[Federal Register Volume 65, Number 1 (Monday, January 3, 2000)]
[Notices]
[Pages 135-136]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-33945]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[Document Identifier: HCFA-R-0296]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Health Care Financing Administration; HHS.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Health Care Financing
Administration (HCFA), Department of Health and Human Services, is
publishing the following summary of proposed collections for public
comment. The proposed collections consist of uniform mandatory notices
to be given to Medicare home health beneficiaries by home health
agencies (HHAs) when the HHA believes that services may not or may no
longer be covered. Interested persons are invited to send comments
regarding burden or any other aspect of these collections of
information requirements. All comments will be considered together,
including those comments submitted with respect to the Emergency
Federal Register notice published on September 22, 1999, with regard to
balancing the burden on providers with the provision of sufficient
information to beneficiaries. We are particularly interested in
receiving input regarding the form of the notices and the order in
which the information is presented. We also invite comments on how best
to fully inform beneficiaries with regard to services not covered by
Medicare. Comments may also be sent regarding 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.
Additionally, we acknowledge that comments regarding these notices
were made by beneficiary advocates in the context of the ongoing
litigation in Healey v. Shalala, Civil Action No.3:98CV00418 (DJS)
(D.Conn.). These comments related to: (1) the extent and type of notice
that is required in cases in which the physician concurs in the
reduction, termination, or denial of services; (2) the incorporation of
a statement regarding a requirement that a beneficiary agree to share
her medical records with the RHHI in the event that she requests the
submission of a demand bill; and (3) general concerns about design and
readability. The comments will be considered along with all other
comments received in response to this request. However, we consider it
most efficient and effective to publish these notices for comment in
their present form and to consider all comments in a single
comprehensive proceeding.
We also received comments from the National Association of Home
Care (``NAHC'') , representing members of the provider community,
regarding these notices. These comments related to the time required
for implementation and general readability concerns. Among other
things, NAHC also stated its belief that the notices misstate, in the
boxes regarding the beneficiaries' choices, the standard under which
coverage is determined. Similarly, these concerns will be considered
with all other comments received in response to this request.
Type of Information Collection Request: Extension of a currently
approved collection;
Title of Information Collection: Home Health Advance Beneficiary
Notices (HHABNs) and Supporting Regulations in 42 CFR Section
411.404-.406, 484.10, and 484.12(a);
Form No.: HCFA-R-0296 (OMB# 0938-0781);
Use: Beneficiaries must receive timely, accurate, complete, and
useful notices which will enable them to make informed consumer
decisions, with a proper understanding of their rights to a Medicare
initial determination, their appeal rights in the case of payment
[[Page 136]]
denial, and how these rights are waived if they refuse to allow their
medical information to be sent to Medicare. It is essential that such
notice be timely, readable and comprehensible, provide clear
directions, and provide accurate and complete information about the
services affected and the reason that Medicare denial of payment for
those services is expected by the HHA. For these reasons, uniform
mandatory notices (the HHABNs) with very specific content and graphic
design have been prepared (they are attached as Exhibits 1-3 hereto),
which are to be used by all HHAs furnishing services to Medicare
beneficiaries.
When an HHA expects payment for the home health services to be
denied by Medicare, a beneficiary must be advised before home health
care is initiated or continued, that in the HHA's opinion, payment
probably will be required from him or her personally. The attached
HHABNs are designed to ensure that HHAs inform beneficiaries in
writing, in a timely fashion, about changes to their home health care,
the fact that they may have to pay for care themselves if Medicare does
not pay, the process they must follow in order to obtain an initial
determination by Medicare and, if payment is denied, to file an appeal,
and the fact that they waive those rights if they refuse to allow their
medical information to be sent to Medicare. The HHABNs are to be issued
by the HHA each time, and as soon as, the HHA makes the assessment that
it believes Medicare payment will not be made. The HHABNs are to be
provided by HHAs in any case where a reduction or termination of
services is to occur, or where services are to be denied before being
initiated, except in any case in which a physician concurs in the
reduction, termination, or denial of services. Failure to do so would
be a violation of the HHA Conditions of Participation in the Medicare
Program, which are currently approved PRA requirements approved under
OMB number 0938-0365, and may result in the HHA being held liable under
the Limitation on Liability (LOL) provision.
Home Health Advance Beneficiary Notices (HHABNs) HHABNs, Exhibits
1-3 serve as notice to the beneficiary that the HHA believes that home
health services are not, or will no longer be, covered in different
situations. HHABN-T, Termination, is used when all home health services
will be terminated. HHABN-I, Initiation, is used when the HHA expects
that Medicare will not pay, even before services have been initiated.
HHABN-R, Reduction, is used when ongoing home health services will be
reduced (e.g., reduced in number, frequency, or for a particular subset
of services, or otherwise).
Frequency: On occasion.
Affected Public: Individuals or Households, Business or other for-
profit, Not-for-profit institutions.
Number of Respondents: 540,000.
Total Annual Responses: 1,080,000.
Total Annual Hours: 180,000.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access HCFA's
Web Site address at http://www/hcfa/gov/regs/prdact95.htm, or E-mail
your request, including your address, phone number, OMB number, and
HCFA document identifier, to P[email protected], or call the Reports
Clearance Office on (410) 786-1326. Written comments and
recommendations for the proposed information collections must be mailed
within 60 days of this notice directly to the HCFA Paperwork Clearance
Officer designated at the following address: Health Care Financing
Administration, Office of Information Services, Security and Standards
Group, Division of HCFA Enterprise Standards, Attention: Dawn
Willinghan, Room N2-14-26, 7500 Security Boulevard, Baltimore, Maryland
21244-1850.
Dated: December 22, 1999.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA Office of Information Services,
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 99-33945 Filed 12-30-99; 8:45 am]
BILLING CODE 4120-03-P