[Federal Register Volume 71, Number 92 (Friday, May 12, 2006)]
[Notices]
[Pages 27725-27726]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-7304]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-1450 (UB-04), CMS-10181]


Agency Information Collection Activities: Submission for OMB 
Review; 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), 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 function; (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 of 
Information Collection: Medicare Uniform Institutional Provider Bill 
and Supporting Regulations in 42 CFR 424.5; Use: Section 42 CFR 
424.5(a)(5) requires providers of services to submit a claim for 
payment prior to any Medicare reimbursement. Charges billed are coded 
by revenue codes. The bill specifies diagnoses according to the 
International Classification of Diseases, Ninth Edition (ICD-9-CM) 
code. Inpatient procedures are identified by ICD-9-CM codes, and 
outpatient procedures are described using the CMS Common Procedure 
Coding System (HCPCS). These are standard systems of identification for 
all major health insurance claims payers. Submission of information on 
the CMS-1450 permits Medicare intermediaries to receive consistent data 
for proper payment. All hardcopy claims processed by Medicare fiscal 
intermediaries must be submitted on the CMS-1450 (UB-04) after May 23, 
2007. Data fields in the X12N 837 data set are consistent with the CMS-
1450 (UB-04) data set.; Form Numbers: CMS-1450 (UB-04) (OMB: 
0938-NEW); Frequency: Reporting--On occasion; Affected Public: Not-for-
profit institutions, business or other for-profit; Number of 
Respondents: 53,111; Total Annual Responses: 179,489,721; Total Annual 
Hours: 308,237.
    2. Type of Information Collection Request: New collection; Title of 
Information Collection: Enrolling Low-Income Beneficiaries into the 
Medicare Prescription Drug Program--Survey of State Agency Experiences; 
Use: The Centers for Medicare and Medicaid Services (CMS) will conduct 
a survey of state Medicaid agencies, state health insurance plans 
(SHIPs), and state pharmaceutical assistance programs (SPAPs) to 
identify best practices for the successful enrollment of all types of 
low-income Medicare beneficiaries into a low-income subsidy and the 
Medicare Part D Prescription Drug Benefit Program. The evaluation will 
assist in identifying the best practices, the factors that make them 
effective, and how the information can be disseminated in an effective 
manor. The information will be used to help CMS as it designs its 
outreach and communication campaigns in subsequent open enrollment 
periods.; Form Number: CMS-10181 (OMB: 0938-NEW); Frequency: 
Reporting--Other, one-time; Affected Public: State, Local or Tribal 
governments, Federal government; Number of Respondents: 126; Total 
Annual Responses: 126; Total Annual Hours: 63.
    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 
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 or faxed within 30 days of this notice 
directly to the OMB desk officer: OMB Human Resources and Housing 
Branch, Attention: Carolyn Lovett, New Executive Office Building, Room 
10235,

[[Page 27726]]

Washington, DC 20503, Fax Number: (202) 395-6974.

    Dated: May 5, 2006.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E6-7304 Filed 5-11-06; 8:45 am]
BILLING CODE 4120-01-P