Federal Register / Vol. 78, No. 101 / Friday, May 24, 2013 / Notices 31555 

burden for progress reporting. In the 

future, CDC may transition from a 

hardcopy report to MIS-based progress 

reporting. 

The MDE information submitted to 

CDC includes baseline and follow-up 

data (12 months post enrollment) for all 

women served through the 

WISEWOMAN program. The MDE 

describe risk factors for the women 

served in each program and the number 

and type of lifestyle program sessions 

they attend. The information allows 

CDC to assess the effectiveness of the 

WISEWOMAN program in reducing the 

burden of cardiovascular disease risk 

factors among women who utilize 

program services. MDE information may 

also be utilized in assessments of 

WISEWOMAN program impact and 

cost-effectiveness. MDE information has 

previously been submitted to CDC in 

two electronic transmissions: the 

burden for Screening and Assessment 

MDE was estimated at 16 hours per 

response and the burden for Lifestyle 

Intervention MDE was estimated at 8 

hours per response. Under the new 

WISEWOMAN cooperative agreements, 

the MDE will be submitted as a single 

electronic file with a combined 

estimated burden per response of 24 

hours. The total number of MDE 

variables will increase from 66 to 87. 

The number of variables relating to 

Lifestyle Interventions will decrease and 

the number of variables relating to 

Screening and Assessment will increase. 

CDC will continue to use the 

information collected from 

WISEWOMAN awardees to support 

continuous program monitoring and 

improvement activities, evaluation, and 

assessment of program outcomes. The 

overall program evaluation is designed 

to demonstrate how WISEWOMAN can 

obtain more complete health data on 

vulnerable populations, promote public 

education about disease incidence, 

cardiovascular disease risk-factors, 

health promotion, to improve the 

availability of screening and diagnostic 

services for under-served women, 

ensure the quality of services provided 

to under-served women, and develop 

strategies for improved interventions. 

The estimated number of 

WISEWOMAN awardees is 21 but may 

be adjusted when new cooperative 

agreements are issued. Participation in 

this information collection is required 

as a condition of cooperative agreement 

funding. There are no costs to 

respondents other than their time. 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondent Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hrs) 

Total burden 

(in hrs) 

WISEWOMAN Grantees Screening and Assessment and Lifestyle Program MDEs.21 2 24 1,008 

........................................ Annual Progress Report ................................. 21 1 8 168 

Total ............................ ......................................................................... ........................ ........................ ........................ 1,176 

Ron A. Otten, 

Director, Office of Scientific Integrity, Office 

of the Associate Director for Science, Office 

of the Director, Centers for Disease Control 

and Prevention. 

[FR Doc. 2013–12406 Filed 5–23–13; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–64, CMS–10295 

and CMS–10401] 

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), 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: Revision of a currently 

approved collection; 

Title of Information Collection: 

Quarterly Medicaid Statement of 

Expenditures for the Medical Assistance 

Program; Use: Form CMS–64 has been 

used since January 1980 by Medicaid 

state agencies to report their actual 

program benefit costs and 

administrative expenses. CMS uses this 

information to compute the federal 

financial participation for the state’s 

Medicaid program costs. Certain 

schedules of the CMS–64 form are used 

by states to report budget, expenditure 

and related statistical information 

required for implementation of the 

Medicaid portion of the State Children’s 

Health Insurance Programs, Title XXI of 

the Social Security Act, established by 

the Balanced Budget Act of 1997. Form 

Number: CMS–64 (OCN: 0938–0067); 

Frequency: Quarterly; Affected Public: 

State, Local, or Tribal Governments; 

Number of Respondents: 56; Total 

Annual Responses: 224; Total Annual 

Hours: 16,464. (For policy questions 

regarding this collection contact 

Abraham John at 410–786–4518. For all 

other issues call 410–786–1326.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Reporting 

Requirements for States Under 

Transitional Medical Assistance (TMA) 

Provisions; Use: The HHS Secretary is 

required to submit annual reports to 

Congress with information collected 

from states in accordance with section 

5004(d) of the American Recovery and 

Reinvestment Act of 2009. Medicaid 

agencies in 50 states complete the 

reports while we review the information 

to determine if each state has met all of 

the reporting requirements specified 

under section 5004(d). We are revising 

this package to remove the requirement 

to report the Medicaid Federal Medical 

Assistance Percentage since it no longer 

needs to be collected from states. Form 

mstockstill on DSK4VPTVN1PROD with NOTICES

31556 Federal Register / Vol. 78, No. 101 / Friday, May 24, 2013 / Notices 

Number: CMS–10295 (OCN: 0938– 

1073). Frequency: Quarterly; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

50; Total Annual Responses: 200; Total 

Annual Hours: 400. (For policy 

questions regarding this collection 

contact Rhonda Simms at 410–786– 

1200. For all other issues call 410–786– 

1326.) 

3. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Standards 

Related to Reinsurance, Risk Corridors 

and Risk Adjustment; Use: Section 1341 

of the Affordable Care Act provides that 

each state must establish a transitional 

reinsurance program to help stabilize 

premiums for coverage in the individual 

market during the first three years of 

Exchange operation. Section 1342 

provides for the establishment of a 

temporary risk corridors program that 

will apply to qualified health plans in 

the individual and small group markets 

for the first three years of Exchange 

operation. Section 1343 provides for a 

program of risk adjustment for all nongrandfathered plans in the individual 

and small group market both inside and 

outside of the Exchange. These riskspreading programs, which will be 

implemented by HHS, states, or both 

HHS and states, are designed to mitigate 

adverse selection and provide stability 

for health insurance issuers in the 

individual and small group markets as 

market reforms and Exchanges are 

implemented. Section 1321(a) also 

provides broad authority for the 

Secretary to establish standards and 

regulations to implement the statutory 

requirements related to Exchanges, 

reinsurance, risk adjustment, and other 

components of title I of the Affordable 

Care Act. The data collection and 

reporting requirements described in this 

information collection request will 

enable states, HHS, or both states and 

HHS to implement the aforementioned 

programs, which will mitigate the 

impact of adverse selection in the 

individual and small group markets 

both inside and outside the Exchange. 

Form Number: CMS–10401 (OCN: 

0938–1155); Frequency: Occasionally; 

Affected Public: Private Sector (business 

or other for-profit and not-for-profit 

institutions); Number of Respondents: 

24,171; Total Annual Responses: 

584,042; Total Annual Hours: 1,013,293. 

(For policy questions regarding this 

collection contact Jaya Ghildiyal at 301– 

492–5149. 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 24, 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 21, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–12465 Filed 5–23–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10293] 

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: Extension of a currently 

approved collection; 

Title of Information Collection: Tribal 

Consultation State Plan Amendment 

Template; Use: Effective July 1, 2009, 

section 5006 of the American Recovery 

and Reinvestment Act of 2009 (Recovery 

Act) amended section 1902(a)(73) of the 

Act to require that certain states utilize 

a process for the state to seek advice on 

a regular, ongoing basis from designees 

of the Indian Health Service (IHS) and 

Urban Indian Organizations concerning 

Medicaid and Children’s Health 

Insurance Program (CHIP) matters 

having a direct effect on them. The 

consultation process is required for the 

37 States in which 1 or more Indian 

Health Programs or Urban Indian 

Organizations furnish health care 

services. The State Medicaid agency for 

each of these States will complete the 

template page and submit it for approval 

as part of a State plan amendment, to 

document how it meets the 

requirements for tribal consultation. 

Form Number: CMS–10293 (OCN: 

0938–1098); Frequency: Reporting— 

Occasionally; Affected Public: State, 

Local, or Tribal Governments; Number 

of Respondents: 37; Total Annual 

Responses: 37; Total Annual Hours: 37. 

(For policy questions regarding this 

collection contact Lane Terwilliger at 

410–786–6618. 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. 

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 July 23, 2013: 

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. 

mstockstill on DSK4VPTVN1PROD with NOTICES