62122 Federal Register / Vol. 70, No. 208 / Friday, October 28, 2005 / Notices 

many of the questions raised by outdoor 

users and public health officials, and 

improve and strengthen evidence-based 

NPS guidelines for backcountry health 

and sanitation practices. To gather this 

information, consent to contact after the 

conclusion of the backcountry trip will 

be obtained from an estimated 7,000 

backcountry users 18 years of age or 

older when they present to the 

Yellowstone National Park’s permit 

offices prior to entering the 

backcountry. A questionnaire (in either 

Internet-based or paper-based format) 

will then be offered to an estimated 

5,600 backcountry users who consent to 

be contacted. Participants will be asked 

about their health (before, during and 

after backcountry travel), water 

consumption, water preparation habits, 

food consumption, food preparation 

habits, sanitation practices, recreational 

water use, animal exposure, and 

demographics. 

This study is the beginning of what 

will be an ongoing effort to improve the 

scientific basis of NPS 

recommendations and policies related 

to protecting human health in the 

backcountry. This effort seeks to begin 

to identify disease transmission 

pathways and assess disease and injury 

risks associated with specific activities, 

choices, and behaviors of backcountry 

visitors, such as water purification, 

sanitation practices, and hygiene. 

Thoroughly understanding transmission 

pathways and the interactions of agent, 

environment, and host will enable the 

NPS to effectively and efficiently 

improve visitor protection efforts. 

There will be no cost to or 

remuneration of respondents other than 

their time. Their participation is 

voluntary and there will be no penalty 

for non-participation. 

Estimate of Annualized Burden Table 

Respondents Form name Number of 

respondents 

Number 

responses 

per respondent 

Hrs/response 

(in hours) 

Total response burden hours 

Backcountry Users of Yellowstone Park ... Consent to Further Contact ...................... 7000 1 2/60 233 

Web-Based Questionnaire ........................ 5600 1 15/60 1400 

Total ....................................................... .................... .................. .................. 1633 

Dated: October 21, 2005. 

Betsey Dunaway, 

Acting Reports Clearance Officer, Centers for 

Disease Control and Prevention. 

[FR Doc. 05–21540 Filed 10–27–05; 8:45 am] 

BILLING CODE 4163–18–P 1 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–R–0021, CMS–

838, CMS–10134, CMS–R–137, CMS–R–257, 

CMS–29/CMS–30, CMS–10150, CMS–381, 

CMS–10161, CMS–10162, and 10136] 

Agency Information Collection 

Activities: Submission for OMB 

Review; 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), Department of Health 

and Human Services, 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 function; 

(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: Withholding 

Medicare Payments to Recover 

Medicaid Overpayments and 

Supporting Regulations in 42 CFR 

447.31; Use: Overpayments may occur 

in either the Medicare and Medicaid 

program, at times resulting in a situation 

where an institution or person that 

provides services owes a repayment to 

one program while still receiving 

reimbursement from the other. Certain 

Medicaid providers which are subject to 

offsets for the collection of Medicaid 

overpayments may terminate or 

substantially reduce their participation 

in Medicaid, leaving the State Medicaid 

Agency unable to recover the amounts 

due. These information collection 

requirements give CMS the authority to 

recover Medicaid overpayments by 

offsetting payments due to a provider 

under the program. Form Number: 

CMS–R–0021 (OMB #0938–0287); 

Frequency: Reporting—On occasion; 

Affected Public: State, Local or Tribal 

Government; Number of Respondents: 

54; Total Annual Responses: 27; Total 

Annual Hours: 81. 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicare Credit 

Balance Reporting Requirements and 

Supporting Regulations in 42 CFR 

405.371, 405.378, and 413.20; Form 

Number: CMS–838 (OMB #0938–0600); 

Use: Section 1815(a) of the Social 

Security Act authorizes the Secretary to 

request information from providers 

which is necessary to properly 

administer the Medicare program. 

Quarterly credit balance reporting is 

needed to monitor and control the 

identification and timely collection of 

improper payments. The reporting 

requirements provide CMS with the 

authority to impose sanctions such as 

the suspension of program payments in 

accordance with 42 CFR 413.20(e) and 

405.371 if providers do not report credit 

balances on a timely basis. Furthermore, 

once a credit balance has been 

identified on a CMS–838 form and 

demand for payment is made, CMS has 

the authority to charge interest if the 

amount is not repaid within 30 days in 

accordance with 42 CFR 405.378. The 

collection of credit balance information 

is needed to ensure that millions of 

dollars in improper program payments 

are collected. Approximately 48,300 

health care providers will be required to 

submit a quarterly credit balance report 

that identifies the amount of improper 

payments they received that are due to 

Medicare. The intermediaries will 

monitor the reports to ensure these 

funds are collected; Frequency: 

Quarterly; Affected Public: Not-forprofit institutions, Business or other forprofit; Number of Respondents: 48,300; 

Total Annual Responses: 193,200; Total 

Annual Hours: 579,600. 

Federal Register / Vol. 70, No. 208 / Friday, October 28, 2005 / Notices 62123 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Physician Group 

Practice (PGP) Standardized 

Ambulatory Care Quality Measure 

Collection Initiative; Use: The Benefits 

Improvement & Protection Act of 2000 

mandated the PGP Demonstration and 

gave the Secretary discretion to use 

quality measures to assess physician 

performance in order to reward 

physicians for improvements in the 

quality and efficiency of health care. 

This demonstration is intended to 

strengthen the Medicare program by 

offering innovative models to people on 

Medicare that improve quality and 

access and lower costs. As a result, 

Medicare beneficiaries will directly 

benefit from these innovative models. 

The demonstration represents the first 

pay for performance project for 

physician group practices and will 

enable comparisons across groups and 

geography; Form Number: CMS–10134 

(OMB #0938–0942); Frequency: 

Annually; Affected Public: Business or 

other for-profit and Not-for-profit 

institutions; Number of Respondents: 

10; Total Annual Responses: 10; Total 

Annual Hours: 790. 

4. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Internal 

Revenue Service/Social Security 

Administration/Centers for Medicare 

and Medicaid Services Data Match and 

Supporting Regulations in 42 CFR 

411.20–491.206; Form Number: CMS–

R–137 (OMB #0938–0565); Use: The 

Data Match project and information 

collection activity provides a ‘‘check 

and balance’’ against the Medicare 

program relying solely on a single 

information collection system. It gives 

CMS the opportunity to pursue 

collection of identified mistaken 

payments (within legal constraints) and 

to update incorrect status indicators to 

prevent further incorrect suspensions or 

mistaken payment or denial. Employers 

identified through a match of IRS, SSA, 

and Medicare records will be contacted 

concerning group health plan coverage 

of identified individuals to ensure 

compliance with Medicare Secondary 

Payer provisions, in accordance with 

the Medicare statute found at 42 U.S.C. 

1395y(b); Frequency: Reporting—

Annually; Affected Public: Business or 

other for-profit, Not-for-profit 

institutions, Farms, Federal 

Government, State, Local or Tribal 

Government; Number of Respondents: 

341,065; Total Annual Responses: 

341,065; Total Annual Hours: 1,986,810. 

5. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicare 

Advantage Disenrollment Form to 

original Medicare; Form Number: CMS–

R–257 (OMB #0938–0741); Use: Section 

4001 of the Balanced Budget Act of 1997 

amended the Social Security Act to add 

Section 1851, including 1851(c)(1) 

which required the establishment of a 

procedure and form to make and change 

Medicare Advantage elections, which 

include disenrollment. The 

disenrollment form provides 

beneficiaries an option to submit a 

disenrollment to a neutral third party, 

process the disenrollment action as a 

change of election and to elicit the 

reasons for disenrollment in order to 

discern and report disenrollment rates; 

Frequency: On occasion and Other (onetime only); Affected Public: Individuals 

or Households, Business or other forprofit, Not-for-profit institutions, and 

Federal Government; Number of 

Respondents: 50,000; Total Annual 

Responses: 50,000; Total Annual Hours: 

3,300. 

6. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Request for 

Certification as Rural Health Clinic and 

Rural Health Clinic Survey Report Form 

and Supporting Regulations in 42 CFR 

491.1–491.11; Form Number: CMS–29 

and CMS–30 (OMB #0938–0074); Use: 

The form CMS–29 is utilized as an 

application to be completed by 

suppliers of Rural Health Clinic (RHC) 

services requesting participation in the 

Medicare/Medicaid programs. This form 

initiates the process of obtaining a 

decision as to whether the conditions 

for certification are met as a supplier of 

RHC services. It also promotes data 

reduction or introduction to and 

retrieval from the Online Survey and 

Certification and Reporting System 

(OSCAR) by CMS Regional Offices (RO). 

The Form CMS–30 is an instrument 

used by the State survey agency to 

record data collected in order to 

determine RHC compliance with 

individual conditions of participation 

and to report it to the Federal 

government. The form is primarily a 

coding worksheet designed to facilitate 

data reduction (keypunching) and 

retrieval into OSCAR at the CMS ROs. 

The form includes basic information on 

compliance (i.e., met, not met and 

explanatory statements) and does not 

require any descriptive information 

regarding the survey activity itself; 

Frequency: Reporting—Annually; 

Affected Public: State, Local or Tribal 

Government; Number of Respondents: 

698; Total Annual Responses: 698; Total 

Annual Hours: 1,222. 

7. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Collection of 

Drug Pricing and Network Pharmacy 

Data from Medicare Prescription Drug 

Plans (PDPs and MA–PDs) and 

Supporting Regulations in 42 CFR 

423.48; Form Number: CMS–10150 

(OMB #0938–0951); Use: Both stand 

alone prescription drug plans (PDPs) 

and Medicare Advantage Prescription 

Drug (MA–PDs) plans will be required 

to submit drug pricing and pharmacy 

network data to CMS. These data will be 

made publicly available to Medicare 

beneficiaries through the new Medicare 

prescription drug plan finder tool that 

will be launched in the fall of 2005 on 

http://www.medicare.gov. The purpose 

of the data is to enable beneficiaries to 

compare, learn, select and enroll in a 

plan that best meets their needs; 

Frequency: Reporting—Weekly; 

Affected Public: Business or other forprofit; Number of Respondents: 350; 

Total Annual Responses: 18,200; Total 

Annual Hours: 36,400. 

8. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Identification of 

Extension Units of Outpatient Physical 

Therapy/Outpatient Speech Pathology 

(OPT/OSP) Providers and Supporting 

Regulations in 42 CFR Sections 

485.701–485.729; Form Number: CMS–

381 (OMB #0938–0273); Use: Medicare 

provides OPT/OSP providers to be 

surveyed to determine compliance with 

Federal regulations. All locations where 

OPT/OSP providers furnish services 

must meet these requirements. The 

CMS–381 is the form used to identify all 

the OPT/OSP locations. Frequency: 

Reporting—Annually; Affected Public: 

Business or other for-profit; Number of 

Respondents: 2960; Total Annual 

Responses: 2960; Total Annual Hours: 

740. 

9. Type of Information Collection 

Request: New Collection; Title of 

Information Collection: New Freedom 

Initiative—Web-based Reporting System 

for Grantees; Form Number: CMS–10161 

(OMB #0938–NEW); Use: CMS currently 

awards competitive grants to States and 

other eligible entities for the purpose of 

designing and implementing effective 

and enduring improvements in 

community-based long-term services 

and supporting systems. We currently 

require grantees to report quarterly, 

semi-annual, and or annually, 

depending on the grant type. CMS 

requires the information obtained 

62124 Federal Register / Vol. 70, No. 208 / Friday, October 28, 2005 / Notices 

through web-based grantee reporting for 

two reasons: (1) In order to effectively 

monitor the grants, and; (2) to report to 

Congress and other interested 

stakeholders the progress and obstacles 

experienced by the grantees. The 

grantees are the respondents to the webbased reporting system; Frequency: 

Reporting—Quarterly, Semi-annually, 

and Annually; Affected Public: State, 

Local or Tribal Government and Not-forprofit institutions; Number of 

Respondents: 298; Total Annual 

Responses: 836; Total Annual Hours: 

6,440. 

10. Type of Information Collection 

Request: New Collection; Title of 

Information Collection: Medicare Care 

Improvement Survey; Use: The purpose 

of this beneficiary survey is to obtain 

information about beneficiary 

behavioral change, physical functioning 

and satisfaction with the Chronic Care 

Improvement (CCI) programs. 

Legislation requires that all of the 

aforementioned data elements be 

collected, as they provide information 

that is critical to the decision-making 

process as it pertains to the expansion 

of the pilot programs. The chronic care 

improvement programs are to be 

designed to incorporate relevant 

features from private sector programs 

but also be sufficiently flexible to adapt 

to the unique needs of their Medicare 

populations. This survey is required to 

support the legislative mandate to 

evaluate the Chronic Care Improvement 

Programs. Beneficiary participation in 

the CCI–I program will be voluntary and 

will not change the scope, duration or 

amount of Medicare fee-for-service 

(FFS) benefits currently received by FFS 

Medicare beneficiaries; Form Number: 

CMS–10162 (OMB #0938–NEW); 

Frequency: Reporting—On occasion; 

Affected Public: Individuals or 

Households; Number of Respondents: 

9,449; Total Annual Responses: 9,449; 

Total Annual Hours: 2,636. 

11. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicare Care 

Management Performance (MCMP) 

Demonstration—Standardized 

Ambulatory Care Quality Collection 

Initiative; Use: The MCMP 

Demonstration was authorized by 

Section 649 of the Medicare 

Prescription Drug, Improvement, and 

Modernization Act of 2003 (MMA). This 

project requires the Secretary to 

establish a pay-for-performance 3-year 

pilot with physicians to promote the 

adoption and use of health information 

technology to improve the quality of 

patient care for chronically ill Medicare 

patients. This demonstration represents 

the first pay for performance project 

fostering the adoption of health 

information technology in small 

physician group practices and will 

enable a test of the concept to improve 

the quality and efficiency of care in Feefor-Service Medicare; Form Number: 

CMS–10136 (OMB #0938–0941); 

Frequency: Annually; Affected Public: 

Business or other for-profit and Not-forprofit institutions; Number of 

Respondents: 800; Total Annual 

Responses: 800; Total Annual Hours: 

19,200. 

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 and (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 28, 2005. OMB Human 

Resources and Housing Branch, 

Attention: CMS Desk Officer, New 

Executive Office Building, Room 10235, 

Washington, DC 20503. 

Dated: October 21, 2005. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 05–21517 Filed 10–27–05; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–1316–N] 

Medicare Program; Meeting of the 

Practicing Physicians Advisory 

Council, December 5, 2005 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice announces a 

quarterly meeting of the Practicing 

Physicians Advisory Council (the 

Council). The Council will meet to 

discuss certain proposed changes in 

regulations and carrier manual 

instructions related to physicians’

services, as identified by the Secretary 

of Health and Human Services (the 

Secretary). This meeting is open to the 

public. 

DATES: The Council meeting is 

scheduled for Monday, December 5, 

2005, from 8:30 a.m. until 3:30 p.m. 

e.s.t. 

ADDRESSES: The meeting will be held in 

Room 705A 7th floor, in the Hubert H. 

Humphrey Building, 200 Independence 

Avenue, SW., Washington, DC 20201. 

MEETING REGISTRATION: Persons wishing 

to attend this meeting must register by 

contacting Kelly Buchanan, the 

Designated Federal Official (DFO) by email at PPAC@cms.hhs.gov or by 

telephone at (410) 786–6132, at least 72 

hours in advance of the meeting. This 

meeting will be held in a Federal 

Government Building, Hubert H. 

Humphrey Building, and persons 

attending the meeting will be required 

to show a photographic identification, 

preferably a valid driver’s license, and 

will be listed on an approved security 

list before persons are permitted 

entrance. Persons not registered in 

advance will not be permitted into the 

Hubert H. Humphrey Building and will 

not be permitted to attend the Council 

meeting. 

FOR FURTHER INFORMATION CONTACT: 

Kelly Buchanan, (410)786–6132, or 

e-mail PPAC@cms.hhs.gov. News media 

representatives must contact the CMS 

Press Office, (202) 690–6145. Please 

refer to the CMS Advisory Committees’

Information Line (1–877–449–5659 toll 

free), (410)786–9379 local) or the 

Internet at http://www.cms.hhs.gov/ 

faca/ppac/default.asp for additional 

information and updates on committee 

activities. 

SUPPLEMENTARY INFORMATION: In 

accordance with section 10(a) of the 

Federal Advisory Committee Act, this 

notice announces the quarterly meeting 

of the Practicing Physicians Advisory 

Council (the Council). The Secretary is 

mandated by section 1868(a)(1) of the 

Social Security Act (the Act) to appoint 

a Practicing Physicians Advisory 

Council based on nominations 

submitted by medical organizations 

representing physicians. The Council 

meets quarterly to discuss certain 

proposed changes in regulations and 

carrier manual instructions related to 

physicians’ services, as identified by the 

Secretary. To the extent feasible and 

consistent with statutory deadlines, the 

Council’s consultation must occur 

before Federal Register publication of 

the proposed changes. The Council 

submits an annual report on its 

recommendations to the Secretary and 

the Administrator of the Centers for 

Medicare & Medicaid Services (CMS) 

not later than December 31 of each year.