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[Federal Register Volume 75, Number 127 (Friday, July 2, 2010)]
[Notices]
[Pages 38530-38531]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-16008]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-297 and CMS-10209]

Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

AGENCY: Centers for Medicare & Medicaid Services.
    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: Extension of a currently 
approved collection; Title of Information Collection: Request for 
Employment Information; Use: Section 1837(i) of the Social Security Act 
provides for a special enrollment period for individuals who delay 
enrolling in Medicare Part B because they are covered by a group health 
plan based on their own or a spouse's current employment status. When 
these individuals apply for Medicare Part B,

[[Page 38531]]

they must provide proof that the group health plan coverage is (or was) 
based on current employment status. This form is used by the Social 
Security Administration to obtain information from employers regarding 
whether a Medicare beneficiary's coverage under a group health plan is 
based on current employment status. Form Number: CMS-R-297 
(OMB: 0938-0787); Frequency: Once; Affected Public: Private 
Sector: Business or other for-profits and Not-for-profit institutions; 
Number of Respondents: 5,000; Total Annual Responses: 5,000; Total 
Annual Hours: 1250. (For policy questions regarding this collection 
contact Kevin Simpson at 410-786-0017. For all other issues call 410-
786-1326.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Chronic Care 
Improvement Program and Medicare Advantage Quality Improvement Project; 
Use: The Social Security Act, section 1852 e(1), (2) and (3)(a)(i), and 
CFR 42, 422.152 describe CMS' regulatory authority to require each 
Medicare Advantage Organization (other than Medicare Advantage (MA) 
private fee for service and MSA plans) that offers one or more MA plans 
to have an ongoing quality assessment and performance improvement 
program. This program must include measuring performance using standard 
measures required by CMS and report its performance to CMS. Form 
Number: CMS-10209 (OMB: 0938-1023); Frequency: Yearly; 
Affected Public: Business or other for-profits and Not-for-profit 
institutions; Number of Respondents: 394; Total Annual Responses: 788; 
Total Annual Hours: 18,912. (For policy questions regarding this 
collection contact Darlene Anderson at 410-786-9824. 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 
e-mail 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.
    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 August 16, 2010.

OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-6974, e-mail: OIRA_submission@omb.eop.gov.

    Dated: June 28, 2010.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 2010-16008 Filed 7-1-10; 8:45 am]
BILLING CODE 4120-01-P
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