Agency Information Collection Activities: Proposed Collection; Comment Request, 20404 [2012-8013]
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20404
Federal Register / Vol. 77, No. 65 / Wednesday, April 4, 2012 / Notices
Reports Clearance Office on (410) 786–
1326.
In commenting on the proposed
information collections please reference
the document identifier or OMB control
number. To be assured consideration,
comments and recommendations must
be submitted in one of the following
ways by June 4, 2012:
1. Electronically. You may submit
your comments electronically to https://
www.regulations.gov. Follow the
instructions for ‘‘Comment or
Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) 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 ___, Room C4–26–05,
7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: March 28, 2012.
Martique Jones,
Director, Regulations Development Group,
Division B Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2012–8009 Filed 4–3–12; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–437A and CMS–
437B]
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
emcdonald on DSK29S0YB1PROD with NOTICES
AGENCY:
VerDate Mar<15>2010
15:28 Apr 03, 2012
Jkt 226001
other forms of information technology to
minimize the information collection
burden.
1. Type of Information Collection
Request: Revision of a currently
approved collection. Title of
Information Collection: State Agency
Sheets for Verifying Exclusions from the
Inpatient Prospective Payment System
and Supporting Regulations in 42 CFR
Parts 412.20–412.29. Use: For first time
verification requests for exclusion from
the Inpatient Prospective Payment
System (IPPS), a hospital/unit must
notify the Regional Office (RO) servicing
the State in which it is located that it
believes it meets the criteria for
exclusion from the IPPS. Currently, all
new inpatient rehabilitation facilities
(IRFs) must provide written certification
that the inpatient population it intends
to serve will meet the requirements of
the IPPS exclusion criteria for IRFs.
They must also complete the Form
CMS–437A if they are a rehabilitation
unit or complete Form CMS–437B if
they are a rehabilitation hospital. This
information is submitted to the State
Agency (SA) no later than 5 months
before the date the hospital/unit would
become subject to IRF–PPS.
CMS proposes to continue to use the
Criteria Worksheets (Forms CMS–437A
and CMS–437B) for verifying first-time
exclusions from the IPPS, for complaint
surveys, for its annual 5 percent
validation sample, and for facility selfattestation. These forms are related to
the survey and certification and
Medicare approval of the IPPS-excluded
rehabilitation units and rehabilitation
hospitals.
For rehabilitation hospitals and
rehabilitation units already excluded
from the IPPS, annual onsite reverification surveys by the SA are not
required. These hospitals and units will
be provided with a copy of the
appropriate CMS–437 Worksheet at
least 120 days prior to the beginning of
its cost reporting period, so that the
hospital/unit official may complete and
sign an attestation statement and
complete and return the appropriate
CMS–437A or CMS–437B at least 120
days prior to the beginning of its cost
reporting period. Fiscal Intermediaries
(FIs) will continue to verify, on an
annual basis, compliance with the 60
percent rule (42 CFR 412.29(b)(2)) for
rehabilitation hospitals and
rehabilitation units through a sample of
medical records and the SA will verify
the medical director requirement.
The SA will maintain the documents
unless instructed otherwise by the RO.
The SA will notify the RO at least 60
days prior to the end of the
rehabilitation hospital’s/unit’s cost
PO 00000
Frm 00052
Fmt 4703
Sfmt 9990
reporting period of the IRF’s compliance
or non-compliance with the payment
requirements. The information collected
on these forms, along with other
information submitted by the IRF is
necessary for determining exclusion
from the IPPS. Hospitals and units that
have already been excluded need not
reapply for exclusion. These facilities
will automatically be reevaluated yearly
to determine whether they continue to
meet the exclusion criteria.
In this PRA package, both forms have
been revised. Form Number: CMS–437A
and CMS–437B (OCN 0938–0986).
Frequency: Yearly. Affected Public:
Private Sector (Business or other forprofits). Number of Respondents: 1,164.
Total Annual Responses: 1,164. Total
Annual Hours: 291. (For policy
questions regarding this collection
contact Georgia Johnson at 410–786–
6859. For all other issues call 410–786–
1326.)
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/
PaperworkReductionActof1995, or
Email 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.
In commenting on the proposed
information collections please reference
the document identifier or OMB control
number. To be assured consideration,
comments and recommendations must
be submitted in one of the following
ways by June 4, 2012:
1. Electronically. You may submit
your comments electronically to https://
www.regulations.gov. Follow the
instructions for ‘‘Comment or
Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) 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 CMS–437A and CMS–
437B (OCN 0938–0986), Room C4–26–
05, 7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: March 28, 2012.
Martique Jones,
Director, Regulations Development Group,
Division B Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2012–8013 Filed 4–3–12; 8:45 am]
BILLING CODE 4120–01–P
E:\FR\FM\04APN1.SGM
04APN1
Agencies
[Federal Register Volume 77, Number 65 (Wednesday, April 4, 2012)]
[Notices]
[Page 20404]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-8013]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-437A and CMS-437B]
Agency Information Collection Activities: Proposed Collection;
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) 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: Revision of a currently
approved collection. Title of Information Collection: State Agency
Sheets for Verifying Exclusions from the Inpatient Prospective Payment
System and Supporting Regulations in 42 CFR Parts 412.20-412.29. Use:
For first time verification requests for exclusion from the Inpatient
Prospective Payment System (IPPS), a hospital/unit must notify the
Regional Office (RO) servicing the State in which it is located that it
believes it meets the criteria for exclusion from the IPPS. Currently,
all new inpatient rehabilitation facilities (IRFs) must provide written
certification that the inpatient population it intends to serve will
meet the requirements of the IPPS exclusion criteria for IRFs. They
must also complete the Form CMS-437A if they are a rehabilitation unit
or complete Form CMS-437B if they are a rehabilitation hospital. This
information is submitted to the State Agency (SA) no later than 5
months before the date the hospital/unit would become subject to IRF-
PPS.
CMS proposes to continue to use the Criteria Worksheets (Forms CMS-
437A and CMS-437B) for verifying first-time exclusions from the IPPS,
for complaint surveys, for its annual 5 percent validation sample, and
for facility self-attestation. These forms are related to the survey
and certification and Medicare approval of the IPPS-excluded
rehabilitation units and rehabilitation hospitals.
For rehabilitation hospitals and rehabilitation units already
excluded from the IPPS, annual onsite re-verification surveys by the SA
are not required. These hospitals and units will be provided with a
copy of the appropriate CMS-437 Worksheet at least 120 days prior to
the beginning of its cost reporting period, so that the hospital/unit
official may complete and sign an attestation statement and complete
and return the appropriate CMS-437A or CMS-437B at least 120 days prior
to the beginning of its cost reporting period. Fiscal Intermediaries
(FIs) will continue to verify, on an annual basis, compliance with the
60 percent rule (42 CFR 412.29(b)(2)) for rehabilitation hospitals and
rehabilitation units through a sample of medical records and the SA
will verify the medical director requirement.
The SA will maintain the documents unless instructed otherwise by
the RO. The SA will notify the RO at least 60 days prior to the end of
the rehabilitation hospital's/unit's cost reporting period of the IRF's
compliance or non-compliance with the payment requirements. The
information collected on these forms, along with other information
submitted by the IRF is necessary for determining exclusion from the
IPPS. Hospitals and units that have already been excluded need not
reapply for exclusion. These facilities will automatically be
reevaluated yearly to determine whether they continue to meet the
exclusion criteria.
In this PRA package, both forms have been revised. Form Number:
CMS-437A and CMS-437B (OCN 0938-0986). Frequency: Yearly. Affected
Public: Private Sector (Business or other for-profits). Number of
Respondents: 1,164. Total Annual Responses: 1,164. Total Annual Hours:
291. (For policy questions regarding this collection contact Georgia
Johnson at 410-786-6859. For all other issues call 410-786-1326.)
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/PaperworkReductionActof1995,
or Email 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.
In commenting on the proposed information collections please
reference the document identifier or OMB control number. To be assured
consideration, comments and recommendations must be submitted in one of
the following ways by June 4, 2012:
1. Electronically. You may submit your comments electronically to
https://www.regulations.gov. Follow the instructions for ``Comment or
Submission'' or ``More Search Options'' to find the information
collection document(s) 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 CMS-437A and CMS-437B (OCN 0938-0986), Room C4-26-05,
7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Dated: March 28, 2012.
Martique Jones,
Director, Regulations Development Group, Division B Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2012-8013 Filed 4-3-12; 8:45 am]
BILLING CODE 4120-01-P