[Federal Register: May 12, 2006 (Volume 71, Number 92)]
[Notices]
[Page 27725-27726]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr12my06-76]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-1450 (UB-04), CMS-10181]
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: New Collection; Title of
Information Collection: Medicare Uniform Institutional Provider Bill
and Supporting Regulations in 42 CFR 424.5; Use: Section 42 CFR
424.5(a)(5) requires providers of services to submit a claim for
payment prior to any Medicare reimbursement. Charges billed are coded
by revenue codes. The bill specifies diagnoses according to the
International Classification of Diseases, Ninth Edition (ICD-9-CM)
code. Inpatient procedures are identified by ICD-9-CM codes, and
outpatient procedures are described using the CMS 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. All hardcopy claims processed by Medicare fiscal
intermediaries must be submitted on the CMS-1450 (UB-04) after May 23,
2007. Data fields in the X12N 837 data set are consistent with the CMS-
1450 (UB-04) data set.; Form Numbers: CMS-1450 (UB-04) (OMB:
0938-NEW); Frequency: Reporting--On occasion; Affected Public: Not-for-
profit institutions, business or other for-profit; Number of
Respondents: 53,111; Total Annual Responses: 179,489,721; Total Annual
Hours: 308,237.
2. Type of Information Collection Request: New collection; Title of
Information Collection: Enrolling Low-Income Beneficiaries into the
Medicare Prescription Drug Program--Survey of State Agency Experiences;
Use: The Centers for Medicare and Medicaid Services (CMS) will conduct
a survey of state Medicaid agencies, state health insurance plans
(SHIPs), and state pharmaceutical assistance programs (SPAPs) to
identify best practices for the successful enrollment of all types of
low-income Medicare beneficiaries into a low-income subsidy and the
Medicare Part D Prescription Drug Benefit Program. The evaluation will
assist in identifying the best practices, the factors that make them
effective, and how the information can be disseminated in an effective
manor. The information will be used to help CMS as it designs its
outreach and communication campaigns in subsequent open enrollment
periods.; Form Number: CMS-10181 (OMB: 0938-NEW); Frequency:
Reporting--Other, one-time; Affected Public: State, Local or Tribal
governments, Federal government; Number of Respondents: 126; Total
Annual Responses: 126; Total Annual Hours: 63.
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,
[[Page 27726]]
Washington, DC 20503, Fax Number: (202) 395-6974.
Dated: May 5, 2006.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. E6-7304 Filed 5-11-06; 8:45 am]
BILLING CODE 4120-01-P