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Federal Register / Vol. 86, No. 159 / Friday, August 20, 2021 / Notices
Jeffrey M. Zirger, Lead, Information Collection Review Office, Office of Scientific Integrity, Office of Science, Centers for Disease Control and Prevention.
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid Services Document Identifier: CMS10280, CMS
1557 and CMS3070GI

Agency Information Collection Activities: Proposed Collection;
Comment Request Centers for Medicare &
Medicaid Services, Health and Human Services HHS.
ACTION: Notice.
AGENCY:

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 the 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 60 days for public comment on the proposed action. Interested persons are invited to send comments regarding our burden estimates 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 agencys 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 must be received by October 19, 2021.
ADDRESSES: When commenting, please reference the document identifier or OMB control number. To be assured consideration, comments and recommendations must be submitted in any one of the following ways:
1. Electronically. You may send your comments electronically to http
www.regulations.gov. Follow the instructions for Comment or Submission or More Search Options to find the information collection documents that are accepting comments.

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2. By regular mail. You may mail written comments to the following address: CMS, Office of Strategic Operations and Regulatory Affairs, Division of Regulations Development, Attention: Document Identifier/OMB
Control Number: ll, Room C42605, 7500 Security Boulevard, Baltimore, Maryland 212441850.
To obtain copies of a supporting statement and any related forms for the proposed collections summarized in this notice, you may make your request using one of following:
1. Access CMS website address at website address at https www.cms.gov/
Regulations-and-Guidance/Legislation/
PaperworkReductionActof1995/PRAListing.html.
FOR FURTHER INFORMATION CONTACT:
William N. Parham at 410 7864669.
SUPPLEMENTARY INFORMATION:
Contents This notice sets out a summary of the use and burden associated with the following information collections. More detailed information can be found in each collections supporting statement and associated materials see ADDRESSES.
CMS10280 Home Health Change of Care Notice CMS1557 Survey Report Form for Clinical Laboratory Improvement Amendments CLIA and Supporting Regulations CMS3070GI ICF/IID Survey Report Form and Supporting Regulations Under the 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. 35023 and 5 CFR
1320.3c and includes agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party.
Section 3506c2A of the PRA
requires federal agencies to publish a 60-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.
Information Collection 1. Type of Information Collection Request: Extension of a currently approved collection; Title of the Information Collection: Home Health Change of Care Notice; Use: The
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purpose of the Home Health Change of Care Notice HHCCN is to notify original Medicare beneficiaries receiving home health care benefits of plan of care changes. Home health agencies HHAs are required to provide written notice to Original Medicare beneficiaries under various circumstances involving the reduction or termination of items and/or services consistent with Home Health Agencies Conditions of Participation COPs.
The home health COP requirements are set forth in 189142 U.S.C.
1395bbb of the Social Security Act the Act. The implementing regulations under 42 CFR 484.10c specify that Medicare patients receiving HHA
services have rights. The patient has the right to be informed, in advance about the care to be furnished, and of any changes in the care to be furnished. The HHA must advise the patient in advance of the disciplines that will furnish care, and the frequency of visits proposed to be furnished. The HHA must advise the patient in advance of any change in the plan of care before the change is made.
Notification is required for covered and non-covered services listed in the plan of care POC. The beneficiary will use the information provided to decide whether or not to pursue alternative options to continue receiving the care noted on the HHCCN. Form Number:
CMS10280 OMB control number:
09381196; Frequency: Yearly; Affected Public: Private Sector Business or other for-profits, Not-for-Profit Institutions;
Number of Respondents: 11,157; Total Annual Responses: 12,385,108; Total Annual Hours: 824,848. For policy questions regarding this collection contact Jennifer McCormick at 410786
2852.
2. 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; Use: The form is used to report surveyor findings during a CLIA survey. For each type of survey conducted i.e., initial certification, recertification, validation, complaint, addition/deletion of specialty/subspecialty, transfusion fatality investigation, or revisit inspections the Survey Report Form incorporates the requirements specified in the CLIA regulations. Form Number:
CMS1557 OMB control number:
09380544; Frequency: Biennially;
Affected Public: Private sector Business or other for-profit and Not-for-profit institutions, State, Local or Tribal Governments and Federal Government;
Number of Respondents: 15,975; Total
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