[Federal Register Volume 73, Number 159 (Friday, August 15, 2008)]
[Notices]
[Pages 47954-47955]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-18958]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-4040 and 4040SP, CMS-R-10, CMS-10130A and 
10130B, and CMS-R-257]


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: Request for 
Enrollment in Supplementary Medical Insurance; Use: Section 1836 of the 
Social Security Act and 42 CFR 407.10 provide the eligibility 
requirements for enrollment in Supplementary Medical Insurance (Part B) 
for individuals age 65 and older who are not entitled to premium-free 
Hospital Insurance (Part A). The form CMS-4040 is used to establish 
entitlement to Part B by individuals ineligible for Part A under Title 
XVIII of the Social Security Act. Form Number: CMS-4040 and 4040SP 
(OMB<greek-i> 0938-0245); Frequency: Once; Affected Public: Individuals 
and households; Number of Respondents: 10,000; Total Annual Responses: 
10,000; Total Annual Hours: 2,500.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: BPD-718: Advance 
Directives (Medicare and Medicaid); Use: Steps have been taken at both 
the Federal and State level to afford greater opportunity for the 
individual to participate in decisions made concerning the medical 
treatment to be received by an adult patient in the event that the 
patient is unable to communicate to others a preference about medical 
treatment. The individual may make his preference known through the use 
of an advance directive, which is a written instruction prepared in 
advance, such as a living will or durable power of attorney. This 
information is documented in a prominent part of the individual's 
medical record. Advance directives as described in the Patient Self-
Determination Act have increased the individual's control over 
decisions concerning medical treatment. The advance directives 
requirement was enacted because Congress wanted individuals to know 
that they have a right to make health care decisions and to refuse 
treatment even when they are unable to communicate. Sections 4206 of 
OBRA '90 defined an advance directive as a written instruction 
recognized under State law relating to the provision of health care 
when an individual is incapacitated (those persons unable to 
communicate their wishes regarding medical treatment).
    All states have enacted legislation defining a patient's right to 
make decisions regarding medical care, including the right to accept or 
refuse medical or surgical treatment and the right to formulate advance 
directives. Participating hospitals, skilled nursing facilities/nursing 
facilities, home health agencies, providers of home health care, 
hospices, religious nonmedical health care institutions, and prepaid or 
eligible organizations (including Health Care Prepayment Plans (HCPPs) 
and Medicare Advantage Organizations (MAOs) such as Coordinated Care 
Plans, Demonstration Projects, Chronic Care Demonstration Projects, 
Program of All Inclusive Care for the Elderly, Private Fee for Service, 
and Medical Savings Accounts must provide written information, at 
explicit time frames, to all adult individuals about: (a) The right to 
accept or refuse medical or surgical treatments; (b) the right to 
formulate an advance directive; (c) a description of applicable State 
law (provided by the State); and (d) the provider's or organization's 
policies and procedures for implementing an advance directive. Form 
Number: CMS-R-10 (OMB<greek-i> 0938-0610); Frequency: Yearly; Affected 
Public: Business or other for-profits; Number of Respondents: 35,484; 
Total Annual Responses: 19,870,000; Total Annual Hours: 927,550.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Federal 
Reimbursement of Emergency Health Services Furnished to Undocumented 
Aliens, Section 1011 of the Medicare Prescription Drug, Improvement and 
Modernization Act of 2003 (MMA): ``Section 1011 Provider Payment 
Determination'' and ``Request for Section 1011 Hospital On-Call 
Payments to Physicians'' Forms; Use: Section 1011 of the MMA requires 
that the Secretary establish a process under which eligible providers 
(certain hospitals, physicians and ambulance providers) may request 
payment for (claim) their otherwise un-reimbursed costs of providing 
eligible services. The Secretary must make quarterly payments directly 
to such providers. The Secretary must also implement measures to ensure 
that inappropriate, excessive, or fraudulent payments are not made 
under Section 1011, including certification by providers of the 
accuracy of their requests for payment. The Section 1011 Provider 
Payment Determination and the Request for Section 1011 Hospital On-Call 
Payments to Physicians forms have been established to address the 
statutory requirements. Form Number: CMS-10130A and 10130B 
(OMB<greek-i> 0938-0952); Frequency: Daily, Weekly,

[[Page 47955]]

Monthly, Quarterly and Yearly; Affected Public: Business or Other For-
Profits and Not-for-Profit Institutions; Number of Respondents: 12,037; 
Total Annual Responses: 300,148; Total Annual Hours: 75,007.
    4. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Medicare 
Advantage & Part D Disenrollment Requests Collected Through 1-800-
MEDICARE; Use: Section 4001 of the Balanced Budget Act of 1997 amended 
the Social Security Act to add Section 1851(c)(1), through which 
Medicare Advantage elections are made and changed. Section 101 of the 
Medicare Prescription Drug, Improvement, and Modernization Act amended 
the Social Security Act to include section 1860D-1(b)(1), through which 
Medicare Prescription Drug Plan enrollments are made and changed. The 
disenrollment process offered at 1-800-MEDICARE provides beneficiaries 
with the option of submitting a disenrollment request to a neutral 
third party, who then processes the disenrollment action as a change of 
enrollment.
    The collection updates: 1. Continue to allow Medicare beneficiaries 
to disenroll from Medicare Advantage plans by calling CMS' toll-free 
call center; 2. Continue to allow Medicare beneficiaries enrolled in 
Medicare Prescription Drug (Part D) Plans to request disenrollment from 
Medicare Prescription Drug Plans, and 3. Retire the CMS-R-257 Medicare 
Advantage Disenrollment Form given limited (zero) requests for the 
paper form since 2005. The information collected in the disenrollment 
process will be used to update the Medicare beneficiary's Health 
Insurance Master Record System in order to disenroll the beneficiary 
from a Medicare Advantage managed care plan or a Medicare prescription 
drug plan on a timely basis. Form Number: CMS-R-257 (OMB<greek-i> 0938-
0741); Frequency: Occasionally; Affected Public: Individuals or 
households; Number of Respondents: 117,000; Total Annual Responses: 
117,000; Total Annual Hours: 19,539.
    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 <a href="/cdn-cgi/l/email-protection#633302130611140c110823000e104d0b0b104d040c15"><span class="__cf_email__" data-cfemail="2777465742555048554c67444a54094f4f5409404851">[email protected]</span></a>, 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 October 14, 2008:
    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: August 7, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E8-18958 Filed 8-14-08; 8:45 am]
BILLING CODE 4120-01-P


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