[Federal Register Volume 68, Number 32 (Tuesday, February 18, 2003)]
[Notices]
[Pages 7793-7794]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-3786]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-R-96, CMS-R-5, CMS-R-245, CMS-R-209 and CMS-
718 BP, 719 BP, 720 BP, 721 BP, SUM, Staffing, SC1, and SC2]


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

AGENCY: Centers for Medicare and 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 and Medicaid 
Services (CMS) (formerly known as the Health Care Financing 
Administration (HCFA), Department of Health and Human Services, 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: Extension of a currently 
approved collection; Title of Information Collection: Emergency and 
Foreign Hospital Services--Beneficiary Statement in Canadian Travel 
Claims and Supporting Regulations in 42 CFR, section 424.123; Form No.: 
CMS-R-96 (OMB 0938-0484); Use: Payment may be made for certain 
Part A inpatient hospital services and Part B outpatient hospital 
services provided in a non-participating U.S. or foreign hospital when 
services are necessary to prevent the death or serious impairment of 
the health of the individual. This statement must be submitted by the 
beneficiary to support their claim for payment.; Frequency: On 
occasion; Affected Public: Individuals or Households; Number of 
Respondents: 1,100; Total Annual Responses: 1,100; Total Annual Hours: 
275.
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Physician 
Certifications/Recertifications in Skilled Nursing Facilities (SNFs) 
Manual Instructions and Supporting Regulations in 42 CFR section 
424.20; Form No.: CMS-R-5 (OMB 0938-0454); Use: This 
information collection requires SNFs to keep record of physician 
certifications and recertifications of information such as the need for 
care and services, estimated duration of the SNF stay, and plan for 
home care; Frequency: On occasion; Affected Public: State, Local or 
Tribal Government, Individuals or Households, Business or other for-
profit, Not-for-profit institutions; Number of Respondents: 2,068,716; 
Total Annual Responses: 883,838; Total Annual Hours: 441,793.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare and 
Medicaid Programs Use of the OASIS as Part of the CoPs for HHAs and 
Supporting Regulations in part 484 of 42 CFR; Form No.: CMS-R-245 
(OMB 0938-0760); Use: This regulation requires HHAs to use a 
standard core assessment data set, the OASIS, to collect information 
and to evaluate adult non-maternity patients. In addition, data from 
the OASIS will be used for purposes of case mix adjusting patients 
under home health PPS and will facilitate the production of necessary 
case mix information at relevant time points in the patient's home 
health stay. Modifications have been made to currently approved OASIS 
forms to allow for the preservation of masking of personally 
identifiable information for the non-Medicare/non-Medicaid individuals; 
Frequency: Upon patient assessment; Affected Public: Business or other 
for-profit, Not-for-profit institutions, Federal Government, State, 
Local, or Tribal Government; Number of Respondents: 7,100; Total Annual 
Responses: 9,510,900; Total Annual Hours: 8,013,013.
    4. Type of Information Collection Request: Extension of a currently

[[Page 7794]]

approved collection; Title of Information Collection: Medicare and 
Medicaid Programs; Use and Reporting OASIS Data as Part of the CoPs for 
HHAs and Supporting Regulations in 42 CFR 484.11 and 484.20; Form No.: 
CMS-R-209 (OMB 0938-0761); Use: HHAs are required to report 
data from the OASIS as a condition of participation. Specifically, the 
above named regulations sections provide guidelines for HHAs for the 
electronic transmission of the OASIS data as well as responsibilities 
of the State agency or OASIS contractor in collecting and transmitting 
this information to HCFA. These requirements are necessary to achieve 
broad-based, measurable improvement in the quality of care furnished 
through Federal programs, and to establish a prospective payment system 
for HHAs.; Frequency: Monthly; Affected Public: Business or other for-
profit, Not-for-profit institutions, Federal Government, State, Local, 
or Tribal Government; Number of Respondents: 6,900; Total Annual 
Responses: 85,200; Total Annual Hours: 838,408.
    5. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Business Proposal 
Formats for Quality Improvement Organizations (QIOs)--previously known 
as Peer Review Organizations and Supporting Regulations in 42 CFR, 
Section 475.101--475.107; Form No.: CMS-718-721 (OMB 0938-
0579); Use: The submission of proposal information by current QIOs and 
other bidders, on the appropriate forms, will satisfy CMS's need for 
meaningful, consistent, and verifiable data with which to evaluate 
contract proposals; Frequency: tri-annually; Affected Public: Business 
or other for-profit, Not-for-profit institutions; Number of 
Respondents: 20; Total Annual Responses: 20; Total Annual Hours: 455.
    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://cms.hhs.gov/regulations/pra/default.asp, or E-
mail your request, including your address, phone number, OMB number, 
and CMS document identifier, 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: OMB 
Human Resources and Housing Branch, Attention: Brenda Aguilar, New 
Executive Office Building, Room 10235, Washington, DC 20503.

    Dated: February 6, 2003.
John P. Burke, III,
Paperwork Reduction Act Team Leader, CMS Reports Clearance Officer, 
Office of Strategic Operations and Regulatory Affairs, Division of 
Regulations Development and Issuances.
[FR Doc. 03-3786 Filed 2-14-03; 8:45 am]
BILLING CODE 4120-03-P