8204 Federal Register / Vol. 81, No. 32 / Thursday, February 18, 2016 / Notices 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondent Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Clinic Data Manager ....................................... Project clinic characteristics form .................. 10 3 30/60 

Pharmacist ...................................................... Project pharmacy characteristics form ........... 10 3 30/60 

Clinic Data Manager ....................................... *Patient Demographic Information form ......... 10 100 5/60 

Clinic Data Manager ....................................... *Initial patient information form ...................... 10 100 1 

Clinic Data Manager ....................................... Quarterly patient information form ................. 10 400 30/60 

Pharmacist ...................................................... Pharmacy record abstraction form ................. 10 400 30/60 

Key informants ................................................ Interviewer data collection worksheet ............ 60 2 30/60 

Project staff (pharmacists) .............................. Staff communication questionnaire ................ 30 2 30/60 

Project staff (medical providers) ..................... Staff communication questionnaire for medical providers.40 2 30/60 

Clinic staff ....................................................... Clinic cost form .............................................. 20 2 10 

Pharmacy staff ................................................ Pharmacy cost form ....................................... 20 2 10 

Leroy A. Richardson, 

Chief, Information Collection Review Office, 

Office of Scientific Integrity, Office of the 

Associate Director for Science, Office of the 

Director, Centers for Disease Control and 

Prevention. 

[FR Doc. 2016–03304 Filed 2–17–16; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

Privacy Act of 1974; Report of a New 

Routine Use for a CMS System of 

Records 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human Services (HHS). 

ACTION: Altered System Notice, Adding 

a New Routine Use for a CMS System 

of Records. 

SUMMARY: In accordance with the 

requirements of the Privacy Act of 1974 

(5 U.S.C. 552a), CMS is adding a new 

routine use to the existing system of 

records titled Enrollment Data Base 

(EDB), System No. 09–70–0502, last 

modified 73 Federal Register 10249 

(February 26, 2008), to assist with 

transmitting data to the Internal 

Revenue Service (IRS) for 10958 

processing. 

The new routine use will authorize 

CMS to disclose information maintained 

in the system ‘‘to the IRS for the 

purposes of reporting Medicare Part A 

enrollment information and to provide 

statements to the individual enrollees 

with respect to whom information is 

reported to the IRS. Disclosures made 

pursuant to the routine use will be 

coordinated through CMS’ Division of 

Medicare Enrollment Coordination, 

Medicare Enrollment and Appeals 

Group, Center for Medicare. 

DATES: Effective Dates: The new routine 

use described in this notice will become 

effective without further notice 30 days 

after publication of this notice in the 

Federal Register, unless comments are 

received that warrant revisions to this 

Notice. Written comments should be 

submitted within 30 days. 

ADDRESSES: The public should address 

comments to: CMS Privacy Officer, 

Division of Security, Privacy Policy and 

Governance, Information Security and 

Privacy Group, Office of Enterprise 

Information, CMS, 7500 Security 

Boulevard, Baltimore, MD 21244–1870, 

Mailstop: N 1–24–08, Office: (410) 786– 

5357 or via email: walter.stone@

cms.hhs.gov. Comments received will be 

available for review at this location, by 

appointment, during regular business 

hours, Monday through Friday from 

9:00 a.m.–3:00 p.m., Eastern Time zone. 

FOR FURTHER INFORMATION CONTACT: 

Roland Herrera, Health Insurance 

Specialist, Division of Medicare 

Enrollment Coordination, Medicare 

Enrollment and Appeals Group, CMS 

Center for Medicare, 7500 Security 

Boulevard, Mail Stop C2–12–16, 

Baltimore, MD 21244, Office phone: 

410.786.0668, Facsimile: 443.380.5418, 

Email: roland.herrara@cms.hhs.gov. 

SUPPLEMENTARY INFORMATION: CMS is 

required to produce reports and 

statements of enrollment in Medicare 

Part A to confirm enrollment in 

minimum essential coverage under 

Section 6055 of the Affordable Care Act. 

The enrollment information must be 

provided to the IRS for tax 

administration purposes to enable the 

IRS to properly assess tax returns filed 

to ensure that Medicare Part A Enrollees 

are not assessed a tax penalty for not 

beenrolled in health care coverage. 

For the reason explained above, the 

following routine use is added to 

Enrollment Data Base (EDB), System No. 

09–70–0502: 

11. To the IRS for the purposes of reporting 

Medicare Part A enrollment information and 

to provide statements to the individual 

enrollees with respect to whom information 

is reported to the IRS. 

Celeste Dade-Vinson, 

Health Insurance Specialist, Centers for 

Medicare & Medicaid Services. 

[FR Doc. 2016–03241 Filed 2–17–16; 8:45 am] 

BILLING CODE 4120–03–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Community Living 

Information Collection; New Funding 

Formula for the State Councils on 

Developmental Disabilities (SCDDs) 

and Protection and Advocacy Systems 

(P&As) Located in Each State and 

Territory 

AGENCY: Administration on Intellectual 

and Developmental Disabilities (AIDD), 

Administration on Disabilities (AoD), 

Administration for Community Living 

(ACL), Department of Health and 

Human Services (HHS), HHS. 

ACTION: Notice of guidance. 

SUMMARY: The Administration on 

Intellectual and Developmental 

Disabilities (AIDD) within the 

Administration on Disabilities (AoD), 

located within the Administration for 

Community Living (ACL) at the United 

States Department of Health and Human 

Services (HHS), is soliciting comments 

from the public on the New Funding 

Formula for the State Councils on 

Developmental Disabilities (SCDDs) and 

Protection and Advocacy Systems 

(P&As) located in each State and 

Territory. 

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