Federal Register / Vol. 90, No. 9 / Wednesday, January 15, 2025 / Notices 3871 

toxicological profiles: benzene, carbon 

disulfide, cyanide, thallium, and 

chlorinated dibenzo-p-dioxins. This 

action is necessary as this is the 

opportunity for members of the public 

and organizations to submit comments 

on drafts of the profiles. The intended 

effect of this action is to ensure that the 

public can note any pertinent additional 

information or reports on studies about 

the health effects caused by exposure to 

the substances covered in these five 

profiles for review. 

We have received requests from 

interested parties to extend the 

comment period. Therefore, we are 

extending the comment period for an 

additional seven days. 

Donata Green, 

Associate Director, Office of Policy, Planning 

and Partnerships, Agency for Toxic 

Substances and Disease Registry. 

[FR Doc. 2025–00827 Filed 1–14–25; 8:45 am] 

BILLING CODE 4163–70–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10330 and 

CMS–10416] 

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 17, 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–10330 Notice of Rescission of 

Coverage and Disclosure 

Requirements for Patient Protection 

under the Affordable Care Act 

CMS–10416 Blueprint for Approval of 

State-based Exchange 

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: Extension of a currently 

approved collection; Title of 

Information Collection: Notice of 

Rescission of Coverage and Disclosure 

Requirements for Patient Protection 

under the Affordable Care Act; Use: 

Section 2712 of the Public Health 

Service Act (PHS Act), as added by the 

Affordable Care Act, contains a 

rescission notice. The No Surprises Act, 

enacted as part of the Consolidated 

Appropriations Act, 2021, sunset the 

patient protections related to choice of 

health care professional under section 

2719A of the PHS Act and recodified 

these patient protections in newly 

added section 9822 of the Internal 

Revenue Code, section 722 of the 

Employee Retirement Income Security 

Act, and section 2799A–7 of the PHS 

Act and extended the applicability of 

these provisions to grandfathered health 

plans for plan years beginning on or 

after January 1, 2022. The rescission 

notice will be used by health plans and 

issuers to provide advance notice to 

certain individuals that their coverage 

may be rescinded as a result of fraud or 

intentional misrepresentation of 

material fact. The patient protection 

notification will be used by certain 

health plans and issuers to inform 

individuals of their right to choose a 

primary care provider or pediatrician 

and to use obstetrical/gynecological 

services without prior authorization. 

The related provisions are finalized in 

the 2015 final regulations titled ‘‘Final 

Rules under the Affordable Care Act for 

Grandfathered Plans, Preexisting 

Condition Exclusions, Lifetime and 

Annual Limits, Rescissions, Dependent 

Coverage, Appeals, and Patient 

Protections’’ (80 FR 72192, November 

18, 2015) and 2021 interim final 

regulations titled ‘‘Requirements 

Related to Surprise Billing; Part I’’ (86 

FR 36872, July 13, 2021). Form Number: 

CMS–10330 (OMB control number 

0938–1094); Annually; Affected Public: 

State, Local, or Tribal Governments, 

Private Sector; Number of Respondents: 

82,638; Total Annual Responses: 

13,741,303; Total Annual Hours: 10. 

(For policy questions regarding this 


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3872 Federal Register / Vol. 90, No. 9 / Wednesday, January 15, 2025 / Notices 

collection, contact Adam Pellillo at 

667–290–9621.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Blueprint for 

Approval of State-based Exchange; Use: 

The Patient Protection and Affordable 

Care Act (ACA) and its implementing 

regulations provide states with 

flexibility in the design and operation of 

Exchanges to ensure states are 

implementing Exchanges that best meet 

the needs of their consumers. States can 

choose to establish and operate a Statebased Exchange (SBE) or a State-based 

Exchange on the Federal Platform (SBE– 

FP). To ensure a state can operate a 

successful and compliant SBE or SBE– 

FP, it is critical that states provide CMS 

with a complete and thorough Exchange 

Blueprint Application, Declaration of 

Intent Letter, and attest to demonstrate 

operational readiness. The information 

collected from states will be used by 

CMS, IRS, SSA and reviewed by other 

Federal agencies to determine if a state 

can implement a complete and fully 

operational Exchange. Form Number: 

CMS–10416 (OMB control number: 

0938–1172); Frequency: Annually; 

Affected Public: State, Local, or Tribal 

governments; Number of Respondents: 

2; Total Annual Responses: 21; Total 

Annual Hours: 106. (For policy 

questions regarding this collection 

contact Tiffany Y. Animashaun at 

Tiffany.Animashaun@cms.hhs.gov.) 

William N. Parham, III, 

Director, Division of Information Collections 

and Regulatory Impacts, Office of Strategic 

Operations and Regulatory Affairs. 

[FR Doc. 2025–00695 Filed 1–14–25; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–R–71 and CMS– 

855B] 

Agency Information Collection 

Activities: Submission for OMB 

Review; 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 

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 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 on the collection(s) of 

information must be received by the 

OMB desk officer by February 14, 2025. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. 

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 Parham at (410) 786–4669. 

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: Extension of a currently 

approved collection; Title of 

Information Collection: Quality 

Improvement Organization (QIO) 

Assumption of Responsibilities and 

Supporting Regulations; Use: The Peer 

Review Improvement Act of 1982 

amended Title XI of the Social Security 

Act to create the Utilization and Quality 

Control Peer Review Organization (PRO) 

program which replaces the Professional 

Standards Review Organization (PSRO) 

program and streamlines peer review 

activities. The term PRO has been 

renamed Quality Improvement 

Organization (QIO). This information 

collection describes the review 

functions to be performed by the QIO. 

It outlines relationships among QIOs, 

providers, practitioners, beneficiaries, 

intermediaries, and carriers. Form 

Number: CMS–R–71 (OMB control 

number: 0938–0445); Frequency: Yearly; 

Affected Public: Business or other forprofit and Not-for-profit institutions; 

Number of Respondents: 6,120; Total 

Annual Responses: 502,246; Total 

Annual Hours: 1,091,597. (For policy 

questions regarding this collection 

contact Cheryl Lehane at 617–461– 

4888.) 

2. Type of Information Collection 

Request: Reinstatement with change of a 

previously approved collection; Title of 

Information Collection: Medicare 

Enrollment Application for Clinics/ 

Group Practices and Other Suppliers; 

Use: Various sections of the Act, the 

United States Code (U.S.C.), Internal 

Revenue Service (IRS) Code, and the 

CFR require providers and suppliers to 

furnish information concerning the 

amounts due and the identification of 

individuals or entities that furnish 

medical services to beneficiaries before 

payment can be made. The Form CMS– 

855B application is submitted when the 

applicant first requests Medicare 

enrollment. The application is used by 

the MACs to collect data to ensure the 

applicant has the necessary credentials 

to provide the health care services for 

which they intend to bill Medicare; this 

includes data that allows the Medicare 

contractor to correctly price, process, 

and pay the applicant’s claims. It also 

gathers information that enables MACs 

to ensure that the supplier is neither 

excluded from the Medicare program 

nor debarred, suspended, or excluded 

from any other Federal agency or 

program. The application is also used by 


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