[Federal Register Volume 78, Number 38 (Tuesday, February 26, 2013)]
[Notices]
[Pages 13058-13059]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-04313]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier CMS-10451, CMS-1450 (UB-04), CMS-R-131 and CMS-
10280]
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: Evaluation and Development of Outcome Measures
for Quality Assessment in Medicare Advantage and Special Needs Plans;
Use: Quality improvement is a major initiative for the Centers for
Medicare and Medicaid Services (CMS). With the passing of the Patient
Protection and Affordable Care Act in March 2010, there is a focused
interest in providing quality and value-based healthcare for Medicare
beneficiaries. In addition, it is critical to develop criteria not only
for quality improvement but also as a means for beneficiaries to
compare healthcare plans to make the choice that is right for them.
It is critical to the CMS mission to expand its quality improvement
efforts from collection of structure and process measures to include
outcome measures. However, the development of outcome measures
appropriate for the programs serving older and/or disabled patients has
been somewhat limited. The development and subsequent implementation of
outcome measures as part of the overall quality improvement program for
CMS is crucial to ensuring that beneficiaries obtain high quality
healthcare. In addition, process of care measures are needed that focus
on the care needs of Medicare beneficiaries, such as factors affecting
continuity of care and transitions.
This request is for data collection to test the use of new tools
available to CMS to measure care pertinent to vulnerable beneficiaries
where quality of care provided by Medicare Advantage Organizations
(MAOs) should be closely monitored. The measures to be evaluated and
developed upon approval of this request relate to (1) Continuity of
information and care from hospital discharge to the outpatient setting,
(2) continuity between mental health provider and primary care provider
(PCP), and (3) items that may be added to the Consumer Assessment of
Healthcare Providers and Systems (CAHPS) survey addressing language-
centered care, cultural competence, physical activity, healthy eating,
and caregiver strain.
Since the publication of the 60-day notice (77 FR 65391), the
information collection request has been revised. The order of questions
has been changed in some locations of the instrument. In addition, we
have revised items to collect documentation about refusal to permit
communication between the mental health provider and the primary care
provider. Form Number: CMS-10451 (OCN: 0938-New); Frequency: Yearly,
occasionally; Affected Public: Individuals or Households, Private
sector--Business or other for-profits ; Number of Respondents: 2,012;
Total Annual Responses: 2,360; Total Annual Hours: 4,630. (For policy
questions regarding this collection contact Susan Radke at 410-786-
4450. For all other issues call 410-786-1326.)
2. Type of Information Collection Request: Extension of a currently
approved 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. Form Numbers: CMS-1450 (UB-
04) (OCN: 0938-0997); Frequency: Reporting--On occasion; Affected
Public: Not-for-profit institutions, Business or other for-profit;
Number of Respondents: 53,111; Total Annual Responses: 181,909,654;
Total Annual Hours: 1,567,455. (For policy questions regarding this
collection contact Matt Klischer at 410-786-7488. For all other issues
call 410-786-1326.)
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Advance
Beneficiary Notice of Noncoverage (ABN); Use: The use of written
notices to inform beneficiaries of their liability under specific
conditions has been available since Title XVIII of the Social Security
Act (the Act), section 1879, Limitation On Liability, was enacted in
1972 (Pub. L. 92-603). Similar required notification and liability
protections are available under other sections of the Act: section
1834(a)(18) refund requirements for certain items when unsolicited
telephone contacts are made, section 1834(j)(4) for the same types of
items when there is neither a required advance coverage determination
nor required supplier number; section 1834(a)(15) also for advance
determinations for these items and section 1842(l) applicable to
physicians not accepting assignment. Implementing regulations are found
at 42 CFR 411.404(b) and (c), and 411.408(d)(2) and (f), on written
notice requirements. These statutory requirements apply only to
Original Medicare, not Medicare Advantage plans.
Under section 1879 of the Act, Medicare beneficiaries may be held
financially responsible for items or services usually covered under
[[Page 13059]]
Medicare, but denied in an individual case under specific statutory
exclusions, if the beneficiary is informed prior to furnishing the
issues or services that Medicare is likely to deny payment.
When required, the ABN is delivered by Part B paid physicians,
providers (including institutional providers like outpatient hospitals)
practitioners (such as chiropractors), and suppliers, as well as
hospice providers and Religious Non-medical Health Care Institutions
paid under Part A. Other Medicare institutional providers paid under
Part A use other approved notice for this purpose.
The revised ABN in this information collection request incorporates
expanded use by Home Health Agencies (HHAs). There have been no
substantive changes to the form. There are no changes that will affect
existing ABN users. Form Number: CMS-R-131 (OMB: 0938-0566);
Frequency: Reporting--Occasionally; Affected Public: Private Sector--
Business or other for-profits and Not-for-profit institutions; Number
of Respondents: 1,288,837; Total Annual Responses: 52,967,771; Total
Annual Hours: 6,177,101. (For policy questions regarding this
collection contact Evelyn Blaemire at 410-786-1803. For all other
issues call 410-786-1326.)
4. Type of Information Collection Request: New collection; Title:
Home Health Change of Care Notice (HHCCN); Use: Home health agencies
(HHAs) are required to provide written notice to original Medicare
beneficiaries under various circumstances involving the initiation,
reduction, or termination of services. The notice used in these
situations has been the Home Health Advance Beneficiary Notice (HHABN),
CMS-R-296.
The HHABN, originally a liability notice specifically for HHA
issuance, was first approved for use and implementation in 2000 with
the home health prospective payment system transition. In 2006, the
notice underwent significant modifications subsequent to the decision
of the U.S. Court of Appeals (2nd Circuit) in Lutwin v. Thompson. HHABN
content and formatting were revised so that it could be used to provide
beneficiaries with change of care notification consistent with HHA
Conditions of Participation (COPs) in addition to its liability notice
function. Three interchangeable option boxes were introduced to the
HHABN to support the added notification purposes. Option Box 1
addressed liability, Option Box 2 addressed change of care for agency
reasons, and Option Box 3 addressed change of care due to provider
orders. HHABN Collection 0938-0781 last received PRA approval in 2009
following minor notice changes such as accessibility reformatting for
compliance with Section 508 of the Rehabilitation Act of 1973, as
amended in 1998, and removal of the beneficiary's health insurance
claim number (HICN).
In an effort to streamline, reduce, and simplify notices issued to
Medicare beneficiaries, HHABN Option Box 1, the liability notice
portion, will be replaced by the existing Advanced Beneficiary Notice
of Noncoverage (ABN) which is approved by OMB (0938-0566), for
conveying information on beneficiary liability. Written notices to
inform beneficiaries of their liability under specific conditions have
been available since the ``limitation on liability'' provisions in
section 1879 of the Social Security Act were enacted in 1972 (Pub. L.
92-603). The ABN (CMS-R-131) is presently used by providers and
suppliers other than HHAs to inform fee for service (FFS) Medicare
beneficiaries of potential liability for certain items/services that
might be billed to Medicare. The HHABN was developed specifically as
the liability notice for HHA issuance. Since 2006, the HHABN has
evolved to serve both liability and change of care notification
purposes. Pursuant to a separate PRA package revising the use of the
ABN, HHAs will now use the ABN for liability notification, and the
HHCCN will be introduced as a separate, distinct document to give
change of care notice in compliance with HHA conditions of
participation. The HHCCN will replace both Option Box 2 and Option Box
3 formats of the HHABN. The single page format of the HHCCN is designed
to specify whether the change of care is due to agency reasons or
provider orders. Form Number: CMS-10280 (OCN: 0938-New); Frequency:
Occasionally; Affected Public: Private Sector--Business or other for-
profits and not-for-profit institutions; Number of Respondents: 10,914;
Total Annual Responses: 14,126,428; Total Annual Hours: 941,385. (For
policy questions regarding this collection contact Evelyn Blaemire at
410-786-1803. 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.
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 March 28, 2013.
OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk
Officer, Fax Number: (202) 395-6974, Email: [email protected].
Dated: February 20, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2013-04313 Filed 2-25-13; 8:45 am]
BILLING CODE 4120-01-P