[Federal Register Volume 68, Number 244 (Friday, December 19, 2003)]
[Notices]
[Page 70801]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-31358]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier: CMS-R-234, CMS-250-254]


Agency Information Collection Activities: Proposed Collection; 
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: Subpart D--
Private Contracts and Supporting Regulations in 42 CFR 405.410, 
405.430, 405.435, 405.440, 405.445, 405.455, 410.61, 415.110, and 
424.24; Form No.: CMS-R-234 (OMB 0938-0730); Use: Section 4507 
of the BBA of 1997 amended section 1802 of the Social Security Act to 
permit certain physicians and practitioners to opt-out of Medicare and 
to provide through private contracts services that would otherwise be 
covered by Medicare. Under such contracts the mandatory claims 
submission and limiting charge rules of section 1848(g) of the Act 
would not apply. Subpart D and the Supporting Regulations contained in 
42 CFR 405.410, 405.430, 405.435, 405.440, 405.445, and 405.455, 
counters the effect of certain provisions of Medicare law that, absent 
section 4507 of BBA 1997, preclude physicians and practitioners from 
contracting privately with Medicare beneficiaries to pay without regard 
to Medicare limits; Frequency: Biennially; Affected Public: Business or 
other for-profit; Number of Respondents: 26,820; Total Annual 
Responses: 26,820; Total Annual Hours: 7,197.
    2. Type of Information Request: Revision of a currently approved 
collection; Title of Information Collection: Medicare Secondary Payer 
Information Collection and Supporting Regulations in 42 CFR 411.25, 
489.2, and 489.20; Form Number: CMS-250 through CMS-254 (OMB 
0938-0214); Use: Medicare Secondary Payer (MSP) is essentially the same 
concept known in the private insurance industry as coordination of 
benefits and refers to those situations where Medicare does not have 
primary responsibility for paying the medical expenses of a Medicare 
beneficiary. CMS contracts with health insuring organizations, herein 
referred to as intermediaries and carriers, to process Medicare claims. 
CMS charges its Medicare intermediaries and carriers with various tasks 
to detect MSP cases; develops and disseminates tools to enable them to 
better perform their tasks; and monitors their performance in 
achievement of their assigned MSP functions. Because intermediaries and 
carriers are also marketing health insurance products that may have 
liability when Medicare is secondary, the MSP provisions create the 
potential for conflict of interest. Recognizing this inherent conflict, 
CMS has taken steps to ensure that its intermediaries and carriers 
process claims in accordance with the MSP provisions, regardless of 
what other insurer is primary. These information collection 
requirements describe the MSP requirements and consist of the 
following:
    1. Initial enrollment questionnaire.
    2. MSP claims investigation, which consists of first claim 
development, trauma code development, self-reporting MSP liability 
development, notice to responsible third party development (411.25 
notice), secondary claims development, and ``08'' development 
(involving claims where information cannot be obtained from the 
beneficiary).
    3. Provider MSP development, which requires the provider to request 
information from the beneficiary or representative during admission and 
other encounters; Frequency: On occasion; Affected Public: Individuals 
or households, Business or other for-profit, and Not-for-profit 
institutions; Number of Respondents: 134,553,682; Total Annual 
Responses: 134,553,682; Total Annual Hours Requested: 1,518,616.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS's 
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 60 days of this notice directly to the CMS Paperwork Clearance 
Officer designated at the following address: CMS, Office of Strategic 
Operations and Regulatory Affairs, Division of Regulations Development 
and Issuances, Attention: Melissa Musotto, Room C5-14-03, 7500 Security 
Boulevard, Baltimore, Maryland 21244-1850.

    Dated: December 12, 2003.
Julie Brown,
Acting, Paperwork Reduction Act Team Leader, Office of Strategic 
Operations and Strategic Affairs, Division of Regulations Development 
and Issuances.
[FR Doc. 03-31358 Filed 12-18-03; 8:45 am]
BILLING CODE 4120-03-P