Federal Register: November 17, 2004 (Volume 69, Number 221)
DOCID: FR Doc 04-25489
SOCIAL SECURITY ADMINISTRATION
Social Security Administration
NOTICE: NOTICES
SUBJECT CATEGORY:
Agency Information Collection Activities: Comment Request
DOCUMENT SUMMARY:
The Social Security Administration (SSA) publishes a list of information
[[Page 67380]]
collection packages that will require clearance by the Office of
Management and Budget (OMB) in compliance with Public Law 10413
effective October 1, 1995, The Paperwork Reduction Act of 1995. The
information collection packages that may be included in this notice are for new information collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility and clarity; and on ways to minimize
burden on respondents, including the use of automated collection
techniques or other forms of information technology. Written comments
and recommendations regarding the information collection(s) should be
submitted to the OMB Desk Officer and the SSA Reports Clearance Officer.
(OMB), Office of Management and Budget, Attn: Desk Officer for SSA, Fax: 2023956974.
(SSA), Social Security Administration, DCFAM, Attn: Reports Clearance
Officer, Fax: 4109656400, Email: OPLM.RCO@ssa.gov.
The information collections listed below have been submitted to OMB
for clearance. In order for your comments to be considered, you must
send them by December 17, 2004. You can obtain a copy of the OMB
clearance package by calling the SSA Reports Clearance Officer at 410 9650454, or by writing to the email address listed above.
1. Application for Help With Medicare Prescription Drug Plan Costs 0960NEW
SSA published a notice in the Federal Register on September 30 (69 FR 58578) informing the public that OMB is reviewing form SSA1020, the Application for Help with Medicare Prescription Drug Plan Costs. At the time this notice was published, SSA received public comments and withheld submission of the forms in order to evaluate these comments. As a result, SSA has revised form SSA1020, submitted it to OMB for its review, and is republishing the Notice below. Comments must be received within 30 days of publication of this Notice in order to be considered.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Pub. L. 108173; MMA) establishes a new Medicare Part D program for voluntary prescription drug coverage for premium, deductible and costsharing subsidies for certain lowincome individuals. The MMA stipulates that subsidies must be available for individuals who are eligible for the program and who meet eligibility criteria for help with premium, deductible, and/or copayment costs. Form SSA1020, the Application for Help with Medicare Prescription Drug Plan Costs, collects information about an applicant's resources and is used by SSA to determine eligibility for this assistance. The respondents are individuals who are eligible for enrollment in the new program and are requesting assistance with the related costs.
Note: Since publishing the 60day Federal Register Notice (69 FR
45879), SSA has decided to conduct a pilot test of form SSA1020 in
March 2005. This test is intended to assist SSA in: (1) Determining
how eligible individuals will respond to its Part D Subsidy
application outreach (scheduled to begin in June 2005) and (2)
testing its systems processing of the SSA1020 application. SSA will use the information to make actual subsidy eligibility
determinations. The Agency will conduct the test with approximately
2,000 beneficiaries potentially eligible for Part D costsharing subsidies by providing them with copies of form SSA1020.
Type of Request: New information collection.
Number of Respondents: 5,000,000.
Frequency of Response: 1.
Average Burden Per Response: 35 minutes.
Estimated Annual Burden: 2,916,667 hours.
2. Appeal of Determination for Help With Medicare Prescription Drug Plan Costs0960NEW
SSA published a notice in the Federal Register on September 30 (69 FR 58578) informing the public that OMB is reviewing form SSA1021, Appeal of Determination for Help with Medicare Prescription Drug Plan Costs. At the time this notice was published, SSA received public comments and withheld submission of the form in order to evaluate the comments. As a result, SSA has revised form SSA1021, submitted it to OMB for its review, and is republishing the Notice below. Comments must be received within 30 days of publication of this Notice in order to be considered.
The Medicare Prescription Drug, Improvement, and Modernization Act
of 2003 (Pub. L. 108173; MMA) establishes a new Medicare Part D
program for voluntary prescription drug coverage for premium,
deductible, and costsharing subsidies for certain lowincome
individuals. The MMA stipulates that subsidies must be available for
individuals who are eligible for the program and who meet eligibility
criteria for help with premium, deductible, and/or copayment costs.
Form SSA1021, the Appeal of Determination for Help with Medicare
Prescription Drug Plan Costs, was developed to obtain information from
individuals who appeal SSA's decisions regarding eligibility or
continuing eligibility for a Medicare Part D subsidy. The respondents
are applicants who are appealing SSA's eligibility or continuing eligibility decisions.
Type of Request: New information collection.
Number of Respondents: 75,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 12,500 hours.
Dated: November 12, 2004.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 0425489 Filed 111604; 8:45 am]
BILLING CODE 419102P
SUMMARY:
Agency information collection activities; proposals, submissions, and approvals,
DOCUMENT BODY 2:
The Social Security Administration (SSA) publishes a list of information
[[Page 67380]]
collection packages that will require clearance by the Office of
Management and Budget (OMB) in compliance with Public Law 10413
effective October 1, 1995, The Paperwork Reduction Act of 1995. The
information collection packages that may be included in this notice are for new information collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility and clarity; and on ways to minimize
burden on respondents, including the use of automated collection
techniques or other forms of information technology. Written comments
and recommendations regarding the information collection(s) should be
submitted to the OMB Desk Officer and the SSA Reports Clearance Officer.
(OMB), Office of Management and Budget, Attn: Desk Officer for SSA, Fax: 2023956974.
(SSA), Social Security Administration, DCFAM, Attn: Reports Clearance
Officer, Fax: 4109656400, Email: OPLM.RCO@ssa.gov.
The information collections listed below have been submitted to OMB
for clearance. In order for your comments to be considered, you must
send them by December 17, 2004. You can obtain a copy of the OMB
clearance package by calling the SSA Reports Clearance Officer at 410 9650454, or by writing to the email address listed above.
1. Application for Help With Medicare Prescription Drug Plan Costs 0960NEW
SSA published a notice in the Federal Register on September 30 (69 FR 58578) informing the public that OMB is reviewing form SSA1020, the Application for Help with Medicare Prescription Drug Plan Costs. At the time this notice was published, SSA received public comments and withheld submission of the forms in order to evaluate these comments. As a result, SSA has revised form SSA1020, submitted it to OMB for its review, and is republishing the Notice below. Comments must be received within 30 days of publication of this Notice in order to be considered.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Pub. L. 108173; MMA) establishes a new Medicare Part D program for voluntary prescription drug coverage for premium, deductible and costsharing subsidies for certain lowincome individuals. The MMA stipulates that subsidies must be available for individuals who are eligible for the program and who meet eligibility criteria for help with premium, deductible, and/or copayment costs. Form SSA1020, the Application for Help with Medicare Prescription Drug Plan Costs, collects information about an applicant's resources and is used by SSA to determine eligibility for this assistance. The respondents are individuals who are eligible for enrollment in the new program and are requesting assistance with the related costs.
Note: Since publishing the 60day Federal Register Notice (69 FR
45879), SSA has decided to conduct a pilot test of form SSA1020 in
March 2005. This test is intended to assist SSA in: (1) Determining
how eligible individuals will respond to its Part D Subsidy
application outreach (scheduled to begin in June 2005) and (2)
testing its systems processing of the SSA1020 application. SSA will use the information to make actual subsidy eligibility
determinations. The Agency will conduct the test with approximately
2,000 beneficiaries potentially eligible for Part D costsharing subsidies by providing them with copies of form SSA1020.
Type of Request: New information collection.
Number of Respondents: 5,000,000.
Frequency of Response: 1.
Average Burden Per Response: 35 minutes.
Estimated Annual Burden: 2,916,667 hours.
2. Appeal of Determination for Help With Medicare Prescription Drug Plan Costs0960NEW
SSA published a notice in the Federal Register on September 30 (69 FR 58578) informing the public that OMB is reviewing form SSA1021, Appeal of Determination for Help with Medicare Prescription Drug Plan Costs. At the time this notice was published, SSA received public comments and withheld submission of the form in order to evaluate the comments. As a result, SSA has revised form SSA1021, submitted it to OMB for its review, and is republishing the Notice below. Comments must be received within 30 days of publication of this Notice in order to be considered.
The Medicare Prescription Drug, Improvement, and Modernization Act
of 2003 (Pub. L. 108173; MMA) establishes a new Medicare Part D
program for voluntary prescription drug coverage for premium,
deductible, and costsharing subsidies for certain lowincome
individuals. The MMA stipulates that subsidies must be available for
individuals who are eligible for the program and who meet eligibility
criteria for help with premium, deductible, and/or copayment costs.
Form SSA1021, the Appeal of Determination for Help with Medicare
Prescription Drug Plan Costs, was developed to obtain information from
individuals who appeal SSA's decisions regarding eligibility or
continuing eligibility for a Medicare Part D subsidy. The respondents
are applicants who are appealing SSA's eligibility or continuing eligibility decisions.
Type of Request: New information collection.
Number of Respondents: 75,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 12,500 hours.
Dated: November 12, 2004.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 0425489 Filed 111604; 8:45 am]
BILLING CODE 419102P