[Federal Register: September 1, 2006 (Volume 71, Number 170)]
[Notices]
[Page 52079-52080]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr01se06-49]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-R-143, CMS-R-247, CMS-10199, and CMS-10184]
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: Medicare Physician Fee Schedule
Geographic Practice Expense Index (GPCI).
Use: This information collection is a survey of State insurance
commissioners and malpractice insurers to acquire premium data for use
in computing the malpractice component of the geographic practice cost
index, a component of the geographic cost index as set forth in the
Omnibus Reconciliation Act of 1989. The data collected in this
information collection request will be used by CMS staff and outside
contractors to update the Medicare physician fee schedule geographic
practice expense index (MGPCI), the malpractice relative value units
(MRVUs), and to supplement the updating of the malpractice component of
the Medicare Economic Index (MEI). The MGPCI is one of the components
of the GPCI, the others being physician work (net income), employee
wages, office rents, medical equipment and supplies, and miscellaneous
expenses. The MRVUs are one of the three components of the fee
schedule, the others being physician work RVUs and practice expense
RVUs. The GPCIs and fee schedule RVUs also used by other Federal
agencies such as the Veteran's Administration and the Department of
Labor. Form Number: CMS-R-143 (OMB: 0938-0575).
Frequency: Reporting--Every three years.
Affected Public: State, Local or Tribal governments, Business or
other for-profit and Not-for-profit institutions.
Number of Respondents: 150.
Total Annual Responses: 50.
Total Annual Hours: 150.
2. Type of Information Collection Request: Extension of a currently
approved collection.
Title of Information Collection: Expanded Coverage for Diabetes
Outpatient Self-Management Training Services and Supporting Regulations
Contained in 42 CFR 410.141, 410.142, 410.143, 410.144, 410.145,
410.146, 414.63.
Use: According to the National Health and Nutrition Examination
Survey (NHANES), as many as 18.7 percent of Americans over age 65 are
at risk for developing diabetes. The goals in the management of
diabetes are to achieve normal metabolic control and reduce the risk of
micro- and macro-vascular complications. Numerous epidemiologic and
interventional studies point to the necessity of maintaining good
glycemic control to reduce the risk of the complications of diabetes.
In expanding the Medicare program to include diabetes outpatient self-
management training services, the Congress intended to empower Medicare
beneficiaries with diabetes to better manage and control their
conditions. The Conference Report indicates that the conferees believed
that ``this provision will provide significant Medicare savings over
time due to reduced hospitalizations and complications arising from
diabetes.'' (H.R. Conf. Rep. No. 105-217, at 701 (1997)).
Form Number: CMS-R-247 (OMB: 0938-818).
Frequency: Recordkeeping and Reporting--On occasion.
Affected Public: Business or other for-profit institutions.
Number of Respondents: 2008.
Total Annual Responses: 8,032; Total Annual Hours: 88,519.
3. Type of Information Collection Request: New collection.
Title of Information Collection: Data Collection for Medicare
Facilities Performing Carotid Artery Stenting with Embolic Protection
in Patients at High Risk for Carotid Endarterectomy.
Use: CMS provides coverage for carotid artery stenting (CAS) with
embolic protection for patients at high risk for carotid endarterectomy
and who also have symptomatic carotid artery stenosis between 50% and
70% or have asymptomatic carotid artery stenosis >= 80% in accordance
with the Category B IDE clinical trials regulation (42 CFR 405.201), a
trial under the CMS Clinical Trial Policy (NCD Manual Sec. 310.1, or
in accordance with the National Coverage Determination on CAS post
approval studies (Medicare NCD Manual 20.7). Accordingly, CMS considers
coverage for CAS reasonable and necessary {section 1862 (A)(1)(a) of
the Social Security Act{time} . However, evidence for use of CAS with
embolic protection for patients at high risk for carotid endarterectomy
and who also have symptomatic carotid artery stenosis >= 70% who are
not enrolled in a study or trial is less compelling. To encourage
responsible and appropriate use of CAS with embolic protection, CMS
issued a Decision Memo for Carotid Artery Stenting on March 17, 2005,
indicating that CAS with embolic protection for patients at high risk
for carotid endarterectomy and who also have symptomatic carotid artery
stenosis >= 70% will be covered only if performed in facilities that
have been determined to be competent. In accordance with this criteria
CMS considers coverage for CAS reasonable and necessary (section
1862(A)(1)(a) of the Social Security Act).
Form Number: CMS-10199 (OMB: 0938-NEW).
Frequency: Reporting--On.
Affected Public: Business or other for-profit, Not-for-profit
institutions.
Number of Respondents: 1,000.
Total Annual Responses: 1,000.
Total Annual Hours: 500.
4. Type of Information Collection Request: New collection.
Title of Information Collection: Payment Error Rate Measurement
(PERM) of Eligibility in Medicaid and the State Children's Health
Insurance Program (SCHIP).
Use: The Improper Payments Information Act (IPIA) of 2002 requires
CMS to produce national error rates for Medicaid and the State
Children's Health Insurance Program (SCHIP). To comply with the IPIA,
CMS will use a national contracting strategy in part to
[[Page 52080]]
produce error rates for Medicaid and SCHIP fee-for-service and managed
care improper payments. The Federal contractor will review states on a
rotational basis so that each state will be measured for improper
payments, in each program, once and only once every three years.
Subsequent to the first publication, we determined that we will
measure Medicaid and SCHIP in the same State. Therefore, states will
measure Medicaid and SCHIP eligibility in the same year measured for
fee-for-service and managed care. We believe this approach will
advantage States through economies of scale (e.g. administrative ease
and shared staffing for both programs reviews). We also determined that
interim case completion timeframes and reporting are critical to the
integrity of the reviews and to keep the reviews on schedule to produce
a timely error rate. An additional revision is that the sample sizes
were increased slightly in order to produce an equal sample size per
strata each month. Finally, this information collection request does,
to a certain extent, duplicate Medicaid eligibility reviews under the
Medicaid Eligibility Quality Control (MEQC) as required by section
1903(u) of the Social Security Act (of the Act) and we proposed this
option in the first publication of this information request.
However, CMS has not finalized its analysis of the associated legal
and policy matters regarding the option to use the payment error rate
measurement (PERM) reviews to satisfy MEQC statutory and regulatory
requirements. We are concerned that using the PERM eligibility reviews
to satisfy requirements for the MEQC program under 1903(u) of the Act
would necessarily require that the data derived from the reviews be
used to determine potential disallowances of Federal funds under the
MEQC program. Therefore, we are still considering whether or not to
make this option available to States. We expect to make a final
decision before the start of the eligibility reviews in FY 2007.
However, in response to State resource concerns, CMS will provide
States the option to contract out the PERM eligibility reviews to
entities not actively involved in the state's eligibility determination
and enrollment activities. The supporting statement reflects those
changes.
As outlined in the October 5, 2005, interim final rule (70 FR
58260), CMS convened an eligibility workgroup comprised of the
Department of Health and Human Services, the Office of Management and
Budget (OMB) and representatives from two states. The Office of
Inspector General (OIG) participated in an advisory capacity. The
workgroup was charged to make recommendations for measuring Medicaid
and SCHIP improper payments based on eligibility errors within the
confines of current statute, with minimal impact on States' resources
and considering public comments on the August 27, 2004, proposed rule
and the October 5, 2005, interim final rule. Based on the eligibility
workgroup's recommendations and public comments, we developed an
eligibility review methodology that we expect will provide consistency
in the reviews of active (i.e., beneficiaries receiving Medicaid or
SCHIP) and negative cases (i.e., beneficiaries whose benefits were
denied or terminated) as well as achieve the confidence and precision
requirements at the national level required by the IPIA.
Form Number: CMS-10184 (OMB: 0938-NEW).
Frequency: Reporting--On occasion and Monthly.
Affected Public: Business or other for-profit, Not-for-profit
institutions.
Number of Respondents: 34.
Total Annual Responses: 1,326.
Total Annual Hours: 535,670.
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.hhs.gov/PaperworkReductionActof1995, 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 or faxed within 30 days of this notice
directly to the OMB desk officer: OMB Human Resources and Housing
Branch, Attention: Carolyn Lovett, New Executive Office Building, Room
10235, Washington, DC 20503. Fax Number: (202) 395-6974.
Dated: August 25, 2006.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 06-7291 Filed 8-31-06; 8:45 am]
BILLING CODE 4120-01-P