Federal Register / Vol. 87, No. 70 / Tuesday, April 12, 2022 / Notices 21661 

as well as any payments provided to 

such physicians. The submitted 

information facilitates various aspects of 

the program. The information collected 

through the registration process is used 

by CMS to validate registration for 

applicable manufacturers, applicable 

GPOs, covered recipients, and physician 

owners or investors that are registering 

for Open Payments. Details collected 

during the dispute resolution and 

correction process allows CMS to notify 

applicable manufacturers and 

applicable GPOs that a covered 

recipient or physician owner or investor 

is initiating a dispute regarding data 

submitted about them and allow CMS to 

relay the nature of the dispute. The 

assumptions documents submitted by 

applicable manufacturers or applicable 

GPOs assist CMS in providing guidance 

(for example, determining form and 

nature of payment categories, 

calculating the value of a payment, 

determining the date of payment, and 

reporting the terms of an ownership or 

investment interest). Form Number: 

CMS–10495 (OMB control number: 

0938–1237); Frequency: Annually; 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

1,612; Total Annual Responses: 1,612; 

Total Annual Hours: 1,920,534. (For 

policy questions regarding this 

collection contact Kathleen Ott at 410– 

786–4246.) 

Dated: April 7, 2022. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2022–07760 Filed 4–11–22; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10377 and 

CMS–10036] 

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 May 12, 2022. 

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/Paperwork

ReductionActof1995/PRA-Listing.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: Extension of a currently 

approved collection; Title of 

Information Collection: Student Health 

Insurance Coverage; Use: Under the 

Student Health Insurance Coverage 

Final Rule published March 21, 2012 

(77 FR 16453), student health insurance 

coverage is a type of individual health 

insurance coverage provided pursuant 

to a written agreement between an 

institution of higher education (as 

defined in the Higher Education Act of 

1965) and a health insurance issuer, and 

provided to students who are enrolled 

in that institution and their dependents. 

The Patient Protection and Affordable 

Care Act; HHS Notice of Benefit and 

Payment Parameters for 2017 Final Rule 

provided that, for policy years 

beginning on or after July 1, 2016, 

student health insurance coverage is 

exempt from the actuarial value (AV) 

requirements under section 1302(d) of 

the Affordable Care Act, but must 

provide coverage with an AV of at least 

60 percent. This provision also requires 

issuers of student health insurance 

coverage to specify in any plan 

materials summarizing the terms of the 

coverage the AV of the coverage and the 

metal level (or the next lowest metal 

level) the coverage would otherwise 

satisfy under § 156.140. This disclosure 

will provide students with information 

that allows them to compare the student 

health coverage with other available 

coverage options. Form Number: CMS– 

10377 (OMB Control Number 0938– 

1157); Frequency: Annually; Affected 

Public: Private Sector; Number of 

Respondents: 48; Total Annual 

Responses: 953,541; Total Annual 

Hours: 48. (For policy questions 

regarding this collection contact Russell 

Tipps at 301–492–4371). 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: IRF–PAI for the 

Collection of Data Pertaining to the 

Inpatient Rehabilitation Facility 

Prospective Payment System and 

Quality Reporting Program; Use: We are 

requesting an extension of the Inpatient 

Rehabilitation Facility-Patient 

Assessment Instrument (IRF–PAI) 

Version 4.0 that will be effective on 

October 1, 2022. On November 2, 2021, 

we issued a final rule (86 FR 62240) 

which finalized proposed modifications 

to the effective date for the reporting of 

measures and certain standardized 

patient assessment data in the Inpatient 

Rehabilitation Facility Quality 


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21662 Federal Register / Vol. 87, No. 70 / Tuesday, April 12, 2022 / Notices 

Reporting Program (IRF QRP). Per the 

final rule CMS will require IRFs to start 

collecting assessment data using IRF– 

PAI Version 4.0 beginning October 1, 

2022. 

The information collection request for 

IRF PAI 4.0 was re-approved on 

December 15, 2021 with an October 1, 

2022 implementation date. CMS is 

asking for an extension of the approved 

IRF–PAI Version 4.0, which expires on 

December 31, 2022. The burden 

associated with this requirement is staff 

time required to complete and encode 

the data from the IRF–PAI. The burden 

associated with collecting and 

transmitting the data is unaffected by 

the proposed extension to the 

assessment instrument. 

The IRF–PAI is required by the CMS 

as part of the Inpatient Rehabilitation 

Facility Prospective Payment System 

(IRF PPS). CMS uses the data to 

determine the payment for each 

Medicare Part A fee-for-service patient 

and Medicare Part C (Medicare 

Advantage) admitted to an inpatient 

rehabilitation unit or hospital. The IRF– 

PAI is also used to gather data for the 

IRF Quality Reporting Program (IRF 

QRP). Form Number: CMS–10036 (OMB 

control number: 0938–0842); Frequency: 

Annually; Affected Public: Private 

Sector: Business and for-profit and Notfor-profit, State, Local or Tribal 

Government and Federal Government; 

Number of Respondents: 1,122; Total 

Annual Responses: 411,622; Total 

Annual Hours: 704,747. (For policy 

questions regarding this collection, 

contact Ariel Adams at 410–786–8571.) 

Dated: April 7, 2022. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2022–07759 Filed 4–11–22; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Submission for OMB Review; U.S. 

Repatriation Program Forms (OMB#: 

0970–0474) 

AGENCY: Office of Human Services 

Emergency Preparedness and Response, 

Administration for Children and 

Families, HHS. 

ACTION: Request for public comment. 

SUMMARY: The Administration for 

Children and Families (ACF) is 

requesting a 3-year extension of the U.S. 

Repatriation Program forms (OMB 

#0970–0474, expiration 4/30/2022). 

There are several changes requested to 

the eight forms. Burden estimates have 

also been updated. 

DATES: Comments due within 30 days of 

publication. OMB must make a decision 

about the collection of information 

between 30 and 60 days after 

publication of this document in the 

Federal Register. Therefore, a comment 

is best assured of having its full effect 

if OMB receives it within 30 days of 

publication. 

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. You can also obtain 

copies of the proposed collection of 

information by emailing infocollection@

acf.hhs.gov. Identify all emailed 

requests by the title of the information 

collection. 

SUPPLEMENTARY INFORMATION: 

Description: The purpose of the U.S. 

Repatriation Program (Program) is to 

provide temporary assistance to eligible 

U.S. citizens and their dependents 

(repatriates) returned by the Department 

of State from a foreign country because 

of destitution, illness, war, threat of war, 

or a similar crisis, and who are without 

available resources, or (2) mental 

illness. Temporary assistance is 

provided upon their arrival in the 

United States and is available initially 

for up to 90 days from a repatriate’s date 

of arrival in the United States. 

Temporary assistance is provided in the 

form of a service loan and is repayable 

to the U.S. Government. 

Temporary assistance is defined in 42 

U.S.C. 1313(c) as money payments, 

medical care, temporary lodging, 

transportation, and other goods and 

services necessary for the health or 

welfare of individuals, including 

guidance, counseling, and other welfare 

services provided to them within the 

United States upon their arrival in the 

United States. Other goods and services 

may include clothes, food, assistance 

with obtaining identification (driver’s 

license, birth certificate), child care, and 

translation services. 

The ACF Office of Human Services 

Emergency Preparedness and Response 

(OHSEPR), at the U.S. Department of 

Health and Human Services (HHS), 

administers the Program. 

OHSEPR made changes to all eight 

forms to ensure the information 

collected aligns with Program statutes 

and regulations as well as the purpose 

and use of the form. Revisions include 

clarifying statutory authority and 

general instructions on completing and 

submitting the forms. These changes 

make the forms more user friendly. 

OHSEPR also reduced the burden hours 

to make them more accurate. 

The following is a description of the 

forms and the proposed revisions: 

Emergency Repatriation Eligibility 

Application (Form RR–01) 

The purpose of this form is for U.S. 

citizens and their dependents to request 

temporary assistance during an 

emergency repatriation. Proposed 

revisions include the following: 

• Changing the title of the form from 

‘Emergency and Group Processing 

Form’ to ‘Emergency Repatriation 

Eligibility Application’ 

• Adding the following information: 

Æ Date and time of applicant’s entry and 

exit to the Emergency Repatriation 

Center 

Æ Applicant’s flight information 

Æ Name and contact information for 

responsible person (if main U.S. 

citizen applicant is a minor) 

Æ Gender option (X) for applicant and 

dependents to align with Department 

of State gender information on 

passports 

Æ Option for applicants and dependents 

to provide alternative ID number 

(instead of passport number) 

Æ Needs assessment section to 

determine applicant’s needs 

Æ Details about quantity of temporary 

assistance requested 

Æ Language to signatory block to specify 

the meaning of signing the form 

Æ Materials/information provided to the 

repatriate 

• Removing eligibility determination 

question regarding availability of next 

of kin/friends to provide resources 

Emergency Repatriation 

Reimbursement Request (Form RR–02) 

The purpose of this form is for states 

to request reimbursement for emergency 

repatriation expenditures. Proposed 

revisions include the following: 

• Changing the title of the form from 

‘Emergency and Group Repatriation 

Financial Form’ to ‘Emergency 

Repatriation Reimbursement Request’ 

• Modifying information about location 

of service provision 

• Adding planning/training/exercise as 

a category for reimbursement 

• Clarifying instructions on 

documentation for allowable costs 


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