment Request 

and Instructions; Use: Under section 

1860D–22 of the Social Security Act and 

implementing regulations at 42 CFR part 

423 subpart R, plan sponsors (e.g., 

employers, unions) who offer 

prescription drug coverage meeting 

specified criteria to their qualified 

covered retirees are eligible to receive a 

28 percent tax-free subsidy for allowable 

drug costs. Plan sponsors must submit 

required prescription drug cost data and 

other information in order to receive the 

subsidy. Subpart R stipulates that plan 

sponsors may elect to submit RDS 

payment requests on a monthly, 

quarterly, interim annual, or annual 

basis; once selected, the payment 

frequency may not be changed during 

the plan year. Form Number: CMS– 

10170 (OCN: 0938–0977); Frequency: 

Occasionally; Affected Public: Private 

sector (business or other for-profits and 

not-for-profit institutions); Number of 

Respondents: 4,500; Total Annual 

Responses: 4,500; Total Annual Hours: 

679,500. (For policy questions regarding 

this collection contact John W. 

Campbell at 410–786–0542.) 

5. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: Retiree 

Drug Subsidy (RDS) Applications and 

Instructions; Use: Under the Medicare 

Prescription Drug, Improvement, and 

Modernization Act of 2003 and 

implementing regulations at 42 CFR part 

423, subpart R plan sponsors (e.g., 

employers, unions) who offer 

prescription drug coverage to their 

qualified covered retirees are eligible to 

receive a 28 percent tax-free subsidy for 

allowable drug costs. In order to qualify, 

plan sponsors must submit a complete 

application with a list of retirees for 

whom it intends to collect the subsidy. 

Once CMS reviews and analyzes the 

information on the application and the 

retiree list, notification will be sent to 

the plan sponsor about its eligibility to 

participate in the RDS program. Form 

Number: CMS–10156 (OCN: 0938– 

0957); Frequency: Yearly and monthly; 

Affected Public: Private sector (business 

or other for-profits and not-for-profit 

institutions); Number of Respondents: 

4,500; Total Annual Responses: 4,500; 

Total Annual Hours: 288,000. (For 

policy questions regarding this 

collection contact John W. Campbell at 

410–786–0542.) 

6. Type of Information Collection 

Request: New Collection (Request for a 

new OMB control number); Title of 

Information Collection: Evaluation of 

the Multi-Payer Advanced Primary Care 

Practice (MAPCP) Demonstration: 

Provider Survey; 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 proposing to conduct this 

provider survey to understand how 

participating practices’ structures and 

functions vary, particularly with respect 

to their adoption of different 

components of the PCMH model of care. 

Researchers evaluating the MAPCP 

Demonstration plan to combine these 

survey data with claims data to conduct 

statistical analyses that identify which 

particular medical home care processes 

are associated with the largest gains in 

health care quality and reductions in 

health care cost trends. Form Number: 

CMS–10485 (OCN: 0938–NEW); 

Frequency: Annually; Affected Public: 

Individuals and households; Number of 

Respondents: 5,799; Total Annual 

Responses: 5,799; Total Annual Hours: 

1,450. (For policy questions regarding 

this collection contact Suzanne Wensky 

at 410–786–0226.) 

Dated: July 9, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–16740 Filed 7–11–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers CMS–10108, CMS– 

10115, and CMS–10130] 

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 a 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 

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Federal Register / Vol. 78, No. 134 / Friday, July 12, 2013 / Notices 41933 

technology to minimize the information 

collection burden. 

DATES: Comments on the collection(s) of 

information must be received by the 

OMB desk officer by August 12, 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 of a currently 

approved collection; Title of 

Information Collection: Medicaid 

Managed Care Regulations; Use: The 

information collection requirements 

contained in this information collection 

request implement regulations that 

allow states greater flexibility to 

implement mandatory managed care 

programs, implement new beneficiary 

protections, and eliminate certain 

requirements viewed by state agencies 

as impediments to the growth of 

managed care programs. Information 

collected includes information about 

managed care programs, grievances and 

appeals, enrollment broker contracts, 

and managed care organizational 

capacity to provide health care services. 

Medicaid enrollees use the information 

collected and reported to make 

informed choices regarding health care, 

including how to access health care 

services and the grievance and appeal 

system. States use the information 

collected and reported as part of its 

contracting process with managed care 

entities, as well as its compliance 

oversight role. We use the information 

collected and reported in an oversight 

role of state Medicaid managed care 

programs. Form Number: CMS–10108 

(OCN: 0938–0920); Frequency: 

Occasionally; Affected Public: 

Individuals or households, Private 

sector (business or other for-profit and 

not-for-profit institutions), and State, 

local or Tribal Government; Number of 

Respondents: 1,640,223; Total Annual 

Responses: 5,217,333; Total Annual 

Hours: 5,872,255. (For policy questions 

regarding this collection contact Amy 

Gentile at 410–786–3499.) 

2. Type of Information Collection 

Request: Reinstatement with change of a 

previously approved collection; Title of 

Information Collection: Federal 

Reimbursement of Emergency Health 

Services Furnished to Undocumented 

Aliens, Section 1011 of the Medicare 

Prescription Drug, Improvement and 

Modernization Act of 2003 (MMA); Use: 

Section 1011 of the Medicare 

Prescription Drug, Improvement and 

Modernization Act of 2003 (MMA) 

provides that the Secretary will 

establish a process (i.e., enrollment and 

claims payment) for eligible providers to 

request payment. The Secretary must 

directly pay hospitals, physicians and 

ambulance providers (including Indian 

Health Service, Indian Tribe and Tribal 

organizations) for their otherwise unreimbursed costs of providing services 

required by section 1867 of the Social 

Security Act and related hospital 

inpatient, outpatient and ambulance 

services. We will use the application 

information to administer this health 

services program and establish an audit 

process. Form Number: CMS–10115 

(OCN: 0938–0929); Frequency: Once 

and occasionally; Affected Public: 

Private sector (business or other forprofit and not-for-profit institutions); 

Number of Respondents: 10,000; Total 

Annual Responses: 10,000; Total 

Annual Hours: 5,000. (For policy 

questions regarding this collection 

contact Fred Rooke at 404–562–7502.) 

3. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: Federal 

Reimbursement of Emergency Health 

Services Furnished to Undocumented 

Aliens, Section 1011 of the Medicare 

Prescription Drug, Improvement and 

Modernization Act of 2003 (MMA): 

‘‘Section 1011 Provider Payment 

Determination’’ and ‘‘Request for 

Section 1011 Hospital On-Call Payments 

to Physicians’’ Forms; Use: Section 1011 

of the MMA requires that the Secretary 

establish a process under which eligible 

providers (certain hospitals, physicians 

and ambulance providers) may request 

payment for (claim) their otherwise unreimbursed costs of providing eligible 

services. The Secretary must make 

quarterly payments directly to such 

providers. The Secretary must also 

implement measures to ensure that 

inappropriate, excessive, or fraudulent 

payments are not made under Section 

1011, including certification by 

providers of the veracity of their 

requests for payment. Both forms have 

been established to address the statutory 

requirements outlined above. Form 

Number: CMS–10130 (OCN: 0938– 

0952); Frequency: Occasionally; 

Affected Public: Private sector (business 

or other for-profit and not-for-profit 

institutions); Number of Respondents: 

12,037; Total Annual Responses: 

300,148; Total Annual Hours: 75,037. 

(For policy questions regarding this 

collection contact Fred Rooke at 404– 

562–7205.) 

Dated: July 9, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–16742 Filed 7–11–13; 8:45 am] 

BILLING CODE 4120–01–P 

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