[Federal Register Volume 76, Number 98 (Friday, May 20, 2011)]
[Notices]
[Pages 29247-29248]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-12473]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-855(O), CMS-855(S) and CMS-855(A, B, I, R)]
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 Enrollment Application for Eligible
Ordering and Referring Physicians and Non-physician Practices Use: CMS
is adding a new CMS-855 Medicare Enrollment Application (CMS 855O--
Medicare Enrollment Application for Ordering and Referring Physicians
only). CMS has found that many providers and suppliers who are not
enrolled in Medicare are ordering and referring physicians for Medicare
enrolled providers and suppliers. The ordering and referring data field
on the CMS 1500 claims submission form requires an ordering or
referring physician to have a Medicare identification number. Without
an ordering or referring physician, specific types of claims submitted
by Medicare approved providers and suppliers are rejected by Medicare
Administrative Contractors (MAC) as required by Medicare regulation.
Therefore, if an ordering or referring physician does not participate
in the Medicare program, but orders or refers his/her patients to a
Medicare provider or supplier, the claim submitted by the Medicare
provider or supplier for the given ordered or referred service is
automatically rejected by the MAC. The CMS 855O allows a physician to
receive a Medicare identification number (without being approved for
billing privileges) for the sole purpose of ordering and referring
beneficiaries to Medicare approved providers and suppliers. This new
Medicare application form allows physicians who do not provide services
to Medicare beneficiaries to be given a Medicare identification number
without having to supply all the data required for the submission of
Medicare claims. It also allows the Medicare program to identify
ordering and referring physicians without having to validate the amount
of data necessary to determine claims payment eligibility (such as
banking information), while continuing to identify the physician's
credentials as valid for ordering and referring purposes. Form Number:
CMS-855(O) (OMB: 0938-NEW0685); Frequency: Yearly; Affected
Public: Private Sector; Business or other for-profit and not-for-profit
institutions; Number of Respondents: 48,000; Total Annual Responses:
48,000; Total Annual Hours: 46,000. (For policy questions regarding
this collection contact Kim McPhillips at 410-786-5374. For all other
issues call 410-786-1326.)
2. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare Durable
Medical Equipment Supplier Enrollment Application; Use: The primary
function of the CMS 855S DMEPOS supplier enrollment application is to
gather information from a supplier that tells us who it is, whether it
meets certain qualifications to be a health care supplier, where it
renders its services or supplies, the identity of the owners of the
enrolling entity, and information necessary to establish the correct
claims payment. The goal of evaluating and revising the CMS 855S DMEPOS
supplier enrollment application is to simplify and clarify the
information collection without jeopardizing our need to collect
specific information. Additionally, periodic revisions are necessary to
incorporate new regulatory requirements.
The goal of this revision of the CMS 855S is to incorporate new
regulatory provisions found at 42 CFR 424.57(c) (1 through 30) and 42
CFR 424.58. These revisions will allow CMS to be in compliance with the
above stated regulations implementing new quality standards for DMEPOS
suppliers, including accreditation requirements. This revision will
also incorporate new supplier standard regulations found in the final
regulation that published on August 27, 2010 (75 FR 52629-52649). Form
Number: CMS-855(S) (OMB: 0938-1056); Frequency: Yearly;
Affected Public: Private Sector; Business or other for-profit and not-
for-profit institutions; Number of Respondents: 140,290; Total Annual
Responses: 140,290; Total Annual Hours: 331,619. (For policy questions
regarding this collection contact Kim McPhillips at 410-786-5374. For
all other issues call 410-786-1326.)
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare
Enrollment Application; Use: The primary function of the CMS-855
Medicare enrollment application is to gather information from a
provider or supplier that tells us who it is, whether it meets certain
qualifications to be a health care provider or supplier, where it
practices or renders its services, the identity of the owners of the
enrolling entity, and other information necessary to establish correct
claims payments. The goal of this submission is to address
[[Page 29248]]
the following issues. The CMS-855A enrollment form currently captures
ownership/managerial information on providers. The data required under
sections 6401 and 6001, however, is more specific than that currently
obtained on the CMS-855A. CMS will therefore create four attachments to
the CMS-855A--two for SNFs and the other two for physician-owned
hospitals--to secure this information. In addition to the application
changes triggered by ACA, CMS is making other revisions to the forms as
well.
This information collection request has been revised since the 60-
day Federal Register notice published on March 22, 2011 (76 FR 13415).
The group/clinic and individual burden has decreased due to the removal
of a previously proposed supplier attachment. However, the overall
burden hour estimate has increased slightly due to additional role-
specific ownership and managerial control data collection for
institutional providers. Form Number: CMS-855(A, B, I, R)
(OMB: 0938-0685); Frequency: Yearly; Affected Public: Private
Sector; Business or other for-profit and not-for-profit institutions;
Number of Respondents: 440,450; Total Annual Responses: 440,450; Total
Annual Hours: 856,395. (For policy questions regarding this collection
contact Kim McPhillips at 410-786-5374. For all other issues call 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 June 20, 2011.
OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk
Officer, Fax Number: (202) 395-6974, E-mail: [email protected].
Dated: May 17, 2011.
Martique Jones,
Director, Regulations Development Group, Division-B, Office of
Strategic Operations and Regulatory Affairs.
[FR Doc. 2011-12473 Filed 5-19-11; 8:45 am]
BILLING CODE 4120-01-P