[Federal Register Volume 72, Number 36 (Friday, February 23, 2007)]
[Notices]
[Pages 8167-8168]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-3026]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-131, CMS-10219, CMS-10097, CMS-255, and 
CMS-437]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services.

    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) 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: Revision of a currently 
approved collection; Title of Information Collection: Advance 
Beneficiary Notice of Noncoverage (ABN); Use: Under section 1879 of the 
Social Security Act, a physician, provider, practitioner or supplier of 
items or services participating in the Medicare Program, or taking a 
claim on assignment, may bill a Medicare beneficiary for items or 
services usually covered under Medicare, but denied in an individual 
case under specific statutory exclusions, if they inform the 
beneficiary, prior to furnishing the service, that Medicare is likely 
to deny payment. 42 CFR 411.404(b) and (c), and 411.408(d)(2) and (f), 
require written notice be provided to inform beneficiaries in advance 
of potential liability for payment.
    While the basic content of the ABN remains the same, there were 
several changes to the notice including but not limited to the 
following: (1) Revised, more user friendly language; (2) combining the 
two versions of the ABN, the General Use ABN, form CMS-R-131-G, and 
CMS-R-131-L, which was used specifically for physician-ordered 
laboratory tests, into a single general notice meeting both needs; (3) 
adding the 1-800-MEDICARE number on the notice; (4) adding information 
about the beneficiary's right to demand Medicare be billed; (5) 
increasing the selection options to 3 from 2, to allow beneficiaries' 
the right to pay out of pocket when they desire; (6) allowing a place 
for other insurance information to be recorded; and (7) describing the 
significance of the signature; Form Number: CMS-R-131 (OMB: 
0938-0566); Frequency: Reporting: Weekly, Monthly, Yearly, Biennially 
and Occasionally; Affected Public: Business or other for-profit and 
not-for-profit institutions; Number of Respondents: 1,270,614; Total 
Annual Responses: 40,302,506; Total Annual Hours: 4,701,959.
    2. Type of Information Collection Request: New collection; Title of 
Information Collection: Health Plan Employer Data And Information Set 
(HEDIS[supreg] ); Use: The Centers for Medicare & Medicaid Services 
(CMS) collects quality performance measures in order to hold the 
Medicare managed care industry accountable for the care being 
delivered, to enable quality improvement, and to provide quality 
information to Medicare beneficiaries in order to promote an informed 
choice. It is critical to CMS' mission that we collect and disseminate 
information that will help beneficiaries choose among health plans, 
contribute to improved quality of care through identification of 
improvement opportunities, and assist CMS in carrying out its oversight 
and purchasing responsibilities.
    In December 1997, OMB approved the request from CMS for the 
information collections under HEDIS[supreg] and assigned the agency 
form number CMS-R-200. The collections approved under that request 
included the HEDIS[supreg] collection (following the technical 
specifications contained in Volume 2, published by the National 
Committee for Quality Assurance (NCQA); the Health of Seniors/Health 
Outcomes Survey (HOS); and the Medicare CAHPS[supreg] survey. Since 
that approval there has been a change in the statutory authority as a 
result of the Balanced Budget Act of 1997. During the latter part of 
2000, CMS instituted several policy changes regarding this collection 
which reduced burden substantially on the part of the managed care 
organizations and the process for finalizing and publishing that policy 
delayed the request for OMB approval. In addition, the renewal of OMB 
authority for the Medicare CAHPS survey was completed as a separate 
request. The HOS renewal was also submitted separately. This request is

[[Page 8168]]

solely for the approval of the HEDIS collection, which is now a stand 
alone collection. Form Number: CMS-10219 (OMB: 0938-NEW); 
Frequency: Yearly; Affected Public: Business or other for-profit and 
Not-for-profit institutions; Number of Respondents: 705; Total Annual 
Responses: 705; Total Annual Hours: 33,840.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare 
Contractor Provider Satisfaction Survey (MCPSS); Form No.: CMS-10097 
(OMB 0938-0915); Use: The Centers for Medicare & Medicaid 
Services will obtain feedback from Medicare providers via a survey 
about satisfaction, attitudes and perceptions regarding the services 
provided by Medicare Fee-for-Service (FFS) Carriers, Fiscal 
Intermediaries, Durable Medical Equipment Suppliers, and Regional Home 
Health Intermediaries and Medicare Administrative Contractors. The 
survey focuses on basic business functions provided by the Medicare 
Contractors such as inquiries, provider communications, claims 
processing, appeals, provider enrollment, medical review and provider 
audit and reimbursement. Providers will receive a notice requesting 
they use a specially constructed Web site to respond to a set of 
questions customized for their contractor's responsibilities. The 
survey will be conducted yearly and annual reports of the survey 
results will be available via an online reporting system for use by 
CMS, Medicare Contractors, and the general public.
    Due to changes in CMS' reporting needs, CMS is requesting a 
potential increase in the number of completed surveys. This increase 
will allow CMS to have not only Contractor-specific, but also 
jurisdiction and state-specific data which, in turn, will enable 
Contractors to increase and implement performance improvement 
activities within their organizations. This increase will affect the 
2008 and 2009 administrations of the survey. Frequency: Reporting--
Annually; Affected Public: Business or other for-profit, not-for-profit 
institutions; Number of Respondents: 24,279; Total Annual Responses: 
24,279; Total Annual Hours: 8,346.
    4. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Municipal Health 
Services Cost Report; Form Number: CMS-255 (OMB 0938-0155); 
Use: In June 1978, the Robert Wood Johnson Foundation (RWJF) and Health 
Care Financing Administration (HCFA), now the Centers for Medicare and 
Medicaid Services (CMS), agreed to collaborate in demonstrations and 
evaluations of new methods of delivering and reimbursing medical 
services in order to simultaneously increase access to primary care and 
decrease total health care costs per person served. The Municipal 
Health Services Program (MHSP) is the first of these cooperative 
efforts. The chief objective of the MHSP is to assist municipalities in 
providing health care services to medically underserved areas. By 
expanding existing programs of health departments and hospitals with a 
limited increase in a municipality's health budget, services 
traditionally provided by public health programs and hospital 
outpatient departments will be brought together in a single locality.
    Participating clinics are reimbursed for all their routine costs 
based on the average cost per visit. Ancillary costs are paid according 
to 14 categories: Laboratory, x-ray, pharmacy, transportation, 
optometrist, dentist, audiologist, podiatrist, eyeglasses, dentures, 
devices, physical therapy, speech therapy, and occupational therapy. In 
order to determine the cost of the clinical services being provided, it 
is necessary to determine the direct and indirect cost incurred by the 
participating clinics for the routine and ancillary cost centers. For 
evaluation purposes, it is necessary to accurately identify the total 
visit count of the clinics for all patients and for Medicare patients. 
The MHSP CMS Form 255 cost report is the form that is being used to 
report the costs to the participating clinics of providing the covered 
services as well as to gather the data needed to properly evaluate the 
demonstration. Frequency: Recordkeeping and Reporting--Annually; 
Affected Public: Not-for-profit institutions; Number of Respondents: 
14; Total Annual Responses: 14; Total Annual Hours: 476.
    5. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Psychiatric Unit 
Criteria Worksheet and Supporting Regulations at 42 CFR 412.25 and 
412.27. Form Number: CMS-437 (OMB 0938-0358); Use: The 
psychiatric unit criteria worksheets are necessary to verify that these 
units comply and remain in compliance with the exclusion criteria for 
the Medicare prospective payment system. Frequency: Reporting--
Annually; Affected Public: Business or other for-profit, not-for-profit 
institutions, and State, Local and Tribal Government; Number of 
Respondents: 1333; Total Annual Responses: 1333; Total Annual Hours: 
333.
    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.
    To be assured consideration, comments and recommendations for the 
proposed information collections must be received at the address below, 
no later than 5 p.m. on April 24, 2007: CMS, Office of Strategic 
Operations and Regulatory Affairs, Division of Regulations 
Development--C, Attention: Bonnie L Harkless, Room C4-26-05, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: February 13, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
 [FR Doc. E7-3026 Filed 2-22-07; 8:45 am]
BILLING CODE 4120-01-P