Agency Information Collection Activities: Submission for OMB Review; Comment Request, 35255-35256 [05-11929]
Download as PDF
Federal Register / Vol. 70, No. 116 / Friday, June 17, 2005 / Notices
Dated: June 3, 2005.
Jim L. Wickliffe,
CMS Paperwork Reduction Act Reports
Clearance Officer, Regulations Development
Group, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 05–11722 Filed 6–16–05; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10143, CMS–
10140, CMS–460, CMS–R–65]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Centers for Medicare &
Medicaid Services, HHS.
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Centers for Medicare & Medicaid
Services (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 function;
(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: New collection; Title of
Information Collection: Monthly State
File of Medicaid/Medicare Dual Eligible
Enrollees and Supporting Regulations in
42 CFR 423.900 through 423.910; Use:
The monthly file of dual eligible
enrollees will be used to determine
those duals with drug benefits for the
phased-down State contribution process
required by the Medicare Modernization
Act of 2003 (MMA). Section 103(a)(2) of
the MMA addresses the phased-down
state contribution (PDSC) process for the
Medicare program. The reporting of the
Medicare/Medicaid dual eligibles on a
monthly basis is necessary to implement
those provisions, and to Support Part D
subsidy determinations and autoassignment of individuals to Part D
plans. The PDSC is a partial recoupment
AGENCY:
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17:59 Jun 16, 2005
Jkt 205001
from the States of ongoing Medicaid
drug costs for dual eligibles assumed by
Medicare under MMA, which absent the
MMA would have been paid for by the
States; Form Number: CMS–10143
(OMB# 0938–NEW); Frequency:
Recordkeeping and Monthly reporting;
Affected Public: State, local or tribal
government; Number of Respondents:
51; Total Annual Responses: 612; Total
Annual hours: 10,710.
2. Type of Information Collection
Request: New Collection; Title of
Information Collection: Claims Error
Rate Testing (CERT)/Electronic Medical
Records Exploratory Survey; Form No.:
CMS–10140 (OMB# 0938–NEW); Use:
The Centers for Medicare and Medicaid
Services (CMS) is using a private vendor
to conduct market research to assess the
value of electronic patient medical
records relative to the Claims Error Rate
Testing (CERT) program and determine
what actions CMS can take to encourage
the use of electronic records for the
purpose of lowering the CERT error rate.
The proposed effort will test the
hypothesis that increased functionality
of electronic records (meaning, greater
connectivity and features), is associated
with lower CERT error rates related to
coding, non-response and incomplete
documentation. The project is expected
to assist CMS in identifying a strategy to
improve the CERT claims error rate by
developing an approach that would both
facilitate and encourage the use of
electronic patient medical records in the
health care setting. This research
focuses on physician practices,
outpatient hospitals, durable medical
equipment (DME) providers and skilled
nursing facilities (SNFs) that have been
randomly sampled as part of the CERT
process.; Frequency: On occasion;
Affected Public: Business or other forprofit; Number of Respondents: 1600;
Total Annual Responses: 1600; Total
Annual Hours: 454.
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Medicare
Participating Physician or Supplier
Agreement; Form No.: CMS–460 (OMB#
0938–0373); Use: Form number CMS–
460 is completed by nonparticipating
physicians and suppliers if they choose
to participate in Medicare Part B. By
signing the agreement, the physician or
supplier agrees to take assignment on all
Medicare claims. To take assignment
means to accept the Medicare allowed
amount as payment in full for the
services they furnish and to charge the
beneficiary no more than the deductible
and coinsurance for the covered service.
In exchange for signing the agreement,
the physician or supplier receives a
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35255
significant number of program benefits
not available to nonparticipating
suppliers. The information associated
with this collection is needed to identify
the recipients of the program benefits;
Frequency: Other—when starting a new
business; Affected Public: Business or
other for-profit; Number of
Respondents: 6000; Total Annual
Responses: 6000; Total Annual Hours:
1500.
4. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Information
Collection Requirements in Final Peer
Review Organization Regulations, 42
CFR sections 1004.40, 1004.50, 1004.60,
1004.70; Form No.: CMS–R–65 (OMB#
0938–0444); Use: This final rule updates
the procedures governing the imposition
and adjudication of program sanctions
predicated on the recommendations of
Peer Review Organizations (PROs).
These changes are being made as a
result of statutory revisions designed to
address health care fraud and abuse
issues in the OIG sanction process. The
Peer Review Improvement Act of 1982
amended Title XI of the Social Security
Act, creating the Utilization and Quality
Control Peer Review Organization
program. Section 1156 of the Social
Security Act imposes obligations on
health care practitioners and other
persons who furnish or order services or
items under Medicare. This section also
provides for sanction actions, if the
Secretary determines that the
obligations as stated by this section are
not met. Quality Improvement
Organizations (QIOs) are responsible for
identifying violations. QIOs may allow
practitioners or other persons,
opportunities to submit relevant
information before determining that a
violation has occurred. These
requirements are used by the QIOs to
collect the information necessary to
make their determinations; Frequency:
On occasion; Affected Public: Not-forprofit institutions; Number of
Respondents: 53; Total Annual
Responses: 1060; Total Annual Hours:
22,684.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access CMS Web site
address at https://www.cms.hhs.gov/
regulations/pra/, or e-mail your request,
including your address, phone number,
OMB number, and CMS document
identifier, to Paperwork@cms.hhs.gov,
or call the Reports Clearance Office on
(410) 786–1326.
Written comments and
recommendations for the proposed
information collections must be mailed
E:\FR\FM\17JNN1.SGM
17JNN1
35256
Federal Register / Vol. 70, No. 116 / Friday, June 17, 2005 / Notices
within 30 days of this notice directly to
the OMB desk officer:
OMB Human Resources and Housing
Branch, Attention: Christopher
Martin, New Executive Office
Building, Room 10235, Washington,
DC 20503.
Dated: June 10, 2005.
Jim L. Wickliffe,
CMS Reports Clearance Officer, Regulations
Development Group, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 05–11929 Filed 6–16–05; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–R–262, CMS–R–
254, CMS–1450, CMS–10146, CMS–10147,
CMS–10154, and CMS–10160]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, HHS.
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Centers for Medicare & Medicaid
Services (CMS) 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: Extension of a currently
approved collection; Title of
Information Collection: Plan Benefit
Package (PBP) and Formulary
Submission for Medicare Advantage
(MA) Plans and Prescription Drug Plans
(PDPs); Form No.: CMS–R–262 (OMB #
0938–0763); Use: Under the Medicare
Modernization Act (MMA), Medicare
Advantage (MA) and Prescription Drug
Plan (PDP) organizations are required to
submit plan benefit package information
to CMS for approval. Organizations will
provide this information through the
AGENCY:
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Jkt 205001
submission of the formulary and the
PBP software; Frequency: On occasion,
annually and other (as required by new
legislation); Affected Public: Business or
other for-profit and Not-for-profit
institutions; Number of Respondents:
470; Total Annual Responses: 2,092;
Total Annual Hours: 5,546.
2. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: National
Medicare Education Program (NMEP);
Form No.: CMS–R–254 (OMB # 0938–
0738); Use: The NMEP was developed to
inform people with Medicare, their
family members, and other interested
parties about their Medicare options.
The Medicare Modernization Act of
2003 expanded the program to include
among other things, a new Prescription
Drug Benefit; therefore, this package has
been revised to include this
information. The NMEP employs
numerous communication channels to
educate people with Medicare and help
them make more informed decisions
concerning the Medicare program
benefits; health plan choices;
supplemental health insurance; rights,
responsibilities, and protections; and
preventive health services. As part of
the NMEP, CMS must provide
information to this population about the
Medicare program and their Health Plan
options, as well as information about
the new prescription drug coverage to
help them choose the option that is right
for them. This survey seeks to assess the
awareness, knowledge, understanding
and experiences of people with
Medicare regarding the Medicare
program overall and these new
initiatives; Frequency: On occasion;
Affected Public: Individuals or
Households; Number of Respondents:
5,700; Total Annual Responses: 5,700;
Total Annual Hours: 1,425.
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Medicare
Uniform Institutional Provider Bill and
Supporting Regulations in 42 CFR
424.5; Form No.: CMS–1450 (OMB #
0938–0279); Use: Section 42 CFR
424.5(a)(5) requires providers of services
to submit claims prior to Medicare
reimbursement. Charges are coded by
revenue codes. The bill specifies
diagnoses according to the International
Classification of Diseases, Ninth Edition
(ICD–9–CM) code. Inpatient procedures
are identified by ICD–9–CM codes, and
outpatient procedures are described
using the Healthcare Common
Procedure Coding System (HCPCS).
These are standard systems of
identification for all major health
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Frm 00036
Fmt 4703
Sfmt 4703
insurance claims payers. Submission of
information on the CMS–1450 permits
Medicare intermediaries to receive
consistent data for proper payment;
Frequency: On occasion; Affected
Public: Not-for-profit institutions,
Business or other for profit; Number of
Respondents: 51,629; Total Annual
Responses: 174,461,278; Total Annual
Hours: 1,997,581.
4. Type of Information Collection
Request: New Collection; Title of
Information Collection: Notice of Denial
of Medicare Prescription Drug Coverage;
Form No.: CMS–10146 (OMB # 0938–
NEW); Use: Pursuant to 42 CFR
423.568(c), if a Part D plan denies drug
coverage, in whole or in part, the Part
D plan must give the enrollee written
notice of the coverage determination;
Frequency: Other: Distribution; Affected
Public: Business or other for profit, Notfor-profit institutions; Individuals or
Households and Federal Government;
Number of Respondents: 450; Total
Annual Responses: 1,056,000; Total
Annual Hours: 528,000.
5. Type of Information Collection
Request: New Collection; Title of
Information Collection: Medicare
Prescription Drug Coverage and Your
Rights; Form No.: CMS–10147 (OMB #
0938–NEW); Use: Pursuant to 42 CFR
423.562(a)(3), a Part D plan sponsor
must arrange with its network
pharmacies to post or distribute notices
informing enrollees to contact their plan
to request a coverage determination or
an exception if the enrollee disagrees
with the information provided by the
pharmacy; Frequency: Other:
Distribution; Affected Public: Business
or other for profit, Not-for-profit
institutions; Individuals or Households
and Federal Government; Number of
Respondents: 41,000; Total Annual
Responses: 35,000,000; Total Annual
Hours: 583,333.
6. Type of Information Collection
Request: New collection; Title of
Information Collection: Physician
Assessment of Hospital Quality Reports;
Form No.: CMS–10154 (OMB # 0938–
NEW); Use: This assessment will
monitor the attitudes and behaviors of
physicians as they relate to the concerns
of their patients who have been exposed
to hospital quality-of-care reports at
CMS’s Web site; Affected Public:
Individuals or Households; Number of
Respondents: 1730; Total Annual
Responses: 1730; Total Annual Hours:
345.75.
7. Type of Information Collection
Request: New collection; Title of
Information Collection: The Personal
Responsibility Survey; Form No.: CMS–
10160 (OMB # 0938–NEW); Use: New
focus on personalizing messages by
E:\FR\FM\17JNN1.SGM
17JNN1
Agencies
[Federal Register Volume 70, Number 116 (Friday, June 17, 2005)]
[Notices]
[Pages 35255-35256]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-11929]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10143, CMS-10140, CMS-460, CMS-R-65]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid
Services (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 function; (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: New collection; Title of
Information Collection: Monthly State File of Medicaid/Medicare Dual
Eligible Enrollees and Supporting Regulations in 42 CFR 423.900 through
423.910; Use: The monthly file of dual eligible enrollees will be used
to determine those duals with drug benefits for the phased-down State
contribution process required by the Medicare Modernization Act of 2003
(MMA). Section 103(a)(2) of the MMA addresses the phased-down state
contribution (PDSC) process for the Medicare program. The reporting of
the Medicare/Medicaid dual eligibles on a monthly basis is necessary to
implement those provisions, and to Support Part D subsidy
determinations and auto-assignment of individuals to Part D plans. The
PDSC is a partial recoupment from the States of ongoing Medicaid drug
costs for dual eligibles assumed by Medicare under MMA, which absent
the MMA would have been paid for by the States; Form Number: CMS-10143
(OMB 0938-NEW); Frequency: Recordkeeping and Monthly
reporting; Affected Public: State, local or tribal government; Number
of Respondents: 51; Total Annual Responses: 612; Total Annual hours:
10,710.
2. Type of Information Collection Request: New Collection; Title of
Information Collection: Claims Error Rate Testing (CERT)/Electronic
Medical Records Exploratory Survey; Form No.: CMS-10140 (OMB
0938-NEW); Use: The Centers for Medicare and Medicaid Services (CMS) is
using a private vendor to conduct market research to assess the value
of electronic patient medical records relative to the Claims Error Rate
Testing (CERT) program and determine what actions CMS can take to
encourage the use of electronic records for the purpose of lowering the
CERT error rate. The proposed effort will test the hypothesis that
increased functionality of electronic records (meaning, greater
connectivity and features), is associated with lower CERT error rates
related to coding, non-response and incomplete documentation. The
project is expected to assist CMS in identifying a strategy to improve
the CERT claims error rate by developing an approach that would both
facilitate and encourage the use of electronic patient medical records
in the health care setting. This research focuses on physician
practices, outpatient hospitals, durable medical equipment (DME)
providers and skilled nursing facilities (SNFs) that have been randomly
sampled as part of the CERT process.; Frequency: On occasion; Affected
Public: Business or other for-profit; Number of Respondents: 1600;
Total Annual Responses: 1600; Total Annual Hours: 454.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare
Participating Physician or Supplier Agreement; Form No.: CMS-460
(OMB 0938-0373); Use: Form number CMS-460 is completed by
nonparticipating physicians and suppliers if they choose to participate
in Medicare Part B. By signing the agreement, the physician or supplier
agrees to take assignment on all Medicare claims. To take assignment
means to accept the Medicare allowed amount as payment in full for the
services they furnish and to charge the beneficiary no more than the
deductible and coinsurance for the covered service. In exchange for
signing the agreement, the physician or supplier receives a significant
number of program benefits not available to nonparticipating suppliers.
The information associated with this collection is needed to identify
the recipients of the program benefits; Frequency: Other--when starting
a new business; Affected Public: Business or other for-profit; Number
of Respondents: 6000; Total Annual Responses: 6000; Total Annual Hours:
1500.
4. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Information
Collection Requirements in Final Peer Review Organization Regulations,
42 CFR sections 1004.40, 1004.50, 1004.60, 1004.70; Form No.: CMS-R-65
(OMB 0938-0444); Use: This final rule updates the procedures
governing the imposition and adjudication of program sanctions
predicated on the recommendations of Peer Review Organizations (PROs).
These changes are being made as a result of statutory revisions
designed to address health care fraud and abuse issues in the OIG
sanction process. The Peer Review Improvement Act of 1982 amended Title
XI of the Social Security Act, creating the Utilization and Quality
Control Peer Review Organization program. Section 1156 of the Social
Security Act imposes obligations on health care practitioners and other
persons who furnish or order services or items under Medicare. This
section also provides for sanction actions, if the Secretary determines
that the obligations as stated by this section are not met. Quality
Improvement Organizations (QIOs) are responsible for identifying
violations. QIOs may allow practitioners or other persons,
opportunities to submit relevant information before determining that a
violation has occurred. These requirements are used by the QIOs to
collect the information necessary to make their determinations;
Frequency: On occasion; Affected Public: Not-for-profit institutions;
Number of Respondents: 53; Total Annual Responses: 1060; Total Annual
Hours: 22,684.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS Web
site address at https://www.cms.hhs.gov/regulations/pra/, or e-mail your
request, including your address, phone number, OMB number, and CMS
document identifier, to Paperwork@cms.hhs.gov, or call the Reports
Clearance Office on (410) 786-1326.
Written comments and recommendations for the proposed information
collections must be mailed
[[Page 35256]]
within 30 days of this notice directly to the OMB desk officer:
OMB Human Resources and Housing Branch, Attention: Christopher Martin,
New Executive Office Building, Room 10235, Washington, DC 20503.
Dated: June 10, 2005.
Jim L. Wickliffe,
CMS Reports Clearance Officer, Regulations Development Group, Office of
Strategic Operations and Regulatory Affairs.
[FR Doc. 05-11929 Filed 6-16-05; 8:45 am]
BILLING CODE 4120-01-P