Agency Information Collection Activities: Submission for OMB Review; Comment Request, 53766-53769 [2013-21257]
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CMS–10497 Evaluation of the Medicare
Health Care Quality (MHCQ)
Demonstration Evaluation: Focus
Group and Interview Protocols
Under the PRA (44 U.S.C. 3501–
3520), federal agencies must obtain
approval from the Office of Management
and Budget (OMB) for each collection of
information they conduct or sponsor.
The term ‘‘collection of information’’ is
defined in 44 U.S.C. 3502(3) and 5 CFR
1320.3(c) and includes agency requests
or requirements that members of the
public submit reports, keep records, or
provide information to a third party.
Section 3506(c)(2)(A) of the PRA
requires federal agencies to publish a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension or reinstatement of an existing
collection of information, before
submitting the collection to OMB for
approval. To comply with this
requirement, CMS is publishing this
notice.
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Information Collections
1. Type of Information Collection
Request: New collection (Request for a
new OMB control number); Title of
Information Collection: Evaluation of
the Medicare Health Care Quality
(MHCQ) Demonstration Evaluation:
Focus Group and Interview Protocols;
Use: The Medicare Health Care Quality
(MHCQ) Demonstration was developed
to address concerns about the U.S.
health care system, which typically
fragments care while also encouraging
both omissions in and duplication of
care. To rectify this situation, Congress
has directed the Centers for Medicare &
Medicaid Services (CMS) to test major
changes to the delivery and payment
systems to improve the quality of care
while also increasing efficiency across
the health care system. This would be
achieved through several types of
interventions: adoption and use of
information technology and decision
support tools by physicians and their
patients, such as evidence-based
medicine guidelines, best practice
guidelines, and shared decision-making
programs; reform of payment
methodologies; improved coordination
of care among payers and providers
serving defined communities;
measurement of outcomes; and
enhanced cultural competence in the
delivery of care.
Section 1866C of the Social Security
Act, as amended by Section 646 of the
Medicare Prescription Drug,
Improvement, and Modernization Act of
2003 (Pub. L. 108–173), section
1866C(b)), requires the Secretary of the
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Department of Health and Human
Services to establish a 5-year
demonstration program under which the
Secretary may approve demonstration
projects that examine health delivery
factors that encourage improved quality
in patient care. This section also
authorizes the Secretary to waive
compliance with such requirements of
Titles XI and XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.) as
may be necessary for the purposes of
carrying out the demonstration project.
The MHCQ Demonstration programs
are designed to examine the extent to
which major, multifaceted changes to
traditional Medicare’s health delivery
and financing systems lead to
improvements in the quality of care
provided to Medicare beneficiaries
without increasing total program
expenditures. Each demonstration site
uses a different approach for changing
health delivery and financing systems,
but all share the goal of improving the
quality and efficiency of medical care
provided to Medicare beneficiaries.
Focus groups and individual interviews
will be conducted at 2 demonstration
sites that are active in the
demonstration: Gundersen Health
System (GHS) and Meridian Health
System (MHS).
This MHCQ Demonstration evaluation
will include analysis of both
quantitative and qualitative sources of
information. This multifaceted approach
will enable this evaluation to consider
a broad variety of evidence for
evaluating the nature and impact of
each site’s interventions. Form Number:
CMS–10497 (OCN: 0938–NEW);
Frequency: Occasionally; Affected
Public: Individuals or households and
Private sector (Not-for-profit
organizations); Number of Respondents:
36; Total Annual Responses: 36; Total
Annual Hours: 108. (For policy
questions regarding this collection
contact Normandy Brangan at 410–786–
6640.).
Dated: August 27, 2013.
Martique Jones,
Deputy Director, Regulations Development
Group, Office of Strategic Operations and
Regulatory Affairs.
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–4040, CMS–
10174, CMS–R–285, CMS–10166, CMS–
10184, CMS–1572, CMS–10175, CMS–379
and CMS–10336)]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
ACTION:
Notice.
The Centers for Medicare &
Medicaid Services (CMS) is announcing
an opportunity for the public to
comment on CMS’ intention to collect
information from the public. Under the
Paperwork Reduction Act of 1995
(PRA), federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension or reinstatement of an existing
collection of information, and to allow
a second opportunity for public
comment on the notice. Interested
persons are invited to send comments
regarding the 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.
DATES: Comments on the collection(s) of
information must be received by the
OMB desk officer by September 30,
2013.
ADDRESSES: When commenting on the
proposed information collections,
please reference the document identifier
or OMB control number. To be assured
consideration, comments and
recommendations must be received by
the OMB desk officer via one of the
following transmissions: OMB, Office of
Information and Regulatory Affairs,
Attention: CMS Desk Officer, Fax
Number: (202) 395–6974 OR Email:
OIRA_submission@omb.eop.gov.
To obtain copies of a supporting
statement and any related forms for the
proposed collection(s) summarized in
this notice, you may make your request
using one of following:
1. Access CMS’ Web site address at
https://www.cms.hhs.gov/
PaperworkReductionActof1995.
SUMMARY:
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2. Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
Reports Clearance Office at (410) 786–
1326.
SUPPLEMENTARY INFORMATION: Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal Agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. The term ‘‘collection of
information’’ is defined in 44 U.S.C.
3502(3) and 5 CFR 1320.3(c) and
includes agency requests or
requirements that members of the public
submit reports, keep records, or provide
information to a third party. Section
3506(c)(2)(A) of the PRA (44 U.S.C.
3506(c)(2)(A)) requires federal agencies
to publish a 30-day notice in the
Federal Register concerning each
proposed collection of information,
including each proposed extension or
reinstatement of an existing collection
of information, before submitting the
collection to OMB for approval. To
comply with this requirement, CMS is
publishing this notice that summarizes
the following proposed collection(s) of
information for public comment:
1. Type of Information Collection
Request: Reinstatement without change
of a previously approved collection;
Title of Information Collection: Request
for Enrollment in Supplementary
Medical Insurance; Use: Form CMS–
4040 (and CMS–4040SP) is used to
establish entitlement to and enrollment
in Medicare Part B for beneficiaries who
file for Part B only. The collected
information is used to determine
entitlement for individuals who meet
the requirements in section 1836(2) of
the Social Security Act as well as the
entitlement of the applicant or their
spouses to an annuity paid by OPM for
premium deduction purposes. Form
Number: CMS–4040 (OCN: 0938–0245);
Frequency: Once; Affected Public:
Individuals or households; Number of
Respondents: 10,000; Total Annual
Responses: 10,000; Total Annual Hours:
2,500. (For policy questions regarding
this collection contact Lindsay Smith at
410–786–6843.)
2. Type of Information Collection
Request: Reinstatement without change
of a previously approved collection;
Title of Information Collection:
Collection of Prescription Drug Event
Data from Contracted Part D Providers
for Payment; Use: The information users
would include Pharmacy Benefit
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Managers, third party administrators
and pharmacies and prescription drug
plans, Medicare Advantage plans that
offer integrated prescription drug and
health care coverage, Fallbacks and
other plans that offer coverage of
outpatient prescription drugs under the
Medicare Part D benefit to Medicare
beneficiaries. The data is used primarily
for payment, but is also used for claim
validation as well as for other legislated
functions such as quality monitoring,
program integrity, and oversight. Form
Number: CMS–10174 (OCN: 0938–
0982); Frequency: Monthly; Affected
Public: Private sector (business or other
for-profits and not-for-profit
institutions); Number of Respondents:
747; Total Annual Responses:
947,881,770; Total Annual Hours: 1,896.
(For policy questions regarding this
collection contact Ivan Iveljic at 410–
786–3312.)
3. Type of Information Collection
Request: Reinstatement without change
of a previously approved collection;
Title of Information Collection: Request
for Retirement Benefit Information; Use:
Section 1818(d)(5) of the Social Security
Act provides that former state and local
government employees (who are age 65
or older, have been entitled to Premium
Part A for at least 7 years, and did not
have the premium paid for by a state, a
political subdivision of a state, or an
agency or instrumentality of one or
more states or political subdivisions)
may have the Part A premium reduced
to zero. These individuals must also
have 10 years of employment with the
state or local government employer or a
combination of 10 years of employment
with a state or local government
employer and a non-government
employer. Form CMS–R–285 is an
essential part of the process of
determining whether an individual
qualifies for the premium reduction.
The Social Security Administration will
use this information to help determine
whether a beneficiary meets the
requirements for reduction of the Part A
premium. Form Number: CMS–R–285
(OCN: 0938–0769); Frequency: Once;
Affected Public: State, Local, or Tribal
Governments; Number of Respondents:
500; Total Annual Responses: 500; Total
Annual Hours: 125. (For policy
questions regarding this collection
contact Lindsay Smith at 410–786–
6843.)
4. Type of Information Collection
Request: Reinstatement of a previously
approved collection; Title of
Information Collection: Payment Error
Rate Measurement in Medicaid &
Children’s Health Insurance Program
(CHIP); Use: The Improper Payments
Information Act (IPIA) of 2002 as
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amended by the Improper Payments
Elimination and Recovery Improvement
Act (IPERIA) of 2012 requires CMS to
produce national error rates for
Medicaid and Children’s Health
Insurance Program (CHIP). To comply
with the IPIA, we will engage a Federal
contractor to produce the error rates in
Medicaid and CHIP. The error rates for
Medicaid and CHIP are calculated based
on the reviews on three components of
both Medicaid and CHIP program. They
are: Fee-for-service claims medical
reviews and data processing reviews,
managed care claims data-processing
reviews, and eligibility reviews. Each of
the review components collects
different types of information, and the
state-specific error rates for each of the
review components will be used to
calculate an overall state-specific error
rate, and the individual state-specific
error rates will be used to produce a
national error rate for Medicaid and
CHIP. The states will be requested to
submit, at their option, test data which
include full claims details to the
contractor prior to the quarterly
submissions to detect potential
problems in the dataset to and ensure
the quality of the data. These states will
be required to submit quarterly claims
data to the contractor who will pull a
statistically valid random sample, each
quarter, by strata, so that medical and
data processing reviews can be
performed. State-specific error rates will
be based on these review results. We
need to collect the fee-for-service claims
data, medical policies, and other
information from states as well as
medical records from providers in order
for the contractor to sample and review
adjudicated claims in those states
selected for medical reviews and data
processing reviews. Based on the
reviews, state-specific error rates will be
calculated which will serve as part of
the basis for calculating national
Medicaid and CHIP error rates. Form
Number: CMS–10166 (OCN: 0938–
0974); Frequency: Yearly, Quarterly;
Affected Public: State, Local, or Tribal
Governments; Number of Respondents:
34; Total Annual Responses: 1650; Total
Annual Hours: 56,100. (For policy
questions regarding this collection
contact Monetha Dockery at 410–786–
0155.)
5. Type of Information Collection
Request: Reinstatement with a change of
a previously approved collection; Title
of Information Collection: Eligibility
Error Rate Measurement in Medicaid
and the Children’s Health Insurance
Program; Use: The Improper Payments
Information Act (IPIA) of 2002 requires
CMS to produce national error rates for
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Medicaid and the Children’s Health
Insurance Program (CHIP). To comply
with the IPIA, we will use a national
contracting strategy to produce error
rates for Medicaid and CHIP fee-forservice and managed care improper
payments. The federal contractor will
review States on a rotational basis so
that each State will be measured for
improper payments, in each program,
once and only once every three years.
Subsequent to the first publication,
we determined that we will measure
Medicaid and CHIP in the same State.
Therefore, States will measure Medicaid
and CHIP eligibility in the same year
measured for fee-for-service and
managed care. We believe this approach
will advantage States through
economies of scale (e.g. administrative
ease and shared staffing for both
programs reviews). We also determined
that interim case completion timeframes
and reporting are critical to the integrity
of the reviews and to keep the reviews
on schedule to produce a timely error
rate. Lastly, the sample sizes were
increased slightly in order to produce an
equal sample size per strata each month.
Each month States submit a monthly
sample selection list, eligibility review
findings for active and negative cases
and claims review findings. At the end
of the cycle, States would have
submitted 48 forms. We are submitting
a new instrument in which we compile
all of the information from the 48 forms
into a format that will allow States to
submit 12 forms for 12 months of
eligibility data. This form will also serve
either of the data substitution options.
Periodically, we will conduct Federal
re-reviews of States’ PERM files to
ensure the accuracy of States’ review
findings and the validity of the review
process. We will select a random
subsample of Medicaid and CHIP cases
from the sample selection lists provided
by each State. States will submit all
pertinent information related to the
review of each sampled case that is we
select. Form Number: CMS–10184
(OCN: 0938–1012); Frequency: Yearly
and Quarterly Affected Public: State,
Local, or Tribal Governments; Number
of Respondents: 34; Total Annual
Responses: 120; Total Annual Hours:
15,755. (For policy questions regarding
this collection contact Monetha Dockery
at 410–786–0155.)
6. Type of Information Collection
Request: Reinstatement with change of a
previously approved collection; Title of
Information Collection: Home Health
Agency Survey and Deficiencies Report;
Use: In order to participate in the
Medicare Program as a Home Health
Agency (HHA) provider, the HHA must
meet federal standards. This form is
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used to record information and patients’
health and provider compliance with
requirements and to report the
information to the federal government.
Form Number: CMS–1572 (OCN: 0938–
0355); Frequency: Yearly; Affected
Public: State, Local or Tribal
Government; Number of Respondents:
3,830; Total Annual Responses: 3,830;
Total Annual Hours: 958. (For policy
questions regarding this collection
contact Patricia Sevast at 410–786–
8135.)
7. Type of Information Collection
Request: Reinstatement with change of a
previously approved collection; Title of
Information Collection: Certification
Statement for Electronic File
Interchange Organizations; Use: Health
care providers can currently obtain a
National Provider Identifier (NPI) via a
paper application or over the Internet
through the National Plan and Provider
Enumeration System (NPPES). These
applications must be submitted
individually, on a per-provider basis.
The Electronic File Interchange (EFI)
process allows provider-designated
organizations (EFIOs) to capture
multiple providers’ NPI application
information on a single electronic file
for submission to NPPES. This process
is also referred to as bulk enumeration.
To ensure that the EFIO has the
authority to act on behalf of each
provider and complies with other
federal requirements, an authorized
official of the EFIO must sign a
certification statement and mail it to us.
Form Number: CMS–10175 (OCN:
0938–0984). Frequency: Occasionally;
Affected Public: Private Sector; Number
of Respondents: 25; Total Annual
Responses: 25; Total Annual Hours: 75.
(For policy questions regarding this
collection contact Leslie Jones at 410–
786–6599.).
8. Type of Information Collection
Request: Reinstatement without change
of a previously approved collection;
Title of Information Collection:
Financial Statement of Debtor and
Supporting Regulations; Use: The Form
CMS–379 is used to collect financial
information which is needed to evaluate
requests from physicians and suppliers
to pay indebtedness under an extended
repayment schedule, or to compromise
a debt less than the full amount.
Normally, when a Medicare
Administrative Contractor (MAC)
overpays a physician or supplier, the
overpayment is associated with a single
claim, and the amount of the
overpayment is moderate. In these
cases, the physician/supplier usually
refunds the overpaid amount in a lump
sum. Alternatively, the MAC may
recoup the overpaid amount against
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future payments. A recoupment is the
recovery by Medicare of any
outstanding Medicare debt by reducing
present or future Medicare payments
and applying the amount withheld to
the indebtedness. The recoupment can
be made only if the physician or
supplier accepts assignment since the
MAC makes payment to the physician
or supplier only on assigned claims.
Sometimes, however, an overpayment
to a physician or supplier is
exceptionally large, and it cannot be
recovered in the normal fashion. The
large overpayment usually results from
aberrant billing practices, such as billing
for more expensive services than were
rendered. This could be discovered
during routine review of a statistically
valid sample of claims. The physician or
supplier may be unable to refund a large
overpaid amount in a single payment.
The MAC cannot recover the
overpayment by recoupment if the
physician/supplier does not accept
assignment of future claims, or is not
expected to file future claims because of
going out of business, illness or death.
In these unusual circumstances, the
MAC has authority to approve or deny
extended repayment schedules up to 12
months, or may recommend to that we
approve up to 60 months. Before the
MAC takes these actions, the MAC will
require full documentation of the
physician’s or supplier’s financial
situation. Thus, the physician or
supplier must complete Form CMS–379.
Form Number: CMS–379 (OCN: 0938–
0270); Frequency: Occasionally;
Affected Public: Private sector (business
or other for-profits); Number of
Respondents: 500; Total Annual
Responses: 500; Total Annual Hours:
1,000. (For policy questions regarding
this collection contact Ronke Fabayo at
410–786–4460.)
9. Type of Information Collection
Request: Reinstatement with change of a
previously approved collection; Title of
Information Collection: Medicare and
Medicaid Programs: Electronic Health
Record Incentive Program; Use: The
American Recovery and Reinvestment
Act of 2009 (Recovery Act) (Pub. L. 111–
5) was enacted on February 17, 2009.
The Recovery Act includes many
measures to modernize our nation’s
infrastructure, and improve affordable
health care. Expanded use of health
information technology (HIT) and
certified electronic health record (EHR)
technology will improve the quality and
value of America’s health care. Title IV
of Division B of the Recovery Act
amends Titles XVIII and XIX of the
Social Security Act (the Act) by
establishing incentive payments to
eligible professionals (EPs), eligible
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hospitals and critical access hospitals
(CAHs), and Medicare Advantage (MA)
organizations participating in the
Medicare and Medicaid programs that
adopt and successfully demonstrate
meaningful use of certified EHR
technology. These Recovery Act
provisions, together with Title XIII of
Division A of the Recovery Act, may be
cited as the ‘‘Health Information
Technology for Economic and Clinical
Health Act’’ or the ‘‘HITECH Act.’’
The HITECH Act creates incentive
programs for EPs and eligible hospitals,
including CAHs, in the Medicare Feefor-Service (FFS), MA, and Medicaid
programs that successfully demonstrate
meaningful use of certified EHR
technology. In their first payment year,
Medicaid EPs and eligible hospitals may
adopt, implement or upgrade to certified
EHR technology. It also, provides for
payment adjustments in the Medicare
FFS and MA programs starting in FY
2015 for EPs and eligible hospitals
participating in Medicare that are not
meaningful users of certified EHR
technology. These payment adjustments
do not pertain to Medicaid providers.
The first final rule for the Medicare
and Medicaid EHR Incentive Program,
which was published in the Federal
Register on July 28, 2010 (CMS–0033–
F), specified the initial criteria EPs,
eligible hospitals and CAHs, and MA
organizations must meet in order to
qualify for incentive payments;
calculation of incentive payment
amounts; payment adjustments under
Medicare for covered professional
services and inpatient hospital services
provided by EPs, eligible hospitals and
CAHs failing to demonstrate meaningful
use of certified EHR technology
beginning in 2015; and other program
participation requirements. On the same
date, the Office of the National
Coordinator of Health Information
Technology (ONC) issued a closely
related final rule (45 CFR part 170, RIN
0991–AB58) that specified the initial set
of standards, implementation
specifications, and certification criteria
for certified EHR technology. ONC has
also issued a separate final rule on the
establishment of certification programs
for health information technology (HIT)
(45 CFR part 170, RIN 0991–AB59). The
functionality of certified EHR
technology should facilitate the
implementation of meaningful use.
Subsequently, final rules have been
issued by CMS (77 FR 53968) and ONC
(77 FR 72985) to create a Stage 2 of
meaningful use criteria and other
changes to the CMS EHR Incentive
Programs and the 2014 Edition
Certification Criteria for EHR
technology.
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The information collection
requirements contained in this
information collection request are
needed to implement the HITECH Act.
In order to avoid duplicate payments,
all EPs are enumerated through their
National Provider Identifier (NPI), while
all eligible hospitals and CAHs are
enumerated through their CMS
Certification Number (CCN). State
Medicaid agencies and CMS use the
provider’s tax identification number and
NPI or CCN combination in order to
make payment, validate payment
eligibility and detect and prevent
duplicate payments for EPs, eligible
hospitals and CAHs. Form Number:
CMS–10336 (OCN: 0938–1158);
Frequency: Occasionally; Affected
Public: Private sector; Number of
Respondents: 214,694; Total Annual
Responses: 214,694; Total Annual
Hours: 2,034,740. (For policy questions
regarding this collection contact Travis
Broome at 214–767–4450.)
Dated: August 27, 2013.
Martique Jones,
Deputy Director, Regulations Development
Group, Office of Strategic Operations and
Regulatory Affairs.
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–7030–N]
Medicare, Medicaid, and Children’s
Health Insurance Programs; Meeting of
the Advisory Panel on Outreach and
Education
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice of meeting.
AGENCY:
This notice announces a
meeting of the Advisory Panel on
Outreach and Education (APOE) (the
Panel) in accordance with the Federal
Advisory Committee Act. The Panel
advises and makes recommendations to
the Secretary of Health and Human
Services and the Administrator of the
Centers for Medicare & Medicaid
Services on opportunities to enhance
the effectiveness of consumer education
strategies concerning Medicare,
Medicaid and the Children’s Health
Insurance Program (CHIP). This meeting
is open to the public.
DATES: Meeting Date: Monday,
September 16, 2013, 8:30 a.m. to 4:00
p.m. Eastern Standard Time (EST).
SUMMARY:
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Deadline for Meeting Registration,
Presentations and Comments: Monday,
September 9, 2013, 5:00 p.m., EST.
Deadline for Requesting Special
Accommodations: Monday, September
9, 2013, 5:00 p.m., EST.
ADDRESSES: Meeting Location: Sheraton
Silver Spring, 8777 Georgia Avenue,
Silver Spring, Maryland 20910.
Presentations and Written Comments:
Kirsten Knutson, Acting Designated
Federal Official (DFO), Division of
Forum and Conference Development,
Office of Communications, Centers for
Medicare & Medicaid Services, 7500
Security Boulevard, Mailstop S1–13–05,
Baltimore, MD 21244–1850 or contact
Ms. Knutson via email at
mailto:Kirsten.Knutson@cms.hhs.gov.
Registration: The meeting is open to
the public, but attendance is limited to
the space available. Persons wishing to
attend this meeting must register at the
Web site https://events.SignUp4.com/
APOESEPT2013MTG or by contacting
the DFO at the address listed in the
ADDRESSES section of this notice or by
telephone at number listed in the FOR
FURTHER INFORMATION CONTACT section of
this notice, by the date listed in the
DATES section of this notice. Individuals
requiring sign language interpretation or
other special accommodations should
contact the DFO at the address listed in
the ADDRESSES section of this notice by
the date listed in the DATES’’ section of
this notice.
FOR FURTHER INFORMATION CONTACT:
Kirsten Knutson, (410) 786–5886.
Additional information about the APOE
is available on the Internet at: https://
www.cms.gov/Regulations-and
Guidance/Guidance/FACA/APOE.html.
Press inquiries are handled through
the CMS Press Office at (202) 690–6145.
SUPPLEMENTARY INFORMATION: In
accordance with section 10(a) of the
Federal Advisory Committee Act
(FACA), this notice announces a
meeting of the Advisory Panel on
Outreach and Education (APOE) (the
Panel). Section 9(a)(2) of the Federal
Advisory Committee Act authorizes the
Secretary of Health and Human Services
(the Secretary) to establish an advisory
panel if the Secretary determines that
the panel is ‘‘in the public interest in
connection with the performance of
duties imposed . . . by law.’’ Such duties
are imposed by section 1804 of the
Social Security Act (the Act), requiring
the Secretary to provide informational
materials to Medicare beneficiaries
about the Medicare program, and
section 1851(d) of the Act, requiring the
Secretary to provide for ‘‘activities . . .
to broadly disseminate information to
[M]edicare beneficiaries . . . on the
E:\FR\FM\30AUN1.SGM
30AUN1
]]>Agencies
[Federal Register Volume 78, Number 169 (Friday, August 30, 2013)]
[Notices]
[Pages 53766-53769]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-21257]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-4040, CMS-10174, CMS-R-285, CMS-10166, CMS-
10184, CMS-1572, CMS-10175, CMS-379 and CMS-10336)]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
ACTION: Notice.
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SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is
announcing an opportunity for the public to comment on CMS' intention
to collect information from the public. Under the Paperwork Reduction
Act of 1995 (PRA), federal agencies are required to publish notice in
the Federal Register concerning each proposed collection of
information, including each proposed extension or reinstatement of an
existing collection of information, and to allow a second opportunity
for public comment on the notice. Interested persons are invited to
send comments regarding the 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.
DATES: Comments on the collection(s) of information must be received by
the OMB desk officer by September 30, 2013.
ADDRESSES: When commenting on the proposed information collections,
please reference the document identifier or OMB control number. To be
assured consideration, comments and recommendations must be received by
the OMB desk officer via one of the following transmissions: OMB,
Office of Information and Regulatory Affairs, Attention: CMS Desk
Officer, Fax Number: (202) 395-6974 OR Email: OIRA_submission@omb.eop.gov.
To obtain copies of a supporting statement and any related forms
for the proposed collection(s) summarized in this notice, you may make
your request using one of following:
1. Access CMS' Web site address at https://www.cms.hhs.gov/PaperworkReductionActof1995.
[[Page 53767]]
2. Email your request, including your address, phone number, OMB
number, and CMS document identifier, to Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at (410) 786-1326.
FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.
SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995
(PRA) (44 U.S.C. 3501-3520), federal Agencies must obtain approval from
the Office of Management and Budget (OMB) for each collection of
information they conduct or sponsor. The term ``collection of
information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and
includes agency requests or requirements that members of the public
submit reports, keep records, or provide information to a third party.
Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires
federal agencies to publish a 30-day notice in the Federal Register
concerning each proposed collection of information, including each
proposed extension or reinstatement of an existing collection of
information, before submitting the collection to OMB for approval. To
comply with this requirement, CMS is publishing this notice that
summarizes the following proposed collection(s) of information for
public comment:
1. Type of Information Collection Request: Reinstatement without
change of a previously approved collection; Title of Information
Collection: Request for Enrollment in Supplementary Medical Insurance;
Use: Form CMS-4040 (and CMS-4040SP) is used to establish entitlement to
and enrollment in Medicare Part B for beneficiaries who file for Part B
only. The collected information is used to determine entitlement for
individuals who meet the requirements in section 1836(2) of the Social
Security Act as well as the entitlement of the applicant or their
spouses to an annuity paid by OPM for premium deduction purposes. Form
Number: CMS-4040 (OCN: 0938-0245); Frequency: Once; Affected Public:
Individuals or households; Number of Respondents: 10,000; Total Annual
Responses: 10,000; Total Annual Hours: 2,500. (For policy questions
regarding this collection contact Lindsay Smith at 410-786-6843.)
2. Type of Information Collection Request: Reinstatement without
change of a previously approved collection; Title of Information
Collection: Collection of Prescription Drug Event Data from Contracted
Part D Providers for Payment; Use: The information users would include
Pharmacy Benefit Managers, third party administrators and pharmacies
and prescription drug plans, Medicare Advantage plans that offer
integrated prescription drug and health care coverage, Fallbacks and
other plans that offer coverage of outpatient prescription drugs under
the Medicare Part D benefit to Medicare beneficiaries. The data is used
primarily for payment, but is also used for claim validation as well as
for other legislated functions such as quality monitoring, program
integrity, and oversight. Form Number: CMS-10174 (OCN: 0938-0982);
Frequency: Monthly; Affected Public: Private sector (business or other
for-profits and not-for-profit institutions); Number of Respondents:
747; Total Annual Responses: 947,881,770; Total Annual Hours: 1,896.
(For policy questions regarding this collection contact Ivan Iveljic at
410-786-3312.)
3. Type of Information Collection Request: Reinstatement without
change of a previously approved collection; Title of Information
Collection: Request for Retirement Benefit Information; Use: Section
1818(d)(5) of the Social Security Act provides that former state and
local government employees (who are age 65 or older, have been entitled
to Premium Part A for at least 7 years, and did not have the premium
paid for by a state, a political subdivision of a state, or an agency
or instrumentality of one or more states or political subdivisions) may
have the Part A premium reduced to zero. These individuals must also
have 10 years of employment with the state or local government employer
or a combination of 10 years of employment with a state or local
government employer and a non-government employer. Form CMS-R-285 is an
essential part of the process of determining whether an individual
qualifies for the premium reduction. The Social Security Administration
will use this information to help determine whether a beneficiary meets
the requirements for reduction of the Part A premium. Form Number: CMS-
R-285 (OCN: 0938-0769); Frequency: Once; Affected Public: State, Local,
or Tribal Governments; Number of Respondents: 500; Total Annual
Responses: 500; Total Annual Hours: 125. (For policy questions
regarding this collection contact Lindsay Smith at 410-786-6843.)
4. Type of Information Collection Request: Reinstatement of a
previously approved collection; Title of Information Collection:
Payment Error Rate Measurement in Medicaid & Children's Health
Insurance Program (CHIP); Use: The Improper Payments Information Act
(IPIA) of 2002 as amended by the Improper Payments Elimination and
Recovery Improvement Act (IPERIA) of 2012 requires CMS to produce
national error rates for Medicaid and Children's Health Insurance
Program (CHIP). To comply with the IPIA, we will engage a Federal
contractor to produce the error rates in Medicaid and CHIP. The error
rates for Medicaid and CHIP are calculated based on the reviews on
three components of both Medicaid and CHIP program. They are: Fee-for-
service claims medical reviews and data processing reviews, managed
care claims data-processing reviews, and eligibility reviews. Each of
the review components collects different types of information, and the
state-specific error rates for each of the review components will be
used to calculate an overall state-specific error rate, and the
individual state-specific error rates will be used to produce a
national error rate for Medicaid and CHIP. The states will be requested
to submit, at their option, test data which include full claims details
to the contractor prior to the quarterly submissions to detect
potential problems in the dataset to and ensure the quality of the
data. These states will be required to submit quarterly claims data to
the contractor who will pull a statistically valid random sample, each
quarter, by strata, so that medical and data processing reviews can be
performed. State-specific error rates will be based on these review
results. We need to collect the fee-for-service claims data, medical
policies, and other information from states as well as medical records
from providers in order for the contractor to sample and review
adjudicated claims in those states selected for medical reviews and
data processing reviews. Based on the reviews, state-specific error
rates will be calculated which will serve as part of the basis for
calculating national Medicaid and CHIP error rates. Form Number: CMS-
10166 (OCN: 0938-0974); Frequency: Yearly, Quarterly; Affected Public:
State, Local, or Tribal Governments; Number of Respondents: 34; Total
Annual Responses: 1650; Total Annual Hours: 56,100. (For policy
questions regarding this collection contact Monetha Dockery at 410-786-
0155.)
5. Type of Information Collection Request: Reinstatement with a
change of a previously approved collection; Title of Information
Collection: Eligibility Error Rate Measurement in Medicaid and the
Children's Health Insurance Program; Use: The Improper Payments
Information Act (IPIA) of 2002 requires CMS to produce national error
rates for
[[Page 53768]]
Medicaid and the Children's Health Insurance Program (CHIP). To comply
with the IPIA, we will use a national contracting strategy to produce
error rates for Medicaid and CHIP fee-for-service and managed care
improper payments. The federal contractor will review States on a
rotational basis so that each State will be measured for improper
payments, in each program, once and only once every three years.
Subsequent to the first publication, we determined that we will
measure Medicaid and CHIP in the same State. Therefore, States will
measure Medicaid and CHIP eligibility in the same year measured for
fee-for-service and managed care. We believe this approach will
advantage States through economies of scale (e.g. administrative ease
and shared staffing for both programs reviews). We also determined that
interim case completion timeframes and reporting are critical to the
integrity of the reviews and to keep the reviews on schedule to produce
a timely error rate. Lastly, the sample sizes were increased slightly
in order to produce an equal sample size per strata each month. Each
month States submit a monthly sample selection list, eligibility review
findings for active and negative cases and claims review findings. At
the end of the cycle, States would have submitted 48 forms. We are
submitting a new instrument in which we compile all of the information
from the 48 forms into a format that will allow States to submit 12
forms for 12 months of eligibility data. This form will also serve
either of the data substitution options. Periodically, we will conduct
Federal re-reviews of States' PERM files to ensure the accuracy of
States' review findings and the validity of the review process. We will
select a random subsample of Medicaid and CHIP cases from the sample
selection lists provided by each State. States will submit all
pertinent information related to the review of each sampled case that
is we select. Form Number: CMS-10184 (OCN: 0938-1012); Frequency:
Yearly and Quarterly Affected Public: State, Local, or Tribal
Governments; Number of Respondents: 34; Total Annual Responses: 120;
Total Annual Hours: 15,755. (For policy questions regarding this
collection contact Monetha Dockery at 410-786-0155.)
6. Type of Information Collection Request: Reinstatement with
change of a previously approved collection; Title of Information
Collection: Home Health Agency Survey and Deficiencies Report; Use: In
order to participate in the Medicare Program as a Home Health Agency
(HHA) provider, the HHA must meet federal standards. This form is used
to record information and patients' health and provider compliance with
requirements and to report the information to the federal government.
Form Number: CMS-1572 (OCN: 0938-0355); Frequency: Yearly; Affected
Public: State, Local or Tribal Government; Number of Respondents:
3,830; Total Annual Responses: 3,830; Total Annual Hours: 958. (For
policy questions regarding this collection contact Patricia Sevast at
410-786-8135.)
7. Type of Information Collection Request: Reinstatement with
change of a previously approved collection; Title of Information
Collection: Certification Statement for Electronic File Interchange
Organizations; Use: Health care providers can currently obtain a
National Provider Identifier (NPI) via a paper application or over the
Internet through the National Plan and Provider Enumeration System
(NPPES). These applications must be submitted individually, on a per-
provider basis. The Electronic File Interchange (EFI) process allows
provider-designated organizations (EFIOs) to capture multiple
providers' NPI application information on a single electronic file for
submission to NPPES. This process is also referred to as bulk
enumeration. To ensure that the EFIO has the authority to act on behalf
of each provider and complies with other federal requirements, an
authorized official of the EFIO must sign a certification statement and
mail it to us. Form Number: CMS-10175 (OCN: 0938-0984). Frequency:
Occasionally; Affected Public: Private Sector; Number of Respondents:
25; Total Annual Responses: 25; Total Annual Hours: 75. (For policy
questions regarding this collection contact Leslie Jones at 410-786-
6599.).
8. Type of Information Collection Request: Reinstatement without
change of a previously approved collection; Title of Information
Collection: Financial Statement of Debtor and Supporting Regulations;
Use: The Form CMS-379 is used to collect financial information which is
needed to evaluate requests from physicians and suppliers to pay
indebtedness under an extended repayment schedule, or to compromise a
debt less than the full amount. Normally, when a Medicare
Administrative Contractor (MAC) overpays a physician or supplier, the
overpayment is associated with a single claim, and the amount of the
overpayment is moderate. In these cases, the physician/supplier usually
refunds the overpaid amount in a lump sum. Alternatively, the MAC may
recoup the overpaid amount against future payments. A recoupment is the
recovery by Medicare of any outstanding Medicare debt by reducing
present or future Medicare payments and applying the amount withheld to
the indebtedness. The recoupment can be made only if the physician or
supplier accepts assignment since the MAC makes payment to the
physician or supplier only on assigned claims.
Sometimes, however, an overpayment to a physician or supplier is
exceptionally large, and it cannot be recovered in the normal fashion.
The large overpayment usually results from aberrant billing practices,
such as billing for more expensive services than were rendered. This
could be discovered during routine review of a statistically valid
sample of claims. The physician or supplier may be unable to refund a
large overpaid amount in a single payment. The MAC cannot recover the
overpayment by recoupment if the physician/supplier does not accept
assignment of future claims, or is not expected to file future claims
because of going out of business, illness or death. In these unusual
circumstances, the MAC has authority to approve or deny extended
repayment schedules up to 12 months, or may recommend to that we
approve up to 60 months. Before the MAC takes these actions, the MAC
will require full documentation of the physician's or supplier's
financial situation. Thus, the physician or supplier must complete Form
CMS-379. Form Number: CMS-379 (OCN: 0938-0270); Frequency:
Occasionally; Affected Public: Private sector (business or other for-
profits); Number of Respondents: 500; Total Annual Responses: 500;
Total Annual Hours: 1,000. (For policy questions regarding this
collection contact Ronke Fabayo at 410-786-4460.)
9. Type of Information Collection Request: Reinstatement with
change of a previously approved collection; Title of Information
Collection: Medicare and Medicaid Programs: Electronic Health Record
Incentive Program; Use: The American Recovery and Reinvestment Act of
2009 (Recovery Act) (Pub. L. 111-5) was enacted on February 17, 2009.
The Recovery Act includes many measures to modernize our nation's
infrastructure, and improve affordable health care. Expanded use of
health information technology (HIT) and certified electronic health
record (EHR) technology will improve the quality and value of America's
health care. Title IV of Division B of the Recovery Act amends Titles
XVIII and XIX of the Social Security Act (the Act) by establishing
incentive payments to eligible professionals (EPs), eligible
[[Page 53769]]
hospitals and critical access hospitals (CAHs), and Medicare Advantage
(MA) organizations participating in the Medicare and Medicaid programs
that adopt and successfully demonstrate meaningful use of certified EHR
technology. These Recovery Act provisions, together with Title XIII of
Division A of the Recovery Act, may be cited as the ``Health
Information Technology for Economic and Clinical Health Act'' or the
``HITECH Act.''
The HITECH Act creates incentive programs for EPs and eligible
hospitals, including CAHs, in the Medicare Fee-for-Service (FFS), MA,
and Medicaid programs that successfully demonstrate meaningful use of
certified EHR technology. In their first payment year, Medicaid EPs and
eligible hospitals may adopt, implement or upgrade to certified EHR
technology. It also, provides for payment adjustments in the Medicare
FFS and MA programs starting in FY 2015 for EPs and eligible hospitals
participating in Medicare that are not meaningful users of certified
EHR technology. These payment adjustments do not pertain to Medicaid
providers.
The first final rule for the Medicare and Medicaid EHR Incentive
Program, which was published in the Federal Register on July 28, 2010
(CMS-0033-F), specified the initial criteria EPs, eligible hospitals
and CAHs, and MA organizations must meet in order to qualify for
incentive payments; calculation of incentive payment amounts; payment
adjustments under Medicare for covered professional services and
inpatient hospital services provided by EPs, eligible hospitals and
CAHs failing to demonstrate meaningful use of certified EHR technology
beginning in 2015; and other program participation requirements. On the
same date, the Office of the National Coordinator of Health Information
Technology (ONC) issued a closely related final rule (45 CFR part 170,
RIN 0991-AB58) that specified the initial set of standards,
implementation specifications, and certification criteria for certified
EHR technology. ONC has also issued a separate final rule on the
establishment of certification programs for health information
technology (HIT) (45 CFR part 170, RIN 0991-AB59). The functionality of
certified EHR technology should facilitate the implementation of
meaningful use. Subsequently, final rules have been issued by CMS (77
FR 53968) and ONC (77 FR 72985) to create a Stage 2 of meaningful use
criteria and other changes to the CMS EHR Incentive Programs and the
2014 Edition Certification Criteria for EHR technology.
The information collection requirements contained in this
information collection request are needed to implement the HITECH Act.
In order to avoid duplicate payments, all EPs are enumerated through
their National Provider Identifier (NPI), while all eligible hospitals
and CAHs are enumerated through their CMS Certification Number (CCN).
State Medicaid agencies and CMS use the provider's tax identification
number and NPI or CCN combination in order to make payment, validate
payment eligibility and detect and prevent duplicate payments for EPs,
eligible hospitals and CAHs. Form Number: CMS-10336 (OCN: 0938-1158);
Frequency: Occasionally; Affected Public: Private sector; Number of
Respondents: 214,694; Total Annual Responses: 214,694; Total Annual
Hours: 2,034,740. (For policy questions regarding this collection
contact Travis Broome at 214-767-4450.)
Dated: August 27, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2013-21257 Filed 8-29-13; 8:45 am]
BILLING CODE 4120-01-P
