Federal Register / Vol. 76, No. 48 / Friday, March 11, 2011 / Notices 13415 

Atlanta, Georgia 30333, Telephone: (404) 

498–2733. 

The Director, Management Analysis and 

Services Office, has been delegated the 

authority to sign Federal Register 

notices pertaining to announcements of 

meetings and other committee 

management activities, for both the 

Centers for Disease Control and 

Prevention and the Agency for Toxic 

Substances and Disease Registry. 

Dated: March 7, 2011. 

Elaine L. Baker, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. 2011–5623 Filed 3–10–11; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10367] 

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: New collection (Request for a 

new OMB Control Number); Title of 

Information Collection: Medicaid State 

Plan Preprint for Use by States When 

Implementing Section 6505 of the 

[Patient Protection and] Affordable Care 

Act; Use: CMS has developed a 

Medicaid State Plan Preprint for use by 

States and specifically to support the 

January 1, 2011, mandate of the 

prohibition on payments outside of the 

United States. The preprint follows the 

format and requested information from 

prior preprints provided to the States by 

CMS and provides a placeholder and 

assurance of compliance with section 

1902(a) of the Social Security Act; Form 

Number: CMS–10367 (OMB#: 0938– 

NEW); Frequency: Occasionally; 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

56; Total Annual Responses: 56; Total 

Annual Hours: 5. (For policy questions 

regarding this collection contact Carla 

Ausby at 410–786–2153. 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 April 11, 2011: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–6974, E-mail: 

OIRA_submission@omb.eop.gov. 

Dated: March 4, 2011. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2011–5685 Filed 3–10–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–2540–10, CMS– 

10115, CMS–10136, CMS–10260, CMS– 

10320, CMS–10381, CMS–855(S), CMS– 

855(A, B, I, R) and CMS–855(O)] 

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: Revision of a currently 

approved collection; Title of 

Information Collection: Skilled Nursing 

Facility and Skilled Nursing Facility 

Health Care Complex Cost Report. Use: 

Form CMS 2540–10 is used by Skilled 

Nursing Facilities (SNFs) and Skilled 

Nursing Facility Complexes 

participating in the Medicare program to 

report the health care costs to determine 

the amount of reimbursable costs for 

services rendered to Medicare 

beneficiaries. It is required under 

sections 1815(a), 1833(e) and 

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

(42 U.S.C. 1395g) to submit annual 

information to achieve settlement of 

costs for health care services rendered to 

Medicare beneficiaries. The revision is 

due to new reporting requirements as 

mandated by the Patient Protection and 

Affordability Act section 6104. The 

Patient Protection and Affordable Care 

Act, § 6104(1) of Public Law 111–148 

amended § 1888(f) of the Social Security 

Act (‘‘Reporting of Direct Care 

Expenditures’’), requires SNFs to 

separately report expenditures for wages 

and benefits for direct care staff 

(registered nurses, licensed professional 

nurses, certified nurse assistants, and 

other medical and therapy staff). In 

implementing these changes Worksheet 

S–3, part V was added. With the 

addition of this worksheet the average 

record keeping time for each provider 

will be increased by 5 hours and the 

average reporting time by 1 hour. Form 

Number: CMS–2540–10 (OMB#: 0938– 

0463); Frequency: Yearly; Affected 

Public: Private Sector; Business or other 

for-profit and not-for-profit institutions; 

Number of Respondents: 15,071; Total 

Annual Responses: 15,071; Total 

Annual Hours: 3,171,602 (For policy 

questions regarding this collection 

contact Amelia Citerone at 410–786– 

3901. For all other issues call 410–786– 

1326.) 

2. Type of Information Collection 

Request: Extension of currently 

approved collection; Title of 


srobinson on DSKHWCL6B1PROD with NOTICES