Federal Register / Vol. 77, No. 97 / Friday, May 18, 2012 / Notices 29645 

provide information for the revision and 

shortening of the survey based on the 

assessment of the reliability and 

construct validity of survey items and 

composites. (c) Case mix adjustment 

analysis—Assess the variables that may 

be considered as case mix adjusters. 

These preliminary research activities 

are not required by regulation, and will 

not be used by CMS to regulate or 

sanction its customers. They will be 

entirely voluntary and the 

confidentiality of respondents and their 

responses will be preserved. 

The information collected will be 

used to revise and test the survey 

instrument described in the Background 

section of the Supporting Statement. 

Within the PRA package, Attachment B 

includes two versions of the survey (one 

modified for accessibility) and 

Attachment C has the introductory 

information. The end result will be an 

improvement in information collection 

instruments and in the quality of data 

collected, a reduction or minimization 

of respondent burden, increased agency 

efficiency, and improved 

responsiveness to the public. Following 

the field test, CMS will seek approval 

from the CAHPS consortium for the 

HCBS Experience Survey to be a new 

addition to the CAHPS® family of 

surveys. 

Form Number: CMS–10389 (OCN 

0938–New). Frequency: Once. Affected 

Public: 1 Individuals and households. 

Number of Respondents: 18,000. Total 

Annual Responses: 18,000. Total 

Annual Hours: 9,000. (For policy 

questions regarding this collection 

contact Anita Yuskauskas at 410–786– 

0268. 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 17, 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 

Numberll, Room C4–26–05, 7500 

Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: May 15, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–12080 Filed 5–17–12; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10136] 

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: Reinstatement of a previously 

approved collection; Title of 

Information Collection: Physician Group 

Practice Transition Demonstration 

(PGP–TD) Performance Assessment Tool 

(‘‘PAT’’); Use: The Physician Group 

Practice (PGP) Demonstration was 

mandated by section 412 of the 

Medicare, Medicaid, and SCHIP 

Benefits Improvement and Protection 

Act of 2000 and is the precursor to the 

Medicare Shared Savings Program. 

Section 1899(k) of the Social Security 

Act, as added by section 10307(k) of the 

Affordable Care Act (as amended by 

section 10307 of the Health Care and 

Education Reconciliation Act of 2010), 

states ‘‘the Secretary may enter into an 

agreement with an ACO under the 

Demonstration under section 1866A, 

subject to rebasing and other 

modifications deemed appropriate by 

the Secretary.’’ The Demonstration 

extension is entitled the PGP Transition 

Demonstration (PGP–TD). 

We are seeking reinstatement of the 

collection of information as it was 

erroneously discontinued. Only a 

portion of the information collection 

requirements previously approved 

under 0938–0941 should have been 

discontinued. The collection of 

information is strictly voluntary in 

nature and was developed in 

conjunction with the industry and 

Demonstration participants. Only 

organizations that voluntarily respond 

and elect to participate in the 

Demonstration will be reporting the 

measures. Moreover, CMS will not be 

using this information to regulate or 

sanction but rather to provide financial 

incentives for improving the quality of 

care. The collection of information to be 

used under this extension is being used 

to test quality data collection systems 

and determine incentive payment levels 

to participating physician group 

practices participating in the PGP–TD. 

In addition, this data will be used to 

evaluate the effectiveness of these 

payment models and provide insight 

into the most appropriate way for the 

agency to collect clinical information. 

Form Number: CMS–10136 (OCN: 

0938–0941); Frequency: Yearly; Affected 

Public: Private Sector—Business or 

other for-profits and not-for-profit 

institutions. Number of Respondents: 

10. Number of Responses: 10. Total 

Annual Hours: 790. (For policy 

questions regarding this collection 

contact Heather Grimsley at 410–786– 

1048. 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. 

mstockstill on DSK4VPTVN1PROD with NOTICES

29646 Federal Register / Vol. 77, No. 97 / Friday, May 18, 2012 / Notices 

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 June 18, 2012. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS 

Desk Officer, Fax Number: (202) 395– 

6974. Email: 

OIRA_submission@omb.eop.gov. 

Dated: May 15, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–12078 Filed 5–17–12; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10424 and CMS– 

10416] 

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; Title of 

Information Collection: Cooperative 

Agreement to Support Establishment of 

the Affordable Care Act’s Health 

Insurance Exchanges; Use: All States 

(including the 50 States, consortia of 

States, and the District of Columbia, 

herein referred to as States) are eligible 

for the Cooperative Agreement to 

Support Establishment of the Affordable 

Care Act’s Health Insurance Exchanges. 

Section 1311 of the Affordable Care Act 

provides for grants to States for the 

planning and establishment of these 

Exchanges. Given the innovative nature 

of Exchanges and the statutorilyprescribed relationship between the 

Secretary and States in their 

development and operation, it is critical 

that the Secretary work closely with 

States to provide necessary guidance 

and technical assistance to ensure that 

States can meet the prescribed 

timelines, federal requirements, and 

goals of the statute. 

In order to provide appropriate and 

timely guidance and technical 

assistance, the Secretary must have 

access to timely, periodic information 

regarding State progress. Consequently, 

the information collection associated 

with these grants is essential to 

facilitating reasonable and appropriate 

federal monitoring of funds, providing 

statutorily-mandated assistance to States 

to implement Exchanges in accordance 

with Federal requirements, and to 

ensure that States have all necessary 

information required to proceed, such 

that retrospective corrective action can 

be minimized. 

There are two levels of awards for 

States to apply for the Establishment 

grants. Level One grants are open to 

States that are participating in either the 

Federally-facilitated Exchange, 

including States that will be 

collaborating with the Federallyfacilitated Exchange on certain 

activities, or developing a State-based 

Exchange. Level Two Establishment 

grants are open to States that are 

establishing a State-based Exchange. 

Level One Establishment grantees may 

apply for additional funding under 

Level Two Establishment grants once 

they have achieved the benchmarks 

identified in the Level Two 

Establishment review criteria. 

HHS anticipates releasing this 

funding opportunity on June 15, 2012. 

There will be ten opportunities for 

applicants to apply for funding. HHS 

anticipates Level One Establishment 

and Level Two Establishment 

applications will be due: August 1, 

2012; November 1, 2012; February 1, 

2013; May 1, 2013; August 1, 2013; 

November 1, 2013; February 3, 2014; 

May 1, 2014; August 1, 2014; and 

November 3, 2014. The Period of 

Performance for Level One 

Establishment grants is up to one year 

after date of award. The Period of 

Performance for Level Two 

Establishment grants is up to three years 

after date of award. Form Number: 

CMS–10424 (OCN: 0938–NEW); 

Frequency: Annually; Affected Public: 

State, Local, or Tribal Governments; 

Number of Respondents: 51; Number of 

Responses: 331; Total Annual Hours: 

50,158. (For policy questions regarding 

this collection contact Katherine 

Harkins at 301–492–4445. For all other 

issues call 410–786–1326.) 

2. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Blueprint for 

Approval of Affordable State-based and 

State Partnership Insurance Exchanges 

Use: All States (including the 50 States, 

the Territories, and the District of 

Columbia herein referred to as States) 

have the opportunity under Section 

1311(b) of the Affordable Care Act to 

establish an Exchange no later than 

October 1, 2013 (Plan Year 2014). 

Given the innovative nature of 

Exchanges and the statutorilyprescribed relationship between the 

Secretary and States in their 

development and operation, it is critical 

that the Secretary work closely with 

States to provide necessary guidance 

and technical assistance to ensure that 

States can meet the prescribed 

timelines, federal requirements, and 

goals of the statute. 

States seeking to establish an 

Exchange must build an Exchange that 

meets the requirements set out in 

Section 1311(d) of the Affordable Care 

Act and 45 CFR 155.105. In order to 

ensure that a State seeking approval as 

a State Exchange or State Partnership 

Exchange in the Federally-facilitated 

Exchange meet all applicable 

requirements the Secretary will require 

a State to submit a Blueprint for 

approval during the Fall of 2012 and to 

demonstrate operational readiness 

through virtual or on-site readiness 

review. The Blueprint has two sections: 

The Blueprint Declaration Letter and the 

Blueprint Application. Submission of 

this Blueprint Declaration Letter will be 

online and on paper and submission of 

the Blueprint Application will be 

online. Form Number: CMS–10416 

(OCN: 0938–New) Frequency: Once; 

Affected Public: State, Local, or Tribal 

governments; Number of Respondents: 

56; Number of Responses: 56; Total 

Annual Hours: 11,816. (For policy 

questions regarding this collection, 

contact Sarah Summer 301–492–4443. 

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 

mstockstill on DSK4VPTVN1PROD with NOTICES