[Federal Register: September 10, 2004 (Volume 69, Number 175)]
[Notices]
[Page 54795]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr10se04-64]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[Document Identifier: CMS-10052, CMS-370, 377, 378, R-54, and CMS-R-
218]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare and Medicaid Services.
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: Revision of currently
approved collection;
Title of Information Collection: Recognition of Pass-Through
Payment for Additional (new) Categories of Devices under the Outpatient
Prospective Payment System and Supporting Regulations in 42 CFR Part
419; Use: Information is necessary to determine eligibility of medical
devices for establishment of additional device categories for payment
under transitional pass-through payment provisions as required by
section 1833(t) (6) of the Social Security Act. Form Number: CMS-10052
(OMB: 0938-0857); Frequency: On occasion; Affected Public:
Business or other for-profit; Number of Respondents: 12; Total Annual
Responses: 12; Total Annual Hours: 192.
2. Type of Information Collection Request: Revision of currently
approved collection;
Title of Information Collection: Ambulatory Surgical Center (ASC)
Health Insurance Benefit Agreement, ASC Request for Certification, ASC
Survey Report and Supporting Regulations in 42 CFR 416.41, 416.43,
416.47, and 416.48; Use: The ASC Health Insurance Benefits Agreement
form is utilized for the purpose of establishing eligibility for
payment under Title XVIII of the Social Security Act. The ASC Request
for Certification form is utilized as an application for facilities
wishing to participate in the Medicare program as an ASC. This form
initiates the process of obtaining a decision as to whether the
conditions of coverage are met. It also promotes data retrieval from
the Online Data Input Edit (ODIE system, a subsystem of the Online
Survey Certification and Report (OSCAR) system by the Centers for
Medicare and Medicaid Services (CMS) Regional Offices (RO)). The ASC
Report Form is an instrument used by the State survey agency to record
data collection in order to determine supplier compliance with
individual conditions of coverage and to report it to the Federal
government. The form is primarily a coding worksheet designed to
facilitate data reduction and retrieval into the ODIE/OSCAR system at
the CMS ROs. This form includes basic information on compliance (i.e.,
met, not met and explanatory statements) and does not require any
descriptive information regarding the survey activity itself; Form
Number: CMS-370, 377, 378, R-54 (OMB: 0938-0266); Frequency:
Annually and other: once; Affected Public: State, local or tribal
government; Number of Respondents: 4,312; Total Annual Responses:
4,312; Total Annual Hours: 2,241.
3. Type of Information Collection Request: Extension of currently
approved collection; Title of Information Collection: ICRS Contained in
45 CFR Part 162; HIPAA Standards for Electronic Transactions; Use: This
submission contains information collection requirements in HCFA-0149-F,
CMS-0003-P, CMS-0005-P, and CMS-003/005-F. This collection establishes
standards for electronic transactions and for code sets to be used in
those transactions. The collection standardizes the approximately 400
formats of electronic health care claims used in the United States. The
use of these standards significantly reduces the administrative burden
associated with paper documents, lowers operating costs, and improves
data quality for health care providers and health plans; Form Number:
CMS-R-218 (OMB 0938-0866); Frequency: On occasion; Affected
Public: Business or other for-profit; Number of Respondents: 3.4
million; Total Annual Responses: 3.4 million; Total Annual Hours: 1
hour.
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://www.cms.gov/regs/prdact95.htm, or e-mail
your request, including your address, phone number, OMB number, and CMS
document identifier, to Paperwork@cms.hhs.gov, or call the Reports
Clearance Office on (410) 786-1326.
Written comments and recommendations for the proposed information
collections must be mailed within 60 days of this notice directly to
the CMS Paperwork Clearance Officer designated at the following
address: CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development and Issuances, Attention: Melissa
Musotto, Room C5-14-03, 7500 Security Boulevard, Baltimore, Maryland
21244-1850.
Dated: August 31, 2004.
John P. Burke, III,
Paperwork Reduction Act Team Leader, Office of Strategic Operations and
Strategic Affairs, Division of Regulations Development and Issuances.
[FR Doc. 04-20270 Filed 9-9-04; 8:45 am]
BILLING CODE 4120-03-P