[Federal Register: February 18, 2003 (Volume 68, Number 32)]
[Notices]
[Page 7793-7794]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr18fe03-65]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[Document Identifier: CMS-R-96, CMS-R-5, CMS-R-245, CMS-R-209 and CMS-
718 BP, 719 BP, 720 BP, 721 BP, SUM, Staffing, SC1, and SC2]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare and Medicaid Services, HHS.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Centers for Medicare and Medicaid
Services (CMS) (formerly known as the Health Care Financing
Administration (HCFA), Department of Health and Human Services, is
publishing the following summary of proposed collections for public
comment. Interested persons are invited to send comments regarding this
burden estimate or any other aspect of this collection of information,
including any of the following subjects: (1) The necessity and utility
of the proposed information collection for the proper performance of
the agency's 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.
1. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Emergency and
Foreign Hospital Services--Beneficiary Statement in Canadian Travel
Claims and Supporting Regulations in 42 CFR, section 424.123; Form No.:
CMS-R-96 (OMB 0938-0484); Use: Payment may be made for certain
Part A inpatient hospital services and Part B outpatient hospital
services provided in a non-participating U.S. or foreign hospital when
services are necessary to prevent the death or serious impairment of
the health of the individual. This statement must be submitted by the
beneficiary to support their claim for payment.; Frequency: On
occasion; Affected Public: Individuals or Households; Number of
Respondents: 1,100; Total Annual Responses: 1,100; Total Annual Hours:
275.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Physician
Certifications/Recertifications in Skilled Nursing Facilities (SNFs)
Manual Instructions and Supporting Regulations in 42 CFR section
424.20; Form No.: CMS-R-5 (OMB 0938-0454); Use: This
information collection requires SNFs to keep record of physician
certifications and recertifications of information such as the need for
care and services, estimated duration of the SNF stay, and plan for
home care; Frequency: On occasion; Affected Public: State, Local or
Tribal Government, Individuals or Households, Business or other for-
profit, Not-for-profit institutions; Number of Respondents: 2,068,716;
Total Annual Responses: 883,838; Total Annual Hours: 441,793.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare and
Medicaid Programs Use of the OASIS as Part of the CoPs for HHAs and
Supporting Regulations in part 484 of 42 CFR; Form No.: CMS-R-245
(OMB 0938-0760); Use: This regulation requires HHAs to use a
standard core assessment data set, the OASIS, to collect information
and to evaluate adult non-maternity patients. In addition, data from
the OASIS will be used for purposes of case mix adjusting patients
under home health PPS and will facilitate the production of necessary
case mix information at relevant time points in the patient's home
health stay. Modifications have been made to currently approved OASIS
forms to allow for the preservation of masking of personally
identifiable information for the non-Medicare/non-Medicaid individuals;
Frequency: Upon patient assessment; Affected Public: Business or other
for-profit, Not-for-profit institutions, Federal Government, State,
Local, or Tribal Government; Number of Respondents: 7,100; Total Annual
Responses: 9,510,900; Total Annual Hours: 8,013,013.
4. Type of Information Collection Request: Extension of a currently
[[Page 7794]]
approved collection; Title of Information Collection: Medicare and
Medicaid Programs; Use and Reporting OASIS Data as Part of the CoPs for
HHAs and Supporting Regulations in 42 CFR 484.11 and 484.20; Form No.:
CMS-R-209 (OMB 0938-0761); Use: HHAs are required to report
data from the OASIS as a condition of participation. Specifically, the
above named regulations sections provide guidelines for HHAs for the
electronic transmission of the OASIS data as well as responsibilities
of the State agency or OASIS contractor in collecting and transmitting
this information to HCFA. These requirements are necessary to achieve
broad-based, measurable improvement in the quality of care furnished
through Federal programs, and to establish a prospective payment system
for HHAs.; Frequency: Monthly; Affected Public: Business or other for-
profit, Not-for-profit institutions, Federal Government, State, Local,
or Tribal Government; Number of Respondents: 6,900; Total Annual
Responses: 85,200; Total Annual Hours: 838,408.
5. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Business Proposal
Formats for Quality Improvement Organizations (QIOs)--previously known
as Peer Review Organizations and Supporting Regulations in 42 CFR,
Section 475.101--475.107; Form No.: CMS-718-721 (OMB 0938-
0579); Use: The submission of proposal information by current QIOs and
other bidders, on the appropriate forms, will satisfy CMS's need for
meaningful, consistent, and verifiable data with which to evaluate
contract proposals; Frequency: tri-annually; Affected Public: Business
or other for-profit, Not-for-profit institutions; Number of
Respondents: 20; Total Annual Responses: 20; Total Annual Hours: 455.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS Web
site address at http://cms.hhs.gov/regulations/pra/default.asp, or E-
mail your request, including your address, phone number, OMB number,
and CMS document identifier, to Paperwork@hcfa.gov, or call the Reports
Clearance Office on (410) 786-1326. Written comments and
recommendations for the proposed information collections must be mailed
within 30 days of this notice directly to the OMB desk officer: OMB
Human Resources and Housing Branch, Attention: Brenda Aguilar, New
Executive Office Building, Room 10235, Washington, DC 20503.
Dated: February 6, 2003.
John P. Burke, III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer,
Office of Strategic Operations and Regulatory Affairs, Division of
Regulations Development and Issuances.
[FR Doc. 03-3786 Filed 2-14-03; 8:45 am]
BILLING CODE 4120-03-P