[Federal Register Volume 78, Number 134 (Friday, July 12, 2013)]
[Notices]
[Pages 41931-41932]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-16740]
[[Page 41931]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-2746, CMS-2728, CMS-R-39, CMS-10170, CMS-
10156 and CMS-10485]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
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 (the 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 September 10, 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:
Contents
This notice sets out a summary of the use and burden associated
with the following information collections. More detailed information
can be found in each collection's supporting statement and associated
materials (see ADDRESSES).
CMS-2746 End Stage Renal Disease Death Notification
CMS-2728 End Stage Renal Disease Medical Evidence Report Medicare
Entitlement and/or Patient Registration
CMS-R-39 Home Health Conditions of Participation (CoP) and Supporting
Regulations
CMS-10170 Retiree Drug Subsidy (RDS) Payment Request and Instructions
CMS-10156 Retiree Drug Subsidy (RDS) Application and Instructions
CMS-10485 Evaluation of the Multi-Payer Advanced Primary Care Practice
(MAPCP) Demonstration: Provider Survey
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 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.
Information Collections
1. Type of Information Collection Request: Revision of a previously
approved collection; Title of Information Collection: End Stage Renal
Disease Death Notification; Use: The End Stage Renal Disease (ESRD)
Death Notification (CMS-2746) is completed by all Medicare-approved
ESRD facilities upon the death of an ESRD patient. Its primary purpose
is to collect fact of death and cause of death of ESRD patients.
Certain other identifying information (e.g., name, Medicare claim
number, and date of birth) is required for matching purposes. Federal
regulations require that the ESRD Networks examine the mortality rates
of every Medicare-approved facility within its area of responsibility.
The death form provides the necessary data to assist the ESRD Networks
in making decisions that result in improved patient care and in cost-
effective distribution of ESRD resources. The data is used by the ESRD
Networks to verify facility deaths and to monitor facility performance.
Form Number: CMS-2746 (OCN: 0938-0448); Frequency: On occasion;
Affected Public: Business or other for-profit, Not-for-profit
institutions; Number of Respondents: 5,964; Total Annual Responses:
75,000; Total Annual Hours: 37,500. (For policy questions regarding
this collection contact Michelle Tucker at 410-786-0736.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: End Stage Renal
Disease Medical Evidence Report Medicare Entitlement and/or Patient
Registration; Use: The End Stage Renal Disease (ESRD) Medical Evidence
Report is completed for all ESRD patients either by the first treatment
facility or by a Medicare-approved ESRD facility when it is determined
by a physician that the patient's condition has reached that stage of
renal impairment that a regular course of kidney dialysis or a kidney
transplant is necessary to maintain life. The data reported on the CMS-
2728 is used by the federal government, ESRD Networks, treatment
facilities, researchers and others to monitor and assess the quality
and type of care provided to end stage renal disease beneficiaries. The
data collection captures the specific medical information required to
determine the Medicare medical eligibility of End Stage Renal Disease
claimants. Form
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Number: CMS-2728 (OCN: 0938-0046); Frequency: Occasionally;
Affected Public: Individuals or households; Number of Respondents:
130,000; Total Annual Responses: 130,000; Total Annual Hours: 97,500.
(For policy questions regarding this collection contact Michelle Tucker
at 410-786-0736.)
3. Type of Information Collection Request: Reinstatement with
change of a currently approved collection; Title of Information
Collection: Home Health Conditions of Participation (CoP) and
Supporting Regulations; Use: The information collection requirements
contained in this request are part of the requirements classified as
the conditions of participation (CoPs) which are based on criteria
prescribed in law and are standards designed to ensure that each
facility has properly trained staff to provide the appropriate safe
physical environment for patients. These particular standards reflect
comparable standards developed by industry organizations such as the
Joint Commission on Accreditation of Healthcare Organizations, and the
Community Health Accreditation Program. The primary users of this
information will be state agency surveyors, the regional home health
intermediaries, CMS and home health agencies (HHAs) for the purpose of
ensuring compliance with Medicare CoPs as well as ensuring the quality
of care provided by HHA patients. Form Numbers: CMS-R-39 (OCN: 0938-
0365); Frequency: Occasionally; Affected Public: Business or for-
profits, not-for-profit institutions, and State, Local or Tribal
governments; Number of Respondents: 13,577; Total Annual Responses:
20,202,576; Total Annual Hours: 6,422,694. (For policy questions
regarding this collection contact Danielle Shearer at 410-786-6617.)
4. Type of Information Collection Request: Reinstatement without
change of a previously approved collection; Title of Information
Collection: Retiree Drug Subsidy (RDS) Payment Request and
Instructions; Use: Under section 1860D-22 of the Social Security Act
and implementing regulations at 42 CFR part 423 subpart R, plan
sponsors (e.g., employers, unions) who offer prescription drug coverage
meeting specified criteria to their qualified covered retirees are
eligible to receive a 28 percent tax-free subsidy for allowable drug
costs. Plan sponsors must submit required prescription drug cost data
and other information in order to receive the subsidy. Subpart R
stipulates that plan sponsors may elect to submit RDS payment requests
on a monthly, quarterly, interim annual, or annual basis; once
selected, the payment frequency may not be changed during the plan
year. Form Number: CMS-10170 (OCN: 0938-0977); Frequency: Occasionally;
Affected Public: Private sector (business or other for-profits and not-
for-profit institutions); Number of Respondents: 4,500; Total Annual
Responses: 4,500; Total Annual Hours: 679,500. (For policy questions
regarding this collection contact John W. Campbell at 410-786-0542.)
5. Type of Information Collection Request: Reinstatement without
change of a previously approved collection; Title of Information
Collection: Retiree Drug Subsidy (RDS) Applications and Instructions;
Use: Under the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 and implementing regulations at 42 CFR part
423, subpart R plan sponsors (e.g., employers, unions) who offer
prescription drug coverage to their qualified covered retirees are
eligible to receive a 28 percent tax-free subsidy for allowable drug
costs. In order to qualify, plan sponsors must submit a complete
application with a list of retirees for whom it intends to collect the
subsidy. Once CMS reviews and analyzes the information on the
application and the retiree list, notification will be sent to the plan
sponsor about its eligibility to participate in the RDS program. Form
Number: CMS-10156 (OCN: 0938-0957); Frequency: Yearly and monthly;
Affected Public: Private sector (business or other for-profits and not-
for-profit institutions); Number of Respondents: 4,500; Total Annual
Responses: 4,500; Total Annual Hours: 288,000. (For policy questions
regarding this collection contact John W. Campbell at 410-786-0542.)
6. Type of Information Collection Request: New Collection (Request
for a new OMB control number); Title of Information Collection:
Evaluation of the Multi-Payer Advanced Primary Care Practice (MAPCP)
Demonstration: Provider Survey; Use: On September 16, 2009, the
Department of Health and Human Services announced the establishment of
the Multi-payer Advanced Primary Care Practice (MAPCP) Demonstration,
under which Medicare joined Medicaid and private insurers as a payer
participant in state-sponsored patient-centered medical home (PCMH)
initiatives. We selected eight states to participate in this
demonstration: Maine, Vermont, Rhode Island, New York, Pennsylvania,
North Carolina, Michigan, and Minnesota.
We are proposing to conduct this provider survey to understand how
participating practices' structures and functions vary, particularly
with respect to their adoption of different components of the PCMH
model of care. Researchers evaluating the MAPCP Demonstration plan to
combine these survey data with claims data to conduct statistical
analyses that identify which particular medical home care processes are
associated with the largest gains in health care quality and reductions
in health care cost trends. Form Number: CMS-10485 (OCN: 0938-NEW);
Frequency: Annually; Affected Public: Individuals and households;
Number of Respondents: 5,799; Total Annual Responses: 5,799; Total
Annual Hours: 1,450. (For policy questions regarding this collection
contact Suzanne Wensky at 410-786-0226.)
Dated: July 9, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2013-16740 Filed 7-11-13; 8:45 am]
BILLING CODE 4120-01-P