[Federal Register Volume 70, Number 174 (Friday, September 9, 2005)]
[Notices]
[Page 53665]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-17734]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-416 and CMS-10156]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

    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) 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 functions; (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: Annual Early and 
Periodic Screening, Diagnostic and Treatment Services (EPSDT) 
Participation Report; Form No.: CMS-416 (OMB <greek-i>0938-0354); Use: 
States are required to submit an annual report on the provision of 
EPSDT services to CMS pursuant to section 1902(1)(43)(D) of the Social 
Security Act. These reports provide CMS with data necessary to assess 
the effectiveness of State EPSDT programs, to determine a state's 
results in achieving its participation goal, and to respond to 
inquiries; Frequency: Annually; Affected Public: State, local or tribal 
Government; Number of Respondents: 56; Total Annual Responses: 56; 
Total Annual Hours: 1,568.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Retiree Drug 
Subsidy (RDS) Application and Instructions; Use: Under the Medicare 
Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 and 
implementing regulations at 42 CFR subpart R plan sponsors (employers, 
unions) who offer prescription drug coverage to their qualified covered 
retirees are eligible to receive a 28% tax-free subsidy for allowable 
drug costs. In order to qualify, plan sponsors must submit a complete 
application to CMS with a list of retirees for whom it intends to 
collect the subsidy; Form Number: CMS-10156 (OMB<greek-i>: 0938-0957); 
Frequency: Quarterly, Monthly, Annually; Affected Public: Business or 
other for-profit, Not-for-profit institutions, Federal, State, local 
and/or tribal Government; Number of Respondents: 50,000; Total Annual 
Responses: 50,000; Total Annual Hours: 2,025,000.
    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/regulations/pra/, or e-mail 
your request, including your address, phone number, OMB number, and CMS 
document identifier, to <a href="/cdn-cgi/l/email-protection#297948594c5b5e465b42694a445a0741415a074e465f"><span class="__cf_email__" data-cfemail="ce9eafbeabbcb9a1bca58eada3bde0a6a6bde0a9a1b8">[email protected]</span></a>, or call the Reports 
Clearance Office on (410) 786-1326.
    Written comments and recommendations for the proposed information 
collections must be mailed within 60 days of this notice to the address 
below: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: Melissa Musotto, Room 
C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: August 25, 2005.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 05-17734 Filed 9-8-05; 8:45 am]
BILLING CODE 4120-01-P


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