Federal Register / Vol. 82, No. 190 / Tuesday, October 3, 2017 / Notices 46063 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10529] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 (the 

PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information (including each proposed 

extension or reinstatement of an existing 

collection of information) and to allow 

60 days for public comment on the 

proposed action. Interested persons are 

invited to send comments regarding our 

burden estimates or any other aspect of 

this collection of information, including 

the necessity and utility of the proposed 

information collection for the proper 

performance of the agency’s functions, 

the accuracy of the estimated burden, 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected, and the use of automated 

collection techniques or other forms of 

information technology to minimize the 

information collection burden. 

DATES: Comments must be received by 

December 4, 2017. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number. To be assured 

consideration, comments and 

recommendations must be submitted in 

any one of the following ways: 

1. Electronically. You may send 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) that are 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 ll, Room C4–26–05, 

7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

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

PaperworkReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

William Parham at (410) 786–4669. 

SUPPLEMENTARY INFORMATION: 

Contents 

This notice sets out a summary of the 

use and burden associated with the 

following information collections. More 

detailed information can be found in 

each collection’s supporting statement 

and associated materials (see 

ADDRESSES). 

CMS–10529 Quarterly Medicaid and 

CHIP Budget and Expenditure 

Reporting for the Medical Assistance 

Program, Administration and CHIP 

Under the PRA (44 U.S.C. 3501– 

3520), federal agencies must obtain 

approval from the Office of Management 

and Budget (OMB) for each collection of 

information they conduct or sponsor. 

The term ‘‘collection of information’’ is 

defined in 44 U.S.C. 3502(3) and 5 CFR 

1320.3(c) and includes agency requests 

or requirements that members of the 

public submit reports, keep records, or 

provide information to a third party. 

Section 3506(c)(2)(A) of the PRA 

requires federal agencies to publish a 

60-day notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, before 

submitting the collection to OMB for 

approval. To comply with this 

requirement, CMS is publishing this 

notice. 

Information Collection 

1. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Quarterly 

Medicaid and CHIP Budget and 

Expenditure Reporting for the Medical 

Assistance Program, Administration and 

CHIP; Use: MBES/CBES is a financial 

reporting system that produces Budget 

and expenditures for Medical 

Assistance and Children’s Health 

Insurance Program. All forms are to be 

filed on a quarterly basis and need to be 

certified by the States to the CMS. The 

forms consist of CMS–21 and –21B, 

CMS–37, and CMS–64. 

Forms CMS–21 and –21B provide 

CMS with the information necessary to 

issue quarterly grant awards, monitor 

current year expenditure levels, 

determine the allowability of state 

claims for reimbursement, develop 

Children’s Health Insurance Program 

(CHIP) financial management 

information, provide for state reporting 

of waiver expenditures, and ensure that 

the federally established allotment is 

not exceeded. They are also necessary in 

the redistribution and reallocation of 

unspent funds over the federally 

mandated timeframes. 

Form CMS–37 due dates are 

November 15, February 15, May 15 and 

August 15 of each fiscal year. While all 

submissions represent equally 

important components of the grant 

award cycle, the May and November 

submissions are particularly significant 

for budget formulation. The November 

submission introduces a new fiscal year 

to the budget cycle and serves as the 

basis for the formulation of the 

Medicaid portion of the President’s 

Budget, which is presented to Congress 

in January. The February and August 

submissions are used primarily for 

budget execution in providing interim 

updates to our Office of Financial 

Management, the Department of Health 

and Human Services, the Office of 

Management and Budget, and Congress 

depending on the scheduling of the 

national budget review process in a 

given fiscal year. The submissions 

provide us with base information 

necessary to track current year 

obligations and expenditures in relation 

to the current year appropriation and to 

notify senior managers of any 

impending surpluses or deficits. 

Form CMS–64 is used to issue 

quarterly grant awards, monitor current 

year expenditure levels, determine 

allowed state claims for reimbursement, 

develop Medicaid financial 

management information provide for 

state reporting of waiver expenditures, 

ensure that the federally-established 

limit is not exceeded for HCBS waivers, 

and to allow for the implementation of 

the Assignment of Rights and Part A and 

Part B Premium (i.e., accounting for 

overdue Part A and Part B Premiums 

under state buy-in agreements)—Billing 

Offsets. Form Number: CMS–10529 

(OMB control number: 0938–1265); 

Frequency: Quarterly; Affected Public: 

State, Local, or Tribal Governments; 

Number of Respondents: 56; Total 

Annual Responses: 672; Total Annual 

Hours: 17,920. (For policy questions 

regarding this collection contact Chris 

Kessler at 410–786–7168). 


asabaliauskas on DSKBBXCHB2PROD with NOTICES
46064 Federal Register / Vol. 82, No. 190 / Tuesday, October 3, 2017 / Notices 

Dated: September 28, 2017. 

William N. Parham, III 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2017–21248 Filed 10–2–17; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Community Living 

Agency Information Collection 

Activities; Public Comment Request; 

Proposed Extension With Changes of 

a Currently Approved Collection; 

Evidence-Based Falls Prevention 

Program 

AGENCY: Administration for Community 

Living, HHS. 

ACTION: Notice. 

SUMMARY: The Administration for 

Community Living (ACL) is announcing 

an opportunity for the public to 

comment on the proposed collection of 

certain information by the agency. 

Under the Paperwork Reduction Act of 

1995 (the PRA), Federal agencies are 

required to publish a notice in the 

Federal Register concerning each 

proposed collection of information, 

including each proposed extension of an 

existing collection of information, and 

to allow 60 days for public comment in 

response to the notice. This notice 

solicits comments on the information 

collection requirements relating to 

ACL’s Evidence-Based Falls Prevention 

Program. This notice solicits comments 

on a proposed extension with minor 

changes of a currently approved 

collection. 

DATES: Submit written or electronic 

comments on the collection of 

information by December 4, 2017. 

ADDRESSES: Submit electronic 

comments on the collection of 

information to shannon.skowronski@

acl.hhs.gov. Submit written comments 

on the collection of information to: 

Shannon Skowronski, U.S. Department 

of Health and Human Services: 

Administration for Community Living, 

Washington, DC 20201. 

FOR FURTHER INFORMATION CONTACT: 

Shannon Skowronski at 

shannon.skowronski@acl.hhs.gov or 

202–795–7438. 

SUPPLEMENTARY INFORMATION: Under the 

PRA (44 U.S.C. 3501–3520), Federal 

agencies must obtain approval from the 

Office of Management and Budget 

(OMB) for each collection of 

information they conduct or sponsor. 

‘‘Collection of information’’ is defined 

in 44 U.S.C. 3502(3) and 5 CFR 

1320.3(c) and includes agency requests 

or requirements that members of the 

public submit reports, keep records, or 

provide information to a third party. 

Section 3506(c)(2)(A) of the PRA (44 

U.S.C. 3506(c)(2)(A)) requires Federal 

agencies to provide a 60-day notice in 

the Federal Register concerning each 

proposed collection of information, 

including each proposed extension or 

update of an existing collection of 

information, before submitting the 

collection to OMB for approval. To 

comply with this requirement, ACL is 

publishing notice of the proposed 

collection of information set forth in 

this document. 

With respect to the following 

collection of information, ACL invites 

comments on: (1) Whether the proposed 

collection of information is necessary 

for the proper performance of ACL’s 

functions, including whether the 

information will have practical utility; 

(2) the accuracy of ACL’s estimate of the 

burden of the proposed collection of 

information, including the validity of 

the methodology and assumptions used; 

(3) ways to enhance the quality, utility, 

and clarity of the information to be 

collected; and (4) ways to minimize the 

burden of the collection of information 

on respondents, including through the 

use of automated collection techniques, 

when appropriate, and other forms of 

information technology. 

The Evidence-Based Falls Prevention 

Programs is a cooperative agreement 

financed through the Prevention and 

Public Health Fund (PPHF), most 

recently with FY 2017 PPHF funds. The 

statutory authority for cooperative 

agreements under the current program 

announcement is contained in the 

Public Health Service Act, 42 U.S.C. 

300u–2 (Community Programs) and 

300u–3 (Information Programs); and 

Consolidated and Further Continuing 

Appropriations Act, 2015, Pub. L. 113– 

235, Div. G., Title II, § 219(a); and the 

Patient Protection and Affordable Care 

Act, 42 U.S.C. 300u–11 (Prevention and 

Public Health Fund). 

The Evidence-Based Falls Prevention 

Programs support a national resource 

center and award competitive grants to 

implement evidence-based community 

programs that have been proven to 

reduce the incidence of falls for older 

adults and adults with disabilities 

(including Tribal elders). The programs 

also identify sustainable funding 

mechanisms for these programs via the 

resource center, promote the importance 

of falls prevention strategies, and 

provide public education about the risks 

of falls and ways to prevent them. 

OMB approval of the existing set of 

Falls Prevention data collection tools 

(OMB Control Number, 0985–0039) 

expires on 01/31/2018. This data 

collection continues to be necessary for 

monitoring program operations and 

outcomes. ACL/AoA proposes to use the 

following tools: (1) Semi-annual 

performance reports to monitor grantee 

progress; (2) a Host Organization Data 

form to record location of agencies that 

sponsor programs that will allow 

mapping of the delivery infrastructure; 

and (3) a set of tools used to collect 

information at each program completed 

by the program leaders (Program 

Information Cover Sheet and 

Attendance Log), a Participant 

Information Form completed by each 

participant, and a Post Program Survey 

to be completed by a random sample of 

participants. ACL/AoA intends to 

continue using an online data entry 

system for the program and participant 

survey data. In addition to nonsubstantive formatting edits, minor 

changes are being proposed to 2 of the 

5 currently approved tools, as indicated 

below. All changes proposed are based 

on feedback from a focus group that 

included a sub-set of current grantees 

and consultation with subject-matter 

experts. 

• On the Participant Information 

Form: 

1. Additional chronic conditions have 

been added to the list of options 

2. Question #11 (assessing the 

frequency and impact of falls) has been 

enhanced to include the location of the 

fall(s) and further assess impact 

3. Two questions have been added 

(#15 and #16) to examine modifications 

made to home and activity level 

• On the Post-Program Survey: 

1. Question #2 (assessing the 

frequency and impact of falls) has been 

enhanced to include the location of the 

fall(s) and further assess impact 

2. Questions #6 and #7 have been 

modified slightly—removing references 

to home modifications and activity 

level. Home modifications and activity 

level are now addressed in questions #8 

and #9 instead. 

Estimated Annualized Burden Hours 

The proposed Falls Prevention Data 

Collection Tools can be found at ACL’s 

Web site at: https://www.acl.gov/aboutacl/public-input. 

The total estimated burden is 4,345 

hours per year. ACL/AoA estimates the 

burden of this collection of information 

as 288 hours for project staff, 1,435 

hours for local agency staff, and 2,622 

hours for individuals. 


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