[Federal Register: September 16, 2005 (Volume 70, Number 179)]
[Notices]
[Page 54749-54750]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr16se05-116]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-R-138, CMS-339, CMS-1450]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid
Services (CMS), 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 function; (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: Medicare
Geographic Classification Review Board (MGCRB) Procedures and
Supporting Regulations in 42 CFR 412.256 and 412.230; Form Nos.: CMS-R-
138 (OMB 0938-0573); Use: Section 1886(d)(10) of the Social
Security Act established the Medicare Geographic Classification Review
Board (MGCRB), an entity with the authority to accept short-term
hospital inpatient prospective payment system applications from
hospitals requesting geographic reclassification for wage index or
standardized payment amounts and to issue decisions on these requests.
This regulation sets up the application process for prospective payment
system hospitals that choose to appeal their geographic status to the
MGCRB. This regulation also establishes procedural guidelines for the
MGCRB; Frequency: Reporting--Annually; Affected Public: Business or
other for-profit, Not-for-profit institutions; Number of Respondents:
500; Total Annual Responses: 500; Total Annual Hours: 500.
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare Provider
Cost Report Reimbursement Questionnaire and Supporting Regulations in
42 CFR 413.20, 413.24, and 415.60; Form Nos.: CMS-339 (OMB
0938-0301); Use: The purpose of Form CMS-339 is to assist the provider
in preparing an acceptable cost report and to minimize subsequent
contact between the provider and its intermediary. Form CMS-339
provides the basic data necessary to support the information in the
cost report. This includes information the provider uses to develop the
provider and professional components of physician compensation so that
compensation can be properly allocated between the Part A and the Part
B trust funds. CMS is currently working on eliminating Form CMS-339 and
including the applicable questions on the individual cost report forms.
Because of the time required to include the applicable questions in
each of the individual cost reports, CMS is revising the currently
approved information collection; Frequency: Annually; Affected Public:
Business or other for-profit, not-for-profit institutions, State, Local
or Tribal Governments; Number of Respondents: 35,904; Total Annual
Responses: 35,904; Total Annual Hours: 618,210.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare Uniform
Institutional Provider Bill and Supporting Regulations in 42 CFR 424.5;
Form No.: CMS-1450 (OMB 0938-0279); Use: Section 42 CFR
424.5(a)(5) requires providers of services to submit claims prior to
Medicare reimbursement. Charges are coded by revenue codes. The bill
specifies diagnoses according to the International Classification of
Diseases, Ninth Edition (ICD-9-CM) codes. Inpatient procedures are
identified by ICD-9-CM codes, and outpatient procedures are described
using the Healthcare Common Procedure Coding System (HCPCS). These are
standard systems of identification for all major health insurance
claims payers. Submission of information on the CMS-1450 permits
Medicare intermediaries to receive consistent data for proper payment;
[[Page 54750]]
Frequency: On occasion; Affected Public: Not-for-profit institutions,
business or other for profit; Number of Respondents: 51,629; Total
Annual Responses: 174,461,278; Total Annual Hours: 1,997,581.
To obtain copies of the supporting statement and any related forms
for these paperwork collections referenced above, access CMS Web site
address at http://www.cms.hhs.gov/regulations/pra/, 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.
To be assured consideration, comments and recommendations for the
proposed information collections must be received by the OMB Desk
Officer at the address below, no later than 5 p.m. on October 17, 2005.
OMB Human Resources and Housing Branch, Attention: Christopher Martin,
New Executive Office Building, Room 10235, Washington, DC 20503.
Dated: September 1, 2005.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 05-18052 Filed 9-15-05; 8:45 am]
BILLING CODE 4120-01-P