[Federal Register Volume 81, Number 24 (Friday, February 5, 2016)]
[Notices]
[Pages 6275-6276]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-02277]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10406 and CMS-10599]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
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,
[[Page 6276]]
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 5, 2016.
ADDRESSES: When commenting, please reference the document identifier or
OMB control number. 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-10406 Medicare Probable Fraud Measurement Pilot; CMS-10599 Medicare
Prior Authorization of Home Health Services Demonstration
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 collection of information, before
submitting the collection to OMB for approval. To comply with this
requirement, CMS is publishing this notice.
1. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare Probable
Fraud Measurement Pilot; Use: The Centers for Medicare & Medicaid
Services (CMS) is seeking Office of Management and Budget (OMB)
approval of the collections required for a probable fraud measurement
pilot. The probable fraud measurement pilot would establish a baseline
estimate of probable fraud in payments for home health care services in
the fee-for-service Medicare program. CMS and its agents will collect
information from home health agencies, the referring physicians and
Medicare beneficiaries selected in a national random sample of home
health claims. The pilot will rely on the information collected along
with a summary of the service history of the HHA, the referring
provider, and the beneficiary to estimate the percentage of total
payments that are associated with probable fraud and the percentage of
all claims that are associated with probable fraud for Medicare fee-
for-service home health. Form Number: CMS-10406 (OMB Control Number
0938-1192); Frequency: Annually; Affected Public: Individual and
Private Sector (Business or other for-profits); Number of Respondents:
6,000; Total Annual Responses: 6,000; Total Annual Hours: 7,500. (For
policy questions regarding this collection contact Cecelia Franco at
(786) 313-0737).
2. Type of Information Collection Request: New Collection; Title of
Information Collection: Medicare Prior Authorization of Home Health
Services Demonstration; Use: Section 402(a)(1)(J) of the Social
Security Amendments of 1967 (42 U.S.C. 1395b-1(a)(1)(J)) authorizes the
Secretary to ``develop or demonstrate improved methods for the
investigation and prosecution of fraud in the provision of care or
services under the health programs established by the Social Security
Act (the Act).'' In accordance with this authority, we seek to develop
and implement a Medicare demonstration project, which we believe will
help assist in developing improved procedures for the identification,
investigation, and prosecution of Medicare fraud occurring among HHAs
providing services to Medicare beneficiaries.
This demonstration would help assure that payments for home health
services are appropriate before the claims are paid, thereby preventing
fraud, waste, and abuse. As part of this demonstration, we propose
performing prior authorization before processing claims for home health
services in: Florida, Texas, Illinois, Michigan, and Massachusetts. We
would establish a prior authorization procedure that is similar to the
Prior Authorization of Power Mobility Device (PMD) Demonstration, which
was implemented by CMS in 2012. This demonstration would also follow
and adopt prior authorization processes that currently exist in other
health care programs such as TRICARE, certain state Medicaid programs,
and in private insurance.
The information required under this collection is requested by
Medicare contractors to determine proper payment or if there is a
suspicion of fraud. Medicare contractors will request the information
from HHA providers submitting claims for payment from the Medicare
program in advance to determine appropriate payment. Form Number: CMS-
10599 (OMB Control Number: 0938-NEW); Frequency: Occasionally; Affected
Public: Private sector (Business or other for-profits and Not-for-
profits); Number of Respondents: 908,740; Number of Responses: 1; Total
Annual Hours: 454,370. (For questions regarding this collection contact
Carla David (410) 786-4799.)
Dated: February 2, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2016-02277 Filed 2-4-16; 8:45 am]
BILLING CODE 4120-01-P