[Federal Register Volume 78, Number 110 (Friday, June 7, 2013)]
[Notices]
[Pages 34387-34390]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-13578]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-8003, CMS-10166, CMS-10184, CMS-10219, CMS-
10242, CMS-2744, CMS-3070, CMS-10336, CMS-10220 and CMS-10175]
Agency Information Collection Activities; Proposed Collection;
Comment Request
ACTION: Notice.
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SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is
announcing an opportunity for the public to comment on CMS' intention
to collect information from the public. Under the Paperwork Reduction
Act of 1995 (PRA), federal agencies are required to publish notice in
the Federal Register concerning each proposed collection of information
(including each proposed extension or reinstatement of an existing
collection of information) and to allow 60 days for public comment on
the proposed action. Interested persons are invited to send comments
regarding our burden estimates 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.
DATES: Comments must be received by August 6, 2013.
ADDRESSES: When commenting, please reference the document identifier or
OMB control number (OCN). To be assured consideration, comments and
recommendations must be submitted in any one of the following ways:
1. Electronically. You may send 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) that are 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.
To obtain copies of a supporting statement and any related forms
for the proposed collection(s) summarized in this notice, you may make
your request using one of following:
1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
2. Email your request, including your address, phone number, OMB
number, and CMS document identifier, to [email protected].
3. Call the Reports Clearance Office at (410) 786-1326.
FOR FURTHER INFORMATION CONTACT:
Reports Clearance Office at (410) 786-1326.
SUPPLEMENTARY INFORMATION: This notice sets out a summary of the use
and burden associated with the following information collections:
CMS-8003--1915(c) Home and Community Based Services (HCBS) Waiver
CMS-10166--Payment Error Rate Measurement in Medicaid & Children's
Health Insurance Program (CHIP)
CMS-10184--Eligibility Error Rate Measurement in Medicaid and the
Children's Health Insurance Program
CMS-10219--Healthcare Effectiveness Data and Information Set
(HEDIS[supreg]) Data Collection for Medicare Advantage
CMS-10242--Emergency and Non-Emergency Ambulance Transports and
Beneficiary Signature Requirements in 42 CFR 424.36(b)
CMS-2744--End Stage Renal Disease (ESRD) Medical Information Facility
Survey
CMS-3070--Intermediate Care Facility (ICF) for the Mentally Retarded
(MR) or Persons with Related Conditions Survey Report Form
CMS-10336--Medicare and Medicaid Programs: Electronic Health Record
Incentive Program
CMS-10220--Security Consent and Surrogate Authorization Form
CMS-10175--Certification Statement for Electronic File Interchange
Organizations
More detailed information can be found in each collection's
supporting statement and associated materials (see ADDRESSES).
Under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501-
3520), federal agencies must obtain approval from the Office of
Management and Budget (OMB) for each collection of information they
conduct or sponsor. The term ``collection of information'' is defined
in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes agency requests
or requirements that members of the public submit reports, keep
records, or
[[Page 34388]]
provide information to a third party. Section 3506(c)(2)(A) of the PRA
requires federal agencies to publish a 60-day notice in the Federal
Register concerning each proposed collection of information, including
each proposed extension or reinstatement of an existing collection of
information, before submitting the collection to OMB for approval. To
comply with this requirement, CMS is publishing this notice.
Proposed Information Collections
1. Type of Information Collection Request: Reinstatement without
change of a previously approved collection; Title of Information
Collection: 1915(c) Home and Community Based Services (HCBS) Waiver;
Use: The web-based application will be used by CMS to review and
adjudicate individual waiver actions. The web-based application will
also be used by states to submit and revise their waiver requests. Form
Number: CMS-8003 (OCN: 0938-0449). Frequency: Yearly. Affected Public:
State, Local, or Tribal Governments. Number of Respondents: 47. Total
Annual Responses: 71. Total Annual Hours: 6,005. (For policy questions
regarding this collection contact Kathy Poisal at 410-786-5940. For all
other issues call 410-786-1326.)
2. Type of Information Collection Request: Reinstatement of a
previously approved collection; Title of Information Collection:
Payment Error Rate Measurement in Medicaid & Children's Health
Insurance Program (CHIP); Use: The Improper Payments Information Act
(IPIA) of 2002 as amended by the Improper Payments Elimination and
Recovery Improvement Act (IPERIA) of 2012 requires CMS to produce
national error rates for Medicaid and Children's Health Insurance
Program (CHIP). To comply with the IPIA, we will engage a federal
contractor to produce the error rates in Medicaid and CHIP. The error
rates for Medicaid and CHIP are calculated based on the reviews on
three components of both Medicaid and CHIP program. They are: Fee-for-
service claims medical reviews and data processing reviews, managed
care claims data-processing reviews, and eligibility reviews. Each of
the review components collects different types of information, and the
state-specific error rates for each of the review components will be
used to calculate an overall state-specific error rate, and the
individual state-specific error rates will be used to produce a
national error rate for Medicaid and CHIP. The states will be requested
to submit, at their option, test data which include full claims details
to the contractor prior to the quarterly submissions to detect
potential problems in the dataset to and ensure the quality of the
data. These states will be required to submit quarterly claims data to
the contractor who will pull a statistically valid random sample, each
quarter, by strata, so that medical and data processing reviews can be
performed. State-specific error rates will be based on these review
results. We need to collect the fee-for-service claims data, medical
policies, and other information from states as well as medical records
from providers in order for the contractor to sample and review
adjudicated claims in those states selected for medical reviews and
data processing reviews. Based on the reviews, state-specific error
rates will be calculated which will serve as part of the basis for
calculating national Medicaid and CHIP error rates. Form Number: CMS-
10166 (OCN: 0938-0974); Frequency: Yearly, Quarterly; Affected Public:
State, Local, or Tribal Governments; Number of Respondents: 34; Total
Annual Responses: 1650; Total Annual Hours: 56,100. (For policy
questions regarding this collection contact Monetha Dockery at 410-786-
0155. For all other issues call 410-786-1326.)
3. Type of Information Collection Request: Reinstatement with a
change of a previously approved collection; Title of Information
Collection: Eligibility Error Rate Measurement in Medicaid and the
Children's Health Insurance Program; Use: The Improper Payments
Information Act (IPIA) of 2002 requires us to produce national error
rates for Medicaid and the Children's Health Insurance Program (CHIP).
To comply with the IPIA, we will use a national contracting strategy to
produce error rates for Medicaid and CHIP fee-for-service and managed
care improper payments. The federal contractor will review states on a
rotational basis so that each state will be measured for improper
payments, in each program, once and only once every three years.
Subsequent to the first publication, we determined that we will
measure Medicaid and CHIP in the same state. Therefore, states will
measure Medicaid and CHIP eligibility in the same year measured for
fee-for-service and managed care. We believe this approach will
advantage states through economies of scale (e.g. administrative ease
and shared staffing for both programs reviews). We also determined that
interim case completion timeframes and reporting are critical to the
integrity of the reviews and to keep the reviews on schedule to produce
a timely error rate. Lastly, the sample sizes were increased slightly
in order to produce an equal sample size per strata each month. Each
month states submit a monthly sample selection list, eligibility review
findings for active and negative cases and claims review findings. At
the end of the cycle, states would have submitted 48 forms. We are
submitting a new instrument in which we compile all of the information
from the 48 forms into a format that will allow states to submit 12
forms for 12 months of eligibility data. This form will also serve
either of the data substitution options. Periodically, we will conduct
federal re-reviews of states' PERM files to ensure the accuracy of
states' review findings and the validity of the review process. We will
select a random subsample of Medicaid and CHIP cases from the sample
selection lists provided by each state. States will submit all
pertinent information related to the review of each sampled case that
we select. Form Number: CMS-10184 (OCN: 0938-1012); Frequency: Yearly,
Quarterly Affected Public: State, Local, or Tribal Governments; Number
of Respondents: 34; Total Annual Responses: 120; Total Annual Hours:
15,755. (For policy questions regarding this collection contact Monetha
Dockery at 410-786-0155. For all other issues call 410-786-1326.)
4. Type of Information Collection Request: Revision of a currently
approved collection. Title of Information Collection: Healthcare
Effectiveness Data and Information Set (HEDIS[supreg]) Data Collection
for Medicare Advantage; Use: The data is used by CMS to: monitor
Medicare Advantage organization performance, inform audit strategies,
and inform beneficiary choice through their display in CMS' consumer-
oriented public compare tools and Web sites. Medicare Advantage
organizations use the data for quality assessment and as part of their
quality improvement programs and activities. Quality Improvement
Organizations and CMS contractors use HEDIS[supreg] data in conjunction
with their statutory authority to improve quality of care, and
consumers who are making informed health care choices. In addition, we
make health plan level HEDIS[supreg] data available to researchers and
others as public use files at www.cms.hhs.gov. Form Number: CMS-10219
(OCN: 0938-1028). Frequency: Yearly. Affected Public: Private sector
(business or other for-profit and not-for-profit institutions); Number
of Respondents: 576. Total Annual Responses: 576. Total Annual Hours:
184,320. (For policy questions regarding this collection contact Lori
Teichman at 410-786-6684. For all other issues call 410-786-1326.)
[[Page 34389]]
5. Type of Information Collection Request: Reinstatement with
change of a previously approved collection; Title of Information
Collection: Emergency and Non-Emergency Ambulance Transports and
Beneficiary Signature Requirements in 42 CFR 424.36(b); Use: Ambulance
providers and suppliers are the primary information users.
Specifically, when ambulance providers and suppliers sign claims on
behalf of beneficiaries they are required by Sec. 424.36(b)(6) to keep
certain documentation in their files for at least four years from the
date of service. The purpose of this information collection is to
document emergency and nonemergency ambulance transports where the
beneficiary was incapable of signing the claim and the ambulance
provider or supplier signed the claim on the beneficiary's behalf. The
information may also be used by: (1) Our Part A and Part B Medicare
Administrative Contractors that process and pay ambulance claims; (2)
our staff who review and audit claims for medical necessity; (3) our
staff who review claims for overpayments; and (4) by others who
investigate ambulance billing practices to ensure compliance under the
False Claims Act and anti-kickback statute. Therefore, besides
ambulance providers and suppliers, the information collected may be
used by CMS, the Office of the General Counsel, the Office of the
Inspector General, the Department of Justice, and the Federal Bureau of
Investigations. Form Number: CMS-10242 (OCN: 0938-1049). Frequency:
Occasionally. Affected Public: Private sector (business or other for-
profit and not-for-profit institutions). Number of Respondents: 11,564.
Total Annual Responses: 15,633,781. Total Annual Hours: 1,303,857. (For
policy questions regarding this collection contact David Walczak at
410-786-4475. For all other issues call 410-786-1326.)
6. Type of Information Collection Request: Revision of a previously
approved collection; Title of Information Collection: End Stage Renal
Disease (ESRD) Medical Information Facility Survey; Use: The End Stage
Renal Disease (ESRD) Medical Information Facility Survey form (CMS-
2744) is completed annually by Medicare-approved providers of dialysis
and transplant services. The CMS-2744 is designed to collect
information concerning treatment trends, utilization of services and
patterns of practice in treating ESRD patients. The information is used
to assess and evaluate the local, regional and national levels of
medical and social impact of ESRD care and is used extensively by
researchers and suppliers of services for trend analysis. The
information is available on the CMS Dialysis Facility Compare Web site
and will enable patients to make informed decisions about their care by
comparing dialysis facilities in their area. Form Number: CMS-2744
(OCN: 0938-0447); Frequency: Yearly; Affected Public: Business or other
for-profit, Not-for-profit institutions; Number of Respondents: 5,964;
Total Annual Responses: 5,964; Total Annual Hours: 47,712. (For policy
questions regarding this collection contact Michelle Tucker at 410-786-
0736. For all other issues call 410-786-1326.)
7. Type of Information Collection Request: Reinstatement with
change of a currently approved collection; Title of Information
Collection: Intermediate Care Facility (ICF) for the Mentally Retarded
(MR) or Persons with Related Conditions Survey Report Form; Use: This
survey form is needed to ensure intermediate care facility (ICF) for
the mentally retarded (MR) provider and client characteristics are
available and updated annually for the federal government's Online
Survey Certification and Reporting (OSCAR) system. It is required for
the provider to fill out at the time of the annual recertification or
initial certification survey conducted by the state Medicaid agency.
The team leader for the state survey team must review and approve the
completed form before completion of the survey. The state Medicaid
survey agency is responsible for transferring the 3070 information into
OSCAR. Form Number: CMS-3070 (OCN: 0938-0062); Frequency: Reporting--
Yearly; Affected Public: Private Sector: Business or other for-profits
and Not-for-profit institutions; Number of Respondents: 6,446; Total
Annual Responses: 6,446; Total Annual Hours: 19,388. (For policy
questions regarding this collection contact Adrienne Rogers at 410-786-
3411. For all other issues call 410-786-1326.)
8. Type of Information Collection Request: Reinstatement with
change of a previously approved collection; Title of Information
Collection: Medicare and Medicaid Programs: Electronic Health Record
Incentive Program; Use: The American Recovery and Reinvestment Act of
2009 (Recovery Act) (Pub. L. 111-5) was enacted on February 17, 2009.
The Recovery Act includes many measures to modernize our nation's
infrastructure, and improve affordable health care. Expanded use of
health information technology (HIT) and certified electronic health
record (EHR) technology will improve the quality and value of America's
health care. Title IV of Division B of the Recovery Act amends Titles
XVIII and XIX of the Social Security Act (the Act) by establishing
incentive payments to eligible professionals (EPs), eligible hospitals
and critical access hospitals (CAHs), and Medicare Advantage (MA)
organizations participating in the Medicare and Medicaid programs that
adopt and successfully demonstrate meaningful use of certified EHR
technology. These Recovery Act provisions, together with Title XIII of
Division A of the Recovery Act, may be cited as the ``Health
Information Technology for Economic and Clinical Health Act'' or the
``HITECH Act.''
The HITECH Act creates incentive programs for EPs and eligible
hospitals, including CAHs, in the Medicare Fee-for-Service (FFS), MA,
and Medicaid programs that successfully demonstrate meaningful use of
certified EHR technology. In their first payment year, Medicaid EPs and
eligible hospitals may adopt, implement or upgrade to certified EHR
technology. It also, provides for payment adjustments in the Medicare
FFS and MA programs starting in FY 2015 for EPs and eligible hospitals
participating in Medicare that are not meaningful users of certified
EHR technology. These payment adjustments do not pertain to Medicaid
providers.
The first final rule for the Medicare and Medicaid EHR Incentive
Program, which was published in the Federal Register on July 28, 2010
(CMS-0033-F), specified the initial criteria EPs, eligible hospitals
and CAHs, and MA organizations must meet in order to qualify for
incentive payments; calculation of incentive payment amounts; payment
adjustments under Medicare for covered professional services and
inpatient hospital services provided by EPs, eligible hospitals and
CAHs failing to demonstrate meaningful use of certified EHR technology
beginning in 2015; and other program participation requirements. On the
same date, the Office of the National Coordinator of Health Information
Technology (ONC) issued a closely related final rule (45 CFR part 170,
RIN 0991-AB58) that specified the initial set of standards,
implementation specifications, and certification criteria for certified
EHR technology. ONC has also issued a separate final rule on the
establishment of certification programs for health information
technology (HIT) (45 CFR part 170, RIN 0991-AB59). The functionality of
certified EHR technology should facilitate the implementation of
meaningful use. Subsequently, final rules have been issued by CMS (77
FR 53968) and ONC (77 FR 72985) to create a Stage 2 of meaningful use
criteria and other
[[Page 34390]]
changes to the CMS EHR Incentive Programs and the 2014 Edition
Certification Criteria for EHR technology.
The information collection requirements contained in this
information collection request are needed to implement the HITECH Act.
In order to avoid duplicate payments, all EPs are enumerated through
their National Provider Identifier (NPI), while all eligible hospitals
and CAHs are enumerated through their CMS Certification Number (CCN).
State Medicaid agencies and CMS use the provider's tax identification
number and NPI or CCN combination in order to make payment, validate
payment eligibility and detect and prevent duplicate payments for EPs,
eligible hospitals and CAHs. Form Number: CMS-10336 (OCN: 0938-1158).
Frequency: Occasionally; Affected Public: Private sector. Number of
Respondents: 214, 694; Total Annual Responses: 214,694. Total Annual
Hours: 2,034,740.16. (For policy questions regarding this collection
contact Travis Broome at 214-767-4450. For all other issues call 410-
786-1326.)
9. Type of Information Collection Request: Reinstatement with
change of a previously approved collection; Title of Information
Collection: Security Consent and Surrogate Authorization Form; Use: The
primary function of the Medicare enrollment application is to obtain
information about the Provider or supplier and whether they meet the
Federal and/or State qualifications to participate in the Medicare
program. In addition, the Medicare enrollment application gathers
information regarding the provider or supplier's practice location, the
identity of the owners of the enrolling organization, and information
necessary to establish the correct claims payment.
Enrollees have the option of submitting either a CMS 855 form, or
submitting information via a web based process. In establishing a web
based application process, we allow providers and suppliers the ability
to enroll in the Medicare program, revalidate their enrollment and make
changes to their enrollment information via Internet-based Provider
Enrollment, Chain and Ownership System (PECOS). Individual providers/
suppliers (hereinafter referred to as ``Individual Providers'') log
into Internet-based PECOS using their User IDs and passwords
established when they applied on-line to the National Plan and Provider
Enumeration System (NPPES) for their National Provider Identifiers
(NPIs). Authorized Officials (AOs) of the provider or supplier
organizations (hereinafter referred to as ``Organizational Providers'')
must register for a user account and authenticate their identity and
connection to the organization they represent before being able to log
into Internet-based PECOS. Once authenticated, AOs for Organizational
Providers, receive complete access to their enrollment information via
Internet-based PECOS. Individuals and AOs of Organizational Providers
are not required to submit a Security Consent and Surrogate
Authorization Form to enroll, revalidate or make changes to their
Medicare enrollment information.
Individual and Organizational Providers may complete their Medicare
enrollment responsibilities on their own or elect to delegate this task
to a Surrogate. A Surrogate is an individual or organization identified
by an Individual or Organizational Provider as someone authorized to
access CMS computer systems, such as Internet-based PECOS, National
Provider Plan and Enumeration System (NPPES) and the Medicare and
Medicaid Electronic Health Records (EHR) Incentive Program Registration
and Attestation System (HITECH), on their behalf and to modify or view
any information contained therein that the Individual or Organizational
Provider may have permission or right to access in accordance with
Medicare statutes, regulations, policies, and usage guidelines for any
CMS system. Surrogates may consist of administrative staff, independent
contractors, 3rd party consulting companies or credentialing
departments. In order for an Individual or Organizational Provider to
delegate the Medicare credentialing process to a Surrogate to access
and update their enrollment information in the above mentioned CMS
systems on their behalf, it is required that a Security Consent and
Surrogate Authorization Form be completed, or Individual and
Organizational Providers use an equivalent online process via the PECOS
Identity and Access Management (I&A) system. The Security Consent and
Surrogate Authorization form replicates business service agreements
between Medicare providers, suppliers or both and Surrogates providing
enrollment services.
We are proposing one version of the Security Consent and Surrogate
Authorization Form. The form, once signed, mailed and approved, grants
a Surrogate access to all current and future enrollment data for the
Individual or Organization Provider. Form Number: CMS-10220 (OCN: 0938-
1035). Frequency: Occasionlly. Affected Public: Individuals and Private
Sector; Number of Respondents: 88,650; Total Annual Responses: 88,650;
Total Annual Hours: 22,162. (For policy questions regarding this
collection contact Alisha Banks at 410-786-0671. For all other issues
call 410-786-1326.)
10. Type of Information Collection Request: Reinstatement with
change of a previously approved collection; Title of Information
Collection: Certification Statement for Electronic File Interchange
Organizations; Use: Health care providers can currently obtain a
National Provider Identifier (NPI) via a paper application or over the
Internet through the National Plan and Provider Enumeration System
(NPPES). These applications must be submitted individually, on a per-
provider basis. The Electronic File Interchange (EFI) process allows
provider-designated organizations (EFIOs) to capture multiple
providers' NPI application information on a single electronic file for
submission to NPPES. This process is also referred to as bulk
enumeration. To ensure that the EFIO has the authority to act on behalf
of each provider and complies with other federal requirements, an
authorized official of the EFIO must sign a certification statement and
mail it to us. Form Number: CMS-10175 (OCN: 0938-0984). Frequency:
Occasionally. Affected Public: Private Sector; Number of Respondents:
25; Total Annual Responses: 25; Total Annual Hours: 75. (For policy
questions regarding this collection contact Leslie Jones at 410-786-
6599. For all other issues call 410-786-1326.)
Dated: June 4, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2013-13578 Filed 6-6-13; 8:45 am]
BILLING CODE 4120-01-P