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[Federal Register Volume 78, Number 82 (Monday, April 29, 2013)]
[Notices]
[Pages 25089-25090]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-09948]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-1984-14, CMS-10115, CMS-10130, and CMS-
10479]

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: Revision of a currently 
approved collection; Title of Information Collection: Hospice Facility 
Cost Report; Use: In accordance with sections 1815(a), 1833(e) and 
1861(v)(1)(A) of the Social Security Act (the Act), providers of 
service in the Medicare program are required to submit annual 
information to achieve reimbursement for health care services rendered 
to Medicare beneficiaries. In addition, 42 CFR 413.20(b) specifies that 
cost reports are required from providers on an annual basis. Such cost 
reports are required to be filed with the provider's Medicare 
contractor. The functions of the Medicare contractor are described in 
section 1816 of the Act. Section 3132 of the Affordable Care Act 
requires that CMS collect appropriate data and information to 
facilitate hospice payment reform. Form Number: CMS-1984-14 (OCN: 0938-
0758); Frequency: Yearly; Affected Public: Private sector (business or 
other for-profit and not-for-profit institutions); Number of 
Respondents: 2,751; Total Annual Responses: 2,751; Total Annual Hours: 
517,188. (For policy questions regarding this collection contact Gail 
Duncan at 410-786-7278. For all other issues call 410-786-1326.)
    2. Type of Information Collection Request: Reinstatement with 
change of a previously approved collection; Title of Information 
Collection: Federal Reimbursement of Emergency Health Services 
Furnished to Undocumented Aliens, Section 1011 of the Medicare 
Prescription Drug, Improvement and Modernization Act of 2003 (MMA). 
Use: Section 1011 of the MMA provides that the Secretary will establish 
a process (i.e., enrollment and claims payment) for eligible providers 
to request payment. The Secretary must directly pay hospitals, 
physicians and ambulance providers (including Indian Health Service, 
Indian Tribe and Tribal organizations) for their otherwise un-
reimbursed costs of providing services required by section 1867 of the 
Social Security Act and related hospital inpatient, outpatient and 
ambulance services. CMS will use the application information to 
administer this health services program and establish an audit process. 
Form Number: CMS-10115 (OCN: 0938-0929); Frequency: Once and 
occasionally; Affected Public: Private sector (business or other for-
profit and not-for-profit institutions); Number of Respondents: 10,000; 
Total Annual Responses: 10,000; Total Annual Hours: 5,000. (For policy 
questions regarding this collection contact Fred Rooke at 404-562-7502. 
For all other issues call 410-786-1326.)
    3. Type of Information Collection Request: Reinstatement without 
change of a previously approved collection; Title of Information 
Collection: Federal Reimbursement of Emergency Health Services 
Furnished to Undocumented Aliens, Section 1011 of the Medicare 
Prescription Drug, Improvement and Modernization Act of 2003 (MMA): 
``Section 1011 Provider Payment Determination'' and ``Request for 
Section 1011 Hospital On-Call Payments to Physicians'' Forms. Use: 
Section 1011 of the MMA requires that the Secretary establish a process 
under which eligible providers (certain hospitals, physicians and 
ambulance providers) may request payment for (claim) their otherwise 
un-reimbursed costs of providing eligible services. The Secretary must 
make quarterly payments directly to such providers. The Secretary must 
also implement measures to ensure that inappropriate, excessive, or 
fraudulent payments are not made under Section 1011, including 
certification by providers of the veracity of their requests for 
payment. Both forms have been established to address the statutory 
requirements outlined above. Form Number: CMS-10130 (OCN: 0938-0952); 
Frequency: Occasionally; Affected Public: Private sector (business or 
other for-profit and not-for-profit institutions); Number of 
Respondents:

[[Page 25090]]

12,037; Total Annual Responses: 300,148; Total Annual Hours: 75,037. 
(For policy questions regarding this collection contact Fred Rooke at 
404-562-7205. For all other issues call 410-786-1326.)
    4. Type of Information Collection Request: New Collection; Title of 
Information Collection: Evaluation of the Multi-Payer Advanced Primary 
Care Practice (MAPCP) Demonstration Focus Group Protocols; Use: On 
September 16, 2009, the Department of Health and Human Services 
announced the establishment of the Multi-payer Advanced Primary Care 
Practice (MAPCP) Demonstration, under which Medicare joined Medicaid 
and private insurers as a payer participant in state-sponsored patient-
centered medical home (PCMH) initiatives. CMS selected eight states to 
participate in this demonstration: Maine, Vermont, Rhode Island, New 
York, Pennsylvania, North Carolina, Michigan, and Minnesota. CMS is 
proposing to conduct in-person focus groups with Medicare and Medicaid 
beneficiaries and their caregivers to more thoroughly understand 
patients' experiences with their PCMHs and how well their PCMHs are 
serving their needs.
    The focus groups will provide CMS with answers to fundamental 
``what, how, and why'' questions about beneficiaries' experiences with 
care and access to and coordination of care. The information obtained 
via in-person, focus groups will be utilized by CMS for the evaluation 
of the MAPCP Demonstration. The focus group data will be collected to 
supplement other qualitative and quantitative analyses from primary and 
secondary data sources by providing data on context, structure, and 
process, as well as select aspects of the key outcomes. The data 
gathered from the interviews will allow for more complete 
interpretation of the quantitative claims and other data analysis by 
taking into account the unique perspectives of beneficiaries. Form 
Number: CMS-10479 (OCN: 0938-NEW); Frequency: Annually; Affected 
Public: Individuals and households; Number of Respondents: 768; Total 
Annual Responses: 384; Total Annual Hours: 1,152. (For policy questions 
regarding this collection contact Suzanne Goodwin at 410-786-0226. 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 June 28, 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.

    Dated: April 23, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2013-09948 Filed 4-26-13; 8:45 am]
BILLING CODE 4120-01-P
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