53026 Federal Register / Vol. 73, No. 178 / Friday, September 12, 2008 / Notices 

Prevention and the Agency for Toxic 

Substances and Disease Registry. 

Dated: September 8, 2008. 

Elaine L. Baker, 

Director, Management Analysis and Service 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. E8–21280 Filed 9–11–08; 8:45 am] 

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DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10270, CMS– 

10136, CMS–10268, and CMS–855(A, B, I, 

R)] 

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: New collection; Title of 

Information Collection: Evaluation of 

the Home Health Pay for Performance 

Demonstration: Survey instrument; Use: 

The Home Health Pay for Performance 

Demonstration is part of a change by 

CMS toward performance-based 

purchasing for a variety of provider 

types. By providing financial incentives 

for achieving high levels of performance 

on standardized quality measures, CMS 

hopes to encourage health care 

providers to improve the quality of care 

provided to Medicare beneficiaries. The 

Home Health Pay for Performance 

Demonstration (HHP4PD) relies on the 

voluntary participation by home health 

agencies within several States, with 

random assignment of participating 

agencies to treatment or control groups 

within each State, where the control 

group will not be eligible for incentive 

payments. These two groups form the 

primary comparison for determining if 

the HHP4PD was effective in creating 

improved, targeted outcomes for 

patients served by home health 

agencies. The information collected will 

be used as part of the evaluation of the 

Home Health Pay for Performance 

Demonstration sponsored by CMS. Form 

Number: CMS–10270 (OMB# 0938— 

New); Frequency: Once; Affected Public: 

Business or other for-profits and not-forprofit institutions; Number of 

Respondents: 570; Total Annual 

Responses: 570; Total Annual Hours: 

285. 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Medicare 

Demonstration Ambulatory Care Quality 

Measure Performance Assessment Tool 

(‘‘PAT’’); Use: CMS is requesting an 

extension of the currently approved tool 

for the collection of ambulatory care 

clinical performance measure data. The 

data will be used to continue 

implementation of two Congressionally 

mandated demonstration projects (the 

Physician Group Practice (PGP) 

Demonstration and the Medicare Care 

Management Performance (MCMP) 

Demonstration) and, starting in 2011, 

support data collection under the new 

Electronic Health Records (EHR) 

Demonstration. Each of these 

demonstrations, test new payment 

methods for improving the quality and 

efficiency of health care services 

delivered to Medicare fee-for-service 

beneficiaries, especially those with 

chronic conditions that account for a 

disproportionate share of Medicare 

expenditures. In addition, the MCMP 

and EHR demonstration specifically 

encourage the adoption of electronic 

health records systems as a vehicle for 

improving how health care is delivered. 

The changes in the estimated burden 

between this submission and the 

original submission are due to the 

following changes: Combining the 

Information Collection Request (ICR) 

application for the PGP and MCMP 

demonstrations into a single ICR 

application. Reduction in the number of 

practices participating in the MCMP 

Demonstration. An increase in the 

estimated cost per hour (salary + fringe) 

for collecting the data. The 

implementation of the new EHR 

Demonstration which will begin 

collecting clinical quality data starting 

in 2011 with 400 Phase I practices. Form 

Number: CMS–10136 (OMB# 0938– 

0941); Frequency: Yearly; Affected 

Public: Business or other for-profits and 

not-for-profit institutions; Number of 

Respondents: 1,060; Total Annual 

Responses: 1,060; Total Annual Hours: 

25,990. 

3. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Consolidated 

Renal Operations in a Web Enabled 

Network (CROWNWeb) Third-party 

Submission Authorization Form; Use: 

The Consolidated Renal Operations in a 

Web Enabled Network (CROWNWeb) 

Third-Party Submission Authorization 

form is to be completed by ‘‘Facility 

Administrators’’ (administrators of 

CMS-certified dialysis facilities) if they 

intend to authorize a third party (a 

business with which the facility is 

associated, or an independent vendor) 

to submit data to CMS to comply with 

the recently-revised Conditions for 

Coverage of dialysis facilities. The 

CROWNWeb system is the system used 

as the collection point of data necessary 

for entitlement of ESRD patients to 

Medicare benefits and for Federal 

Government monitoring and assessing 

of the quality and types of care provided 

to renal patients. The information 

collected through the CWTPSA form 

will allow CMS and its contractors to 

receive data from authorized parties 

acting on behalf of CMS-certified 

dialysis facilities. CMS anticipates that 

roughly 3,000 signed forms will be 

received by February 2009, and that the 

total number of forms may reach 5,100 

by February 2012. Form Number: CMS– 

10266 (OMB# 0938—New); Frequency: 

Monthly; Affected Public: Business or 

other for-profits and not-for-profit 

institutions; Number of Respondents: 

5,100; Total Annual Responses: 5,100; 

Total Annual Hours: 425. 

4. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Medicare 

Enrollment Application; Form Number: 

CMS–855 (A, B, I, R) (OMB#: 0938– 

0685); Use: The primary function of the 

Medicare enrollment application is to 

gather information from a provider or 

supplier that tells us who it is, whether 

it meets certain qualifications to be a 

health care provider or supplier, where 

it practices or renders its services, the 

identity of the owners of the enrolling 

entity, and information necessary to 

establish correct claims payments. We 

are revising this currently approved 

information collection. The goal of the 

revisions to this information collection 

request (ICR) is to adjust the burden 

associated with this ICR to account for 

the removal of the CMS–855(S) 

application. Frequency: Recordkeeping 


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Federal Register / Vol. 73, No. 178 / Friday, September 12, 2008 / Notices 53027 

and Reporting—On occasion; Affected 

Public: Business or other for-profit and 

not-for-profit institutions; Number of 

Respondents: 400,000; Total Annual 

Responses: 400,000; Total Annual 

Hours: 785,702. 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS Web site 

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

PaperworkReductionActof1995, or email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov, 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 October 14, 2008. OMB Human 

Resources and Housing Branch, 

Attention: OMB Desk Officer, New 

Executive Office Building, Room 10235, 

Washington, DC 20503, Fax Number: 

(202) 395–6974. 

Dated: September 5, 2008. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E8–21157 Filed 9–10–08; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10156, CMS– 

9042 and CMS–29/30] 

Agency Information Collection 

Activities: Proposed Collection; 

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) 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: Revision of a currently 

approved collection; Title of 

Information Collection: Retiree Drug 

Subsidy (RDS) Applications and 

Instructions; Use: Under the Medicare 

Prescription Drug, Improvement, and 

Modernization Act of 2003 and 

implementing regulations at 42 CFR Part 

423 Subpart R, Plan Sponsors (e.g., 

employers or unions) who offer 

prescription drug coverage to their 

qualified covered retirees are eligible to 

receive a 28% tax-free subsidy for 

allowable drug costs. Plan Sponsors 

must submit a complete application to 

CMS in order to be considered for the 

RDS Program. Form Number: CMS– 

10165 (OMB# 0938–0957); Frequency: 

Yearly; Affected Public: Business or 

other for-profits and not-for-profit 

institutions, and State, Local, or Tribal 

Governments; Number of Respondents: 

4,500; Total Annual Responses: 4,500; 

Total Annual Hours: 288,000. 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Accelerated 

Payments and supporting regulations 42 

CFR, Section 412.116(f), 412.632(e), 

413.64(g), 413.350(d), and 484.245; Use: 

Section 1815(a) of the Social Security 

Act describes payment to providers of 

services. When a delay in Medicare 

payment by a fiscal intermediary for 

covered services causes financial 

difficulties for a provider, the provider 

may request an accelerated payment. An 

accelerated payment also may be made 

in highly exceptional situations where a 

provider has incurred a temporary delay 

in its bill processing beyond the 

provider’s normal billing cycle. 

Accelerated payments are limited to 

providers that are not receiving periodic 

interim payments. Form CMS–9042 is 

used by fiscal intermediaries to assess a 

provider’s eligibility for accelerated 

payments. Form Number: CMS–9042 

(OMB# 0938–0269); Frequency: Yearly; 

Affected Public: Business or other forprofits and not-for-profit institutions; 

Number of Respondents: 880; Total 

Annual Responses: 880; Total Annual 

Hours: 440. 

3. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Request for 

Certification as Rural Health Clinic 

(RHC) and RHC Survey Report Form 

and Supporting Regulations in 42 CFR 

491.1–491.11; Use: The CMS–29 is 

utilized as an application to be 

completed by suppliers of 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 Automated Survey 

Process Environment (ASPEN) and 

related survey and certification 

databases by the CMS Regional Offices. 

Form Number: CMS–29/30 (OMB# 

0938–0074); Frequency: Yearly; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

766; Total Annual Responses: 766; Total 

Annual Hours: 192. 

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 email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov, 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 November 12, 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 llll, Room C4–26– 

05, 7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Date: September 5, 2008. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E8–21159 Filed 9–11–08; 8:45 am] 

BILLING CODE 4120–01–P 


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