```

[Federal Register Volume 78, Number 101 (Friday, May 24, 2013)]
[Notices]
[Pages 31556-31557]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-12370]

-----------------------------------------------------------------------

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.

[[Page 31557]]

    Dated: May 20, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2013-12370 Filed 5-23-13; 8:45 am]
BILLING CODE 4120-01-P
```