[Federal Register Volume 80, Number 25 (Friday, February 6, 2015)]
[Notices]
[Pages 6726-6727]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-02414]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers CMS-10410, CMS-R-74, CMS-2552-10 and CMS-855R]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services.
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 April 7, 2015.
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-10410 Medicaid Program; Eligibility Changes under the Affordable
Care Act of 2010
CMS-R-74 Income and Eligibility Verification System Reporting and
Supporting Regulations
CMS-2552-10 Hospital and Hospital Health Care Complex Cost Report
CMS-855R Medicare Enrollment Application: Reassignment of Medicare
Benefits
Under the 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
[[Page 6727]]
collection of information, before submitting the collection to OMB for
approval. To comply with this requirement, CMS is publishing this
notice.
Information Collection
1. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicaid Program;
Eligibility Changes under the Affordable Care Act of 2010; Use: The
eligibility systems are essential to the goal of increasing coverage in
insurance affordability programs while reducing administrative burden
on states and consumers. The electronic transmission and automation of
data transfers are key elements in managing the expected insurance
affordability program caseload that started in 2014. Accomplishing the
same work without these information collection requirements would not
be feasible. Form Number: CMS-10410 (OMB control number 0938-1147);
Frequency: Occasionally; Affected Public: Individuals or households,
and State, Local, and Tribal Governments; Number of Respondents:
25,500,096; Total Annual Responses: 76,500,149; Total Annual Hours:
21,278,142. (For policy questions regarding this collection contact
Brenda Sheppard at 410-786-8534).
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Income and
Eligibility Verification System Reporting and Supporting Regulations;
Use: A state Medicaid agency that currently obtains and uses
information from certain sources, or with more frequency than
specified, could continue to do so to the extent that the verifications
are useful and not redundant. An agency that has found it effective to
verify all wage or benefit information with another agency or with the
recipient is encouraged to continue these practices if it chooses. On
the other hand, the agency may implement an approved targeting plan
under 42 CFR 435.953. The agency's experience should guide its decision
whether to exceed these regulatory requirements on income and
eligibility verification. While states may target resources when
verifying income of course, agencies are still held accountable for
their accuracy in eligibility determinations. Form Number: CMS-R-74
(OMB control number 0938-0467); Frequency: Occasionally; Affected
Public: State, Local, or Tribal Governments; Number of Respondents: 50;
Total Annual Responses: 71; Total Annual Hours: 134,865. (For policy
questions regarding this collection contact Brenda Sheppard at 410-786-
8534).
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Hospital and
Hospital Health Care Complex Cost Report; Use: Providers of services
participating in the Medicare program are required under sections
1815(a) and 1861(v)(1)(A) of the Social Security Act (42 U.S.C. 1395g)
to submit annual information to achieve settlement of costs for health
care services rendered to Medicare beneficiaries. In addition,
regulations at 42 CFR 413.20 and 413.24 require adequate cost data and
cost reports from providers on an annual basis.
We are requesting the Office of Management and Budget review and
approve this revision to the Form CMS-2552-10, Hospital and Hospital
Health Care Complex Cost Report. These cost reports are filed annually
by hospitals participating in the Medicare program to determine the
reasonable costs incurred to provide medical services to patients. The
revisions made to the hospital cost report are in accordance with the
statutory requirement for hospice payment reform in Sec. 3132 of the
Patient Protection and Affordable Care Act (ACA) (March 23, 2010) and
the statutory requirement establishing a prospective payment system for
Federally Qualified Health Centers in Sec. 10501(i)(3)(A) of the ACA,
codified in section 1834(o) of the Act. Form Number: CMS-2552-10 (OMB
control number 0938-0050); Frequency: Yearly; Affected Public: State,
Local, or Tribal Governments, private sector (for-profit and not-for-
profit institutions); Number of Respondents: 6,157; Total Annual
Responses: 6,157; Total Annual Hours: 4,143,661. (For policy questions
regarding this collection contact Gail Duncan at 410-786-7278).
4. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Medicare
Enrollment Application: Reassignment of Medicare Benefits; Use: The
primary function of the CMS 855R enrollment application is to allow
physicians and non-physician practitioners to reassign their Medicare
benefits to a group practice and to gather information from the
individual that tells us who he/she is, where he or she renders
services, and information necessary to establish correct claims
payment. The goal of periodically evaluating and revising the CMS 855R
enrollment application is to simplify and clarify the information
collection without jeopardizing our need to collect specific
information.
At this time, CMS is making very few minor revisions to the CMS
855R (Reassignment of Benefits) Medicare enrollment application (OMB
No. 0938-1179). Two sections within the form are being reversed to
maintain sync with online and paper forms. The previously approved CMS
855R section 2 collected information regarding the individual
practitioner who is reassigning benefits and section 3 collected
information regarding the organization/group receiving the reassigned
benefits. These two sections have been reversed so that section 2 now
collects information on the regarding the organization/group receiving
the reassigned benefits and section 3 now collects information on the
individual practitioner who is reassigning benefits. No information or
data collection within these sections was revised. The sections were
merely re-sequenced and re-numbered to maintain sync between online and
paper forms. With the exception of this section reversal and adding the
word ``optional'' to sections 4 and 5 (primary practice location and
contact person information), there are no other revisions. These
revisions offer no new data collection in this revision package. The
addition of the optional choice in sections 4 and 5 could potentially
reduce the burden to providers who choose not to complete either or
both optional sections. Form Number: CMS-855R (OMB control number 0938-
1179); Frequency: Occasionally; Affected Public: State, Local, or
Tribal Governments, private sector (for-profit and not-for-profit
institutions); Number of Respondents: 379,619; Total Annual Responses:
379,619; Total Annual Hours: 94,905. (For policy questions regarding
this collection contact Kim McPhillips at 410-786-5374).
Dated: February 3, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2015-02414 Filed 2-5-15; 8:45 am]
BILLING CODE 4120-01-P