[Federal Register: October 28, 2005 (Volume 70, Number 208)]
[Notices]
[Page 62122-62124]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr28oc05-46]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-R-0021, CMS-838, CMS-10134, CMS-R-137, CMS-R-
257, CMS-29/CMS-30, CMS-10150, CMS-381, CMS-10161, CMS-10162, and
10136]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & 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 & 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: Withholding
Medicare Payments to Recover Medicaid Overpayments and Supporting
Regulations in 42 CFR 447.31; Use: Overpayments may occur in either the
Medicare and Medicaid program, at times resulting in a situation where
an institution or person that provides services owes a repayment to one
program while still receiving reimbursement from the other. Certain
Medicaid providers which are subject to offsets for the collection of
Medicaid overpayments may terminate or substantially reduce their
participation in Medicaid, leaving the State Medicaid Agency unable to
recover the amounts due. These information collection requirements give
CMS the authority to recover Medicaid overpayments by offsetting
payments due to a provider under the program. Form Number: CMS-R-0021
(OMB 0938-0287); Frequency: Reporting--On occasion; Affected
Public: State, Local or Tribal Government; Number of Respondents: 54;
Total Annual Responses: 27; Total Annual Hours: 81.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare Credit
Balance Reporting Requirements and Supporting Regulations in 42 CFR
405.371, 405.378, and 413.20; Form Number: CMS-838 (OMB 0938-
0600); Use: Section 1815(a) of the Social Security Act authorizes the
Secretary to request information from providers which is necessary to
properly administer the Medicare program. Quarterly credit balance
reporting is needed to monitor and control the identification and
timely collection of improper payments. The reporting requirements
provide CMS with the authority to impose sanctions such as the
suspension of program payments in accordance with 42 CFR 413.20(e) and
405.371 if providers do not report credit balances on a timely basis.
Furthermore, once a credit balance has been identified on a CMS-838
form and demand for payment is made, CMS has the authority to charge
interest if the amount is not repaid within 30 days in accordance with
42 CFR 405.378. The collection of credit balance information is needed
to ensure that millions of dollars in improper program payments are
collected. Approximately 48,300 health care providers will be required
to submit a quarterly credit balance report that identifies the amount
of improper payments they received that are due to Medicare. The
intermediaries will monitor the reports to ensure these funds are
collected; Frequency: Quarterly; Affected Public: Not-for-profit
institutions, Business or other for-profit; Number of Respondents:
48,300; Total Annual Responses: 193,200; Total Annual Hours: 579,600.
[[Page 62123]]
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Physician Group
Practice (PGP) Standardized Ambulatory Care Quality Measure Collection
Initiative; Use: The Benefits Improvement & Protection Act of 2000
mandated the PGP Demonstration and gave the Secretary discretion to use
quality measures to assess physician performance in order to reward
physicians for improvements in the quality and efficiency of health
care. This demonstration is intended to strengthen the Medicare program
by offering innovative models to people on Medicare that improve
quality and access and lower costs. As a result, Medicare beneficiaries
will directly benefit from these innovative models. The demonstration
represents the first pay for performance project for physician group
practices and will enable comparisons across groups and geography; Form
Number: CMS-10134 (OMB 0938-0942); Frequency: Annually;
Affected Public: Business or other for-profit and Not-for-profit
institutions; Number of Respondents: 10; Total Annual Responses: 10;
Total Annual Hours: 790.
4. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Internal Revenue
Service/Social Security Administration/Centers for Medicare and
Medicaid Services Data Match and Supporting Regulations in 42 CFR
411.20-491.206; Form Number: CMS-R-137 (OMB 0938-0565); Use:
The Data Match project and information collection activity provides a
``check and balance'' against the Medicare program relying solely on a
single information collection system. It gives CMS the opportunity to
pursue collection of identified mistaken payments (within legal
constraints) and to update incorrect status indicators to prevent
further incorrect suspensions or mistaken payment or denial. Employers
identified through a match of IRS, SSA, and Medicare records will be
contacted concerning group health plan coverage of identified
individuals to ensure compliance with Medicare Secondary Payer
provisions, in accordance with the Medicare statute found at 42 U.S.C.
1395y(b); Frequency: Reporting--Annually; Affected Public: Business or
other for-profit, Not-for-profit institutions, Farms, Federal
Government, State, Local or Tribal Government; Number of Respondents:
341,065; Total Annual Responses: 341,065; Total Annual Hours:
1,986,810.
5. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare
Advantage Disenrollment Form to original Medicare; Form Number: CMS-R-
257 (OMB 0938-0741); Use: Section 4001 of the Balanced Budget
Act of 1997 amended the Social Security Act to add Section 1851,
including 1851(c)(1) which required the establishment of a procedure
and form to make and change Medicare Advantage elections, which include
disenrollment. The disenrollment form provides beneficiaries an option
to submit a disenrollment to a neutral third party, process the
disenrollment action as a change of election and to elicit the reasons
for disenrollment in order to discern and report disenrollment rates;
Frequency: On occasion and Other (one-time only); Affected Public:
Individuals or Households, Business or other for-profit, Not-for-profit
institutions, and Federal Government; Number of Respondents: 50,000;
Total Annual Responses: 50,000; Total Annual Hours: 3,300.
6. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Request for
Certification as Rural Health Clinic and Rural Health Clinic Survey
Report Form and Supporting Regulations in 42 CFR 491.1-491.11; Form
Number: CMS-29 and CMS-30 (OMB 0938-0074); Use: The form CMS-
29 is utilized as an application to be completed by suppliers of Rural
Health Clinic (RHC) services requesting participation in the Medicare/
Medicaid programs. This form initiates the process of obtaining a
decision as to whether the conditions for certification are met as a
supplier of RHC services. It also promotes data reduction or
introduction to and retrieval from the Online Survey and Certification
and Reporting System (OSCAR) by CMS Regional Offices (RO). The Form
CMS-30 is an instrument used by the State survey agency to record data
collected in order to determine RHC compliance with individual
conditions of participation and to report it to the Federal government.
The form is primarily a coding worksheet designed to facilitate data
reduction (keypunching) and retrieval into OSCAR at the CMS ROs. The
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; Frequency:
Reporting--Annually; Affected Public: State, Local or Tribal
Government; Number of Respondents: 698; Total Annual Responses: 698;
Total Annual Hours: 1,222.
7. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Collection of
Drug Pricing and Network Pharmacy Data from Medicare Prescription Drug
Plans (PDPs and MA-PDs) and Supporting Regulations in 42 CFR 423.48;
Form Number: CMS-10150 (OMB 0938-0951); Use: Both stand alone
prescription drug plans (PDPs) and Medicare Advantage Prescription Drug
(MA-PDs) plans will be required to submit drug pricing and pharmacy
network data to CMS. These data will be made publicly available to
Medicare beneficiaries through the new Medicare prescription drug plan
finder tool that will be launched in the fall of 2005 on http://www.medicare.gov.
The purpose of the data is to enable beneficiaries to
compare, learn, select and enroll in a plan that best meets their
needs; Frequency: Reporting--Weekly; Affected Public: Business or other
for-profit; Number of Respondents: 350; Total Annual Responses: 18,200;
Total Annual Hours: 36,400.
8. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Identification of
Extension Units of Outpatient Physical Therapy/Outpatient Speech
Pathology (OPT/OSP) Providers and Supporting Regulations in 42 CFR
Sections 485.701-485.729; Form Number: CMS-381 (OMB 0938-
0273); Use: Medicare provides OPT/OSP providers to be surveyed to
determine compliance with Federal regulations. All locations where OPT/
OSP providers furnish services must meet these requirements. The CMS-
381 is the form used to identify all the OPT/OSP locations. Frequency:
Reporting--Annually; Affected Public: Business or other for-profit;
Number of Respondents: 2960; Total Annual Responses: 2960; Total Annual
Hours: 740.
9. Type of Information Collection Request: New Collection; Title of
Information Collection: New Freedom Initiative--Web-based Reporting
System for Grantees; Form Number: CMS-10161 (OMB 0938-NEW);
Use: CMS currently awards competitive grants to States and other
eligible entities for the purpose of designing and implementing
effective and enduring improvements in community-based long-term
services and supporting systems. We currently require grantees to
report quarterly, semi-annual, and or annually, depending on the grant
type. CMS requires the information obtained
[[Page 62124]]
through web-based grantee reporting for two reasons: (1) In order to
effectively monitor the grants, and; (2) to report to Congress and
other interested stakeholders the progress and obstacles experienced by
the grantees. The grantees are the respondents to the web-based
reporting system; Frequency: Reporting--Quarterly, Semi-annually, and
Annually; Affected Public: State, Local or Tribal Government and Not-
for-profit institutions; Number of Respondents: 298; Total Annual
Responses: 836; Total Annual Hours: 6,440.
10. Type of Information Collection Request: New Collection; Title
of Information Collection: Medicare Care Improvement Survey; Use: The
purpose of this beneficiary survey is to obtain information about
beneficiary behavioral change, physical functioning and satisfaction
with the Chronic Care Improvement (CCI) programs. Legislation requires
that all of the aforementioned data elements be collected, as they
provide information that is critical to the decision-making process as
it pertains to the expansion of the pilot programs. The chronic care
improvement programs are to be designed to incorporate relevant
features from private sector programs but also be sufficiently flexible
to adapt to the unique needs of their Medicare populations. This survey
is required to support the legislative mandate to evaluate the Chronic
Care Improvement Programs. Beneficiary participation in the CCI-I
program will be voluntary and will not change the scope, duration or
amount of Medicare fee-for-service (FFS) benefits currently received by
FFS Medicare beneficiaries; Form Number: CMS-10162 (OMB 0938-
NEW); Frequency: Reporting--On occasion; Affected Public: Individuals
or Households; Number of Respondents: 9,449; Total Annual Responses:
9,449; Total Annual Hours: 2,636.
11. Type of Information Collection Request: Extension of a
currently approved collection; Title of Information Collection:
Medicare Care Management Performance (MCMP) Demonstration--Standardized
Ambulatory Care Quality Collection Initiative; Use: The MCMP
Demonstration was authorized by Section 649 of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (MMA).
This project requires the Secretary to establish a pay-for-performance
3-year pilot with physicians to promote the adoption and use of health
information technology to improve the quality of patient care for
chronically ill Medicare patients. This demonstration represents the
first pay for performance project fostering the adoption of health
information technology in small physician group practices and will
enable a test of the concept to improve the quality and efficiency of
care in Fee-for-Service Medicare; Form Number: CMS-10136 (OMB
0938-0941); Frequency: Annually; Affected Public: Business or
other for-profit and Not-for-profit institutions; Number of
Respondents: 800; Total Annual Responses: 800; Total Annual Hours:
19,200.
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 and (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 November 28,
2005. OMB Human Resources and Housing Branch, Attention: CMS Desk
Officer, New Executive Office Building, Room 10235, Washington, DC
20503.
Dated: October 21, 2005.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 05-21517 Filed 10-27-05; 8:45 am]
BILLING CODE 4120-01-P