[Federal Register Volume 65, Number 80 (Tuesday, April 25, 2000)]
[Notices]
[Pages 24217-24218]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-10268]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-R-296]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

    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. As a result of comments to the effect that the 
notices are poorly designed in that they are too long, complex, and 
overcrowded with symbols, the Home Health Advance Beneficiary Notices 
have been revised. These revisions consist of simplifications of the 
graphics, giving the notices a notably less cluttered look; reordering 
of the text and options, and elimination of some repetition in order to 
reduce complexity. As a result of comments suggesting a fourth option 
for billing another insurer and suggesting removal of the reference to 
the beneficiary's ``need'' for care in Option ``A,'' the Home Health 
Advance Beneficiary Notices have been revised by adding clarifying 
language to Option ``B'' (now Option ``1''), emphasizing that other 
insurers may be billed, and by rewording Option ``A'' (now Option 
``2''), removing the reference to the ``need'' for care. As a result of 
a comment that there was a lack of information in the notices about 
legal assistance for beneficiaries, the Home Health Advance Beneficiary 
Notices have been revised to include information about legal assistance 
for beneficiaries and some other related access-to-assistance 
information, as a new page, and to include a brief notice about 
beneficiaries' right to have their personal health information kept 
confidential. Interested persons are invited to send comments regarding 
the revisions, and burden or any other aspect of these collections of 
information requirements. 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.
    Type of Information Collection Request: Revision 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 
denial, and how these rights are waived if they refuse to allow their 
health 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, which are to be used by all

[[Page 24218]]

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 or through other 
insurance. The 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 health 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 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, even before services have been initiated, that 
Medicare will not pay. 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 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 and phone number, to [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 30 days of this notice directly to the OMB Desk Officer 
designated at the following address: OMB Human Resources and Housing 
Branch, Attention: Allison Eydt, New Executive Office Building, Room 
10235, Washington, D.C. 20503.

    Dated: April 10, 2000.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA, Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 00-10268 Filed 4-24-00; 8:45 am]
BILLING CODE 4120-03-P