[Federal Register Volume 75, Number 161 (Friday, August 20, 2010)]
[Notices]
[Pages 51462-51463]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-20385]
[[Page 51462]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10052, CMS-R-216, CMS-R-53, CMS-10215, CMS-
724, CMS-116 and CMS-1500(08-05)]
Agency Information Collection Activities: Proposed Collection;
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) 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 functions; (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: Recognition of
pass-through payment for additional (new) categories of devices under
the Outpatient Prospective Payment System and Supporting Regulations in
42 CFR, Part 419; Use: Section 201(b) of the Balanced Budget Act of
1999 amended section 1833(t) of the Social Security Act (the Act) by
adding new section 1833(t)(6). This provision requires the Secretary to
make additional payments to hospitals for a period of 2 to 3 years for
certain drugs, radiopharmaceuticals, biological agents, medical devices
and brachytherapy devices. Section 402 of the Benefits Improvement and
Protection Act of 2000 made changes to the transitional pass-through
provision for medical devices. The most significant change is the
required use of categories as the basis for determining transitional
pass-through eligibility for medical devices, through the addition of
section 1833(t)(6)(B) of the Act. This information collection is
necessary to determine eligibility of medical devices for establishment
of additional device categories for payment under transitional pass-
through payment provisions as required by section 1833(t)(6) of the
Act. Form Number: CMS-10052 (OMB: 0938-0857); Frequency: Once;
Affected Public: Private Sector: Business or other for-profits; Number
of Respondents: 10; Total Annual Responses: 10; Total Annual Hours:
160. (For policy questions regarding this collection contact Christina
S. Ritter at 410-786-4636. For all other issues call 410-786-1326.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Issuance of
Advisory Opinions Concerning Physicians' Referrals; Use: Section
1877(g)(6) of the Social Security Act requires that the Department of
Health and Human Services accept requests for advisory opinions made
after November 3, 1997 and before August 21, 2000. Section 543 of the
Benefits Improvement and Protection Act of 2001, Public Law 106-554,
extended indefinitely the period during which the Department of Health
and Human Services accepts requests for these advisory opinions. CMS
promulgated 42 CFR 411.370 through 411.389 to comply with this
statutory mandate. The collection of information contained in 42 CFR
411.372 and 411.373 is necessary to allow CMS to consider requests for
advisory opinions and provide accurate and useful opinions. Form
Number: CMS-R-216 (OMB: 0938-0714); Frequency: Occasionally;
Affected Public: Private Sector: Business or other for-profits and not-
for profit institutions; Number of Respondents: 25; Total Annual
Responses: 25; Total Annual Hours: 500. (For policy questions regarding
this collection contact John Davis at 410-786-0008. For all other
issues call 410-786-1326.)
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Imposition of
Cost Sharing Charges under Medicaid and Supporting Regulations in 42
CFR 447.53; Use: The purpose of this collection is to ensure that
States impose normal cost sharing charges upon categorically and
medically needy individuals as allowed by law and implementing
regulations. States must identify in their State plan the service for
which the charge is made, the amount of the charge, the basis for
determining the charge, the basis for determining whether an individual
is unable to pay the charge and the way in which the individual will be
identified to providers, and the procedures for implementing and
enforcing the exclusions from cost sharing. Form Number: CMS-R-53
(OMB: 0938-0429); Frequency: Occasionally; Affected Public:
State, Local, or Tribal Governments; Number of Respondents: 56; Total
Annual Responses: 2; Total Annual Hours: 20. (For policy questions
regarding this collection contact Barbara Washington at 410-786-9964.
For all other issues call 410-786-1326.)
4. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicaid Payment
for Prescription Drugs--Physicians and Hospital Outpatient Departments
Collecting and Submitting Drug Identifying Information to State
Medicaid Programs; Use: Section 6002 of the Deficit Reduction Act (DRA)
of 2005 added provisions under section 1927 of the Social Security Act
to require physicians in their offices and hospital outpatient settings
or other entities (e.g., non-profit facilities) to collect and submit
the drug National Drug Code (NDC) numbers on Medicaid claims to their
State in order for Federal Financial Participation to be available for
these drugs. Form Number: CMS-10215 (OMB: 0938-1026);
Frequency: Weekly; Affected Public: Private Sector: Business or other
for-profits and Not-for-profit institutions; Number of Respondents:
20,000; Total Annual Responses: 3,910,000; Total Annual Hours: 15,836.
(For policy questions regarding this collection contact Bernadette
Leeds at 410-786-9463. For all other issues call 410-786-1326.)
5. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare/Medicaid
Psychiatric Hospital Survey Data; Use: The CMS-724 form is used to
collect data that is not collected elsewhere and assists CMS in program
planning and evaluation and in maintaining an accurate database on
providers participating in the psychiatric hospital program. Form
Number: CMS-724 (OMB: 0938-0378); Frequency: Annually;
Affected Public: Private Sector: Business or other for-profits and Not-
for-profit institutions; Number of Respondents: 500; Total Annual
Responses: 150; Total Annual Hours: 75. (For policy questions regarding
this collection contact Kelley Leonette at 410-786-6664. For all other
issues call 410-786-1326.)
6. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Clinical
Laboratory Improvement Amendments (CLIA) Application Form and
Supporting Regulations in 42 CFR
[[Page 51463]]
493.1-.2001 Medicare/Medicaid Psychiatric Hospital Survey Data; Use:
The application must be completed by entities performing laboratory's
testing specimens for diagnostic or treatment purposes. This
information is vital to the certification process. Form Number: CMS-116
(OMB: 0938-0581); Frequency: Biennially and Occasionally;
Affected Public: Private Sector: Business or other for-profits and Not-
for-profit institutions; Number of Respondents: 219,000; Total Annual
Responses: 31,520; Total Annual Hours: 23,640. (For policy questions
regarding this collection contact Sheila Ward at 410-786-3115. For all
other issues call 410-786-1326.)
7. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Health Insurance
Common Claims Form and Supporting Regulations at 42 CFR Part 424,
Subpart C; Form Number: CMS-1500(08-05), CMS-1490-S (OMB:
0938-0999); Use: The Form CMS-1500 answers the needs of many health
insurers. It is the basic form prescribed by CMS for the Medicare
program for claims from physicians and suppliers. The Medicaid State
Agencies, CHAMPUS/TriCare, Blue Cross/Blue Shield Plans, the Federal
Employees Health Benefit Plan, and several private health plans also
use it; it is the de facto standard ``professional'' claim form.
Medicare carriers use the data collected on the CMS-1500 and the
CMS-1490S to determine the proper amount of reimbursement for Part B
medical and other health services (as listed in section 1861(s) of the
Social Security Act) provided by physicians and suppliers to
beneficiaries. The CMS-1500 is submitted by physicians/suppliers for
all Part B Medicare. Serving as a common claim form, the CMS-1500 can
be used by other third-party payers (commercial and nonprofit health
insurers) and other Federal programs (e.g., CHAMPUS/TriCare, Railroad
Retirement Board (RRB), and Medicaid).
However, as the CMS-1500 displays data items required for other
third-party payers in addition to Medicare, the form is considered too
complex for use by beneficiaries when they file their own claims.
Therefore, the CMS-1490S (Patient's Request for Medicare Payment) was
explicitly developed for easy use by beneficiaries who file their own
claims. The form can be obtained from any Social Security office or
Medicare carrier. Frequency: Reporting--On occasion; Affected Public:
State, Local, or Tribal Government, Business or other-for-profit, Not-
for-profit institutions; Number of Respondents: 1,048,243; Total Annual
Responses: 991,160,925; Total Annual Hours: 23,815,541.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS'
Web Site at http://www.cms.hhs.gov/PaperworkReductionActof1995, or E-
mail your request, including your address, phone number, OMB number,
and CMS document identifier, to [email protected], or call the
Reports Clearance Office on (410) 786-1326.
In commenting on the proposed information collections please
reference the document identifier or OMB control number. To be assured
consideration, comments and recommendations must be submitted in one of
the following ways by October 19, 2010:
1. Electronically. You may submit your comments electronically to
http://www.regulations.gov. Follow the instructions for ``Comment or
Submission'' or ``More Search Options'' to find the information
collection document(s) accepting comments.
2. By regular mail. You may mail written comments to the following
address:
CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development, Attention: Document Identifier/OMB
Control Number, Room C4-26-05, 7500 Security Boulevard, Baltimore,
Maryland 21244-1850.
Dated: August 13, 2010.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 2010-20385 Filed 8-19-10; 8:45 am]
BILLING CODE 4120-01-P