Federal Register / Vol. 74, No. 48 / Friday, March 13, 2009 / Notices 10917 

Dated: March 5, 2009. 

Maryam I. Daneshvar, 

Acting Reports Clearance Officer, Centers for 

Disease Control and Prevention. 

[FR Doc. E9–5489 Filed 3–12–09; 8:45 am] 

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DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–R–305, CMS– 

643, CMS–359/360/R–55 and CMS–10277] 

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: External Quality 

Review Protocols; Use: The results of 

Medicare reviews, Medicare 

accreditation services, and Medicaid 

external quality reviews will be used by 

States in assessing the quality of care 

provided to Medicaid beneficiaries by 

managed care organizations and to 

provide information on the quality of 

care provided to the general public 

upon request. Form Number: CMS–R– 

305 (OMB#: 0938–0786); Frequency: 

Reporting—Yearly; Affected Public: 

State, Local or Tribal Governments; 

Number of Respondents: 40; Total 

Annual Responses: 40; Total Annual 

Hours: 520,000. (For policy questions 

regarding this collection contact Gary B. 

Jackson at 410–786–1218. For all other 

issues call 410–786–1326.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Hospice Survey 

and Deficiencies Report; Use: In order to 

participate in the Medicare program, a 

hospice must meet certain Federal 

health and safety conditions of 

participation. This form is used by State 

surveyors to record data about a 

hospice’s compliance with these 

conditions of participation in order to 

initiate the certification or 

recertification process. Form Number: 

CMS–643 (OMB#: 0938–0379); 

Frequency: Reporting—Yearly; Affected 

Public: State, Local or Tribal 

Governments; Number of Respondents: 

3377; Total Annual Responses: 1130; 

Total Annual Hours: 1130. (For policy 

questions regarding this collection 

contact Kim Roche at 410–786–3524. 

For all other issues call 410–786–1326.) 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Comprehensive 

Outpatient Rehabilitation Facility 

(CORF) Eligibility and Survey Forms 

and Information Collection 

Requirements at 42 CFR 485.54 through 

485.66; Use: In order to participate in 

the Medicare program as a CORF, 

providers must meet Federal conditions 

of participation. The certification form 

is needed to determine if providers meet 

at least preliminary requirements. The 

survey form is used to record provider 

compliance with the individual 

conditions and report findings to CMS. 

Form Number: CMS–359/360/R–55 

(OMB#: 0938–0267); Frequency: 

Reporting—Occasionally; Affected 

Public: Private Sector: Business or other 

for-profits; Number of Respondents: 

476; Total Annual Responses: 60; Total 

Annual Hours: 223,285. (For policy 

questions regarding this collection 

contact Georgia Johnson at 410–786– 

6859. For all other issues call 410–786– 

1326.) 

4. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Hospice 

Conditions of Participation and 

Supporting Regulations in 42 CFR 

418.52, 418.54, 418.56, 418.58, 418.60, 

418.64, 418.66, 418.70, 418.72, 418.74, 

418.76, 418.78, 418.100, 418.106, 

4118.108, 418.110, 418.112, and 

418.114; Use: The Conditions of 

Participation and accompanying 

requirements are used by Federal and 

State surveyors as a basis for 

determining whether a hospice qualifies 

for approval or re-approval under 

Medicare. The healthcare industry and 

CMS believe that the availability of the 

records and general content of records 

as specified in the Conditions of 

Participation final rule (72 FR 32088), is 

standard medical practice, and is 

necessary in order to ensure the wellbeing and safety of patients and 

professional treatment accountability. 

Form Number: CMS–10277 (OMB#: 

0938–New); Frequency: Reporting and 

Recordkeeping—Yearly; Affected 

Public: Business or other for-profit and 

Not-for-profit institutions; Number of 

Respondents: 2,872; Total Annual 

Responses: 1,808,345; Total Annual 

Hours: 2,152,396. (For policy questions 

regarding this collection contact 

Danielle Shearer at 410–786–6617. 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 

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 May 12, 2009: 

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 ll, Room C4–26–05, 

7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: March 9, 2009. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E9–5457 Filed 3–12–09; 8:45 am] 

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