[Federal Register: May 21, 2007 (Volume 72, Number 97)]
[Notices]
[Page 28543-28544]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr21my07-88]
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages that will require clearance by the
Office of Management and Budget (OMB) in compliance with Pub. L. 104-
13, the Paperwork Reduction Act of 1995, effective October 1, 1995. The
information collection packages that included in this notice are for
new information collections and revisions to existing OMB-approved
information collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility, and clarity; and on ways to minimize
burden on respondents, including the use of automated collection
techniques or other forms of information technology. Written comments
and recommendations regarding the information collection(s) should be
submitted to the OMB Desk Officer and the SSA Reports Clearance
Officer. The information can be mailed, faxed or emailed to the
individuals at the addresses and fax numbers listed below:
(OMB), Office of Management and Budget, Attn: Desk Officer for SSA.
Fax: 202-395-6974. E-mail address: OIRA_Submission@omb.eop.gov.
(SSA), Social Security Administration, DCFAM, Attn: Reports Clearance
Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235.
Fax: 410-965-6400. E-mail address: OPLM.RCO@ssa.gov.
I. The information collection listed below is pending at SSA and
will be submitted to OMB within 60 days from the date of this notice.
Therefore, your comments should be submitted to SSA within 60 days from
the date of this publication. You can obtain copies of the collection
instrument by calling the SSA Reports Clearance Officer at 410-965-0454
or by writing to the address listed above.
Medicare Quality Review Forms--20 CFR 418(b)(5)--0960-0707. The
Social Security Administration (SSA) uses the Medicare Quality Review
Forms collection to verify the information reported on Medicare Part D
Subsidy applications (OMB No. 0960-0696) for a selected number of
applicants. SSA is planning to expand the scope of this collection by
conducting Quality Reviews with some current recipients of Medicare
Part D subsidies who have recently undergone the redetermination
process (OMB No. 0960-0723). This ICR is for two new appointment
letters (forms SSA-9313 and SSA-9314) that such beneficiaries will
complete to schedule an appointment for their Quality Review. The
respondents are current recipients of Medicare Part D subsidies who
have recently undergone a redetermination and who were selected for a
Quality Review.
Type of Request: Revision to an existing OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Form number and name respondents response response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-9301 (Medicare Subsidy Quality Review Case 10,000 1 35 5,833
Analysis Questionnaire)........................
SSA-9302 (Notice of Quality Review 10,000 1 15 2,500
Acknowledgement Form for those with Phones)....
SSA-9303 (Notice of Quality Review 1,000 1 15 250
Acknowledgement Form for those without Phones).
SSA-9304 (Checklist of Required Information;
burden accounted for with forms SSA-9302, SSA-
9303)..........................................
SSA-9308 (Request for Information).............. 20,000 1 15 5,000
SSA-9310 (Request for Documents)................ 10,000 1 5 833
SSA-9309 (Life Insurance Verification Form)..... 8,000 1 15 2,000
SSA-8510 (Authorization to the Social Security 10,000 1 5 833
Administration to Obtain Personal Information).
SSA-9313 (Notice of Appointment Quality Review 4,500 1 15 1,125
Acknowledgement Form)*.........................
SSA-9314 (Notice of Quality Review 500 1 15 125
Acknowledgement Form (unknown phone numbers)*..
---------------------------------------------------------------
Total....................................... .............. .............. .............. 18,499
----------------------------------------------------------------------------------------------------------------
* These are the two new forms being cleared in the current ICR for this collection.
II. The information collection listed below has been submitted to
OMB for clearance. Your comments on the information collection would be
most useful if received by OMB and SSA within 30 days from the date of
this
[[Page 28544]]
publication. You can obtain a copy of the OMB clearance package by
calling the SSA Reports Clearance Officer at 410-965-0454, or by
writing to the address listed above.
Electronic Records Express--0960--NEW. Electronic Records Express
(ERE) is a new Internet-based platform which facilitates the electronic
submission of medical and school records needed for the disability
process. These records are currently mailed as hard paper copies to SSA
and state Disability Determination Services (DDSs) under the aegis of
OMB No. 0960-0555, the Clearance of Information Collections Conducted
by State Disability Determination Services on Behalf of SSA. While SSA
and the DDSs will continue to accept paper copies, ERE offers
respondents the opportunity to submit these records electronically. The
revised burden for the actual document submission will continue to be
covered under 0960-0555; this new collection covers the ERE
registration and user training process. The respondents are medical
providers and school professionals who submit information to SSA on
behalf of disability applicants or beneficiaries.
Type of Request: New information collection.
Number of Respondents: 20,000.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 1,667 hours.
Dated: May 15, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E7-9726 Filed 5-18-07; 8:45 am]
BILLING CODE 4191-02-P