Federal Register / Vol. 79, No. 244 / Friday, December 19, 2014 / Notices 75815 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondent Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(hours) 

Clinic Data manager at clinic .......................... Data Manager electronic Transmission .........

Record Abstraction (No Form) .......................

22 6 3 

Health Department Data Manager .................. Case Reports (No Form) ............................... 10 12 16 

Gonorrhea Patients sampled and interviewed Patient Interview ............................................. 3,225 1 10/60 

Leroy A. Richardson, 

Chief, Information Collection Review Office, 

Office of Scientific Integrity, Office of the 

Associate Director for Science, Office of the 

Director, Centers for Disease Control and 

Prevention. 

[FR Doc. 2014–29715 Filed 12–18–14; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10536 and 

CMS–R–262] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 

(PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, and to allow 

a second opportunity for public 

comment on the notice. Interested 

persons are invited to send comments 

regarding the 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. 

DATES: Comments on the collection(s) of 

information must be received by the 

OMB desk officer by January 20, 2015. 

ADDRESSES: When commenting on the 

proposed information collections, 

please reference the document identifier 

or OMB control number. To be assured 

consideration, comments and 

recommendations must be received by 

the OMB desk officer via one of the 

following transmissions: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–5806 OR Email: 

OIRA_submission@omb.eop.gov. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

http://www.cms.hhs.gov/

PaperworkReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326. 

SUPPLEMENTARY INFORMATION: Under the 

Paperwork Reduction Act of 1995 (PRA) 

(44 U.S.C. 3501–3520), federal agencies 

must obtain approval from the Office of 

Management and Budget (OMB) for each 

collection of information they conduct 

or sponsor. The term ‘‘collection of 

information’’ is defined in 44 U.S.C. 

3502(3) and 5 CFR 1320.3(c) and 

includes agency requests or 

requirements that members of the public 

submit reports, keep records, or provide 

information to a third party. Section 

3506(c)(2)(A) of the PRA (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-day notice in the 

Federal Register concerning each 

proposed collection of information, 

including each proposed extension or 

reinstatement of an existing collection 

of information, before submitting the 

collection to OMB for approval. To 

comply with this requirement, CMS is 

publishing this notice that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: New collection (Request for a 

new OMB control number); Title of 

Information Collection: Medicaid 

Eligibility and Enrollment (EE) 

Implementation Advanced Planning 

Document (IAPD) Template; Use: To 

assess the appropriateness of states’ 

requests for enhanced federal financial 

participation for expenditures related to 

Medicaid eligibility determination 

systems, we will review the submitted 

information and documentation to make 

an approval determination for the 

advanced planning document. The 

package has been revised subsequent to 

the publication of the 60-day Federal 

Register notice (79 FR 51571). Form 

Number: CMS–10536 (OMB control 

number: 0938–New); Frequency: Yearly, 

once, and occasionally; Affected Public: 

State, Local, or Tribal Governments; 

Number of Respondents: 56; Total 

Annual Responses: 168; Total Annual 

Hours: 1,344. (For policy questions 

regarding this collection contact 

Christine Gerhardt at 410–786–0693). 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: CY 2016 Plan 

Benefit Package (PBP) Software and 

Formulary Submission; Use: We require 

that Medicare Advantage and 

Prescription Drug Plan organizations 

submit a completed PBP and formulary 

as part of the annual bidding process. 

During this process, organizations 

prepare their proposed plan benefit 

packages for the upcoming contract year 

and submit them to us for review and 

approval. We publish beneficiary 

education information using a variety of 

formats. The specific education 

initiatives that utilize PBP and 

formulary data include web application 

tools on www.medicare.gov and the plan 

benefit insert in the Medicare & You 

handbook. In addition, organizations 

utilize the PBP data to generate their 

Summary of Benefits marketing 

information. Please note that the 

package has been revised subsequent to 

the publication of the 60-day Federal 

Register notice (79 FR 57931). Form 

Number: CMS–R–262 (OMB control 

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75816 Federal Register / Vol. 79, No. 244 / Friday, December 19, 2014 / Notices 

number 0938–0763); Frequency: Yearly; 

Affected Public: Private sector— 

Business or other for-profits and Notfor-profit institutions; Number of 

Respondents: 598; Total Annual 

Responses: 5,872; Total Annual Hours: 

56,411. (For policy questions regarding 

this collection contact Kristy Holtje at 

410–786–2209). 

Dated: December 16, 2014. 

Martique Jones, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2014–29739 Filed 12–18–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10241, CMS– 

R–305 and CMS–224–14] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services. 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 (the 

PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information (including each proposed 

extension or reinstatement of an existing 

collection of information) and to allow 

60 days for public comment on the 

proposed action. Interested persons are 

invited to send comments regarding our 

burden estimates 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. 

DATES: Comments must be received by 

February 17, 2015. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number (OCN). To be 

assured consideration, comments and 

recommendations must be submitted in 

any one of the following ways: 

1. Electronically. You may send 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) that are 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 ll, Room C4–26–05, 

7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

http://www.cms.hhs.gov/

PaperworkReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326. 

SUPPLEMENTARY INFORMATION: 

Contents 

This notice sets out a summary of the 

use and burden associated with the 

following information collections. More 

detailed information can be found in 

each collection’s supporting statement 

and associated materials (see 

ADDRESSES). 

CMS–10241 Survey of Retail Prices: 

Payment and Utilization Rates, and 

Performance Rankings 

CMS–R–305 External Quality Review 

(EQR) of Medicaid Managed Care 

Organizations (MCOs) and Supporting 

Regulations 

CMS–224–14 Federally Qualified 

Health Center Cost Report Form 

Under the Paperwork Reduction Act 

(PRA) (44 U.S.C. 3501–3520), federal 

agencies must obtain approval from the 

Office of Management and Budget 

(OMB) for each collection of 

information they conduct or sponsor. 

The term ‘‘collection of information’’ is 

defined in 44 U.S.C. 3502(3) and 5 CFR 

1320.3(c) and includes agency requests 

or requirements that members of the 

public submit reports, keep records, or 

provide information to a third party. 

Section 3506(c)(2)(A) of the PRA 

requires federal agencies to publish a 

60-day notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

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: Survey of Retail 

Prices: Payment and Utilization Rates, 

and Performance Rankings; Use: This 

study is divided into two parts. Part I 

focuses on the retail community 

pharmacy consumer prices. It also 

includes reporting by the states of 

payment and utilization rates for the 50 

most widely prescribed drugs, and 

comparing state drug payment rates 

with the national retail survey prices. 

(Effective July 1, 2013, CMS has 

suspended Part I of the survey, pending 

funding decisions.) Part II focuses on 

the retail community pharmacy 

ingredient costs. This segment surveys 

the average acquisition costs of all 

covered outpatient drugs purchased by 

retail community pharmacies. The 

prices will be updated on at least a 

monthly basis. Form Number: CMS– 

10241 (OMB control number 0938– 

1041); Frequency: Yearly and 

Occasionally; Affected Public: Private 

sector—Business or other for-profits and 

State, Local, or Tribal Governments; 

Number of Respondents: 30,051; Total 

Annual Responses: 30,051; Total 

Annual Hours: 15,765. (For policy 

questions regarding this collection 

contact: Lisa Ferrandi at 410–786–5445). 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: External Quality 

Review (EQR) of Medicaid Managed 

Care Organizations (MCOs) and 

Supporting Regulations; Use: State 

agencies must provide to the EQR 

organization (EQRO) information 

obtained through methods consistent 

with the protocols specified by CMS. 

This information is used by the EQRO 

to determine the quality of care 

furnished by an MCO. Since the EQR 

results are made available to the general 

public, this allows Medicaid/CHIP 

enrollees and potential enrollees to 

make informed choices regarding the 

selection of their providers. It also 

allows advocacy organizations, 

researchers, and other interested parties 

access to information on the quality of 

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