[Federal Register: March 14, 2003 (Volume 68, Number 50)]
[Notices]
[Page 12356-12357]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr14mr03-45]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[Document Identifier: CMS-368/R144, CMS-R-240, and CMS-566]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare and Medicaid Services.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid
Services (CMS) (formerly known as the Health Care Financing
Administration (HCFA)), 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 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:
Medicaid Drug Rebate; Form No.: CMS-368/R144 (OMB 0938-0582);
Use: Section 1927 requires State Medicaid agencies to report to drug
manufacturers and CMS on the drug utilization for their State and the
amount of rebate to be paid by the manufacturer; Frequency: Quarterly;
Affected Public: State, local, or tribal government; Number of
Respondents: 51; Total Annual Responses: 204; Total Annual Hours:
6,125.
(2) Type of Information Collection Request: Extension of a
currently approved collection; Title of Information Collection:
Prospective Payments for Hospital Outpatient Services and Supporting
Regulations in 42 CFR 413.24, 413.65, and 419.42; Form No.: CMS-R-240
(OMB 0938-0798); Use: As required by sections 4521, 4522, and
4523 of the Balanced Budget Act of 1997, HCFA-1005FC eliminates the
formula driven overpayment for certain outpatient hospital services,
extends reductions in payment for costs of hospital outpatient
services, and establishes in regulations a prospective payment system
for hospital outpatient services. The rule also establishes in
regulations the requirements for designating certain entities as
provider-based or as a department of a hospital; Frequency: Other--as
needed; Affected Public: Business or other for-profit, and Not-for-
profit institutions; Number of Respondents: 750; Total Annual
Responses: 2,272; Total Annual Hours: 41,063.
(3) Type of Information Collection Request: Extension of a
currently approved collection; Title of Information Collection:
Medicare Managed Care Disenrollment Form; Form No.: CMS-566 (0938-
0507); Use: This form provides Medicare beneficiaries the option to
disenroll from their Medicare managed care plan through a neutral third
party. CMS and SSA have established an agreement via a formal
Memorandum of Understanding for SSA to process beneficiary
disenrollments from Medicare managed care plans. Prior to 1999, the
Social Security Act provided Medicare beneficiaries enrolled in
Medicare managed care plans with the option of disenrolling from the
plan at a Social Security Field Office; however, section 4001 of the
Balanced Budget Act of 1997 amended the Social Security Act, removing
this requirement from the statute; Frequency: On Occasion; Affected
Public: Individuals or Households, Business or other for-profit, Not-
for-profit institutions, and Federal Government; Number of Respondents:
85,000; Total Annual Responses: 85,000; Total Annual Hours: 2,805.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS's
Web site address at http://cms.hhs.gov/regulations/pra/default.asp, or
E-mail your request, including your address, phone number, OMB number,
and CMS document identifier, to Paperwork@hcfa.gov, or call the Reports
Clearance Office on (410) 786-1326. Written comments and
recommendations for the proposed information collections must be mailed
[[Page 12357]]
within 60 days of this notice directly to the CMS Paperwork Clearance
Officer designated at the following address: CMS, Office of Strategic
Operations and Regulatory Affairs, Division of Regulations Development
and Issuances, Attention: Dawn Willinghan, Room N2-14-26, 7500 Security
Boulevard, Baltimore, Maryland 21244-1850.
Dated: March 6, 2003.
John P. Burke, III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer,
Office of Strategic Operations and Strategic Affairs, Division of
Regulations Development and Issuances.
[FR Doc. 03-6139 Filed 3-13-03; 8:45 am]
BILLING CODE 4120-03-P