Agency Information Collection Activities: Submission for OMB Review; Comment Request, 31616-31618 [2012-12811]
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claims from physicians and suppliers.
The Medicaid State Agencies,
CHAMPUS/TriCare, Blue Cross/Blue
Shield Plans, the Federal Employees
Health Benefit Plan, and several private
health plans also use it; it is the de facto
standard ‘‘professional’’ claim form.
Medicare carriers use the data
collected on the CMS–1500 and the
CMS–1490S to determine the proper
amount of reimbursement for Part B
medical and other health services (as
listed in section 1861(s) of the Social
Security Act) provided by physicians
and suppliers to beneficiaries. The
CMS–1500 is submitted by physicians/
suppliers for all Part B Medicare.
Serving as a common claim form, the
CMS–1500 can be used by other thirdparty payers (commercial and nonprofit
health insurers) and other Federal
programs (e.g., CHAMPUS/TriCare,
Railroad Retirement Board (RRB), and
Medicaid).
However, as the CMS–1500 displays
data items required for other third-party
payers in addition to Medicare, the form
is considered too complex for use by
beneficiaries when they file their own
claims. Therefore, the CMS–1490S
(Patient’s Request for Medicare
Payment) was explicitly developed for
easy use by beneficiaries who file their
own claims. The form can be obtained
from any Social Security office or
Medicare carrier. Form Number: CMS–
1500(08/05), CMS–1490–S (OMB#:
0938–0999); Frequency: Reporting—On
occasion; Affected Public: State, Local,
or Tribal Government, Business or
other-for-profit, Not-for-profit
institutions; Number of Respondents:
1,448,346; Total Annual Responses:
988,005,045; Total Annual Hours:
21,418,336. (For policy questions
regarding this collection contact Brian
Reitz at 410–786–5001. For all other
issues call 410–786–1326.)
2. Type of Information Collection
Request: New collection; Title of
Information Collection: Health
Insurance Common Claims Form and
Supporting Regulations at 42 CFR part
424, Subpart C; Use: The Form CMS–
1500 answers the needs of many health
insurers. It is the basic form prescribed
by CMS for the Medicare program for
claims from physicians and suppliers.
The Medicaid State Agencies,
CHAMPUS/TriCare, Blue Cross/Blue
Shield Plans, the Federal Employees
Health Benefit Plan, and several private
health plans also use it; it is the de facto
standard ‘‘professional’’ claim form.
Medicare carriers use the data
collected on the CMS–1500 and the
CMS–1490S to determine the proper
amount of reimbursement for Part B
medical and other health services (as
VerDate Mar<15>2010
17:01 May 25, 2012
Jkt 226001
listed in section 1861(s) of the Social
Security Act) provided by physicians
and suppliers to beneficiaries. The
CMS–1500 is submitted by physicians/
suppliers for all Part B Medicare.
Serving as a common claim form, the
CMS–1500 can be used by other thirdparty payers (commercial and nonprofit
health insurers) and other Federal
programs (e.g., CHAMPUS/TriCare,
Railroad Retirement Board (RRB), and
Medicaid).
However, as the CMS–1500 displays
data items required for other third-party
payers in addition to Medicare, the form
is considered too complex for use by
beneficiaries when they file their own
claims. Therefore, the CMS–1490S
(Patient’s Request for Medicare
Payment) was explicitly developed for
easy use by beneficiaries who file their
own claims. The form can be obtained
from any Social Security office or
Medicare carrier.
Most recently, the National Uniform
Claim Committee (NUCC) has revised
the CMS–1500. The NUCC began
revision work on the 1500 Claim Form,
version 02/12 in 2009. The goal of this
work was to align the paper form with
some of the changes in the electronic
Health Care Claim: Professional (837),
005010X222 Technical Report Type 3
(5010) and 005010X222A1 Technical
Report Type 3 (5010A1). During the
revision work, consideration was given
to different approaches to revising the
form. The NUCC decided to proceed
with making ‘‘minor changes’’ to the
current form, which was defined as no
physical changes to the existing form
lines or underlying layout of the form.
Once the CMS–1500 (02/12) has been
approved, the CMS–1500 (08/05) will be
discontinued after a form runoff period
during which both the CMS–1500 (08/
05) and the CMS–1500 (02/12) can be
used. Form Number: CMS–1500(02/12),
CMS–1490–S (OMB#: 0938–New);
Frequency: Reporting—On occasion;
Affected Public: State, Local, or Tribal
Government, Business or other-forprofit, Not-for-profit institutions;
Number of Respondents: 1,448,346;
Total Annual Responses: 988,005,045;
Total Annual Hours: 21,418,336. (For
policy questions regarding this
collection contact Brian Reitz at 410–
786–5001. 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
PO 00000
Frm 00053
Fmt 4703
Sfmt 4703
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 July 30, 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 llll, Room C4–26–
05, 7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: May 22, 2012.
Martique Jones,
Director, Regulations Development Group,
Division B, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2012–12810 Filed 5–25–12; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier CMS–10426, CMS–
10421 and CMS–10415]
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
AGENCY:
E:\FR\FM\29MYN1.SGM
29MYN1
srobinson on DSK4SPTVN1PROD with NOTICES
Federal Register / Vol. 77, No. 103 / Tuesday, May 29, 2012 / Notices
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: End Stage Renal
Disease (ESRD) System Access Request
Form; Use: Within CMS, the Office of
Clinical Standards and Quality is
developing a new suite of systems to
support the End Stage Renal Disease
(ESRD) program. Due to the sensitivity
of the data being collected and reported,
CMS must ensure that only authorized
personnel have access to data. Personnel
are given access to the ESRD systems
through the creation of user IDs and
passwords within the QualityNet
Identity Management System (QIMS);
however, once within the system, the
system determines the rights and
privileges the personnel has over the
data within the system.
The sole purpose the End Stage Renal
Disease System (ESRD) System Access
Request Form is to identify the
individual’s data access rights once
within the ESRD system. This function
and the associated data collection is
currently being accomplished under
‘‘Part B’’ of the QualityNet Identity
Management System Account Form
(CMS–10267; OCN: 0938–1050). Once
the ESRD System Access Form is
approved, the QualityNet Identity
Management System (QIMS) Account
Form will be revised to remove Part B
from the QIMS data collection. Form
Number: CMS–10426 (OCN: 0938–
New); Frequency: Yearly; Affected
Public: Private Sector—Business or
other for-profits. Number of
Respondents: 25,000. Number of
Responses: 25,000. Total Annual Hours:
6,250. (For policy questions regarding
this collection contact Michelle Tucker
at 410–786–0736. For all other issues
call 410–786–1326.)
2. Type of Information Collection
Request: New collection; Title of
Information Collection: Fee-for-Service
Recovery Audit Prepayment Review
Demonstration and Prior Authorization
Demonstration; Use: The Centers for
Medicare & Medicaid Services (CMS) is
requesting the Office of Management
and Budget (OMB) approval of the
collections required for two
demonstrations of prepayment review
and prior authorization. The first
demonstration would allow Medicare
Recovery Auditors to review claims on
a pre-payment basis in certain States.
The second demonstration would
establish a prior authorization program
for Power Mobility Device claims in
certain States.
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Jkt 226001
For the Recovery Audit Prepayment
Review Demonstration, CMS and its
agents will request additional
documentation, including medical
records, to support submitted claims. As
discussed in more detail in Chapter 3 of
the Program Integrity Manual,
additional documentation includes any
medical documentation, beyond what is
included on the face of the claim that
supports the item or service that is
billed. For Medicare to consider
coverage and payment for any item or
service, the information submitted by
the provider or supplier (e.g., claims)
must be supported by the
documentation in the patient’s medical
records. When conducting complex
medical review, the contractor specifies
documentation they require in
accordance with Medicare’s rules and
policies. In addition, providers and
suppliers may supply additional
documentation not explicitly listed by
the contractor. This supporting
information may be requested by CMS
and its agents on a routine basis in
instances where diagnoses on a claim do
not clearly indicate medical necessity,
or if there is a suspicion of fraud.
For the Prior Authorization of Power
Mobility Devices (PMDs)
Demonstration, CMS will pilot prior
authorization for Power Mobility
Devices. Prior authorization will allow
the applicable documentation that
supports a claim to be submitted before
the item is delivered. For prior
authorization, relevant documentation
for review is submitted before the item
is delivered or the service is rendered.
CMS will conduct this demonstration in
California, Florida, Illinois, Michigan,
New York, North Carolina and Texas
based on beneficiary address as reported
to the Social Security Administration
and recorded in the Common Working
File (CWF). For the demonstration, a
prior authorization request can be
completed by the (ordering) physician
or treating practitioner and submitted to
the appropriate DME MAC for an initial
decision. The supplier may also submit
the request on behalf of the physician or
treating practitioner. The physician,
treating practitioner or supplier who
submits the request on behalf of the
physician or treating practitioner, is
referred to as the ‘‘submitter.’’ Under
this demonstration, the submitter will
submit to the DME MAC a request for
prior authorization and all relevant
documentation to support Medicare
coverage of the PMD item.
CMS has decided to amend the
requirement when subsequent prior
authorization requests are submitted.
Currently, CMS or its agents have up to
30 business days in which to conduct a
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31617
review and communicate a decision.
CMS now proposes to allow up to 20
business days to provide suppliers and
the Medicare beneficiaries’ quality
services within reasonable time period
to facilitate the delivery of necessary
equipment which enhances mobility
related activities of daily living and
supports independence.
These demonstrations have been
designed to develop and demonstrate
improved methods for the investigation
and prosecution of fraud in the
provision of care or services under the
health programs established by the
Social Security Act. The information
required under this information
collection request is requested by
Medicare contractors to determine
proper payment or if there is a suspicion
of fraud. For the RAC demonstration,
Medicare contractors may request the
information from providers or suppliers
submitting claims for payment from the
Medicare program when data analysis
indicates aberrant billing patterns or
other information which may present a
vulnerability to the Medicare program.
Under the prior authorization
demonstration, for certain PMDs, with a
history of aberrant billing patterns, this
information is requested in advance to
determine appropriate payment or if
there is a suspicion of fraud. Form
Number: CMS–10421 (OCN 0938—
New); Frequency: Occasionally;
Affected Public: State, Local or Tribal
Governments; Number of Respondents:
479,750; Total Annual Responses:
479,750; Total Annual Hours: 243,060.
(For policy questions regarding this
collection contact Debbie Skinner at
410–786–7480. For all other issues call
410–786–1326.)
3. Type of Information Collection
Request: New collection; Title of
Information Collection: Generic
Clearance for the Collection Customer
Satisfaction Surveys; Use: This
collection of information is necessary to
enable the Agency to garner customer
and stakeholder feedback in an efficient,
timely manner, in accordance with our
commitment to improving service
delivery. The information collected
from our customers and stakeholders
will help ensure that users have an
effective, efficient, and satisfying
experience with the Agency’s programs.
This feedback will provide insights into
customer or stakeholder perceptions,
experiences and expectations, provide
an early warning of issues with service,
or focus attention on areas where
communication, training or changes in
operations might improve delivery of
products or services. These collections
will allow for ongoing, collaborative and
actionable communications between the
E:\FR\FM\29MYN1.SGM
29MYN1
srobinson on DSK4SPTVN1PROD with NOTICES
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Federal Register / Vol. 77, No. 103 / Tuesday, May 29, 2012 / Notices
Agency and its customers and
stakeholders. It will also allow feedback
to contribute directly to the
improvement of program management.
Collecting voluntary customer
feedback is the least burdensome, most
effective way for the Agency to
determine whether or not its public Web
sites are useful to and used by its
customers. Generic clearance is needed
to ensure that the Agency can
continuously improve its Web sites
though regular surveys developed from
these pre-defined questions. Surveying
the Agency Web sites on a regular,
ongoing basis will help ensure that
users have an effective, efficient, and
satisfying experience on any of the Web
sites, maximizing the impact of the
information and resulting in optimum
benefit for the public. The surveys will
ensure that this communication channel
meets customer and partner priorities,
builds the Agency’s brands, and
contributes to the Agency’s health and
human services impact goals. Form
Number: CMS–10415 (OCN 0938—
New); Frequency: Occasionally;
Affected Public: Individuals and
Households, Business or other forprofits and Not-for-profit institutions,
State, Local or Tribal Governments;
Number of Respondents: 1,000,000;
Total Annual Responses: 1,000,000;
Total Annual Hours: 67,000. (For policy
questions regarding this collection
contact John Booth at 410–786–6577.
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.
To be assured consideration,
comments and recommendations for the
proposed information collections must
be received by the OMB desk officer at
the address below, no later than 5 p.m.
on June 28, 2012. OMB, Office of
Information and Regulatory Affairs,
Attention: CMS Desk Officer, Fax
Number: (202) 395–6974, Email:
OIRA_submission@omb.eop.gov.
Dated: May 22, 2012.
Martique Jones,
Director, Regulations Development Group,
Division B, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2012–12811 Filed 5–25–12; 8:45 am]
BILLING CODE 4120–01–P
VerDate Mar<15>2010
16:12 May 25, 2012
Jkt 226001
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services (CMS)
[CMS–2382–N]
Medicaid Program; Announcement of
Requirements and Registration for
CMS Provider Screening Innovator
Challenge
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
The Centers for Medicare &
Medicaid Services (CMS), is announcing
the launch of the ‘‘CMS Provider
Screening Innovator Challenge.’’ This
Challenge is sponsored by CMS and is
presented as part of the Partnership for
Program Integrity Innovation program,
and will be administered by the
National Aeronautic and Space
Administration’s (NASA) Federal Center
of Excellence for Collaborative
Innovation. This Challenge addresses
our goals of improving our abilities to
streamline operations, screen providers,
and reduce fraud and abuse.
Specifically, the challenge is an
innovation competition to develop a
multi-State, multi-program provider
screening software application which
would be capable of risk scoring,
credentialing validation, identity
authentication, and sanction checks,
while lowering burden on providers and
reducing administrative and
infrastructure expenses for States and
Federal programs. More information
pertaining to the Medicaid and CHIP
programs can be found at
www.medicaid.gov.
DATES: Important dates concerning the
Challenge include the following:
Challenge Competition Begin: 6:00
p.m., e.d.t., May 30, 2012.
Challenge Competition End: To be
determined, but expected to be
completed by October/November 2012
timeframe.
FOR FURTHER INFORMATION CONTACT: John
‘‘Chip’’ Garner, 410–786–3012.
SUPPLEMENTARY INFORMATION:
SUMMARY:
Subject of Challenge Competition
Entrants are asked to develop artifacts
and components of software
applications that can be integrated into
an open source solution that can deliver
a reliable, scalable, and cost-effective
provider-screening capability for
multiple States (or for the nation).
We expect the winning entry to
exhibit the following characteristics:
1. Reduced processing and transaction
time for submitting and receiving
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queries to authoritative data sources
regarding provider credentials and
sanctions.
2. Reductions in time needed by
providers to submit information and
resolve discrepancies.
3. Administrative/infrastructure
savings from a multi-tenant provider
screening solution.
4. Improved availability of key
provider data relevant for program
participation and oversight.
5. Improved timeliness and accuracy
in provider participation, oversight, and
enrollment decisions.
6. Improved ability to implement
sections 1902(a)(39) and 1902(a)(77) of
the Social Security Act, as amended by
the Patient Protection and Affordable
Care Act (Pub. L. 111–148 and 111–152)
subsections 6401(b) and (c) (Provider
Screening and Other Enrollment
Requirements Under Medicare,
Medicaid, and CHIP), and section 6501
(Termination of Provider Participation
Under Medicaid if Terminated by
Medicare or Other State Plan).
7. Assist in better driving alignment of
the Medicaid Information Technology
Architecture (MITA) 3.0 framework to
the Information and Technology
Architecture levels. More information
pertaining to MITA can be found at the
following Web site: www.medicaid.gov/
Medicaid-CHIP–Program-Information/
By-Topics/Data-and-Systems/MedicaidInformation-Technology-ArchitectureMITA.html.
General Eligibility Rules for
Participating in the Competition
To be eligible to win a prize under
this Challenge, an individual or entity
must comply with all the requirements
under this section.
An individual or entity shall not be
deemed ineligible solely because the
individual or entity used Federal
facilities or consulted with Federal
employees during a competition if such
facilities and employees are made
available to all individuals and entities
participating in the competition on an
equitable basis.
A Federal entity or Federal employee
acting within the scope of his or her
employment is not eligible to
participate. A Federal employee seeking
to participate in this competition
outside the scope of his/her
employment should consult his/her
ethics official prior to developing the
submission. Employees of CMS, the
Challenge judges, and employees of any
other company or individual involved
with the design, production, execution,
or distribution of the Challenge, along
with such employees’ or judges’
immediate families (spouse, parents and
E:\FR\FM\29MYN1.SGM
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]]>Agencies
[Federal Register Volume 77, Number 103 (Tuesday, May 29, 2012)]
[Notices]
[Pages 31616-31618]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-12811]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier CMS-10426, CMS-10421 and CMS-10415]
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
[[Page 31617]]
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: End Stage Renal Disease (ESRD) System Access
Request Form; Use: Within CMS, the Office of Clinical Standards and
Quality is developing a new suite of systems to support the End Stage
Renal Disease (ESRD) program. Due to the sensitivity of the data being
collected and reported, CMS must ensure that only authorized personnel
have access to data. Personnel are given access to the ESRD systems
through the creation of user IDs and passwords within the QualityNet
Identity Management System (QIMS); however, once within the system, the
system determines the rights and privileges the personnel has over the
data within the system.
The sole purpose the End Stage Renal Disease System (ESRD) System
Access Request Form is to identify the individual's data access rights
once within the ESRD system. This function and the associated data
collection is currently being accomplished under ``Part B'' of the
QualityNet Identity Management System Account Form (CMS-10267; OCN:
0938-1050). Once the ESRD System Access Form is approved, the
QualityNet Identity Management System (QIMS) Account Form will be
revised to remove Part B from the QIMS data collection. Form Number:
CMS-10426 (OCN: 0938-New); Frequency: Yearly; Affected Public: Private
Sector--Business or other for-profits. Number of Respondents: 25,000.
Number of Responses: 25,000. Total Annual Hours: 6,250. (For policy
questions regarding this collection contact Michelle Tucker at 410-786-
0736. For all other issues call 410-786-1326.)
2. Type of Information Collection Request: New collection; Title of
Information Collection: Fee-for-Service Recovery Audit Prepayment
Review Demonstration and Prior Authorization Demonstration; Use: The
Centers for Medicare & Medicaid Services (CMS) is requesting the Office
of Management and Budget (OMB) approval of the collections required for
two demonstrations of prepayment review and prior authorization. The
first demonstration would allow Medicare Recovery Auditors to review
claims on a pre-payment basis in certain States. The second
demonstration would establish a prior authorization program for Power
Mobility Device claims in certain States.
For the Recovery Audit Prepayment Review Demonstration, CMS and its
agents will request additional documentation, including medical
records, to support submitted claims. As discussed in more detail in
Chapter 3 of the Program Integrity Manual, additional documentation
includes any medical documentation, beyond what is included on the face
of the claim that supports the item or service that is billed. For
Medicare to consider coverage and payment for any item or service, the
information submitted by the provider or supplier (e.g., claims) must
be supported by the documentation in the patient's medical records.
When conducting complex medical review, the contractor specifies
documentation they require in accordance with Medicare's rules and
policies. In addition, providers and suppliers may supply additional
documentation not explicitly listed by the contractor. This supporting
information may be requested by CMS and its agents on a routine basis
in instances where diagnoses on a claim do not clearly indicate medical
necessity, or if there is a suspicion of fraud.
For the Prior Authorization of Power Mobility Devices (PMDs)
Demonstration, CMS will pilot prior authorization for Power Mobility
Devices. Prior authorization will allow the applicable documentation
that supports a claim to be submitted before the item is delivered. For
prior authorization, relevant documentation for review is submitted
before the item is delivered or the service is rendered. CMS will
conduct this demonstration in California, Florida, Illinois, Michigan,
New York, North Carolina and Texas based on beneficiary address as
reported to the Social Security Administration and recorded in the
Common Working File (CWF). For the demonstration, a prior authorization
request can be completed by the (ordering) physician or treating
practitioner and submitted to the appropriate DME MAC for an initial
decision. The supplier may also submit the request on behalf of the
physician or treating practitioner. The physician, treating
practitioner or supplier who submits the request on behalf of the
physician or treating practitioner, is referred to as the
``submitter.'' Under this demonstration, the submitter will submit to
the DME MAC a request for prior authorization and all relevant
documentation to support Medicare coverage of the PMD item.
CMS has decided to amend the requirement when subsequent prior
authorization requests are submitted. Currently, CMS or its agents have
up to 30 business days in which to conduct a review and communicate a
decision. CMS now proposes to allow up to 20 business days to provide
suppliers and the Medicare beneficiaries' quality services within
reasonable time period to facilitate the delivery of necessary
equipment which enhances mobility related activities of daily living
and supports independence.
These demonstrations have been designed to develop and demonstrate
improved methods for the investigation and prosecution of fraud in the
provision of care or services under the health programs established by
the Social Security Act. The information required under this
information collection request is requested by Medicare contractors to
determine proper payment or if there is a suspicion of fraud. For the
RAC demonstration, Medicare contractors may request the information
from providers or suppliers submitting claims for payment from the
Medicare program when data analysis indicates aberrant billing patterns
or other information which may present a vulnerability to the Medicare
program. Under the prior authorization demonstration, for certain PMDs,
with a history of aberrant billing patterns, this information is
requested in advance to determine appropriate payment or if there is a
suspicion of fraud. Form Number: CMS-10421 (OCN 0938--New); Frequency:
Occasionally; Affected Public: State, Local or Tribal Governments;
Number of Respondents: 479,750; Total Annual Responses: 479,750; Total
Annual Hours: 243,060. (For policy questions regarding this collection
contact Debbie Skinner at 410-786-7480. For all other issues call 410-
786-1326.)
3. Type of Information Collection Request: New collection; Title of
Information Collection: Generic Clearance for the Collection Customer
Satisfaction Surveys; Use: This collection of information is necessary
to enable the Agency to garner customer and stakeholder feedback in an
efficient, timely manner, in accordance with our commitment to
improving service delivery. The information collected from our
customers and stakeholders will help ensure that users have an
effective, efficient, and satisfying experience with the Agency's
programs. This feedback will provide insights into customer or
stakeholder perceptions, experiences and expectations, provide an early
warning of issues with service, or focus attention on areas where
communication, training or changes in operations might improve delivery
of products or services. These collections will allow for ongoing,
collaborative and actionable communications between the
[[Page 31618]]
Agency and its customers and stakeholders. It will also allow feedback
to contribute directly to the improvement of program management.
Collecting voluntary customer feedback is the least burdensome,
most effective way for the Agency to determine whether or not its
public Web sites are useful to and used by its customers. Generic
clearance is needed to ensure that the Agency can continuously improve
its Web sites though regular surveys developed from these pre-defined
questions. Surveying the Agency Web sites on a regular, ongoing basis
will help ensure that users have an effective, efficient, and
satisfying experience on any of the Web sites, maximizing the impact of
the information and resulting in optimum benefit for the public. The
surveys will ensure that this communication channel meets customer and
partner priorities, builds the Agency's brands, and contributes to the
Agency's health and human services impact goals. Form Number: CMS-10415
(OCN 0938--New); Frequency: Occasionally; Affected Public: Individuals
and Households, Business or other for-profits and Not-for-profit
institutions, State, Local or Tribal Governments; Number of
Respondents: 1,000,000; Total Annual Responses: 1,000,000; Total Annual
Hours: 67,000. (For policy questions regarding this collection contact
John Booth at 410-786-6577. 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.
To be assured consideration, comments and recommendations for the
proposed information collections must be received by the OMB desk
officer at the address below, no later than 5 p.m. on June 28, 2012.
OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk
Officer, Fax Number: (202) 395-6974, Email: OIRA_submission@omb.eop.gov.
Dated: May 22, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-12811 Filed 5-25-12; 8:45 am]
BILLING CODE 4120-01-P
