[Federal Register Volume 75, Number 175 (Friday, September 10, 2010)]
[Notices]
[Pages 55329-55330]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-22592]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-416]


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

AGENCY: Centers for Medicare & Medicaid Services.

    In compliance with the requirement of section 3506I(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: Revision of a currently 
approved collection; Title of Information Collection: Annual Early and 
Periodic Screening, Diagnostic and Treatment (EPSDT) Services 
Participation Report; Form Number: CMS-416 (OMB<greek-i>: 0938-0354); 
Use: States are required to submit an annual report on the provision of 
EPSDT services pursuant to section 1902(a)(43)(D) of the Social 
Security Act. These reports provide CMS with data necessary to assess 
the effectiveness of State EPSDT programs, to determine a State's 
results in

[[Page 55330]]

achieving its participation goal and to respond to inquiries. 
Respondents are State Medicaid Agencies. The data is due April 1 of 
every year so States need to have the form and instructions as soon as 
possible in order to report timely. Frequency: Yearly; Affected Public: 
State, Tribal and Local governments; Number of Respondents: 56; Total 
Annual Responses: 112; Total Annual Hours: 1,568. (For policy questions 
regarding this collection contact Cindy Ruff at 410-786-5916. 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 address 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#2c7c4d5c495e5b435e476c4f415f0244445f024b435a"><span class="__cf_email__" data-cfemail="9dcdfcedf8efeaf2eff6ddfef0eeb3f5f5eeb3faf2eb">[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 October 12, 2010.
    OMB, Office of Information and Regulatory Affairs, Attention: CMS 
Desk Officer, Fax Number: (202) 395-6974, E-mail: <a href="/cdn-cgi/l/email-protection#ade2e4ffecf2ded8cfc0c4dedec4c2c3edc2c0cf83c8c2dd83cac2db"><span class="__cf_email__" data-cfemail="16595f4457496563747b7f65657f797856797b743873796638717960">[email protected]</span></a>.

    Dated: September 3, 2010.
Martique Jones,
Director, Regulations Development Division-B, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2010-22592 Filed 9-9-10; 8:45 am]
BILLING CODE 4120-01-P


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