[Federal Register: January 14, 2009 (Volume 74, Number 9)]
[Notices]
[Page 2078-2079]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr14ja09-70]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10161, CMS-1882, CMS-437A and B, CMS-1557 and
CMS-10036]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services.
In compliance with the requirement of section 3506(c)(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: Extension of a currently
approved collection; Title of Information Collection: New Freedom
Initiative--Web-based Reporting System for Grantees; Use: CMS currently
awards competitive grants to States and other eligible entities for the
purpose of designing and implementing effective and enduring
improvements in community-based long-term services
[[Page 2079]]
and support systems. CMS currently requires grantees to report on a
quarterly, semi-annual, and or annual basis depending upon the grant
type. CMS requires the information obtained through web-based grantee
reporting for two reasons: (1) In order to effectively monitor the
grants; and, (2) To report to Congress and other interested
stakeholders the progress and obstacles experienced by the grantees.
The grantees are the respondents to the web-based reporting system.
Form Number: CMS-10161 (OMB 0938-0979); Frequency: annually,
semi-annually, and quarterly; Affected Public: State, Local or Tribal
Governments; Number of Respondents: 171; Total Annual Responses: 428;
Total Annual Hours: 3,764.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Request for
Certification as a Supplier of Portable X-ray Services and Portable X-
ray Survey Report Form under the Medicare/Medicaid Program and
Supporting Regulations in 42 CFR 486.100-486.110; Use: The Medicare
program requires portable X-ray suppliers to be surveyed for health and
safety standards. The CMS-1882 is the survey form that records survey
results. The CMS-1880 is used by the surveyor to determine if a
portable X-ray applicant meets the eligibility requirements. Form
Numbers: CMS-1880/1882 (OMB 0938-0027); Frequency:
Occasionally; Affected Public: State, Local or Tribal Governments;
Number of Respondents: 544; Total Annual Responses: 68; Total Annual
Hours: 4,760.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Rehabilitation
Hospital Criteria Worksheet and Rehabilitation Hospital Criteria
Worksheet; Use: The rehabilitation hospital and rehabilitation unit
criteria worksheets are necessary to verify that these facilities/units
comply and remain in compliance with the exclusion criteria for the
Medicare prospective payment system. Form Number: CMS-437A and 437B
(OMB 0938-0986); Frequency: Annually; Affected Public:
Business or other for-profit; Number of Respondents: 1,227; Total
Annual Responses: 1,227; Total Annual Hours: 307.
4. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Survey Report
Form for Clinical Laboratory Improvement Amendments (CLIA) and
Supporting Regulations in 42 CFR 493.1-493.2001; Use: This form is used
by the State to determine a laboratory's compliance with CLIA. This
information is needed for a laboratory's CLIA certification and
recertification. Form Number: CMS-1557 (OMB 0938-0544);
Frequency: Biennially; Affected Public: Business or other for-profit,
Not-for-profit institutions, State, Local or Tribal Governments and
Federal Government; Number of Respondents: 21,000; Total Annual
Responses: 10,500; Total Annual Hours: 5,248.
5. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Inpatient
Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) data
and Supporting Regulations in 42 CFR 412 Subpart P; Use: This
instrument with its supporting manual is needed to permit the Secretary
of Health and Human Services, and CMS, to implement Section 1886(j) of
the Social Security Act. The statute requires the Secretary to develop
a prospective payment system for inpatient rehabilitation facility
services for the Medicare program. This payment system is to cover both
operating and capital costs for inpatient rehabilitation facility
services. It applies to inpatient rehabilitation hospitals as well as
rehabilitation units of acute care hospitals. CMS implemented the
inpatient rehabilitation facility prospective payment system for cost
reporting periods beginning on or after January 1, 2002.
Form Number: CMS-10036 (OMB 0938-0842); Frequency:
Annually; Affected Public: Business or other for-profit, Not-for-profit
institutions, State, Local or Tribal Governments and Federal
Government; Number of Respondents: 1,202; Total Annual Responses:
396,660; Total Annual Hours: 337,161.
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 Paperwork@cms.hhs.gov, 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 February 13,
2009: OMB, Office of Information and Regulatory Affairs, Attention: CMS
Desk Officer, New Executive Office Building, Room 10235, Washington, DC
20503, Fax Number: (202) 395-6974.
Dated: January 8, 2009.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. E9-687 Filed 1-13-09; 8:45 am]
BILLING CODE 4120-01-P