[Federal Register Volume 77, Number 239 (Wednesday, December 12, 2012)]
[Pages 74018-74019]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-29951]



Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10280 and CMS-R-131]

Agency Information Collection Activities: Proposed Collection; 
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) 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 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.
    1. 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), 
    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.)

[[Page 74019]]

    2. 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; 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 
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.)
    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 Paperwork@cms.hhs.gov, or call 
the Reports Clearance Office on (410) 786-1326.
    In commenting on the proposed information collections please 
reference the document identifier or OMB control number. To be assured 
consideration, comments and recommendations must be submitted in one of 
the following ways by February 11, 2013:
    1. Electronically. You may submit 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) 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.

    Dated: December 7, 2012.
Martique Jones,
Director, Division of Regulations Development-B, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2012-29951 Filed 12-11-12; 8:45 am]