[Federal Register: October 24, 2008 (Volume 73, Number 207)]
[Notices]
[Page 63478-63479]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr24oc08-82]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-R-10, CMS-4040 and 4040SP, CMS-10130A and
10130B, and CMS-R-257]
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: BPD-718: Advance
Directives (Medicare and Medicaid); Use: Steps have been taken, at both
the Federal and State level, to afford greater opportunity for the
individual to participate in decisions made concerning the medical
treatment to be received by an adult patient in the event that the
patient is unable to communicate to others a preference about medical
treatment. The individual may make his preference known through the use
of an advance directive, which is a written instruction prepared in
advance, such as a living will or durable power of attorney. This
information is documented in a prominent part of the individual's
medical record. Advance directives as described in the Patient Self-
Determination Act have increased the individual's control over
decisions concerning medical treatment. The advance directives
requirement was enacted because Congress wanted individuals to know
that they have a right to make health care decisions and to refuse
treatment even when they are unable to communicate. Sections 4206 of
OBRA '90 defined an advance directive as a written instruction
recognized under State law relating to the provision of health care
when an individual is incapacitated (those persons unable to
communicate their wishes regarding medical treatment).
All States have enacted legislation defining a patient's right to
make decisions regarding medical care, including the right to accept or
refuse medical or surgical treatment and the right to formulate advance
directives. Participating hospitals, skilled nursing facilities/nursing
facilities, home health agencies, providers of home health care,
hospices, religious nonmedical health care institutions, and prepaid or
eligible organizations (including Health Care Prepayment Plans (HCPPs)
and Medicare Advantage Organizations (MAOs) such as Coordinated Care
Plans, Demonstration Projects, Chronic Care Demonstration Projects,
Program of All Inclusive Care for the Elderly, Private Fee for Service,
and Medical Savings Accounts) must provide written information, at
explicit time frames, to all adult individuals about: (a) The right to
accept or refuse medical or surgical treatments; (b) the right to
formulate an advance directive; (c) a description of applicable State
law (provided by the State); and (d) the provider's or organization's
policies and procedures for implementing an advance directive. Form
Number: CMS-R-10 (OMB 0938-0610); Frequency: Yearly; Affected
Public: Business or other for-profits; Number of Respondents: 35,484;
Total Annual Responses: 19,870,000; Total Annual Hours: 927,550.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of
[[Page 63479]]
Information Collection: Request for Enrollment in Supplementary Medical
Insurance; Use: Section 1836 of the Social Security Act and 42 CFR
407.10 provide the eligibility requirements for enrollment in
Supplementary Medical Insurance (Part B) for individuals age 65 and
older who are not entitled to premium-free Hospital Insurance (Part A).
The form CMS-4040 is used to establish entitlement to Part B by
individuals ineligible for Part A under Title XVIII of the Social
Security Act. Form Number: CMS-4040 and 4040SP (OMB 0938-
0245); Frequency: Once; Affected Public: Individuals and households;
Number of Respondents: 10,000; Total Annual Responses: 10,000; Total
Annual Hours: 2,500.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Federal
Reimbursement of Emergency Health Services Furnished to Undocumented
Aliens, section 1011 of the Medicare Prescription Drug, Improvement,
and Modernization Act of 2003 (MMA): ``Section 1011 Provider Payment
Determination'' and ``Request for section 1011 Hospital On-Call
Payments to Physicians'' Forms; Use: Section 1011 of the MMA requires
that the Secretary establish a process under which eligible providers
(certain hospitals, physicians and ambulance providers) may request
payment for (claim) their otherwise un-reimbursed costs of providing
eligible services. The Secretary must make quarterly payments directly
to such providers. The Secretary must also implement measures to ensure
that inappropriate, excessive, or fraudulent payments are not made
under section 1011, including certification by providers of the
accuracy of their requests for payment. The Section 1011 Provider
Payment Determination and the Request for section 1011 Hospital On-Call
Payments to Physicians forms have been established to address the
statutory requirements. Form Number: CMS-10130A and 10130B
(OMB 0938-0952); Frequency: Daily, Weekly, Monthly, Quarterly
and Yearly; Affected Public: Business or Other For-Profits and Not-for-
Profit Institutions; Number of Respondents: 12,037; Total Annual
Responses: 300,148; Total Annual Hours: 75,007.
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare
Advantage & Part D Disenrollment Requests Collected Through 1-800-
MEDICARE; Use: Section 4001 of the Balanced Budget Act of 1997 amended
the Social Security Act to add section 1851(c)(1), through which
Medicare Advantage elections are made and changed. Section 101 of the
Medicare Prescription Drug, Improvement, and Modernization Act amended
the Social Security Act to include section 1860D-1(b)(1), through which
Medicare Prescription Drug Plan enrollments are made and changed. The
disenrollment process offered at 1-800-MEDICARE provides beneficiaries
with the option of submitting a disenrollment request to a neutral
third party, who then processes the disenrollment action as a change of
enrollment.
The collection updates: 1. Continue to allow Medicare beneficiaries
to disenroll from Medicare Advantage plans by calling CMS' toll-free
call center; 2. Continue to allow Medicare beneficiaries enrolled in
Medicare Prescription Drug (Part D) Plans to request disenrollment from
Medicare Prescription Drug Plans, and 3. Retire the CMS-R-257 Medicare
Advantage Disenrollment Form given limited (zero) requests for the
paper form since 2005. The information collected in the disenrollment
process will be used to update the Medicare beneficiary's Health
Insurance Master Record System in order to disenroll the beneficiary
from a Medicare Advantage managed care plan or a Medicare prescription
drug plan on a timely basis. Form Number: CMS-R-257 (OMB 0938-
0741); Frequency: Occasionally; Affected Public: Individuals or
households; Number of Respondents: 117,000; Total Annual Responses:
117,000; Total Annual Hours: 19,539.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access the 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.
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 24, 2008:
OMB, Office of Information and Regulatory Affairs, Attention: CMS
Desk Officer, New Executive Office Building, Room 10235, Washington, DC
20503, Fax Number: (202) 395-6974.
Dated: October 16, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. E8-25204 Filed 10-23-08; 8:45 am]
BILLING CODE 4120-01-P