[Federal Register Volume 77, Number 185 (Monday, September 24, 2012)]
[Notices]
[Pages 58847-58848]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-23367]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-846-849, 10125 and 10126]
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
[[Page 58848]]
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: Durable Medical Equipment Medicare Administrative Contractor
Certificate of Medical Necessity and Supporting Documentation
Requirements; Use: The certificates of medical necessity (CMNs) collect
information required to help determine the medical necessity of certain
items. CMS requires CMNs where there may be a vulnerability to the
Medicare program. Each initial claim for these items must have an
associated CMN for the beneficiary. Suppliers (those who bill for the
items) complete the administrative information (e.g., patient's name
and address, items ordered, etc.) on each CMN. The 1994 Amendments to
the Social Security Act require that the supplier also provide a
narrative description of the items ordered and all related accessories,
their charge for each of these items, and the Medicare fee schedule
allowance (where applicable). The supplier then sends the CMN to the
treating physician or other clinicians (e.g., physician assistant, LPN,
etc.) who completes questions pertaining to the beneficiary's medical
condition and signs the CMN. The physician or other clinician returns
the CMN to the supplier who has the option to maintain a copy and then
submits the CMN (paper or electronic) to CMS, along with a claim for
reimbursement. This clearance request is for CMNs with the form
numbers, CMS 846-849, 10125 and 10126. Form Numbers: CMS-846, 847, 848,
849, 10125, 10126 (OCN: 0938-0679); Frequency: Occasionally; Affected
Public: Individuals or Households; Number of Respondents: 462,000;
Total Annual Responses: 462,000; Total Annual Hours: 92,400. (For
policy questions regarding this collection contact Doris Jackson at
410-786-4459. For all other issues call 410-786-1326.)
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 Email 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 November 23, 2012:
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: September 18, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-23367 Filed 9-21-12; 8:45 am]
BILLING CODE 4120-01-P