58708 Federal Register / Vol. 70, No. 194 / Friday, October 7, 2005 / Notices 

Annual Responses: 125,000; Total 

Annual Hours: 62,500. 

To obtain copies of the supporting 

statement and any related forms for 

these 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 Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office on (410) 786–

1326. 

To be assured consideration, 

comments and recommendations for the 

proposed information collections must 

be received by the OMB Desk Officer at 

the address below, no later than 5 p.m. 

on November 7, 2005. 

OMB Human Resources and Housing 

Branch, Attention: CMS Desk Officer, 

New Executive Office Building, Room 

10235, Washington, DC 20503. 

Dated: September 29, 2005. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 05–20101 Filed 10–6–05; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–1557 and CMS–

1880/1882 and CMS 10142] 

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: Survey Report 

Form Clinical Laboratory Improvement 

Amendments (CLIA) and supporting 

regulations under 42 CFR 493.1–

493.2001; Form Number: CMS–1557 

(OMB#: 0938–0544); Use: This form is 

used by the State agency to determine 

a laboratory’s compliance with CLIA. 

This information is needed for a 

laboratory’s CLIA certification and 

recertification; Frequency: 

Recordkeeping and Reporting—

Biennially; Affected Public: Business or 

other for-profit, Not-for-profit 

institutions, Federal, State, Local or 

Tribal Government; Number of 

Respondents: 25,000; Total Annual 

Responses: 12,500; Total Annual Hours: 

6,250. 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: The Request for 

Certification as a Supplier of Portable XRay Services and Portable X-Ray Survey 

Report Form under the Medicare and 

Medicaid Program—Portable X-Ray 

Survey Report and Supporting 

Regulations under 42 CFR 486.100–

486.110; Form Number: CMS–1880/ 

1882 (OMB#: 0938–0027); Use: The 

Medicare program requires portable Xray suppliers to be surveyed for health 

and safety standards. The CMS–1882 is 

the survey form that records survey 

results. The CMS–1880 is used by the 

surveyor to determine if a portable X-ray 

applicant meets the eligibility 

requirements. This information serves 

as a screen for the State survey agency 

to determine if the portable X-ray 

supplier has the basic capabilities to 

participate in the Medicare program. 

CMS will use this information to make 

certification decisions; Frequency: 

Reporting—On occasion; Affected 

Public: Business or other for-profit; 

Number of Respondents: 655; Total 

Annual Responses: 98; Total Annual 

Hours: 172. 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Bid Pricing Tool 

(BPT) for Medicare Advantage and 

Prescription Drug Plans (PDP) contained 

in 42 Code of Federal Regulation (CFR): 

422.250, 422.252, 422.254, 422.256, 

422.258, 422.262, 422.264, 422.266, 

422.270, 422.300, 422.304, 422.306, 

422.308, 422.310, 422.312, 422.314, 

422.316, 422.318, 422.320, 422.322, 

422.324, 423.251, 423.258, 423.265, 

423.272, 423.279, 423.286, 423.293, 

423.301, 423.308, 423.315, 423.322, 

423.329, 423.336, 423.343, 423.346, 

423.350 ; Form Number: CMS–10142 

(OMB#: 0938–0944); Use: Under the 

Medicare Modernization Act, Medicare 

Advantage Organizations (MAO) and 

Prescription Drug Plans (PDP) are 

required to submit an actuarial pricing 

bid to CMS for approval. The BPT 

software is used by MAOs and PDPs to 

price their plan benefit package. The 

BPT software is used by CMS to review 

and approve the plan pricing proposed 

by each organization; Frequency: 

Reporting ‘‘ On occasion, Annually and 

As required by new legislation; Affected 

Public: Business or other for-profit and 

not-for-profit institutions; Number of 

Respondents: 350; Total Annual 

Responses: 350; Total Annual Hours: 

12,050. 

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 Paperwork@cms.hhs.gov, 

or call the Reports Clearance Office on 

(410) 786–1326. 

To be assured consideration, 

comments and recommendations for the 

proposed information collections must 

be received at the address below, no 

later than 5 p.m. on December 6, 2005. 

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: September 30, 2005. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 05–20228 Filed 10–6–05; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10171] 

Emergency Clearance: Public 

Information Collection Requirements 

Submitted to the Office of Management 

and Budget (OMB) 

AGENCY: Centers for Medicare & 

Medicaid Services. 

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), Department of Health