Federal Register / Vol. 90, No. 2 / Friday, January 3, 2025 / Notices 321 

with regard to regulation of laboratories 

participating in CLIA. The surveyor will 

provide the laboratory with the CMS– 

209 form. While the surveyor performs 

other aspects of the survey, the 

laboratory will complete the CMS–209 

by recording the personnel data needed 

to support their compliance with the 

personnel requirements of CLIA. For 

this submission, we are making minor 

revisions to the collection instrument. 

We revised the instructions for clarity 

and removed the references to specific 

regulations. Form Number: CMS–209 

(OMB control number 0938–0151); 

Frequency: Biennially; Affected Public: 

Private Sector—State, Local, or Tribal 

Governments; and Federal Government; 

Number of Respondents: 16,404; Total 

Annual Responses: 8,202; Total Annual 

Hours: 4,101. (For policy questions 

regarding this collection contact Penny 

Keller at 410–786–2035.) 

William N. Parham, III, 

Director, Division of Information Collections 

and Regulatory Impacts, Office of Strategic 

Operations and Regulatory Affairs. 

[FR Doc. 2024–31553 Filed 1–2–25; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10565 and 

CMS–1763] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, Health and Human 

Services (HHS). 

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 

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 

the necessity and utility of the proposed 

information collection for the proper 

performance of the agency’s functions, 

the accuracy of the estimated burden, 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected, and the use of automated 

collection techniques or other forms of 

information technology to minimize the 

information collection burden. 

DATES: Comments must be received by 

March 4, 2025. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number. 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, please access the CMS PRA 

website by copying and pasting the 

following web address into your web 

browser: https://www.cms.gov/ 

Regulations-and-Guidance/Legislation/ 

PaperworkReductionActof1995/PRAListing. 

FOR FURTHER INFORMATION CONTACT: 

William N. Parham at (410) 786–4669. 

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–10565 Medicare Advantage 

Model of Care Submission 

Requirements 

CMS–1763 Request for Termination of 

Medicare Premium Part A, Part B, or 

Part B Immunosuppressive Drug 

Coverage (Part B–ID) and Supporting 

Statute and Regulations 

Under the 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 Collections 

1. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Medicare 

Advantage Model of Care Submission 

Requirements; Use: Section 1859(f)(7) of 

the Act and 42 CFR 422.101(f)(3) 

requires that all SNP MOCs be approved 

by NCQA. This approval is based on 

NCQA’s evaluation of SNPs’ MOC 

narratives using MOC scoring 

guidelines. Section 50311 of the BBA of 

2018 modified the MOC requirements 

for C–SNPs in section 1859 (f)(5)(B)(i-v) 

of the Act, requiring them to submit on 

an annual basis. The BBA mandated 

additional changes for C–SNPs related 

to care management, HRAs, 

individualized care plans, a minimum 

benchmark for scoring, etc., for which 

CMS has applied these requirements to 

all SNP types. 

SNPs will submit initial and renewal 

MOCs as well as summaries of any 

substantive off-cycle MOC changes to 

CMS through HPMS. This is the 

platform that CMS uses to coordinate 

communication and the collection of 

information from MAOs. 

NCQA and CMS will use information 

collected in the SNP Application HPMS 

module to review and approve MOC 

narratives in order for an MAO to offer 

a new SNP in the upcoming calendar 

year(s). This information is used by 

CMS as part of the MA SNP application 

process. NCQA and CMS will use 

information collected in the Renewal 

Submission section of the HPMS MOC 

module to review and approve the MOC 

narrative for the SNP to receive a new 

approval period and operate in the 

upcoming calendar year(s). Form 

Number: CMS–10565 (OMB control 

number 0938–1296); Frequency: 

Occasionally; Affected Public: Private 

Sector, Business or other for-profits; 

Number of Respondents: 2,088; Total 

Annual Responses: 2,088; Total Annual 

Hours: 8,638. (For policy questions 

regarding this collection contact Daniel 


lotter on DSK11XQN23PROD with NOTICES1
322 Federal Register / Vol. 90, No. 2 / Friday, January 3, 2025 / Notices 

Lehman at 410–786–8929 or 

daniel.lehman@cms.hhs.gov.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Request for 

Termination of Medicare Premium Part 

A, Part B, or Part B Immunosuppressive 

Drug Coverage (Part B–ID) and 

Supporting Statute and Regulations; 

Use: Sections 1818(c)(5), 1818A(c)(2)(B) 

and 1838(b)(1) of the Act and 

corresponding regulations at 42 CFR 

406.28(a) and 407.27(c) require that a 

Medicare enrollee wishing to 

voluntarily terminate Part B or premium 

Part A coverage file a written request 

with CMS or SSA. Pursuant to 1838(h) 

of the Act and the corresponding 

regulation at 42 CFR 407.62(a), 

individuals wishing to terminate their 

Part B–ID coverage must notify SSA. 

The statute and regulations also specify 

when coverage ends based upon the 

date the request for termination is filed. 

The CMS–1763 is the form used by 

individuals who wish to terminate their 

Medicare Part A, Part B or Part B–ID. 

This 2024 iteration is a revision that 

does not propose any program changes. 

Per the Office of Communication’s plain 

language suggestion, the title has been 

updated to ‘‘Request for Termination of 

Medicare Premium Part A, Part B, or 

Part B Immunosuppressive Drug 

Coverage (Part B–ID).’’ The 2024 

submission saw an increase in the 

burden due to utilization of the form 

and improvement in the accuracy of the 

data exchanges between CMS and SSA. 

Updated wage information for a Federal 

Government employee is also 

responsible for part of the increase. 

Form Number: CMS–1763 (OMB control 

number 0938–0025); Frequency: 

Biennially; Affected Public: Private 

Sector—State, Local, or Tribal 

Governments; and Federal Government; 

Number of Respondents: 197,518; Total 

Annual Responses: 197,518; Total 

Annual Hours: 33,578. (For policy 

questions regarding this collection 

contact Tyrissa Woods at 410–786–0286 

or tyrissa.woods@cms.hhs.gov.) 

William N. Parham, III, 

Director, Division of Information Collections 

and Regulatory Impacts, Office of Strategic 

Operations and Regulatory Affairs. 

[FR Doc. 2024–31567 Filed 1–2–25; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

[CFDA Number(s): 93.645] 

Notice of Allotment Percentages to 

States for Child Welfare Services State 

Grants; Correction 

AGENCY: Administration for Children 

and Families, Department of Health and 

Human Services. 

ACTION: Notice; correction. 

SUMMARY: The Administration for 

Children and Families published a 

document in the Federal Register 

published Wednesday, December 4, 

2024, concerning notice of Allotment 

Percentages to States for Child Welfare 

Services State Grants. The formula used 

to calculate the allotment percentages 

for each state was not applied correctly. 

Although the percentage for the State of 

Alabama percentage was calculated 

correctly, the formula used to calculate 

the allotment percentages was not 

correctly applied to the remaining 

states. 

FOR FURTHER INFORMATION CONTACT: 

Sona Cook, 214–767–2973. 

SUPPLEMENTARY INFORMATION: 

Correction 

In the Federal Register of December 4, 

2024, in FR Doc. 2024–28398, on page 

96256, in the second and third columns, 

the ALLOTMENT table contained an 

incorrect formula for the Allotment 

Percentages to States for Child Welfare 

Services State Grants. The updated 

ALLOTMENT table with the correct 

allotment percentage for each State is as 

follows: 

ALLOTMENT ** 

State Percentage 

Alabama ................................ 61.01 

Alaska * ................................. 48.58 

Arizona .................................. 55.49 

Arkansas ............................... 58.66 

California ............................... 41.38 

Colorado ............................... 43.03 

Connecticut ........................... 35.99 

Delaware ............................... 52.51 

District of Columbia 1 ............ 30.00 

Florida ................................... 51.25 

Georgia ................................. 56.80 

Hawaii * ................................. 52.67 

Idaho ..................................... 57.12 

Illinois .................................... 48.26 

Indiana .................................. 55.74 

Iowa ...................................... 54.48 

Kansas .................................. 53.25 

Kentucky ............................... 60.14 

Louisiana .............................. 57.73 

Maine .................................... 53.63 

ALLOTMENT **—Continued 

State Percentage 

Maryland ............................... 46.19 

Massachusetts ...................... 35.02 

Michigan ............................... 56.10 

Minnesota ............................. 47.65 

Mississippi ............................ 64.18 

Missouri ................................ 55.55 

Montana ................................ 53.73 

Nebraska .............................. 49.64 

Nevada ................................. 52.74 

New Hampshire .................... 43.28 

New Jersey ........................... 41.18 

New Mexico .......................... 60.32 

New York .............................. 41.19 

North Carolina ...................... 55.66 

North Dakota ........................ 47.82 

Ohio ...................................... 55.81 

Oklahoma ............................. 56.84 

Oregon .................................. 51.55 

Pennsylvania ........................ 50.59 

Rhode Island ........................ 51.41 

South Carolina ...................... 58.86 

South Dakota ........................ 47.83 

Tennessee ............................ 55.38 

Texas .................................... 52.76 

Utah ...................................... 54.33 

Vermont ................................ 52.28 

Virginia .................................. 47.50 

Washington ........................... 42.58 

West Virginia ........................ 62.16 

Wisconsin ............................. 53.26 

Wyoming ............................... 42.78 

America Samoa .................... 70.00 

Guam .................................... 70.00 

Puerto Rico ........................... 70.00 

N. Mariana Islands ............... 70.00 

Virgin Islands ........................ 70.00 

Anthony Petruccelli, 

Senior Grants Policy Specialist, Office of 

Grants Policy, Office of Administration. 

[FR Doc. 2024–31515 Filed 1–2–25; 8:45 am] 

BILLING CODE 4184–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Food and Drug Administration 

[Docket No. FDA–2024–N–5784] 

Interested Parties Meeting: 

Implementation of the Best 

Pharmaceuticals for Children Act and 

Pediatric Research Equity Act 

AGENCY: Food and Drug Administration, 

HHS. 

ACTION: Notice of public meeting; 

request for comments. 

SUMMARY: The Food and Drug 

Administration’s (FDA, Agency, or we) 

Office of Pediatric Therapeutics, the 

Center for Drug Evaluation and 

Research, and the Center for Biologics 

Evaluation and Research are 

announcing a public meeting entitled 

‘‘Interested Parties Meeting: 


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