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[Federal Register Volume 75, Number 15 (Monday, January 25, 2010)]
[Notices]
[Pages 3907-3908]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-1341]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10066, CMS-R-193, CMS-10295 and CMS-10234]

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: Detailed Notice 
of Discharge (DND); Use: A beneficiary/enrollee who wishes to appeal a 
determination by a Medicare health plan or hospital that inpatient care 
is no longer necessary, may request Quality Improvement Organization 
(QIO) review of the determination. On the date the QIO receives the 
beneficiary's/enrollee's request, it must notify the plan and hospital 
that the beneficiary/enrollee has filed a request for an expedited 
determination. The plan (for a managed care enrollee) or hospital (for 
an original Medicare beneficiary), in turn, must deliver a detailed 
notice to the enrollee/beneficiary. Form Number: CMS-10066 
(OMB: 0938-1019); Frequency: Reporting--Yearly; Affected 
Public: Business or other for-profits and Not-for-profit institutions; 
Number of Respondents: 6163; Total Annual Responses: 13,218; Total 
Annual Hours: 13,218. (For policy questions regarding this collection 
contact Evelyn Blaemire at 410-786-1803. For all other issues call 410-
786-1326.)
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Important

[[Page 3908]]

Message from Medicare (IM); Use: Requirements that hospitals notify 
beneficiaries in inpatient hospital settings of their rights as a 
hospital patient including their discharge appeal rights are referenced 
in Section 1866 of the Social Security Act (The Act). The authority for 
the right to an expedited determination is set forth at Sections 1869 
and 1154 of the Act. The hospital must deliver valid, written notice 
(the IM) of a patient's rights as a hospital patient including the 
discharge appeal rights, within 2 calendar days of admission. A follow-
up copy of the signed IM is given again as far as possible in advance 
of discharge, but no more than 2 calendar days before. Follow-up notice 
is not required if provision of the admission IM falls within 2 
calendar days of discharge. The collection has been revised to include 
documentation of the time when the beneficiary signs the document when 
it is delivered initially and as a follow up copy. Form Number: CMS-R-
193 (OMB: 0938-1019); Frequency: Reporting--Yearly; Affected 
Public: Business or other for-profits and Not-for-profit institutions; 
Number of Respondents: 3193; Total Annual Responses: 13,218; Total 
Annual Hours: 19,680,000. (For policy questions regarding this 
collection contact Evelyn Blaemire at 410-786-1803. For all other 
issues call 410-786-1326.)
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Recovery Act--
Reporting Requirements for States Under FMAP Increase and TMA 
Provisions; Use: The American Recovery and Reinvestment Act of 2009 
(Recovery Act), Public Law 111-5, requires that States submit quarterly 
reports to the Secretary of Health and Human Services in accordance 
with section 5001 Temporary Increase of Medicaid Federal Medical 
Assistance Percentage (FMAP) and section 5004(d) Extension of 
Transitional Medical Assistance (TMA). The reports under section 5001 
are required for the period of October 1, 2008--September 30, 2011. The 
reports under section 5004 are required beginning on July 1, 2009 until 
the Federal authority for TMA coverage sunsets (now scheduled to sunset 
on December 31, 2010). Each State Medicaid agency will submit its 
quarterly reports to the appropriate Regional Office of CMS. The 
reports will be compiled and summarized for annual reports to Congress. 
Form Number: CMS-10295 (OMB: 0938-1073); Frequency: 
Reporting--Quarterly; Affected Public: State, Local, or Tribal 
Governments; Number of Respondents: 50; Total Annual Responses: 200; 
Total Annual Hours: 600. (For policy questions regarding this 
collection contact Richard Strauss at 410-786-2019. For all other 
issues call 410-786-1326.)
    4. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: State Plan Pre-
print implementing Section 6087 of the Deficit Reduction Act: Optional 
Self-Direction Personal Assistance Services (PAS) Program (Cash and 
Counseling); Form Number: CMS-10234 (OMB: 0938-1024); Use: 
Information submitted via the State Plan Amendment (SPA) pre-print is 
used by CMS and Regional Offices to analyze a State's proposal to 
implement Section 6087 of the Deficit Reduction Act (DRA). State 
Medicaid Agencies will complete the SPA pre-print, and submit it to CMS 
for a comprehensive analysis. The pre-print contains assurances, check-
off items, and areas for States to describe policies and procedures for 
subjects such as quality assurance, risk management, and voluntary and 
involuntary disenrollment; Frequency: Reporting--Once; Affected Public: 
State, Local, or Tribal Government; Number of Respondents: 56; Total 
Annual Responses: 20; Total Annual Hours: 400. (For policy questions 
regarding this collection contact Carrie Smith at 410-786-4485. For all 
other issues call 410-786-1326.)
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS' 
Web site at http://www.cms.hhs.gov/PaperworkReductionActof1995, or e-
mail your request, including your address, phone number, OMB number, 
and CMS document identifier, to [email protected], or call the 
Reports Clearance Office on (410) 786-1326.
    In commenting on the proposed information collections please 
reference the document identifier or OMB control number. To be assured 
consideration, comments and recommendations must be submitted in one of 
the following ways by March 26, 2010:
    1. Electronically. You may submit your comments electronically to 
http://www.regulations.gov. Follow the instructions for ``Comment or 
Submission'' or ``More Search Options'' to find the information 
collection document(s) accepting comments.
    2. By regular mail. You may mail written comments to the following 
address: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: Document Identifier/OMB 
Control Number, Room C4-26-05, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.

    Dated: January 15, 2010.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 2010-1341 Filed 1-22-10; 8:45 am]
BILLING CODE 4120-01-P
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