[Federal Register Volume 70, Number 222 (Friday, November 18, 2005)]
[Notices]
[Pages 69974-69975]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-22904]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10130, CMS-10164 and CMS 10156]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

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 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: Federal Funding 
of Emergency Health Services (section 1011): Provider Payment 
Determination and Request for section 1011 On-Call Payments; Form No.: 
CMS-10130 (OMB <greek-i> 0938-0952); Use: Section 1011 of MMA provides 
that the Secretary will establish a process for eligible providers to 
request payment. The Secretary must directly pay hospitals, physicians, 
and ambulance providers (including Indian Health Service, Indian tribe 
and tribal organizations) for their otherwise un-reimbursed costs of 
providing services required by Section 1867 of the Social Security Act 
(EMTALA) and related hospital inpatient, outpatient and ambulance 
services. Payments may be made only for services furnished to

[[Page 69975]]

certain individuals described in the statute as: (1) Undocumented 
aliens; (2) aliens who have been paroled into the United States at a 
United States port of entry for the purpose of receiving eligible 
services; and (3) Mexican citizens permitted to enter the United States 
for not more than 30 days under the authority of a biometric machine 
readable border crossing identification card (also referred to as a 
``laser visa'') issued in accordance with the requirements of 
regulations prescribed under a specific section of the Immigration and 
Nationality Act as published in the Bureau of Customs and Border 
Protection's interim final rule dated August 13, 2004.; Frequency: 
Other--as needed; Affected Public: Business or other for-profit, Not-
for-profit institutions, and State, Local or Tribal Governments; Number 
of Respondents: 7,503,000; Total Annual Responses: 7,512,000; Total 
Annual Hours: 634,000.
    2. Type of Information Collection Request: New Collection; Title of 
Information Collection: Electronic Data Interchange (EDI) Enrollment 
Form and Centers for Medicare and Medicaid Services EDI Registration 
Form; Form No.: CMS-10164 (OMB <greek-i> 0938-NEW); Use: CMS is 
requiring that providers who wish to conduct Electronic Data 
Interchange (EDI) transactions, specifically the HIPAA Eligibility 
Inquiry and Response (270/271) directly with CMS at the Baltimore data 
center, provide certain information related to their organization and/
or organizations conducting EDI business on their behalf. Health care 
providers, clearinghouses, and health plans that wish to access the 
Medicare system for the purposes of conducting other EDI business 
transactions are also required to complete this form. Furthermore, CMS 
has incorporated changes to the collection as a result of public 
comments. One specific comment resulted in the combining of the 
information collected related to Medicare Modernization Act (MMA) 
section 1011 and Medicare Fee-For Service Part A and Part B. Both 
programs collect similar information for the purposes of provider 
enrollment and trading partner profile information related to the 
exchange of EDI transactions. To further reduce the burden on providers 
enrolling in either the MMA section 1011 and/or the Medicare Fee-For 
Service program the CMS-10164 collection will change terms from 
``Carrier/FI'' to ``Medicare contractor''. The purpose is to 
generically refer to the organization that CMS contracts with to 
operate the specific program function such as MMA section 1011 or 
Medicare Part A, Medicare Part B for a specific jurisdiction. The 
information will be used to assure that profile data for those entities 
that access the section 1011 and/or Medicare system are entered 
appropriately. Frequency: Recordkeeping and Reporting--Other (As-
Needed); Affected Public: Business or other for-profit, Not-for-profit 
institutions; Number of Respondents: 1,220,000; Total Annual Responses: 
1,220,000; Total Annual Hours: 400,000.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Retiree Drug 
Subsidy (RDS) Application and Instructions; Form Number: CMS'10156 
(OMB<greek-i>: 0938'' 0957); 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% taxfree 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; 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 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 <a href="/cdn-cgi/l/email-protection#b8e8d9c8ddcacfd7cad3f8dbd5cb96d0d0cb96dfd7ce"><span class="__cf_email__" data-cfemail="db8bbaabbea9acb4a9b09bb8b6a8f5b3b3a8f5bcb4ad">[email protected]</span></a>, 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 December 19, 
2005. OMB Human Resources and Housing Branch, Attention: Carolyn 
Lovett, CMS Desk Officer,New Executive Office Building, Room 
10235,Washington, DC 20503.

    Dated: November 9, 2005.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 05-22904 Filed 11-17-05; 8:45 am]
BILLING CODE 4120-01-P


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