[Federal Register Volume 72, Number 229 (Thursday, November 29, 2007)]
[Notices]
[Pages 67603-67605]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-23163]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10054, CMS-R-118 and CMS-10246]


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

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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: Extension without change 
of a currently approved collection; Title of Information Collection: 
Recognition of payment for new technology services for New Technology 
ambulatory payment classification (APC) groups under the Outpatient 
Prospective Payment System and Supporting Regulations in 42 CFR part 
419; Use: CMS needs to keep pace with emerging new technologies and 
make them accessible to Medicare beneficiaries in a timely manner. It 
is necessary that CMS continue to collect appropriate information from 
interested parties such as hospitals, medical device manufacturers, 
pharmaceutical companies and others that bring to CMS' attention 
specific services that they wish us to evaluate for New Technology APC 
payment. The information that CMS seeks to continue to collect is 
necessary to determine whether certain new services are eligible for 
payment in New Technology APCs, to determine appropriate coding and to 
set an appropriate payment rate for the new technology service. The 
intent of these provisions is to ensure timely beneficiary access to 
new and appropriate technologies. Interested parties such as hospitals, 
device manufacturers, pharmaceutical companies, and physicians use this 
information to apply for New Technology APC payments for certain 
services covered in the Outpatient Prospective Payment System. Form 
Numbers: CMS-10054 (OMB : 0938-0860); Frequency: Reporting--
Once; Affected Public: Business or other for-profits; Number of 
Respondents: 15; Total Annual Responses: 15; Total Annual Hours: 180.
    2. Type of Information Collection Request: Reinstatement without 
change of a previously approved collection; Title of Information 
Collection: Quality Improvement (formerly Peer Review) Organization 
Contracts: Solicitation of Statements of Interest from In-State 
Organizations, General Notice and Supporting Regulations in 42 CFR, 
475.102, 475.103, 475.104, 475.105, 475.106; Use: The criteria that an 
organization must satisfy in order to be eligible for a Medicare 
Quality Improvement Organization (QIO) contract are specified by law 
and set forth in sections 1152 and 1153 of the Social Security Act (the 
Act). In very basic terms, the applicant organization must demonstrate 
that it is either a physician-sponsored or physician-access 
organization. The qualifications for in-State status for an otherwise 
qualified QIO organization are also set forth in section 1153(i)(3) of 
the Act.
    To comply with section 1153 of the Act, we must publish the 
solicitation of statements of interest from qualified in-State 
organizations no later than January 31, 2008. We wish to publish notice 
of contract expiration dates and the time periods during which 
interested, qualified organizations may submit statements of interest 
and proposals for these contracts substantially sooner than the January 
2008 deadline, in order to give maximal notice and opportunity to all 
qualified and potentially interested organizations. We are soliciting 
information in the form of responses to our request for statements of 
interest from qualified in-State organizations who may wish to compete 
for the QIO contracts for their respective States. The responses should 
contain an indication of interest and information demonstrating the 
interested organizations' eligibility to qualify as a QIO under the 
requirements of sections 1152 and 1153 of the Act. Form Number: CMS-R-
118 (OMB : 0938-0526); Frequency: Reporting--On occasion; 
Affected Public: Business or other for-profit; Number of Respondents: 
53; Total Annual Responses: 53; Total Annual Hours: 1.
    3. Type of Information Collection Request: New collection; Title of 
Information Collection: Cost and Resource Utilization (CRU) Data 
Collection for the Medicare Post Acute Care Payment Reform 
Demonstration; Use: The CRU data collection is part of the Post-Acute 
Care Payment Reform Demonstration mandated by Section 5008 of the 
Deficit Reduction Act of 2005. This demonstration is intended to 
address problems with the current Medicare payment systems for post-
acute care services, including those for Long Term Care Hospitals, 
Inpatient Rehabilitation Facilities, Skilled Nursing Facilities, and 
Home Health Agencies. Each of these four types of providers currently 
has a separate prospective payment system (PPS) with its own case-mix 
groups, payment units, and rates. Each case-mix grouper uses a unique 
set of items to measure patients, making it difficult to compare 
severity, costs, and outcomes across settings. These four provider 
types form a continuum of care where patients may overlap in terms of 
the conditions being treated, but they primarily differ in terms of the 
severity of the patients' medical or functional impairments. The 
current payment methods are designed as silos that do not recognize the 
potential overlap in case mix or the complimentary nature of the 
services across an episode, nor does it allow for standardized measures 
of costs across settings since each PPS was developed independently 
using different measurement systems and underlying assumptions.
    The Post-Acute Care Payment Reform Demonstration will examine the 
relative costliness and outcomes of post acute cases admitted to 
different settings for similar conditions. The work will differ from 
past attempts in this area because it will use a standardized case mix 
tool for measuring patient severity and a standardized resource data 
collection tool in all four post acute settings. Specifically, the 
legislation requires that CMS provide information on both the fixed and 
variables costs for each individual treated in post acute care 
settings.
    The CRU data collection instruments are designed to collect a 
provider's routine costs to specific patients because in general, 
nurses' and many other direct care providers' time spent on behalf of 
specific patients and on activities not patient-specific, is not 
reported. In addition, charges for therapist services reported on 
claims may not sufficiently measure true relative differences in 
therapy resource costs among patients. The data will be used, along 
with Medicare claims and cost report data, to examine substitution 
issues: how do costs and outcomes differ for post acute care patients 
with similar case mix acuity when treated in one of the various 
settings. The results will be used to provide CMS and the Congress 
information on setting-neutral payment models, revisions to single 
setting payment systems, current discharge placement patterns, and 
patient outcomes across settings.
    Since the August 24, 2007, Federal Register notice (72 FR 48645), 
we have made minor changes to the CRU instrument in response to public 
comments and internal review. The changes are primarily wording changes 
and direction clarifications. These changes are not expected to impact 
the data collection burden. Form Number: CMS-10246 (OMB : 
0938-New); Frequency: Reporting and Recordkeeping; Affected Public: 
Private Sector--Business or other for-profits and not-for-profit 
institutions; Number of Respondents: 138; Total Annual Responses: 
61,589; Total Annual Hours: 28,783.
    To obtain copies of the supporting statement and any related forms 
for the

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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 by the OMB desk 
officer at the address below, no later than 5 p.m. on December 31, 
2007.
    OMB Human Resources and Housing Branch, Attention: Carolyn Lovett, 
New Executive Office Building, Room 10235, Washington, DC 20503, Fax 
Number: (202) 395-6974.

    Dated: November 21, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
 [FR Doc. E7-23163 Filed 11-28-07; 8:45 am]
BILLING CODE 4120-01-P