Change Requests

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Medicare Enrollment Application for Physician and Non-Physician Practitioners (CMS-855I)

Key Information

Abstract

The primary function of the CMS-855I Medicare enrollment application for physicians and non-physician practitioners is to gather information from an individual provider or supplier that tells us who he/she is, whether he/she meets certain qualifications to be a Medicare health care provider or supplier, where he/she practices or renders services, and other information necessary to establish correct claims payments.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 424.500	View Law

Pub.L. 109 - 220 508	View Law

42 USC 424.502	View Law

31 USC 7701(c)	View Law

5 USC 522(b)(4)	View Law

26 USC 501(c)	View Law

26 USC 3402(t)	View Law

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Essential Community Provider-Network Adequacy (ECP/NA) Data Collection to Support QHP Certification (CMS-10803)

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Abstract

In accordance with section 1311(c)(1)(C) of the Affordable Care Act (ACA), Qualified Health Plan (QHP) issuers, including Stand-alone Dental Plan (SADP) issuers, are required to ensure access to a sufficient number and geographic distribution of essential community providers (ECPs), where available, that serve predominantly low-income, medically-underserved individuals. Under 45 Code of Federal Regulations (CFR) 156.235, the Secretary of HHS has established criteria for inclusion of a sufficient number and geographic distribution of ECPs, where available, in an issuer’s network to ensure reasonable and timely access to a broad range of such providers for low-income, medically underserved individuals in their service areas. To satisfy this ECP requirement, medical QHP and SADP issuers must submit an Essential Community Provider/Network Adequacy (ECP/NA) template as part of their QHP application, in which they must list the ECPs with whom they have contracted. In the Issuer Module, issuers will also have to attest to meeting each element of the ECP standard. In accordance with section 1311(c)(1)(B) of the ACA, QHP issuers, including SADP issuers, are required to ensure a sufficient choice of providers (in a manner consistent with the applicable provisions under section 2702(c) of the Public Health Service Act). Under CFR 156.230, QHPs that use a provider network must ensure that the network is sufficient in number and types of providers, including providers that specialize in mental health and substance use disorder services, to assure that all services will be accessible without unreasonable delay. This information collection request (ICR) serves as a formal request for a new clearance associated with the Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2023 Proposed Rule (2023 Payment Notice). This ICR details the burden associated with collecting and reviewing essential community provider and network adequacy data.

Federal Register Notices

60-Day FRN	View Notice

Authorizing Statutes

45 USC 156	View Law

Pub.L. 111 - 156 1311	View Law

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Medicare Quality of Care Complaint Form (CMS-10287)

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Abstract

In accordance with Section 1154(a)(14) of the Social Security Act, QIOs are required to conduct appropriate reviews of all written complaints submitted by beneficiaries concerning the quality of care received. This form will establish a standard form for all beneficiaries to utilize and ensure pertinent information is obtained by QIOs to effectively process these complaints.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1395c-3(a)(14)	View Law

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Accrediting Agencies Reporting Activities for Institutions and Programs - Database of Accredited Postsecondary Institution and Programs (DAPIP)

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Abstract

Sections 496(a)(7) (a)(8) (c)(7) and (c)(8) of the Higher Education Act (HEA) and federal regulations at 34 CFR 34 CFR § § 602.26 and 602.27 contain certain requirements for reporting by recognized accrediting agencies to the Department on the institutions and programs the agencies accredit. This collection specifies the required and requested reporting. It also discusses the channel for reporting this information and reporting information the accrediting agency may wish to submit voluntarily to ensure that the Department's Database of Accredited Postsecondary Institutions and Programs is accurate and comprehensive.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

20 USC 1099b	View Law

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Passenger Ferry Grant Program, Electric or Low-Emitting Ferry Pilot Program, and Ferry Service for Rural Communities Program

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Abstract

The Passenger Ferry Grant Program provides funding for passenger ferries through a competitive process for capital projects that support passenger ferry systems in urbanized areas, such as ferry vessels, terminals, and related infrastructure. The Electric or Low-Emitting Ferry Pilot Program makes federal funds available for projects that support the purchase of electric or low-emitting ferry vessels. The Ferry Service for Rural Communities Program makes federal funds available to states to ensure basic essential ferry service is provided to rural areas. This information collection (IC) request is for an extension without change of a currently approved collection, which is due to expire on February 28, 2026. This is a voluntary program where applicants submit initial information at the application stage, and if funding is awarded, additional information is submitted during the project management stage. Eligible recipients include direct recipients of Section 5307 Urbanized Area Formula Program funding, designated recipients of Section 5307 funding, public entities engaged in providing public transportation passenger ferry service in urban areas that are eligible to be direct recipients, states, territories, and tribal governments. Information is collected online via FTA's Transit Award Management System (TrAMS).

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 117 - 58 71102-71103	View Law

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The Recognition Process for Accrediting Agencies, State Approval Agencies; Evaluation of Foreign Medical, and Foreign Veterinary Accrediting Agencies(e-Recognition)

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Abstract

The United States (U.S.) Secretary of Education (the Secretary) is required by law to publish a list of nationally recognized accrediting agencies that have been determined to be reliable authorities regarding the quality of education or training offered by the institutions or programs they accredit. The system is the e-Recognition system. In determining whether a specific agency should be recognized, the Secretary evaluates the submission for compliance with the criteria for Recognition contained in regulations. The collection of information is necessary for the Secretary to evaluate compliance with each of the criteria and to monitor the continued compliance with the criteria during any period of recognition granted. The authority for collecting this information is contained in the Higher Education Act of 1965, as amended § 496 (HEA), and implementing regulations at 34 CFR § 602. The data is required in order for recognized accrediting agencies to demonstrate compliance with 34 CFR § 602. The Secretary will use these criteria in determining whether an accrediting agency is a reliable authority as to the quality of education or training provided by institutions of higher education they accredit. The data is required by State Agencies for the approval of Vocational Education to demonstrate compliance with 34 CFR § 603. The Secretary will use these criterial to determine whether a State Agency for the Approval of Vocational Education is a reliable authority as to the quality of education or training provided by the vocational institutions of higher education they accredit. The data is also required in order for State approval Agencies for Nurse Education to demonstrate compliance with the criteria and procedures for recognition of State Agencies for Approval of Nurse Education. The Secretary will use these criteria in determining whether a State agency is a reliable authority as to the quality of training offered by schools of nursing.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

20 USC 1099b	View Law

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Supporting Statement for Agent/Broker Consent Information Collection (CMS-10840)

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Abstract

The Patient Protection and Affordable Care Act, Public Law 111-148, enacted on March 23, 2010, and the Health Care and Education Reconciliation Act, Public Law 111-152, enacted on March 30, 2010 (collectively, “Affordable Care Act”), expanded access to health insurance for individuals and employees of small businesses through the establishment of new Affordable Insurance Exchanges (Exchanges), also called Marketplaces. The Exchanges, which became operational on January 1, 2014, enhance competition in the health insurance market, expand access to affordable health insurance for millions of Americans, and provide consumers with a place to easily compare and shop for health insurance coverage. Section 1312(e) of the Affordable Care Act directs the Secretary of the Department of Health and Human Services (HHS) to establish procedures under which a state may permit agents and brokers to enroll qualified individuals and employers into qualified health plans (QHPs) offered through an Exchange and to enable these agents and brokers to assist individuals in applying for advance payments of the premium tax credit and cost-sharing reductions. Authority for collection of this information comes from 45 C.F.R. §155.220(c)(5), which states that “HHS or its designee may periodically monitor and audit an agent, broker, or web-broker under this subpart to assess its compliance with the applicable requirements of this section.” This information collection specifically details what information will be required to be collected and maintained by agents, brokers, and web-brokers were they to receive a request from HHS for consent records. Currently, HHS only plans to collect information from a small percentage of agents, brokers, or web-brokers in conjunction with active investigations of potential fraud. Utilizing §155.220(c)(5) and the information to be collected under newly proposed §§ 155.220(j)(2)(ii)(A)(1-2) and 155.220(j)(2)(iii)(A-C), HHS will be able to verify whether or not an agent, broker, or web-broker has obtained consent from a consumer they are assisting in enrolling in coverage in the individual market, and whether the consumer has reviewed their eligibility information and confirmed its accuracy.

Federal Register Notices

60-Day FRN	View Notice

Authorizing Statutes

45 USC 155.220	View Law

Pub.L. 111 - 148 1312	View Law

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Collection of Diagnostic Data in the Abbreviated RAPS Format from Medicare Advantage Organizations for Risk Adjusted Payments (CMS-10062)

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Abstract

Section 1853 of the Social Security Act, hereafter referred to as “the Act,” requires CMS to make advance monthly payments to a Medicare Advantage (MA) organization for each beneficiary enrolled in an MA plan offered by the organization for coverage of Medicare Part A and Part B benefits. Section 1853(a)(1)(C) of the Act requires CMS to adjust the monthly payment amount for each enrollee to take into account the health status of MA plan enrollees. CMS used RAPS data, in combination with encounter data and Fee-For-Service (FFS) data, to develop the diagnosis-based portion of the risk scores for risk adjusted payment to MA organizations, PACE organizations, and MMPs. Risk adjustment allows CMS to pay plans for the health risk of the beneficiaries they enroll, instead of paying an identical average amount for each enrollee. By risk adjusting plan payments, CMS is able to make appropriate and accurate payments for enrollees with differences in expected costs. Risk adjustment is used to adjust bidding and payment based on the health status and demographic characteristics of an enrollee. Risk scores measure individual beneficiaries’ relative risk and the risk scores are used to adjust payments for each beneficiary’s expected expenditures. By risk adjusting plan bids, CMS is able to also use standardized bids as base payments to plans.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1395w-23	View Law

42 USC 1395 w-23	View Law

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Data Request and Attestation for PDP Sponsors (CMS-10691)

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Abstract

42 CFR 423.513(g)(1)(i) states that beginning in plan year 2020, a PDP sponsor may submit a request to CMS for the data described in paragraph (g)(2) about enrollees in its prescription drug plans. In addition, paragraph (g)(5) provides that as a condition of receiving the requested data, the PDP sponsor must attest that it will adhere to the permitted uses and limitations on the use of the Medicare claims data listed in paragraphs (g)(3) and (4).

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 115 - 123 50354	View Law

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Financial Report Form ETA-9130

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ETA utilizes the e-Grants Federal Reporting System, an online 9130 reporting system for recipients to enter and certify quarterly financial data. The data collected is used to assess the effectiveness of ETA programs and to monitor and analyze the financial activity of its recipients. This data collection format permits ETA to evaluate program effectiveness, monitor compliance with statutory limitations, and analyze financial activity, while complying with OMB efforts to streamline Federal financial reporting.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

29 USC 3245	View Law

Pub.L. 106 - 107 8	View Law

29 USC 3244(c) and (d)	View Law

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Bus Testing Program

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Abstract

This information collection (IC) request seeks a three-year extension without change for the currently approved collection under OMB Control Number 2132‑0550, “Bus Testing Program.” There have been no changes to the respondent universe, burden hours, or program requirements since OMB last approved this collection in 2023. The response to this collection remains required to obtain or retain a benefit, as federal funds may not be obligated or expended for the acquisition of a new transit bus unless the vehicle satisfies all requirements of FTA’s Bus Testing Program. Respondents to this collection are transit bus manufacturers who submit testing requests to FTA when introducing a new bus model or when major modifications are made to a model previously tested. All information is submitted through FTA’s online bus testing portal. Required information includes bus model and manufacturer details, vehicle specifications, documentation demonstrating compliance with Federal Motor Vehicle Safety Standards, and descriptions of major design changes, if applicable. While the program itself has not changed, this updated IC reflects increased cost estimates for both respondents and the federal government due solely to updated labor rates.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

49 USC 5318	View Law

49 USC 5323(c)	View Law

Pub.L. 112 - 141 5318(e)	View Law

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Tobacco Retailer Training Programs

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Abstract

FDA intends to issue regulations establishing standards for approved tobacco retailer training programs. In the interim, FDA published a guidance document which is intended to assist tobacco retailers to voluntarily implement effective training programs for employees. Until FDA promulgates regulations, the agency intends to use the lower maximum civil money penalties schedule for all retailers who violate the restriction of the sale and distribution of cigarettes and smokeless tobacco products, whether or not they have implemented a training program. FDA may consider further reducing the civil money penalty for retailers who have implemented a training program. Retailers who have received a Complaint for Civil Money Penalties or No-Tobacco Sale Order and who wish to submit evidence that they have a training program in place, for purposes of settlement negotiations only, may do so when filing an Answer to the Complaint.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

21 USC 387f(d)	View Law

Pub.L. 111 - 31 103	View Law

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Research Performance Progress Report (RPPR)

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Abstract

Agencies are able to utilize this uniform format for reporting performance progress on Federally funded research projects. The Research Performance Progress Report (RPPR) directly benefits award recipients by making it easier for them to administer Federal grant and cooperative agreement programs through standardization of the types of information required in interim performance reports, thereby reducing their administrative effort and costs. The RPPR also makes it easier to compare the outputs, outcomes, etc. of research programs across the government.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1861 et seq.	View Law

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Recreation Survey Questions

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Abstract

Data obtained from the Recreation Survey Questions will have application to the overall effort expended throughout the Bureau of Reclamation. From the highest level in the organization to the field unit responsible for day-to-day operations and maintenance. Reclamation recreation planners and managers will use the data to help formulate decisions regarding where to plan and develop facilities, services and opportunities while concentrating financial and personnel resources to produce the highest level of public service.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

16 USC 460	View Law

43 USC 37	View Law

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Diversions, Return Flow, and Consumptive Use of Colorado River Water in the Lower Colorado River Basin

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Abstract

The United States is required to collect this information by the Supreme Court and requires water users to report this information under water delivery contracts.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

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Pension Benefit Statement

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Abstract

Section 105(a) of the Employee Retirement Income Security Act (ERISA) requires administrators of defined contribution plans and defined benefit plans to provide periodic pension benefit statements to participants and certain beneficiaries. If a defined contribution plan permits participants and beneficiaries to direct their own investments, benefit statements must be provided at least once each quarter. If the defined contribution plan does not permit participants and beneficiaries to direct their own investments, benefit statements must be provided at least once each year. In the case of defined benefit plans, benefit statements generally must be provided at least once every three years. Section 105(a)(2)(A)(i)(I) requires a benefit statement to indicate the participant's or beneficiary's “total benefits accrued.” On December 20, 2019, ERISA section 105 was amended by section 203 of the Setting Every Community Up for Retirement Enhancement Act of 2019 (SECURE Act). As amended, ERISA section 105 requires, in relevant part, that “a lifetime income disclosure . . . be included in only one pension benefit statement provided to participants of defined contribution plans during any one 12-month period.” A lifetime income disclosure “shall set forth the lifetime income stream equivalent of the total benefits accrued with respect to the participant or beneficiary.” A lifetime income stream equivalent means the amount of monthly payments the participant or beneficiary would receive if the total accrued benefits of such participant or beneficiary were used to provide a single life annuity and a qualified joint and survivor annuity.

Federal Register Notices

60-Day FRN	View Notice

Authorizing Statutes

29 USC 1104	View Law

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The Used Car Rule

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Abstract

The Federal Trade Commission seeks renewed OMB clearance for the information collection provisions implementing the provisions of the Used Car Trade Regulation Rule, 16 CFR Part 455. The Used Car Rule requires dealers to display on used cars offered for sale a window sticker called a “Buyers Guide” containing warranty and other information. The Rule also requires Spanish language versions of the Buyers Guide when dealers conduct sales in Spanish.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

15 USC 2301-2132	View Law

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Form USM-523A, Sequestered Juror Information Form

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Abstract

The United States Marshals Service is responsible for ensuring the security of federal courthouses, courtrooms, and federal jurist. The information collected in this form assists Marshals Service personnel in the planning of, and response to, potential security needs of the court and jurors during the course of proceedings.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

28 USC 561	View Law

28 USC 509	View Law

28 USC 510	View Law

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Approval of Laboratories for Conducting Aquatic Animal Tests for Export Health Certificates

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Abstract

The purpose of this information collection is to provide approval to laboratories to conduct tests for the export of aquatic animals. The information collection activities permit APHIS to vet the laboratories.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

7 USC 8301	View Law

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Pacific Cod Trawl Cooperative Program

Key Information

Abstract

This is a renewal and revision of a previously approved collection for the Pacific Cod Trawl Cooperative Program (PCTC Program). This collection contains ongoing information collection requirements submitted by participating harvesters and processors for the following forms: (1) Application for PCTC Program Cooperative Quota (CQ), (2) Application for Inter-Cooperative Transfer of CQ, (3) Application for Transfer of PCTC Program Quota Share (QS) for Processors, and (4) Notification of Intent to Process PCTC Program Pacific Cod. As part of this revision, NMFS is removing the following forms which are no longer needed: (1) Application for PCTC Program Quota Share (QS) and (2) Ninety-Day Transfer Window for Non-Exempt American Fisheries Act (AFA) License Limitation Program (LLP) holders. This revision also removes the formal appeal process for CQ allocations, as this was only used during implementation of the program. The PCTC Program is a limited access privilege program for the harvest of Pacific cod in the Bering Sea and Aleutian Islands trawl catcher vessel sector. This program is necessary to increase the value of fishery, minimize bycatch to the extent practicable, provide for the sustained participation of fishery-dependent communities, ensure the sustainability and viability of the resource, and promote safety and stability in the harvesting and processing sectors. This information collection contains the collection instruments necessary for NMFS to implement the PCTC Program and manage cooperative quota and quota share in this fishery.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 94 - 265 303	View Law

16 USC 773c	View Law

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National Incident-Based Reporting System (NIBRS)

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Under Title 28, United States Code (U.S.C.), Section (§) 534 and 34 U.S.C. § 41303, this collection requests incident-based data from law enforcement agencies in order for the FBI UCR Program to collect and disseminate NIBRS data.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

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Semi-Annual Performance Report for the Financial Assistance to Victims of Domestic Violence, Dating Violence, Sexual Assault, and Stalking Program (FAV Program)

Key Information

Abstract

The Financial Assistance Grants for Victims of Sexual Assault, Domestic Violence, Dating Violence, and Stalking Program (hereinafter referred to as the FAV Program), supports victim service providers, Tribal governments, and Tribal organizations to provide flexible financial assistance to survivors of sexual assault, domestic violence, dating violence, and stalking. Currently, there are different statutory and regulatory reporting requirements that affect FAV Program grantees. VAWA 2000 requires all VAWA grantees, including FAV Program grantees, to report on the effectiveness of their programs.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 119 - 74 5	View Law

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Application for Asylum and for Withholding of Removal

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Abstract

The information collected on this application will be used to determine whether an alien applying for asylum and/or withholding of removal in the United States is classifiable as a refugee, or eligible for protection under the Convention Against Torture, and is eligible to remain in the United States.

Federal Register Notices

60-Day FRN	View Notice

Authorizing Statutes

8 USC 1158	View Law

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Explosives licensee/permittee out-of-business records

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Abstract

Regulations under 27 CFR 555.128 require explosives licensees/permittees to transfer required records to the ATF Out-of-Business Records Center when they discontinue business without a successor. The records on licensee/permittee importing, manufacturing, shipping, receiving, selling, or otherwise disposing of explosive materials aid ATF in conducting investigations into trafficking and other criminal misuse of explosives.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

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Job Corps Application Data

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Abstract

ETA 652, Job Corps Applicant Data Sheet, is critical to the screening process. This form is completed by the admissions representative in collaboration with each applicant to determine the applicant’s eligibility for the Job Corps program in accordance with WIOA and Job Corps policy and to collect socio-demographic and employment barriers information for program planning, evaluation, and data reporting purposes. This ICR also contains verbal questions on dependents and childcare.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

29 USC 3194-3195	View Law

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