Submission for Office of Management and Budget (OMB) Review; National Medical Support Notice Part A (OMB No.: 0970-0222), 57701-57703 [2022-20367]
Download as PDF
<![CDATA[
Federal Register / Vol. 87, No. 182 / Wednesday, September 21, 2022 / Notices
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: ll, 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, please access the CMS PRA
website by copying and pasting the
following web address into your web
browser: https://www.cms.gov/
Regulations-and-Guidance/Legislation/
PaperworkReductionActof1995/PRAListing.
FOR FURTHER INFORMATION CONTACT:
William N. Parham at (410) 786–4669.
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).
khammond on DSKJM1Z7X2PROD with NOTICES
CMS–855O Medicare Registration
Application
CMS–855I Medicare Enrollment
Application for Physician and NonPhysician Practitioners
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.
VerDate Sep<11>2014
19:54 Sep 20, 2022
Jkt 256001
Information Collection
1. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare
Registration Application; Use: Various
sections of the Social Security Act (Act),
the United States Code (U.S.C.), Internal
Revenue Service Code (Code) and the
Code of Federal Regulations (CFR)
require providers and suppliers to
furnish information concerning the
amounts due and the identification of
individuals or entities that furnish
medical services to beneficiaries before
allowing payment. The principal
function of the CMS–855O is to gather
information from a physician or other
eligible professional to help CMS
determine whether he or she meets
certain qualifications to enroll in the
Medicare program for the sole purpose
of ordering or certifying certain
Medicare items or services. The CMS–
855O allows a physician or other
eligible professional to enroll in
Medicare without approval for billing
privileges.
The collection and verification of this
information protects our beneficiaries
from illegitimate providers/suppliers.
These procedures also protect the
Medicare Trust Funds against fraud.
The CMS–855O gathers information that
allow Medicare contractors to ensure
that the physician or eligible
professional is not sanctioned from the
Medicare and/or Medicaid program(s),
or debarred, or excluded from any other
Federal agency or program.
Furthermore, the data collected also
ensures that the applicant has the
necessary credentials to order and
certify health care services. This is the
sole instrument implemented for this
purpose. Form Number: CMS–855O
(OMB control number 0938–1135);
Frequency: Occasionally; Affected
Public: Private Sector (Business or other
for-profits), State, Local, or Tribal
Governments; Number of Respondents:
6,190; Number of Responses: 6,190;
Total Annual Hours: 3,095. (For policy
questions regarding this collection
contact Frank Whelan at 410–786–
1302).
2. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare
Enrollment Application for Physician
and Non-Physician Practitioners; Use:
The Social Security Act (Act) requires
providers and suppliers to furnish
information concerning the amounts
due and the identification of individuals
or entities that furnish medical services
to beneficiaries before allowing
PO 00000
Frm 00022
Fmt 4703
Sfmt 4703
57701
payment. The primary function of the
CMS–855I Medicare enrollment
application for physicians and nonphysician practitioners is to gather
information from an individual provider
or supplier that tells us who he/she is,
whether he/she meets certain
qualifications to be a Medicare health
care provider or supplier, where he/she
practices or renders services, and other
information necessary to establish
correct claims payments.
The collection and verification of this
information is the first line defense to
defend and protect our beneficiaries
from illegitimate physicians, nonphysician practitioners, and other
eligible professionals and to protect the
Medicare Trust Fund against fraud. It
gathers information that allow Medicare
contractors to ensure only legitimate
physicians, non-physician practitioners,
and other eligible professionals enroll in
the Medicare program, and are not
sanctioned from the Medicare and/or
Medicaid program(s), or debarred, or
excluded from any other Federal agency
or program. This is the sole instrument
implemented for this purpose. Form
Number: CMS–855I (OMB control
number 0938–1355); Frequency:
Occasionally; Affected Public: State,
Local, or Tribal Governments, Private
Sector (not-for-profit institutions);
Number of Respondents: 472,617;
Number of Responses: 472,617; Total
Annual Hours: 961,651.
(For policy questions regarding this
collection contact Frank Whelan at 410–786–
1302).
Dated: September 16, 2022.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2022–20440 Filed 9–20–22; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Submission for Office of Management
and Budget (OMB) Review; National
Medical Support Notice Part A (OMB
No.: 0970–0222)
Office of Child Support
Enforcement, Administration for
Children and Families, Department of
Health and Human Services.
ACTION: Request for public comments.
AGENCY:
The Office of Child Support
Enforcement (OCSE), Administration for
Children and Families (ACF), is
SUMMARY:
E:\FR\FM\21SEN1.SGM
21SEN1
57702
Federal Register / Vol. 87, No. 182 / Wednesday, September 21, 2022 / Notices
requesting a three-year extension of the
National Medical Support Notice
(NMSN) Part A. This request includes
minor revisions to the NMSN Part A
form, revisions to and separation of the
instructions into a stand-alone
attachment, a Part A sample, and the
addition of the State Medical Support
Contacts and Program Requirements
matrix.
To allow states to program the
changes to the proposed NMSN Part A,
OCSE also requests an extension of the
current version of the NMSN Part A for
an additional year. The current Office of
Management and Budget (OMB)
approval expires on October 31, 2022.
Comments due within 30 days of
publication. OMB must make a decision
about the collection of information
between 30 and 60 days after
publication of this document in the
Federal Register. Therefore, a comment
is best assured of having its full effect
if OMB receives it within 30 days of
publication.
DATES:
Written comments and
recommendations for the proposed
ADDRESSES:
information collection should be sent
within 30 days of publication of this
notice to https://www.reginfo.gov/
public/do/PRAMain. Find this
particular information collection by
selecting ‘‘Currently under 30-day
Review—Open for Public Comments’’ or
by using the search function. You can
also obtain copies of the proposed
collection of information by emailing
infocollection@acf.hhs.gov. Identify all
emailed requests by the title of the
information collection.
SUPPLEMENTARY INFORMATION:
Description: Federal law requires that
all child support orders under Title IV–
D of the Social Security Act include
medical coverage. The Child Support
Performance and Incentive Act of 1998
(CSPIA) requires enforcement of this
provision; the NMSN Part A is the
means to enforce health care orders.
This information collection expedites
requests for medical coverage between
state child support enforcement
agencies and employers. OCSE
maintains Part A of the NMSN, which
states initiate and send to a parent’s
employer to complete. States must
Total number
of respondents
Information collection title
supply some sensitive information to
the parent’s employer in order to enroll
the child(ren) in the correct health
coverage plan. This information
includes names, dates of birth, Social
Security numbers, and addresses. The
employer retains the income
withholding part of the form and
withholds from the employee/obligor’s
income any premium payments that
may be required by the employer’s
health care plan. Then the employer’s
health care administrator enrolls the
child(ren) in the health care plan. The
Department of Labor (DOL) maintains
Part B of the NMSN. This request
includes minor revisions to the NMSN
Part A form, revisions to and separation
of the instructions into a stand-alone
attachment, a Part A sample, and the
addition of the State Medical Support
Contacts and Program Requirements
matrix. OCSE will also request from
OMB that the NMSN Part A expiration
date match the expiration date of the
NMSN Part B, which will be submitted
by DOL.
Respondents: States and employers.
Annual Burden Estimates:
Annual
number of
responses per
respondent
Average
burden hours
per response
Annual burden
hours
2019 Form—Estimated Burden for Use Through 2023
National Medical Support Notice—Part A—Notice to Withhold for Health
Care Coverage—States ...............................................................................
National Medical Support Notice—Part A—Notice to Withhold for Health
Care Coverage—Employers ........................................................................
54
90,194
.17
827,981
1,310,727
3.72
.17
828,904
Estimated Annual Burden 2022–2023: ....................................................
........................
........................
........................
1,656,885
khammond on DSKJM1Z7X2PROD with NOTICES
Revised Form—Estimated Burden for Implementation in 2023
National Medical Support Notice—Part A—Notice to Withhold for Health
Care Coverage—States ...............................................................................
National Medical Support Notice—Part A—Notice to Withhold for Health
Care Coverage—Employers ........................................................................
State Medical Support Contacts and Program Requirement Matrix—States
54
90,194
.17
827,981
1,310,727
54
3.72
1
.17
1
828,904
54
Estimated Annual Burden Beginning 2023: .............................................
........................
........................
........................
1,656,939
VerDate Sep<11>2014
19:54 Sep 20, 2022
Jkt 256001
PO 00000
Frm 00023
Fmt 4703
Sfmt 4703
E:\FR\FM\21SEN1.SGM
21SEN1
Federal Register / Vol. 87, No. 182 / Wednesday, September 21, 2022 / Notices
Estimated Total Annual Burden
Hours: 1,656,885 while states update
systems and then 1,656,939 once states
use the revised collection.
Authority: 45 U.S.C. 303.32; the
Personal Responsibility and Work
Opportunity Reconciliation Act of 1996,
Pub. L. 104–193; CSPIA, Pub. L. 105–
200, Sec. 401(c); Sec. 609(a)(5)(C) of the
Employee Retirement Income Security
Act of 1974.
Mary B. Jones,
ACF/OPRE Certifying Officer.
[FR Doc. 2022–20367 Filed 9–20–22; 8:45 am]
BILLING CODE 4184–41–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Agency Information Collection
Activities: Submission to OMB for
Review and Approval; Public Comment
Request; COVID–19 Provider Relief
Fund and American Rescue Plan (ARP)
Rural Payment Reporting Activities,
OMB No. 0906–0068—Revision.
Health Resources and Services
Administration (HRSA), Department of
Health and Human Services.
ACTION: Notice.
AGENCY:
In compliance with of the
Paperwork Reduction Act of 1995,
HRSA has submitted an Information
Collection Request (ICR) to the Office of
Management and Budget (OMB) for
review and approval. Comments
submitted during the first public review
of this ICR will be provided to OMB.
OMB will accept further comments from
the public during the review and
approval period. OMB may act on
HRSA’s ICR only after the 30-day
comment period for this Notice has
closed.
DATES: Comments on this ICR should be
received no later than October 21, 2022.
ADDRESSES: Written comments and
recommendations for the proposed
SUMMARY:
khammond on DSKJM1Z7X2PROD with NOTICES
Reporting period
Period
Period
Period
Period
Period
Period
Period
1
2
3
4
5
6
7
................................
................................
................................
................................
................................
................................
................................
19:54 Sep 20, 2022
ARP Rural payment agreed to a set of
Terms & Conditions (T&Cs), which,
among other requirements, mandate
compliance with certain reporting
requirements that will facilitate
appropriate oversight of recipients’ use
of funds.
Information collected will allow for
(1) assessing whether recipients have
met statutory and programmatic
requirements, (2) conducting audits, (3)
gathering data required to report on
findings with respect to the
disbursements of PRF and ARP Rural
payments, and (4) program evaluation.
HRSA staff will also use information
collected to identify and report on
trends in health care metrics and
expenditures before and during the
allowable period for expending PRF and
ARP Rural payments.
Included in this revision are the
following:
• A new funding source is now
included in the data collection form
(the American Rescue Plan Act of
2021 (Pub. L. 117–2) (ARP Rural))
• Additional reporting periods are
added for reporting entities to report
on use of funds (Reporting Period 5,
6, and 7)
• Updated burden estimates to include
ARP Rural payment reporting in
Reporting Period 4
• Updated burden estimates to reflect
the number of reporting entities and
additional reporting periods
• Adjusted burden estimates for
providers who have additional
reporting requirements
Likely Respondents: PRF and ARP
Rural payment recipients who have
received more than $10,000 in aggregate
PRF and ARP Rural payments during
one of the Payment Received Periods
outlined below and that agreed to the
associated T&Cs are required to submit
a report in the PRF Reporting Portal
during the applicable Reporting Time
Period.
Payment received period (payments exceeding $10,000
in aggregate received)
April 10, 2020, to June 30, 2020 ....................................
July 1, 2020, to December 31, 2020 ..............................
January 1, 2021, to June 30, 2021 .................................
July 1, 2021, to December 31, 2021 ..............................
January 1, 2022, to June 30, 2022 .................................
July 1, 2022, to December 31, 2022 ..............................
January 1, 2023, to June 30, 2023 .................................
Burden Statement: Burden in this
context means the time expended by
VerDate Sep<11>2014
information collection should be sent
within 30 days of publication of this
notice to https://www.reginfo.gov/
public/do/PRAMain. Find this
particular information collection by
selecting ‘‘Currently under Review—
Open for Public Comments’’ or by using
the search function.
FOR FURTHER INFORMATION CONTACT: To
request a copy of the clearance requests
submitted to OMB for review, email
Samantha Miller, the HRSA Information
Collection Clearance Officer at
paperwork@hrsa.gov or call (240) 276–
7189.
SUPPLEMENTARY INFORMATION:
Information Collection Request Title:
COVID–19 Provider Relief Fund (PRF)
Reporting Activities OMB No. 0906–
0068—Revision.
Abstract: HRSA disburses the PRF
and American Rescue Plan (ARP) Rural
payments to eligible health care
providers to support health care-related
expenses or lost revenues attributable to
the COVID–19 pandemic. Providers who
have attested to the Terms and
Conditions regarding their PRF and ARP
Rural payment(s), including the
requirement that the provider ‘‘shall
submit reports as the Secretary
determines are needed to ensure
compliance with conditions that are
imposed on this Payment, and such
reports shall be in such form, with such
content, as specified by the Secretary in
future program instructions directed to
all Recipients,’’ will be using the PRF
Reporting Portal to submit information
about their use of PRF and ARP Rural
payments. In anticipation of the
approved OMB form (control number
0906–0068) expiring on January 31,
2023, HRSA is undergoing the revision
of the ICR approval to include the ARP
Rural reporting requirements and to
allow for data collection beyond the
January 31, 2023 expiration.
A 60-day notice published in the
Federal Register, 87, FR pp. 20441
(April 7, 2022). There was one request
for program information.
Need and Proposed Use of the
Information: Recipients of a PRF and
Jkt 256001
Reporting time period
July 1, 2021, to September 30, 2021.
January 1, 2022, to March 31, 2022.
July 1, 2022, to September 30, 2022.
January 1, 2023, to March 31, 2023.
July 1, 2023, to September 30, 2023.
January 1, 2024, to March 31, 2024.
July 1, 2024, to September 30, 2024.
persons to generate, maintain, retain,
disclose or provide the information
PO 00000
Frm 00024
Fmt 4703
Sfmt 4703
57703
requested. This includes the time
needed to review instructions; to
E:\FR\FM\21SEN1.SGM
21SEN1
]]>Agencies
[Federal Register Volume 87, Number 182 (Wednesday, September 21, 2022)]
[Notices]
[Pages 57701-57703]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-20367]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
Submission for Office of Management and Budget (OMB) Review;
National Medical Support Notice Part A (OMB No.: 0970-0222)
AGENCY: Office of Child Support Enforcement, Administration for
Children and Families, Department of Health and Human Services.
ACTION: Request for public comments.
-----------------------------------------------------------------------
SUMMARY: The Office of Child Support Enforcement (OCSE), Administration
for Children and Families (ACF), is
[[Page 57702]]
requesting a three-year extension of the National Medical Support
Notice (NMSN) Part A. This request includes minor revisions to the NMSN
Part A form, revisions to and separation of the instructions into a
stand-alone attachment, a Part A sample, and the addition of the State
Medical Support Contacts and Program Requirements matrix.
To allow states to program the changes to the proposed NMSN Part A,
OCSE also requests an extension of the current version of the NMSN Part
A for an additional year. The current Office of Management and Budget
(OMB) approval expires on October 31, 2022.
DATES: Comments due within 30 days of publication. OMB must make a
decision about the collection of information between 30 and 60 days
after publication of this document in the Federal Register. Therefore,
a comment is best assured of having its full effect if OMB receives it
within 30 days of publication.
ADDRESSES: Written comments and recommendations for the proposed
information collection should be sent within 30 days of publication of
this notice to https://www.reginfo.gov/public/do/PRAMain. Find this
particular information collection by selecting ``Currently under 30-day
Review--Open for Public Comments'' or by using the search function. You
can also obtain copies of the proposed collection of information by
emailing [email protected]. Identify all emailed requests by
the title of the information collection.
SUPPLEMENTARY INFORMATION:
Description: Federal law requires that all child support orders
under Title IV-D of the Social Security Act include medical coverage.
The Child Support Performance and Incentive Act of 1998 (CSPIA)
requires enforcement of this provision; the NMSN Part A is the means to
enforce health care orders.
This information collection expedites requests for medical coverage
between state child support enforcement agencies and employers. OCSE
maintains Part A of the NMSN, which states initiate and send to a
parent's employer to complete. States must supply some sensitive
information to the parent's employer in order to enroll the child(ren)
in the correct health coverage plan. This information includes names,
dates of birth, Social Security numbers, and addresses. The employer
retains the income withholding part of the form and withholds from the
employee/obligor's income any premium payments that may be required by
the employer's health care plan. Then the employer's health care
administrator enrolls the child(ren) in the health care plan. The
Department of Labor (DOL) maintains Part B of the NMSN. This request
includes minor revisions to the NMSN Part A form, revisions to and
separation of the instructions into a stand-alone attachment, a Part A
sample, and the addition of the State Medical Support Contacts and
Program Requirements matrix. OCSE will also request from OMB that the
NMSN Part A expiration date match the expiration date of the NMSN Part
B, which will be submitted by DOL.
Respondents: States and employers.
Annual Burden Estimates:
----------------------------------------------------------------------------------------------------------------
Annual number Average
Information collection title Total number of responses burden hours Annual burden
of respondents per respondent per response hours
----------------------------------------------------------------------------------------------------------------
2019 Form--Estimated Burden for Use Through 2023
----------------------------------------------------------------------------------------------------------------
National Medical Support Notice--Part A--Notice 54 90,194 .17 827,981
to Withhold for Health Care Coverage--States...
National Medical Support Notice--Part A--Notice 1,310,727 3.72 .17 828,904
to Withhold for Health Care Coverage--Employers
---------------------------------------------------------------
Estimated Annual Burden 2022-2023:.......... .............. .............. .............. 1,656,885
----------------------------------------------------------------------------------------------------------------
Revised Form--Estimated Burden for Implementation in 2023
----------------------------------------------------------------------------------------------------------------
National Medical Support Notice--Part A--Notice 54 90,194 .17 827,981
to Withhold for Health Care Coverage--States...
National Medical Support Notice--Part A--Notice 1,310,727 3.72 .17 828,904
to Withhold for Health Care Coverage--Employers
State Medical Support Contacts and Program 54 1 1 54
Requirement Matrix--States.....................
---------------------------------------------------------------
Estimated Annual Burden Beginning 2023:..... .............. .............. .............. 1,656,939
----------------------------------------------------------------------------------------------------------------
[[Page 57703]]
Estimated Total Annual Burden Hours: 1,656,885 while states update
systems and then 1,656,939 once states use the revised collection.
Authority: 45 U.S.C. 303.32; the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996, Pub. L. 104-193; CSPIA, Pub. L.
105-200, Sec. 401(c); Sec. 609(a)(5)(C) of the Employee Retirement
Income Security Act of 1974.
Mary B. Jones,
ACF/OPRE Certifying Officer.
[FR Doc. 2022-20367 Filed 9-20-22; 8:45 am]
BILLING CODE 4184-41-P
