Federal Register / Vol. 80, No. 25 / Friday, February 6, 2015 / Notices 6727 

collection of information, before 

submitting the collection to OMB for 

approval. To comply with this 

requirement, CMS is publishing this 

notice. 

Information Collection 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicaid 

Program; Eligibility Changes under the 

Affordable Care Act of 2010; Use: The 

eligibility systems are essential to the 

goal of increasing coverage in insurance 

affordability programs while reducing 

administrative burden on states and 

consumers. The electronic transmission 

and automation of data transfers are key 

elements in managing the expected 

insurance affordability program 

caseload that started in 2014. 

Accomplishing the same work without 

these information collection 

requirements would not be feasible. 

Form Number: CMS–10410 (OMB 

control number 0938–1147); Frequency: 

Occasionally; Affected Public: 

Individuals or households, and State, 

Local, and Tribal Governments; Number 

of Respondents: 25,500,096; Total 

Annual Responses: 76,500,149; Total 

Annual Hours: 21,278,142. (For policy 

questions regarding this collection 

contact Brenda Sheppard at 410–786– 

8534). 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Income and 

Eligibility Verification System Reporting 

and Supporting Regulations; Use: A 

state Medicaid agency that currently 

obtains and uses information from 

certain sources, or with more frequency 

than specified, could continue to do so 

to the extent that the verifications are 

useful and not redundant. An agency 

that has found it effective to verify all 

wage or benefit information with 

another agency or with the recipient is 

encouraged to continue these practices 

if it chooses. On the other hand, the 

agency may implement an approved 

targeting plan under 42 CFR 435.953. 

The agency’s experience should guide 

its decision whether to exceed these 

regulatory requirements on income and 

eligibility verification. While states may 

target resources when verifying income 

of course, agencies are still held 

accountable for their accuracy in 

eligibility determinations. Form 

Number: CMS–R–74 (OMB control 

number 0938–0467); Frequency: 

Occasionally; Affected Public: State, 

Local, or Tribal Governments; Number 

of Respondents: 50; Total Annual 

Responses: 71; Total Annual Hours: 

134,865. (For policy questions regarding 

this collection contact Brenda Sheppard 

at 410–786–8534). 

3. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Hospital and 

Hospital Health Care Complex Cost 

Report; Use: Providers of services 

participating in the Medicare program 

are required under sections 1815(a) 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. In addition, 

regulations at 42 CFR 413.20 and 413.24 

require adequate cost data and cost 

reports from providers on an annual 

basis. 

We are requesting the Office of 

Management and Budget review and 

approve this revision to the Form CMS– 

2552–10, Hospital and Hospital Health 

Care Complex Cost Report. These cost 

reports are filed annually by hospitals 

participating in the Medicare program to 

determine the reasonable costs incurred 

to provide medical services to patients. 

The revisions made to the hospital cost 

report are in accordance with the 

statutory requirement for hospice 

payment reform in § 3132 of the Patient 

Protection and Affordable Care Act 

(ACA) (March 23, 2010) and the 

statutory requirement establishing a 

prospective payment system for 

Federally Qualified Health Centers in 

§ 10501(i)(3)(A) of the ACA, codified in 

section 1834(o) of the Act. Form 

Number: CMS–2552–10 (OMB control 

number 0938–0050); Frequency: Yearly; 

Affected Public: State, Local, or Tribal 

Governments, private sector (for-profit 

and not-for-profit institutions); Number 

of Respondents: 6,157; Total Annual 

Responses: 6,157; Total Annual Hours: 

4,143,661. (For policy questions 

regarding this collection contact Gail 

Duncan at 410–786–7278). 

4. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Medicare 

Enrollment Application: Reassignment 

of Medicare Benefits; Use: The primary 

function of the CMS 855R enrollment 

application is to allow physicians and 

non-physician practitioners to reassign 

their Medicare benefits to a group 

practice and to gather information from 

the individual that tells us who he/she 

is, where he or she renders services, and 

information necessary to establish 

correct claims payment. The goal of 

periodically evaluating and revising the 

CMS 855R enrollment application is to 

simplify and clarify the information 

collection without jeopardizing our 

need to collect specific information. 

At this time, CMS is making very few 

minor revisions to the CMS 855R 

(Reassignment of Benefits) Medicare 

enrollment application (OMB No. 0938– 

1179). Two sections within the form are 

being reversed to maintain sync with 

online and paper forms. The previously 

approved CMS 855R section 2 collected 

information regarding the individual 

practitioner who is reassigning benefits 

and section 3 collected information 

regarding the organization/group 

receiving the reassigned benefits. These 

two sections have been reversed so that 

section 2 now collects information on 

the regarding the organization/group 

receiving the reassigned benefits and 

section 3 now collects information on 

the individual practitioner who is 

reassigning benefits. No information or 

data collection within these sections 

was revised. The sections were merely 

re-sequenced and re-numbered to 

maintain sync between online and 

paper forms. With the exception of this 

section reversal and adding the word 

‘‘optional’’ to sections 4 and 5 (primary 

practice location and contact person 

information), there are no other 

revisions. These revisions offer no new 

data collection in this revision package. 

The addition of the optional choice in 

sections 4 and 5 could potentially 

reduce the burden to providers who 

choose not to complete either or both 

optional sections. Form Number: CMS– 

855R (OMB control number 0938–1179); 

Frequency: Occasionally; Affected 

Public: State, Local, or Tribal 

Governments, private sector (for-profit 

and not-for-profit institutions); Number 

of Respondents: 379,619; Total Annual 

Responses: 379,619; Total Annual 

Hours: 94,905. (For policy questions 

regarding this collection contact Kim 

McPhillips at 410–786–5374). 

Dated: February 3, 2015. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2015–02414 Filed 2–5–15; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Community Living 

Administration on Intellectual and 

Developmental Disabilities (AIDD); 

Notice of Meeting 

AGENCY: President’s Committee for 

People with Intellectual Disabilities 

(PCPID). 


asabaliauskas on DSK5VPTVN1PROD with NOTICES
6728 Federal Register / Vol. 80, No. 25 / Friday, February 6, 2015 / Notices 

ACTION: Notice of meeting. 

DATES: Thursday, February 19, 2015 

from 9:00 a.m. to 4:30 p.m.; and Friday, 

February 20, 2015 from 9:00 a.m. to 2:00 

p.m. (EST) 

These meetings will be open to the 

general public. 

ADDRESSES: These meetings will be held 

in the U.S. Department of Health and 

Human Services/Hubert H. Humphrey 

Building located at 200 Independence 

Avenue SW., Conference Room 505A, 

Washington, DC 20201. 

Individuals who would like to 

participate via conference call may do 

so by dialing toll-free 888–935–0260, 

when prompted enter pass code: 

3656064. Individuals whose full 

participation in the meeting will require 

special accommodations (e.g., sign 

language interpreting services, assistive 

listening devices, materials in 

alternative format such as large print or 

Braille) should notify Dr. MJ Karimi, 

PCPID Team Lead, via email at 

MJ.Karimie@acl.hhs.gov, or via 

telephone at 202–357–3588, no later 

than Friday, February 13, 2015. The 

PCPID will attempt to accommodate 

requests made after that date, but cannot 

guarantee the ability to grant requests 

received after this deadline. All meeting 

sites are barrier free, consistent with the 

Americans with Disabilities Act (ADA) 

and the Federal Advisory Committee 

Act (FACA). 

Agenda: The Committee Members 

will discuss preparation of the PCPID 

2015 Report to the President, including 

its content and format, and related data 

collection and analysis required to 

complete the writing of the Report. They 

will also receive presentations from 

selected experts in the field of 

Technology for People with Intellectual 

and Developmental Disabilities. 

Additional Information: For further 

information, please contact Dr. MJ 

Karimi, Team Lead, President’s 

Committee for People with Intellectual 

Disabilities, One Massachusetts Avenue 

NW., Room 4206, Washington, DC 

20201. Telephone: 202–357–3588. Fax: 

202–205–8037. Email: MJ.Karimie@

acl.hhs.gov. 

SUPPLEMENTARY INFORMATION: The 

PCPID acts in an advisory capacity to 

the President and the Secretary of 

Health and Human Services, through 

the Administration on Intellectual and 

Developmental Disabilities, on a broad 

range of topics relating to programs, 

services and supports for persons with 

intellectual disabilities. The PCPID 

Executive Order stipulates that the 

Committee shall: (1) Provide such 

advice concerning intellectual 

disabilities as the President or the 

Secretary of Health and Human Services 

may request; and (2) provide advice to 

the President concerning the following 

for people with intellectual disabilities: 

(A) Expansion of educational 

opportunities; (B) promotion of 

homeownership; (C) assurance of 

workplace integration; (D) improvement 

of transportation options; (E) expansion 

of full access to community living; and 

(F) increasing access to assistive and 

universally designed technologies. 

Dated: January 28, 2015. 

Aaron Bishop, 

Commissioner, Administration on Intellectual 

and Developmental Disabilities (AIDD). 

[FR Doc. 2015–02514 Filed 2–5–15; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Food and Drug Administration 

[Docket No. FDA–2010–N–0161] 

Agency Information Collection 

Activities; Submission for Office of 

Management and Budget Review; 

Comment Request; Export of Food and 

Drug Administration Regulated 

Products: Export Certificates 

AGENCY: Food and Drug Administration, 

HHS. 

ACTION: Notice. 

SUMMARY: The Food and Drug 

Administration (FDA) is announcing 

that a proposed collection of 

information has been submitted to the 

Office of Management and Budget 

(OMB) for review and clearance under 

the Paperwork Reduction Act of 1995. 

DATES: Fax written comments on the 

collection of information by March 9, 

2015. 

ADDRESSES: To ensure that comments on 

the information collection are received, 

OMB recommends that written 

comments be faxed to the Office of 

Information and Regulatory Affairs, 

OMB, Attn: FDA Desk Officer, FAX: 

202–395–7285, or emailed to oira_

submission@omb.eop.gov. All 

comments should be identified with the 

OMB control number 0910–0498. Also 

include the FDA docket number found 

in brackets in the heading of this 

document. 

FOR FURTHER INFORMATION CONTACT: FDA 

PRA Staff, Office of Operations, Food 

and Drug Administration, 8455 

Colesville Rd., COLE–14526, Silver 

Spring, MD 20993–0002, PRAStaff@

fda.hhs.gov. 

SUPPLEMENTARY INFORMATION: In 

compliance with 44 U.S.C. 3507, FDA 

has submitted the following proposed 

collection of information to OMB for 

review and clearance. 

Export of Food and Drug 

Administration Regulated Products: 

Export Certificates—(OMB Control 

Number 0910–0498)—Extension 

In April 1996, a law entitled ‘‘The 

FDA Export Reform and Enhancement 

Act of 1996’’ (FDAERA) amended 

sections 801(e) and 802 of the FD&C Act 

(21 U.S.C. 381(e) and 382). It was 

designed to ease restrictions on 

exportation of unapproved 

pharmaceuticals, biologics, and devices 

regulated by FDA. Section 801(e)(4) of 

the FDAERA provides that persons 

exporting certain FDA regulated 

products may request FDA to certify 

that the products meet the requirements 

of 801(e) and 802 or other requirements 

of the FD&C Act. This section of the law 

requires FDA to issue certification 

within 20 days of receipt of the request 

and to charge firms up to $175 for the 

certifications. 

This section of the FD&C Act 

authorizes FDA to issue export 

certificates for regulated 

pharmaceuticals, biologics, and devices 

that are legally marketed in the United 

States, as well as for these same 

products that are not legally marketed 

but are acceptable to the importing 

country, as specified in sections 801(e) 

and 802 of the FD&C Act. FDA has 

developed four types of certificates that 

satisfy the requirements of section 

801(e)(4)(B) of the FD&C Act: (1) 

Certificates to Foreign Governments, (2) 

Certificates of Exportability, (3) 

Certificates of a Pharmaceutical Product, 

and (4) Non-Clinical Research Use Only 

Certificates. Table 1 of this document 

lists the different certificates and details 

their use: 


asabaliauskas on DSK5VPTVN1PROD with NOTICES