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[Federal Register: April 19, 2010 (Volume 75, Number 74)]
[Notices]               
[Page 20367-20368]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr19ap10-42]                         

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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 Pre-
print implementing Section 6087 of the Deficit Reduction Act: Optional 
Self-Direction 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 pre-print, 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

[[Page 20368]]

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 Not-for-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 Not-for-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 
E-mail 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
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