32270 Federal Register / Vol. 86, No. 115 / Thursday, June 17, 2021 / Notices 

respond to inquiries from Congress, 

oversight agencies, and the public about 

Part C and D SOs. The validated data 

also allows CMS to effectively monitor 

and compare the performance of SOs 

over time. Validated plan-reported data 

may be used for Star Ratings, Display 

measures and other performance 

measures. Additionally, SOs can take 

advantage of the DV process to 

effectively assess their own performance 

and make improvements to their 

internal operations and reporting 

processes. Form Number: CMS–10305 

(OMB control number: 0938–1115); 

Frequency: Yearly; Affected Public: 

State, Local, or Tribal Governments; 

Number of Respondents: 761; Total 

Annual Responses: 761; Total Annual 

Hours: 20,945. (For policy questions 

regarding this collection contact 

Chanelle Jones at 410–786–8008.) 

Dated: June 14, 2021. 

William N. Parham, III 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2021–12835 Filed 6–16–21; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–417 and CMS– 

209] 

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 July 19, 2021. 

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, you may make your request 

using one of following: 

1. Access CMS’ website address at 

website address at: https://

www.cms.gov/Regulations-andGuidance/Legislation/ 

PaperworkReductionActof1995/PRAListing.html. 

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: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: Hospice 

Request for Certification and Supporting 

Regulations; Use: The Hospice Request 

for Certification Form is the 

identification and screening form used 

to initiate the certification process and 

to determine if the provider has 

sufficient personnel to participate in the 

Medicare program. The CMS–417 form 

is completed by existing hospices at the 

time of their recertification surveys, to 

update their certification information. 

Form Number: CMS–417 (OMB Control 

number: 0938–0313); Frequency: 

Annually; Affected Public: Private 

Sector—Business or other for-profits; 

Number of Respondents: 2,059; Total 

Annual Responses: 2,059; Total Annual 

Hours: 1,544. (For policy questions 

regarding this collection contact 

Caroline Gallaher at 410–786–8705.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Laboratory 

Personnel Report (CLIA) and Supporting 

Regulations; Use: The information 

collected on this survey form is used in 

the administrative pursuit of the 

Congressionally-mandated program 

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. The 

surveyor will then use this information 

in choosing a sample of personnel to 

verify compliance with the personnel 

requirements. Information on personnel 

qualifications of all technical personnel 

is needed to ensure the sample is 

representative of the entire laboratory. 

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: 19,163; Total 

Annual Responses: 9,582; Total Annual 

Hours: 4,791. (For policy questions 

regarding this collection contact 

Kathleen Todd at 410–786–3385.) 

Dated: June 14, 2021. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2021–12807 Filed 6–16–21; 8:45 am] 

BILLING CODE 4120–01–P 


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