[Federal Register: August 29, 2003 (Volume 68, Number 168)]
[Notices]               
[Page 52041-52042]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr29au03-68]                         

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-1537, CMS-R-200, CMS-10094 and CMS-R-247]

 
Agency Information Collection Activities: Submission for OMB 
Review; 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 (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 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: Reinstatement, with 
change, of a previously approved collection for which approval has 
expired; Title of Information Collection: Medicare/Medicaid Hospital 
Surveyor's Worksheet Form and Supporting Regulations in 42 CFR 488.26 
and 442.30; Form No.: CMS-1537 (OMB 0938-0382); Use: Section 
1861(e) of the Social Security Act (the Act) provides that hospitals 
participating in

[[Page 52042]]

Medicare under the Act must meet specific requirements. These 
requirements are presented as Condition of Participation. State 
agencies can determine compliance with these conditions through the use 
of this worksheet form; Frequency: Other: 3-5 years; Affected Public: 
State, Local, or Tribal Government, Business or other for-profit, Not-
for-profit institutions; Number of Respondents: 3323; Total Annual 
Responses: 3323; Total Annual Hours: 553.
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Health Plan 
Employer Data and Information Set (HEDIS) and Health Outcome Survey 
(HOS) and supporting regulations at 42 CFR 422.152; Form No.: CMS-R-200 
(OMB 0938-0701); Use: The Centers for Medicare and Medicaid 
Services (formerly HCFA) collects quality performance measures in order 
to hold the Medicare managed care industry accountable for the care 
being delivered, to enable quality improvement, and to provide quality 
information to Medicare beneficiaries in order to promote informed 
choice. It is critical to CMS's mission that we collect and disseminate 
information that will help beneficiaries choose among health plans, 
contribute to improved quality of care through identification of 
improvement opportunities and assist CMS in carrying out its oversight 
and purchasing responsibilities; Frequency: Annually; Affected Public: 
Business or other for-profit, Not-for-profit institutions, and 
Individuals or Households; Number of Respondents: 166,709; Total Annual 
Responses: 70,992; Total Annual Hours: 498,436.
    3. Type of Information Collection Request: New Collection; Title of 
Information Collection: Evaluation of the Medicaid Health Reform 
Demonstrations; Form No.: CMS-10094 (OMB 0938-NEW); Use: This 
survey is part of an evaluation of the State of Vermont's pharmacy 
assistance programs, which principally serve low income Medicare 
beneficiaries who do not have other coverage for prescription drugs. 
The surveys will explore the issues of self-selection into the pharmacy 
programs, motivations for joining or not joining, the extent of 
pharmacy coverage among low income Medicare beneficiaries who are not 
enrolled and the impact of coverage on Medicare spending. The Vermont 
evaluation is part of a larger evaluation of Section 1115 Medicaid 
demonstration programs in five states. (The other states are 
California, Kentucky, Minnesota, and New York. The survey will take 
place only in Vermont); Frequency: Other: One-time; Affected Public: 
Individuals or Households; Number of Respondents: 11,310; Total Annual 
Responses: 11,310; Total Annual Hours: 1,087.
    4. Type of Information Collection Request: Reinstatement, without 
change, of a previously approved collection; Title of Information 
Collection: Expanded Coverage for Diabetes Outpatient Self-Management 
Training Services and Supporting Regulations Contained in 42 CFR 
410.141-410.146 and 414.63; Form No.: CMS-R-247 (OMB 0938-
0818); Use: 42 CFR 410.141-410.146 and 414.63 provide for uniform 
coverage of diabetes outpatient self-management training services. 
These services include educational and training services furnished to a 
beneficiary with diabetes by an entity approved to furnish the 
services. The physician or qualified nonphysician practitioner treating 
the beneficiary's diabetes certifies that these services are needed as 
part of a comprehensive plan of care. The regulations set forth the 
quality standards that an entity is required to meet in order to 
participate in furnishing diabetes outpatient self-management training 
services; Frequency: On occasion; Affected Public: Business or other 
for-profit; Number of Respondents: 1,708; Total Annual Responses: 
6,832; Total Annual Hours: 53,013.5.
    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 
within 30 days of this notice directly to the OMB desk officer: OMB 
Human Resources and Housing Branch, Attention: Brenda Aguilar, New 
Executive Office Building, Room 10235, Washington, DC 20503, Fax 
Number: (202) 395-6974.

    Dated: August 21, 2003.
Dawn Willinghan,
Acting Paperwork Reduction Act Team Leader, CMS Reports Clearance 
Officer, Office of Strategic Operations and Strategic Affairs, Division 
of Regulations Development and Issuances.
[FR Doc. 03-22076 Filed 8-28-03; 8:45 am]

BILLING CODE 4120-03-M