Agency Information Collection Activities: Proposed Collection; Comment Request, 54725-54727 [2014-21798]
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54725
Federal Register / Vol. 79, No. 177 / Friday, September 12, 2014 / Notices
ESTIMATED ANNUALIZED BURDEN TO RESPONDENTS—Continued
Form name
School staff ......................................
Web-based instrument for San Francisco Unified
School District.
School Climate Index Interview Guide for District-level
Administrators.
School Climate Index Interview Guide for School-level
Administrators.
School Climate Index Interview Guide for School Staff
District-level Administrators ..............
School-level Administrators ..............
School Staff ......................................
Leroy A. Richardson,
Chief, Information Collection Review Office,
Office of Scientific Integrity, Office of the
Associate Director for Science, Office of the
Director, Centers for Disease Control and
Prevention.
[FR Doc. 2014–21754 Filed 9–11–14; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10525]
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.
tkelley on DSK3SPTVN1PROD with NOTICES
SUMMARY:
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17:58 Sep 11, 2014
Jkt 232001
Comments on the collection(s) of
information must be received by the
OMB desk officer by October 14, 2014.
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)
395–5806 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.
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
DATES:
PO 00000
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Number of
responses per
respondent
Number of
respondents
Respondents
Sfmt 4703
Average
burden
per response
(in hours)
163
1
25/60
1
1
1
9
1
1
19
1
1.5
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: Existing collection in use
without an OMB control number; Title
of Information Collection: Health Plan
Monitoring System Level I and Level II
Data Entry for the Program of AllInclusive Care for the Elderly; Use: This
information collection would require
Program of All-Inclusive Care for the
Elderly (PACE) organizations to enter
Level I and Level II data into the CMS’s
Health Plan Monitoring System. The
collected information will be used to
develop a quality improvement strategy
for PACE. Form Number: CMS–10525
(OMB control number: 0938—New);
Frequency: Quarterly and occasionally;
Affected Public: Private sector—
Business or other for-profits and Notfor-profit institutions); Number of
Respondents: 100; Total Annual
Responses: 7,000; Total Annual Hours:
1,575. (For policy questions regarding
this collection contact Tamika Gladney
at 410–786–0648).
Dated: September 9, 2014.
Martique Jones,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2014–21799 Filed 9–11–14; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10291, CMS–
10421 and CMS–10114]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, HHS.
AGENCY:
E:\FR\FM\12SEN1.SGM
12SEN1
54726
ACTION:
Federal Register / Vol. 79, No. 177 / Friday, September 12, 2014 / Notices
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 (the
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
60 days for public comment on the
proposed action. Interested persons are
invited to send comments regarding our
burden estimates 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.
SUMMARY:
Comments must be received by
November 12, 2014:
DATES:
When commenting, please
reference the document identifier or
OMB control number (OCN). To be
assured consideration, comments and
recommendations must be submitted in
any one of the following ways:
1. Electronically. You may send 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) that are 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.
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.
2. Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov.
tkelley on DSK3SPTVN1PROD with NOTICES
ADDRESSES:
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17:58 Sep 11, 2014
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3. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
Reports Clearance Office at (410) 786–
1326.
SUPPLEMENTARY INFORMATION:
Contents
This notice sets out a summary of the
use and burden associated with the
following information collections. More
detailed information can be found in
each collection’s supporting statement
and associated materials (see
ADDRESSES).
CMS–10291 State Collection and
Reporting of Dental Provider and
Benefit Package Information on the
Insure Kids Now! Web site and
Hotline
CMS–10421 Fee-for-Service Recovery
Audit Prepayment Review
Demonstration and Prior
Authorization Demonstration
CMS–10114 National Provider
Identifier (NPI) Application and
Update Form and Supporting Regs in
45 CFR 142.408, 45 CFR 162.408, 45
CFR 162.406
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.
Information Collection
1. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: State Collection
and Reporting of Dental Provider and
Benefit Package Information on the
Insure Kids Now! Web site and Hotline;
Use: On the Insure Kids Now (IKN) Web
site, the Secretary is required to post a
current and accurate list of dentists and
providers that provide dental services to
children enrolled in the state plan (or
waiver) under Medicaid or the state
child health plan (or waiver) under
CHIP. States collect the information
PO 00000
Frm 00050
Fmt 4703
Sfmt 4703
pertaining to their Medicaid and CHIP
dental benefits. Form Number: CMS–
10291 (OMB control number: 0938–
1065); Frequency: Yearly and quarterly;
Affected Public: State, Local, or Tribal
Governments; Number of Respondents:
51; Total Annual Responses: 255; Total
Annual Hours: 10,838. (For policy
questions regarding this collection
contact Laurie Norris at 410–786–6543).
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Fee-for-Service
Recovery Audit Prepayment Review
Demonstration and Prior Authorization
Demonstration; Use: On July 23, 2012,
the Office of Management and Budget
approved the collections required for
two demonstrations of prepayment
review and prior authorization. The first
demonstration allows Medicare
Recovery Auditors to review claims on
a pre-payment basis in certain States.
The second demonstration established a
prior authorization program for Power
Mobility Device claims in certain States.
For the Recovery Audit Prepayment
Review Demonstration, CMS and its
agents 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, we are piloting prior
authorization for PMDs. 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
E:\FR\FM\12SEN1.SGM
12SEN1
tkelley on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 79, No. 177 / Friday, September 12, 2014 / Notices
California, Florida, Illinois, Michigan,
New York, North Carolina, Texas,
Pennsylvania, Ohio, Louisiana,
Missouri, Maryland, New Jersey,
Indiana, Kentucky, Georgia, Tennessee,
Washington, and Arizona 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.
Form Number: CMS–10421 (OMB
control number: 0938–1169); Frequency:
Occasionally; Affected Public: State,
Local or Tribal Governments; Number of
Respondents: 333,750; Total Annual
Responses: 333,750; Total Annual
Hours: 170,060. (For policy questions
regarding this collection contact Daniel
Schwartz at 410–786–4197.)
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: National
Provider Identifier (NPI) Application
and Update Form and Supporting
Regulations in 45 CFR 142.408, 45 CFR
162.406, 45 CFR 162.408; Use: The
National Provider Identifier (NPI)
Application and Update Form is used
by health care providers to apply for
NPIs and furnish updates to the
information they supplied on their
initial applications. The form is also
used to deactivate their NPIs if
necessary. The NPI Application/Update
form has been revised to provide
additional guidance on how to
accurately complete the form. The NPI
Application/Update form has been
revised to provide additional guidance
on how to accurately complete the form.
This collection includes clarification on
information that is required on
applications/changes. Minor changes on
the application/update form include
adding a ‘Subpart’ check box in the
Other Name section and a revision
within the PRA Disclosure Statement.
This collection also includes changes to
the instructions. Form Number: CMS–
10114 (OMB control number: 0938–
0931); Frequency: Reporting—On
occasion; Affected Public: Business or
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17:58 Sep 11, 2014
Jkt 232001
other for-profit, not-for-profit
institutions, and Federal government;
Number of Respondents: 608,880; Total
Annual Responses: 608,880; Total
Annual Hours: 112,660. (For policy
questions regarding this collection
contact Leslie Jones at 410–786–6599.)
Dated: September 9, 2014.
Martique Jones,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
54727
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2014–N–1219]
Agency Information Collection
Activities; Proposed Collection;
Comment Request; Survey of Health
Care Practitioners for Device Labeling
Format and Content
AGENCY:
[FR Doc. 2014–21798 Filed 9–11–14; 8:45 am]
BILLING CODE 4120–01–P
ACTION:
Food and Drug Administration,
HHS.
Notice.
The Food and Drug
Administration (FDA) is announcing an
opportunity for public comment on the
proposed collection of certain
information by the Agency. Under the
Paperwork Reduction Act of 1995 (the
PRA), Federal Agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information and to allow 60 days for
public comment in response to the
notice. This notice solicits comments on
the proposed information collection
‘‘Survey of Health Care Practitioners for
Device Labeling Format and Content.’’
DATES: Submit either electronic or
written comments on the collection of
information by November 12, 2014.
ADDRESSES: Submit electronic
comments on the collection of
information to https://
www.regulations.gov. Submit written
comments on the collection of
information to the Division of Dockets
Management (HFA–305), Food and Drug
Administration, 5630 Fishers Lane, Rm.
1061, Rockville, MD 20852. All
comments should be identified with the
docket number found in brackets in the
heading of this document.
FOR FURTHER INFORMATION CONTACT: FDA
PRA Staff, Office of Operations, Food
and Drug Administration, 8455
Colesville Rd., COLE–14526, Silver
Spring, MD 20993–0002, PRAStaff@
fda.hhs.gov.
SUPPLEMENTARY INFORMATION: 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.
‘‘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 provide a 60-day notice in
the Federal Register concerning each
SUMMARY:
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2010–N–0110]
Agency Information Collection
Activities; Announcement of Office of
Management and Budget Approval;
Prescription Drug Advertisements
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
The Food and Drug
Administration (FDA) is announcing
that a collection of information entitled
‘‘Prescription Drug Advertisements’’ has
been approved by the Office of
Management and Budget (OMB) under
the Paperwork Reduction Act of 1995.
FOR FURTHER INFORMATION CONTACT: FDA
PRA Staff, Office of Operations, Food
and Drug Administration, 8455
Colesville Rd., COLE–14526, Silver
Spring, MD 20993–0002,
PRAStaff@fda.hhs.gov.
SUMMARY:
On June
12, 2014, the Agency submitted a
proposed collection of information
entitled ‘‘Prescription Drug
Advertisements’’ to OMB for review and
clearance under 44 U.S.C. 3507. An
Agency may not conduct or sponsor,
and a person is not required to respond
to, a collection of information unless it
displays a currently valid OMB control
number. OMB has now approved the
information collection and has assigned
OMB control number 0910–0686. The
approval expires on August 31, 2017. A
copy of the supporting statement for this
information collection is available on
the Internet at https://www.reginfo.gov/
public/do/PRAMain.
SUPPLEMENTARY INFORMATION:
Dated: September 8, 2014.
Leslie Kux,
Assistant Commissioner for Policy.
[FR Doc. 2014–21727 Filed 9–11–14; 8:45 am]
BILLING CODE 4164–01–P
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Agencies
[Federal Register Volume 79, Number 177 (Friday, September 12, 2014)]
[Notices]
[Pages 54725-54727]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-21798]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10291, CMS-10421 and CMS-10114]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
[[Page 54726]]
ACTION: Notice.
-----------------------------------------------------------------------
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 (the 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 60 days for public
comment on the proposed action. Interested persons are invited to send
comments regarding our burden estimates 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 must be received by November 12, 2014:
ADDRESSES: When commenting, please reference the document identifier or
OMB control number (OCN). To be assured consideration, comments and
recommendations must be submitted in any one of the following ways:
1. Electronically. You may send 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) that are 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.
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.
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:
Contents
This notice sets out a summary of the use and burden associated
with the following information collections. More detailed information
can be found in each collection's supporting statement and associated
materials (see ADDRESSES).
CMS-10291 State Collection and Reporting of Dental Provider and Benefit
Package Information on the Insure Kids Now! Web site and Hotline
CMS-10421 Fee-for-Service Recovery Audit Prepayment Review
Demonstration and Prior Authorization Demonstration
CMS-10114 National Provider Identifier (NPI) Application and Update
Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR
162.406
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.
Information Collection
1. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: State Collection
and Reporting of Dental Provider and Benefit Package Information on the
Insure Kids Now! Web site and Hotline; Use: On the Insure Kids Now
(IKN) Web site, the Secretary is required to post a current and
accurate list of dentists and providers that provide dental services to
children enrolled in the state plan (or waiver) under Medicaid or the
state child health plan (or waiver) under CHIP. States collect the
information pertaining to their Medicaid and CHIP dental benefits. Form
Number: CMS-10291 (OMB control number: 0938-1065); Frequency: Yearly
and quarterly; Affected Public: State, Local, or Tribal Governments;
Number of Respondents: 51; Total Annual Responses: 255; Total Annual
Hours: 10,838. (For policy questions regarding this collection contact
Laurie Norris at 410-786-6543).
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Fee-for-Service
Recovery Audit Prepayment Review Demonstration and Prior Authorization
Demonstration; Use: On July 23, 2012, the Office of Management and
Budget approved the collections required for two demonstrations of
prepayment review and prior authorization. The first demonstration
allows Medicare Recovery Auditors to review claims on a pre-payment
basis in certain States. The second demonstration established a prior
authorization program for Power Mobility Device claims in certain
States.
For the Recovery Audit Prepayment Review Demonstration, CMS and its
agents 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, we are piloting prior authorization for PMDs. 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
[[Page 54727]]
California, Florida, Illinois, Michigan, New York, North Carolina,
Texas, Pennsylvania, Ohio, Louisiana, Missouri, Maryland, New Jersey,
Indiana, Kentucky, Georgia, Tennessee, Washington, and Arizona 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.
Form Number: CMS-10421 (OMB control number: 0938-1169); Frequency:
Occasionally; Affected Public: State, Local or Tribal Governments;
Number of Respondents: 333,750; Total Annual Responses: 333,750; Total
Annual Hours: 170,060. (For policy questions regarding this collection
contact Daniel Schwartz at 410-786-4197.)
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: National Provider
Identifier (NPI) Application and Update Form and Supporting Regulations
in 45 CFR 142.408, 45 CFR 162.406, 45 CFR 162.408; Use: The National
Provider Identifier (NPI) Application and Update Form is used by health
care providers to apply for NPIs and furnish updates to the information
they supplied on their initial applications. The form is also used to
deactivate their NPIs if necessary. The NPI Application/Update form has
been revised to provide additional guidance on how to accurately
complete the form. The NPI Application/Update form has been revised to
provide additional guidance on how to accurately complete the form.
This collection includes clarification on information that is required
on applications/changes. Minor changes on the application/update form
include adding a `Subpart' check box in the Other Name section and a
revision within the PRA Disclosure Statement. This collection also
includes changes to the instructions. Form Number: CMS-10114 (OMB
control number: 0938-0931); Frequency: Reporting--On occasion; Affected
Public: Business or other for-profit, not-for-profit institutions, and
Federal government; Number of Respondents: 608,880; Total Annual
Responses: 608,880; Total Annual Hours: 112,660. (For policy questions
regarding this collection contact Leslie Jones at 410-786-6599.)
Dated: September 9, 2014.
Martique Jones,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 2014-21798 Filed 9-11-14; 8:45 am]
BILLING CODE 4120-01-P