55216 Federal Register / Vol. 77, No. 174 / Friday, September 7, 2012 / Notices 

nominated for consideration: (1) A letter 

of nomination that clearly states the 

name and affiliation of the nominee, the 

basis for the nomination (i.e., specific 

attributes which qualify the nominee for 

service in this capacity), and a statement 

that the nominee is willing to serve as 

a member of the Committee; (2) the 

nominator’s name, address, daytime 

telephone number, and the home and/ 

or work address, telephone number, and 

email address of the individual being 

nominated; and (3) a current copy of the 

nominee’s curriculum vitae. Federal 

employees should not be nominated for 

consideration of appointment to this 

Committee. 

The Department makes every effort to 

ensure that the membership of HHS 

Federal advisory committees is fairly 

balanced in terms of points of view 

represented and the committee’s 

function. Every effort is made to ensure 

that individuals from a broad 

representation of geographic areas, 

women and men, ethnic and minority 

groups, and the disabled are given 

consideration for membership on HHS 

Federal advisory committees. 

Appointment to this Committee shall be 

made without discrimination on the 

basis of age, race, ethnicity, gender, 

sexual orientation, disability, and 

cultural, religious, or socioeconomic 

status. 

Individuals who are selected to be 

considered for appointment will be 

required to provide detailed information 

regarding their financial holdings, 

consultancies, and research grants or 

contracts. Disclosure of this information 

is necessary in order to determine if the 

selected candidate is involved in any 

activity that may pose a potential 

conflict with the official duties to be 

performed as a member of SACHRP. 

Dated: August 31, 2012. 

Jerry Menikoff, 

Director, Office for Human Research 

Protections, Executive Secretary, Secretary’s 

Advisory Committee on Human Research 

Protections. 

[FR Doc. 2012–22103 Filed 9–6–12; 8:45 am] 

BILLING CODE 4150–36–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10003] 

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: Notice 

of Denial of Medical Coverage (or 

Payment); Use: In the July 6, 2012, 

Federal Register (77 FR 40064), the 

Centers for Medicare and Medicaid 

Services (CMS) published a 60-day 

notice regarding the information 

collection request approved under 

0938–0829. However, due to technical 

difficulties, the documents associated 

with the information collection request 

were not made available to the public 

until August 14, 2012. Because of the 

technical difficulties, CMS is 

republishing the notice to allow the 

public to have a full 60-day comment 

period. 

Section 1852(g)(1)(B) of the Social 

Security Act (SSA) requires Medicare 

health plans to provide enrollees with a 

written notice in understandable 

language that explains the plan’s 

reasons for denying a request for a 

service or payment for a service the 

enrollee has already received. The 

written notice must also include a 

description of the applicable appeals 

processes. Regulatory authority for this 

notice is set forth in Subpart M of Part 

422 at 42 CFR 422.568, 422.572, 

417.600(b), and 417.840. 

Section 1932 of the Social Security 

Act (SSA) sets forth requirements for 

Medicaid managed care plans, including 

beneficiary protections related to 

appealing a denial of coverage or 

payment. The Medicaid managed care 

appeals regulations are set forth in 

Subpart F of Part 438 of Title 42 of the 

CFR. Rules on the content of the written 

denial notice can be found at 42 CFR 

438.404. 

This notice combines the existing 

Notice of Denial of Medicare Coverage 

with the Notice of Denial of Payment 

and includes optional language to be 

used in cases where a Medicare health 

plan enrollee also receives full Medicaid 

benefits that are being managed by the 

Medicare health plan. Form Number: 

CMS–10003 (OCN: 0938–0829). 

Frequency: Occasionally. Affected 

Public: Private Sector (business or other 

for-profits, not-for-profit institutions). 

Number of Respondents: 665. Total 

Annual Responses: 6,960,410. Total 

Annual Hours: 1,159,604. (For policy 

questions regarding this collection 

contact Gladys Wheeler at 410–786– 

0273. 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 November 6, 2012: 

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: September 4, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–22087 Filed 9–6–12; 8:45 am] 

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