[Federal Register Volume 82, Number 201 (Thursday, October 19, 2017)]
[Notices]
[Pages 48719-48720]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-22699]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-18F5, CMS-10137, and CMS-10651]


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

AGENCY: Centers for Medicare & Medicaid Services, HHS.

ACTION: Notice.

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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 (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 a second opportunity 
for public comment on the notice. Interested persons are invited to 
send comments regarding the burden estimate 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 on the collection(s) of information must be received by 
the OMB desk officer by November 20, 2017.

ADDRESSES: When commenting on the proposed information collections, 
please reference the document identifier or OMB control number. To be 
assured consideration, comments and recommendations must be received by 
the OMB desk officer via one of the following transmissions: OMB, 
Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-5806 OR Email: 
<a href="/cdn-cgi/l/email-protection#56191f0417092523343b3f25253f393816393b347833392678313920"><span class="__cf_email__" data-cfemail="abe4e2f9eaf4d8dec9c6c2d8d8c2c4c5ebc4c6c985cec4db85ccc4dd">[email protected]</span></a>
    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 Web site address at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to <a href="/cdn-cgi/l/email-protection#613100110413160e130a21020c124f0909124f060e17"><span class="__cf_email__" data-cfemail="c797a6b7a2b5b0a8b5ac87a4aab4e9afafb4e9a0a8b1">[email protected]</span></a>.
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: William Parham at (410) 786-4669.

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(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 (44 U.S.C. 3506(c)(2)(A)) requires 
federal agencies to publish a 30-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 that 
summarizes the following proposed collection(s) of information for 
public comment:
    1. Type of Information Collection Request: Reinstatement without 
change of a previously approved collection; Title of Information 
Collection: Application for Hospital Insurance and Supporting 
Regulations; Use: Individuals who are already entitled to retirement or 
disability benefits under Social Security or Railroad Retirement Board 
(RRB) benefits are automatically entitled to premium-free Medicare 
Hospital Insurance (Part A) when they attain age 65 or reach the 25th 
month of disability benefit entitlement. These individuals do not file 
a separate application for Medicare Part A because their application 
for Social Security or RRB benefits is also an application for

[[Page 48720]]

Part A. The form is for individuals who are not eligible for Social 
Security for RRB benefits, but may qualify for premium-free Medicare 
Part A based on certain requirements outlined in Sec.  406.11 and 
406.15 or for certain disabled individuals who may enroll in premium 
Medicare Part A based on certain requirements outlined in Sec.  406.20. 
Individuals may also choose to enroll in Medicare Part B at the same 
time they apply for Medicare Part A. Form Number: CMS-18F5 (OMB control 
number: 0938-0251); Frequency: Once; Affected Public: Individuals or 
households; Number of Respondents: 51,000; Total Annual Responses: 
51,000; Total Annual Hours: 29,580. (For policy questions regarding 
this collection contact Carla Patterson at 410-786-8911.)
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Solicitation for 
Applications for Medicare Prescription Drug Plan 2019 Contracts; Use: 
Coverage for the prescription drug benefit is provided through 
contracted prescription drug (PD) plans or through Medicare Advantage 
(MA) plans that offer integrated prescription drug and health care 
coverage (MA-PD plans). Cost Plans that are regulated under Section 
1876 of the Social Security Act, and Employer Group Waiver Plans may 
also provide a Part D benefit. Organizations wishing to provide 
services under the Prescription Drug Benefit Program must complete an 
application, negotiate rates, and receive final approval from CMS. 
Existing Part D Sponsors may also expand their contracted service area 
by completing the Service Area Expansion application. Form Number: CMS-
10137 (OMB control number: 0938-0936); Frequency: Yearly; Affected 
Public: Private sector (Business or other For-profits and Not-for-
profit institutions); Number of Respondents: 243; Total Annual 
Responses: 243; Total Annual Hours: 2,240. (For policy questions 
regarding this collection contact Arianne Spaccarelli at 410-786-5715.)
    3. Type of Information Collection Request: New collection (Request 
for a new OMB control number); Title of Information Collection: CMS 
Tribal Long Term Services and Supports (LTSS) Program Survey; Use: The 
Survey will provide CMS with an inventory of LTSS programs for older 
adults or individuals with disabilities managed by American Indian and 
Alaska Native (AI/AN) tribes. Information on tribal LTSS programs has 
previously been gathered through publicly available data via online 
research. However, not all of the information, including program 
contact information and program focus, are regularly available online 
as tribal Web sites are not updated frequently. Therefore, the survey 
will enable the collection of the most accurate information possible. 
The respondents include 424 LTSS programs run by AI/AN tribes. Once the 
survey has been conducted, CMS will feature the survey data, 
specifically a list of AI/AN managed LTSS programs, online on CMS.gov. 
The dissemination of survey data on CMS.gov will allow tribal 
communities and the general public to access this important data. 
Documentation of these programs will support sharing of LTSS best 
practices and innovative models employed in Indian Country. CMS will 
use the survey data to generate further content on LTSS in Indian 
Country, including literature reviews and reports on best practices. 
Form Number: CMS-10651 (OMB control number: 0938-New); Frequency: 
Yearly; Affected Public: State, Local, or Tribal Governments; Number of 
Respondents: 425; Total Annual Responses: 425; Total Annual Hours: 106. 
(For policy questions regarding this collection contact John Johns at 
410-786-7253.)

    Dated: October 16, 2017.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2017-22699 Filed 10-18-17; 8:45 am]
 BILLING CODE 4120-01-P


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