Agency Information Collection Activities: Submission for OMB Review; Comment Request, 50100-50102 [2018-21590]
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Federal Register / Vol. 83, No. 193 / Thursday, October 4, 2018 / Notices
burden estimates or any other aspect of
this collection of information, including
the necessity and utility of the proposed
information collection for the proper
performance of the agency’s functions,
the accuracy of the estimated burden,
ways to enhance the quality, utility, and
clarity of the information to be
collected, and the use of automated
collection techniques or other forms of
information technology to minimize the
information collection burden.
Comments must be received by
December 3, 2018.
DATES:
When commenting, please
reference the document identifier or
OMB control number. 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’ website address at
https://www.cms.gov/Regulations-andGuidance/Legislation/Paperwork
ReductionActof1995/PRA-Listing.html.
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.
ADDRESSES:
FOR FURTHER INFORMATION CONTACT:
William Parham at (410) 786–1326.
SUPPLEMENTARY INFORMATION:
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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).
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Jkt 247001
CMS–10391 Methods for Assuring
Access to Covered Medicaid Services
Under 42 CFR 447.203 and 447.204
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. Title of Information Collection:
Methods for Assuring Access to Covered
Medicaid Services Under 42 CFR
447.203 and 447.204; Type of
Information Collection Request:
Extension of a currently approved
collection; Use: Current regulations at
42 CFR 447.203(b) require states to
develop an access monitoring review
plan (AMRP) that is updated at least
every three years for: Primary care
services, physician specialist services,
behavioral health services, pre and postnatal obstetric services (including labor
and delivery), and home health services.
When states reduce rates for other
Medicaid services, they must add those
services to the AMRP and monitor the
effects of the rate reductions for 3 years.
If access issues are detected, a state
must submit a corrective action plan to
CMS within 90 days and work to
address the issues within 12 months.
Section 447.203(b)(7) requires that states
have mechanisms to obtain ongoing
beneficiary and provider feedback. A
state is also required to maintain a
record of data on public input and how
the state responded to the input. Prior
to submitting proposals to reduce or
restructure Medicaid service payment
rates, states must receive input from
beneficiaries, providers, and other
affected stakeholders on the extent of
beneficiary access to the affected
services.
The information is used by states to
document that access to care is in
compliance with section 1902(a)(30)(A)
of the Social Security Act, to identify
issues with access within a state’s
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Sfmt 4703
Medicaid program, and to inform any
necessary programmatic changes to
address issues with access to care. CMS
uses the information to make informed
approval decisions on State plan
amendments that propose to make
Medicaid rate reductions or restructure
payment rates and to provide the
necessary information for CMS to
monitor ongoing compliance with
section 1902(a)(30)(A). Beneficiaries,
providers and other affected
stakeholders may use the information to
raise access issues to state Medicaid
agencies and work with agencies to
address those issues. Form Number:
CMS–10391 (OMB control number:
0938–1134); Frequency: Annually;
Affected Public: State, Local, or Tribal
Governments); Number of Respondents:
51; Number of Responses: 212; Total
Annual Hours: 12,262. (For questions
regarding this collection contact Jeremy
Silanskis at 410–786–1592.)
Dated: September 28, 2018.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2018–21587 Filed 10–3–18; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10008, CMS–R–
234, and CMS–R–194]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Centers for Medicare &
Medicaid Services, Department of
Health and Human Services.
ACTION: Notice.
AGENCY:
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 the necessity and
utility of the proposed information
SUMMARY:
E:\FR\FM\04OCN1.SGM
04OCN1
daltland on DSKBBV9HB2PROD with NOTICES
Federal Register / Vol. 83, No. 193 / Thursday, October 4, 2018 / Notices
collection for the proper performance of
the agency’s functions, the accuracy of
the estimated burden, ways to enhance
the quality, utility, and clarity of the
information to be collected, and 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 November 5, 2018.
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’ website address at
https://www.cms.hhs.gov/Paperwork
ReductionActof1995.
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:
William Parham at (410) 786–4669.
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 with a change of
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17:43 Oct 03, 2018
Jkt 247001
a previously approved collection; Title
of Information Collection: Eligibility of
Drugs, Biologicals, and
Radiopharmaceutical Agents for
Transitional Pass-Through Status Under
the Hospital Outpatient Prospective
Payment System (OPPS); Use: Section
201(b) of the BBRA 1999 amended
section 1833(t) of the Act by adding new
section 1833(t)(6). This provision
requires the Secretary to make
additional payments to hospitals for a
period of 2 to 3 years for certain drugs,
radiopharmaceuticals, biological agents,
medical devices and brachytherapy
devices. Section 1833(t)(6)(A)(iv)
establishes the criteria for determining
the application of this provision to new
items. Section 1833(t)(6)(C)(i) provides
that the additional payment for drugs
and biologicals be the amount by which
the amount determined under section
1842(o) of the Act exceeds the portion
of the otherwise applicable hospital
outpatient department fee schedule
amount that the Secretary determines to
be associated with the drug or
biological. Section 1833(t)(6)(D)(i) of the
Act sets the payment rate for passthrough eligible drugs and biologicals
(assuming that no pro rata reduction in
pass-through payment is necessary) as
the amount determined under section
1842(o) of the Act. Section 303(c) of
Pub. L. 108–173 amended Title XVIII of
the Act by adding new section 1847A.
This new section establishes the use of
the average sales price (ASP)
methodology for payment for drugs and
biologicals described in section
1842(o)(1)(C) of the Act furnished on or
after January 1, 2005. Therefore, as we
stated in the November 15, 2004 Federal
Register (69 FR 65776), in CY 2005, we
will pay under the OPPS for drugs,
biologicals and radiopharmaceuticals
with pass-through status consistent with
the provisions of section 1842(o) of the
Act as amended by Public Law 108–173
at a rate that is equivalent to the
payment these drugs and biologicals
will receive in the physician office
setting, and established in accordance
with the methodology described in the
CY 2005 Physician Fee Schedule final
rule. Information on Average Sales Price
is found at https://www.cms.hhs.gov/
McrPartBDrugAvgSalesPrice/. The
intent of these provisions is to ensure
that timely beneficiary access to new
pharmacological technologies is not
jeopardized by inadequate payment
levels. Form Number: CMS–10008
(OMB control number 0938–0802);
Frequency: Yearly; Affected Public:
Private sector (Business or other forprofits); Number of Respondents: 30;
Total Annual Responses: 30; Total
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50101
Annual Hours: 480. (For policy
questions regarding this collection
contact Raymond Bulls at 410–786–
7267).
2. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Subpart D—
Private Contracts; Use: Section 4507 of
the Balanced Budget Act of 1997 (BBA
1997) amended section 1802 of the
Social Security Act (the Act) to permit
certain physicians and practitioners to
opt-out of Medicare and to provide
through private contracts services that
would otherwise be covered by
Medicare. Under such contracts the
mandatory claims submission and
limiting charge rules of section 1848(g)
of the Act would not apply. Subpart D
and the supporting regulations
contained in 42 CFR 405.410, 405.430,
405.435, 405.440, 405.445, and 405.455,
counters the effect of certain provisions
of Medicare law that, absent section
1802 of the Act, preclude physicians
and practitioners from contracting
privately with Medicare beneficiaries to
pay without regard to Medicare limits.
The most recent approval of this
information collection request (ICR) was
issued by the Office of Management and
Budget on March 2, 2016. We are now
seeking to renew this approval before it
expires on March 31, 2019. We have
made no changes to the information
being collected. We updated our burden
estimate to reflect changes in the
number of physicians and practitioners
who have opted out and refinements to
our methodology for estimating the
burden associated with contracts. We
have also updated the cost estimate to
account for the current Bureau of Labor
Statistics (BLS) wage estimates and to
include the estimated costs for Medicare
Advantage plans. Form Number: CMS–
R–234 (OMB control number 0938–
0730); Frequency: Yearly; Affected
Public: Private sector (Business or other
for-profits); Number of Respondents:
57,722; Total Annual Responses:
57,722; Total Annual Hours: 23,557.
(For policy questions regarding this
collection contact Frederick Grabau at
410–786–0206).
3. Type of Information Collection
Request: Reinstatement without a
change of a previously approved
collection; Title of Information
Collection: Medicare Disproportionate
Share Adjustment Procedures and
Criteria; Use: Section 1886(d)(5)(F) of
the Social Security Act established the
Medicare disproportionate share
adjustment (DSH) for hospitals, which
provides additional payment to
hospitals that serve a disproportionate
share of the indigent patient population.
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04OCN1
50102
Federal Register / Vol. 83, No. 193 / Thursday, October 4, 2018 / Notices
This payment is an add-on to the set
amount per case the Centers for
Medicare and Medicaid Services (CMS)
pays to hospitals under the Medicare
Inpatient Prospective Payment System
(IPPS). Under current regulations at 42
CFR 412.106, in order to meet the
qualifying criteria for this additional
DSH payment, a hospital must prove
that a disproportionate percentage of its
patients are low income using
Supplemental Security Income (SSI)
and Medicaid as proxies for this
determination. This percentage includes
two computations: (1) The ‘‘Medicare
fraction’’ or the ‘‘SSI ratio’’ which is the
percent of patient days for beneficiaries
who are eligible for Medicare Part A and
SSI and (2) the ‘‘Medicaid fraction’’
which is the percent of patient days for
patients who are eligible for Medicaid
but not Medicare. Once a hospital
qualifies for this DSH payment, CMS
also determines a hospital’s payment
adjustment based on these two fractions.
42 CFR 412.106 allows hospitals to
request that the Medicare fraction of the
DSH adjustment be calculated on a cost
reporting basis rather than a federal
fiscal year. Once requested, the hospital
must accept the result irrespective of
whether it increases or decreases their
DSH payment. The routine use
procedure and the DUA allows hospitals
to request the detailed Medicare data so
they can make an informed choice
before deciding whether to request that
the Medicare fraction be calculated on
the basis of a cost reporting period
rather than a federal fiscal year. Form
Number: CMS–R–194 (OMB control
number 0938–0691); Frequency: Yearly;
Affected Public: Private sector (Business
or other for-profits); Number of
Respondents: 800; Total Annual
Responses: 800; Total Annual Hours:
400. (For policy questions regarding this
collection contact Emily Lipkin at 410–
786–3633.)
Dated: September 28, 2018.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2018–21590 Filed 10–3–18; 8:45 am]
daltland on DSKBBV9HB2PROD with NOTICES
BILLING CODE 4120–01–P
VerDate Sep<11>2014
17:43 Oct 03, 2018
Jkt 247001
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2014–N–1721]
Agency Information Collection
Activities; Proposed Collection;
Comment Request; Investigational
New Drug Applications
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
The Food and Drug
Administration (FDA, Agency, or we) is
announcing an opportunity for public
comment on the proposed collection of
certain information by the Agency.
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 of an
existing collection of information, and
to allow 60 days for public comment in
response to the notice. This notice
solicits comments on regulations under
which the clinical investigation of the
safety and effectiveness of unapproved
new drugs and biological products can
be conducted.
DATES: Submit either electronic or
written comments on the collection of
information by December 3, 2018.
ADDRESSES: You may submit comments
as follows. Please note that late,
untimely filed comments will not be
considered. Electronic comments must
be submitted on or before December 3,
2018. The https://www.regulations.gov
electronic filing system will accept
comments until 11:59 p.m. Eastern Time
at the end of December 3, 2018.
Comments received by mail/hand
delivery/courier (for written/paper
submissions) will be considered timely
if they are postmarked or the delivery
service acceptance receipt is on or
before that date.
SUMMARY:
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal:
https://www.regulations.gov. Follow the
instructions for submitting comments.
Comments submitted electronically,
including attachments, to https://
www.regulations.gov will be posted to
the docket unchanged. Because your
comment will be made public, you are
solely responsible for ensuring that your
comment does not include any
confidential information that you or a
third party may not wish to be posted,
such as medical information, your or
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Sfmt 4703
anyone else’s Social Security number, or
confidential business information, such
as a manufacturing process. Please note
that if you include your name, contact
information, or other information that
identifies you in the body of your
comments, that information will be
posted on https://www.regulations.gov.
• If you want to submit a comment
with confidential information that you
do not wish to be made available to the
public, submit the comment as a
written/paper submission and in the
manner detailed (see ‘‘Written/Paper
Submissions’’ and ‘‘Instructions’’).
Written/Paper Submissions
Submit written/paper submissions as
follows:
• Mail/Hand delivery/Courier (for
written/paper submissions): Dockets
Management Staff (HFA–305), Food and
Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
• For written/paper comments
submitted to the Dockets Management
Staff, FDA will post your comment, as
well as any attachments, except for
information submitted, marked and
identified, as confidential, if submitted
as detailed in ‘‘Instructions.’’
Instructions: All submissions received
must include the Docket No. FDA–
2014–N–1721 for ‘‘Agency Information
Collection Activities; Proposed
Collection; Comment Request;
Investigational New Drug
Applications.’’ Received comments,
those filed in a timely manner (see
ADDRESSES), will be placed in the docket
and, except for those submitted as
‘‘Confidential Submissions,’’ publicly
viewable at https://www.regulations.gov
or at the Dockets Management Staff
between 9 a.m. and 4 p.m., Monday
through Friday.
• Confidential Submissions—To
submit a comment with confidential
information that you do not wish to be
made publicly available, submit your
comments only as a written/paper
submission. You should submit two
copies total. One copy will include the
information you claim to be confidential
with a heading or cover note that states
‘‘THIS DOCUMENT CONTAINS
CONFIDENTIAL INFORMATION.’’ The
Agency will review this copy, including
the claimed confidential information, in
its consideration of comments. The
second copy, which will have the
claimed confidential information
redacted/blacked out, will be available
for public viewing and posted on
https://www.regulations.gov. Submit
both copies to the Dockets Management
Staff. If you do not wish your name and
contact information to be made publicly
available, you can provide this
E:\FR\FM\04OCN1.SGM
04OCN1
Agencies
[Federal Register Volume 83, Number 193 (Thursday, October 4, 2018)]
[Notices]
[Pages 50100-50102]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-21590]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10008, CMS-R-234, and CMS-R-194]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, Department of Health
and Human Services.
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 (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 the necessity and utility of the
proposed information
[[Page 50101]]
collection for the proper performance of the agency's functions, the
accuracy of the estimated burden, ways to enhance the quality, utility,
and clarity of the information to be collected, and 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 November 5, 2018.
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:
[email protected].
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' website address at https://www.cms.hhs.gov/PaperworkReductionActof1995.
2. Email your request, including your address, phone number, OMB
number, and CMS document identifier, to [email protected].
3. Call the Reports Clearance Office at (410) 786-1326.
FOR FURTHER INFORMATION CONTACT: William Parham at (410) 786-4669.
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 with a
change of a previously approved collection; Title of Information
Collection: Eligibility of Drugs, Biologicals, and Radiopharmaceutical
Agents for Transitional Pass-Through Status Under the Hospital
Outpatient Prospective Payment System (OPPS); Use: Section 201(b) of
the BBRA 1999 amended section 1833(t) of the Act by adding new section
1833(t)(6). This provision requires the Secretary to make additional
payments to hospitals for a period of 2 to 3 years for certain drugs,
radiopharmaceuticals, biological agents, medical devices and
brachytherapy devices. Section 1833(t)(6)(A)(iv) establishes the
criteria for determining the application of this provision to new
items. Section 1833(t)(6)(C)(i) provides that the additional payment
for drugs and biologicals be the amount by which the amount determined
under section 1842(o) of the Act exceeds the portion of the otherwise
applicable hospital outpatient department fee schedule amount that the
Secretary determines to be associated with the drug or biological.
Section 1833(t)(6)(D)(i) of the Act sets the payment rate for pass-
through eligible drugs and biologicals (assuming that no pro rata
reduction in pass-through payment is necessary) as the amount
determined under section 1842(o) of the Act. Section 303(c) of Pub. L.
108-173 amended Title XVIII of the Act by adding new section 1847A.
This new section establishes the use of the average sales price (ASP)
methodology for payment for drugs and biologicals described in section
1842(o)(1)(C) of the Act furnished on or after January 1, 2005.
Therefore, as we stated in the November 15, 2004 Federal Register (69
FR 65776), in CY 2005, we will pay under the OPPS for drugs,
biologicals and radiopharmaceuticals with pass-through status
consistent with the provisions of section 1842(o) of the Act as amended
by Public Law 108-173 at a rate that is equivalent to the payment these
drugs and biologicals will receive in the physician office setting, and
established in accordance with the methodology described in the CY 2005
Physician Fee Schedule final rule. Information on Average Sales Price
is found at https://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/. The
intent of these provisions is to ensure that timely beneficiary access
to new pharmacological technologies is not jeopardized by inadequate
payment levels. Form Number: CMS-10008 (OMB control number 0938-0802);
Frequency: Yearly; Affected Public: Private sector (Business or other
for-profits); Number of Respondents: 30; Total Annual Responses: 30;
Total Annual Hours: 480. (For policy questions regarding this
collection contact Raymond Bulls at 410-786-7267).
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Subpart D--
Private Contracts; Use: Section 4507 of the Balanced Budget Act of 1997
(BBA 1997) amended section 1802 of the Social Security Act (the Act) to
permit certain physicians and practitioners to opt-out of Medicare and
to provide through private contracts services that would otherwise be
covered by Medicare. Under such contracts the mandatory claims
submission and limiting charge rules of section 1848(g) of the Act
would not apply. Subpart D and the supporting regulations contained in
42 CFR 405.410, 405.430, 405.435, 405.440, 405.445, and 405.455,
counters the effect of certain provisions of Medicare law that, absent
section 1802 of the Act, preclude physicians and practitioners from
contracting privately with Medicare beneficiaries to pay without regard
to Medicare limits. The most recent approval of this information
collection request (ICR) was issued by the Office of Management and
Budget on March 2, 2016. We are now seeking to renew this approval
before it expires on March 31, 2019. We have made no changes to the
information being collected. We updated our burden estimate to reflect
changes in the number of physicians and practitioners who have opted
out and refinements to our methodology for estimating the burden
associated with contracts. We have also updated the cost estimate to
account for the current Bureau of Labor Statistics (BLS) wage estimates
and to include the estimated costs for Medicare Advantage plans. Form
Number: CMS-R-234 (OMB control number 0938-0730); Frequency: Yearly;
Affected Public: Private sector (Business or other for-profits); Number
of Respondents: 57,722; Total Annual Responses: 57,722; Total Annual
Hours: 23,557. (For policy questions regarding this collection contact
Frederick Grabau at 410-786-0206).
3. Type of Information Collection Request: Reinstatement without a
change of a previously approved collection; Title of Information
Collection: Medicare Disproportionate Share Adjustment Procedures and
Criteria; Use: Section 1886(d)(5)(F) of the Social Security Act
established the Medicare disproportionate share adjustment (DSH) for
hospitals, which provides additional payment to hospitals that serve a
disproportionate share of the indigent patient population.
[[Page 50102]]
This payment is an add-on to the set amount per case the Centers for
Medicare and Medicaid Services (CMS) pays to hospitals under the
Medicare Inpatient Prospective Payment System (IPPS). Under current
regulations at 42 CFR 412.106, in order to meet the qualifying criteria
for this additional DSH payment, a hospital must prove that a
disproportionate percentage of its patients are low income using
Supplemental Security Income (SSI) and Medicaid as proxies for this
determination. This percentage includes two computations: (1) The
``Medicare fraction'' or the ``SSI ratio'' which is the percent of
patient days for beneficiaries who are eligible for Medicare Part A and
SSI and (2) the ``Medicaid fraction'' which is the percent of patient
days for patients who are eligible for Medicaid but not Medicare. Once
a hospital qualifies for this DSH payment, CMS also determines a
hospital's payment adjustment based on these two fractions. 42 CFR
412.106 allows hospitals to request that the Medicare fraction of the
DSH adjustment be calculated on a cost reporting basis rather than a
federal fiscal year. Once requested, the hospital must accept the
result irrespective of whether it increases or decreases their DSH
payment. The routine use procedure and the DUA allows hospitals to
request the detailed Medicare data so they can make an informed choice
before deciding whether to request that the Medicare fraction be
calculated on the basis of a cost reporting period rather than a
federal fiscal year. Form Number: CMS-R-194 (OMB control number 0938-
0691); Frequency: Yearly; Affected Public: Private sector (Business or
other for-profits); Number of Respondents: 800; Total Annual Responses:
800; Total Annual Hours: 400. (For policy questions regarding this
collection contact Emily Lipkin at 410-786-3633.)
Dated: September 28, 2018.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2018-21590 Filed 10-3-18; 8:45 am]
BILLING CODE 4120-01-P