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Federal Register / Vol. 86, No. 208 / Monday, November 1, 2021 / Notices
lotter on DSK11XQN23PROD with NOTICES1

FOR FURTHER INFORMATION CONTACT:

William Parham at 410 7864669.
SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 PRA
44 U.S.C. 35013520, 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 44 U.S.C.
3506c2A requires federal agencies to publish a 30-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 that summarizes the following proposed collections of information for public comment:
1. 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 Annual Responses: 7,988; Total Annual Hours: 3,994. For policy questions regarding this collection contact Kathleen Todd at 4107863385.
2. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: ICF/IID Survey Report Form and Supporting Regulations; Use: The information collected with forms 3070G, CMS
3070H and CMS3070I is used by the surveyors from the State Survey Agencies SAs to determine the level of compliance with the ICF/IID Conditions of Participation CoPs necessary to
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participate in the Medicare/Medicaid program and to report any noncompliance with the ICF/IID CoPs to the Federal government. These forms summarize the survey team characteristics, facility characteristics, client population, and the special needs of clients. These forms are used in conjunction with the CMS regulation text and additional surveyor aids such as the CMS interpretive guidelines and probes. The CMS3070GI forms serves as coding worksheets, designed to facilitate data entry and retrieval into the Automated Survey Processing Environment Suite ASPEN in the State and at the CMS regional offices. Form Number: CMS3070GI OMB control number: 09380062; Frequency:
ReportingYearly; Affected Public:
Business or other for-profits and Notfor-profit institutions; Number of Respondents: 5,758; Total Annual Responses: 5,758; Total Annual Hours:
17,274. For policy questions regarding this collection contact Caroline Gallaher at 4107868705.
Dated: October 27, 2021.
William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs.
FR Doc. 202123779 Filed 102921; 8:45 am BILLING CODE 412001P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid Services Document Identifiers CMSR235 and CMSR262

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
SUMMARY:

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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 January 3, 2022.
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.
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.
CMSR235 Data Use Agreement DUA Form, Research Identifiable Files Request Packet CMSR262 CMS Plan Benefit Package PBP and Formulary CY
2023
Under the PRA 44 U.S.C. 3501
3520, federal agencies must obtain approval from the Office of Management
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