[Federal Register Volume 77, Number 103 (Tuesday, May 29, 2012)]
[Notices]
[Pages 31616-31618]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-12811]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS-10426, CMS-10421 and CMS-10415]


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

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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: End Stage Renal Disease (ESRD) System Access 
Request Form; Use: Within CMS, the Office of Clinical Standards and 
Quality is developing a new suite of systems to support the End Stage 
Renal Disease (ESRD) program. Due to the sensitivity of the data being 
collected and reported, CMS must ensure that only authorized personnel 
have access to data. Personnel are given access to the ESRD systems 
through the creation of user IDs and passwords within the QualityNet 
Identity Management System (QIMS); however, once within the system, the 
system determines the rights and privileges the personnel has over the 
data within the system.
    The sole purpose the End Stage Renal Disease System (ESRD) System 
Access Request Form is to identify the individual's data access rights 
once within the ESRD system. This function and the associated data 
collection is currently being accomplished under ``Part B'' of the 
QualityNet Identity Management System Account Form (CMS-10267; OCN: 
0938-1050). Once the ESRD System Access Form is approved, the 
QualityNet Identity Management System (QIMS) Account Form will be 
revised to remove Part B from the QIMS data collection. Form Number: 
CMS-10426 (OCN: 0938-New); Frequency: Yearly; Affected Public: Private 
Sector--Business or other for-profits. Number of Respondents: 25,000. 
Number of Responses: 25,000. Total Annual Hours: 6,250. (For policy 
questions regarding this collection contact Michelle Tucker at 410-786-
0736. For all other issues call 410-786-1326.)
    2. Type of Information Collection Request: New collection; Title of 
Information Collection: Fee-for-Service Recovery Audit Prepayment 
Review Demonstration and Prior Authorization Demonstration; Use: The 
Centers for Medicare & Medicaid Services (CMS) is requesting the Office 
of Management and Budget (OMB) approval of the collections required for 
two demonstrations of prepayment review and prior authorization. The 
first demonstration would allow Medicare Recovery Auditors to review 
claims on a pre-payment basis in certain States. The second 
demonstration would establish a prior authorization program for Power 
Mobility Device claims in certain States.
    For the Recovery Audit Prepayment Review Demonstration, CMS and its 
agents will request additional documentation, including medical 
records, to support submitted claims. As discussed in more detail in 
Chapter 3 of the Program Integrity Manual, additional documentation 
includes any medical documentation, beyond what is included on the face 
of the claim that supports the item or service that is billed. For 
Medicare to consider coverage and payment for any item or service, the 
information submitted by the provider or supplier (e.g., claims) must 
be supported by the documentation in the patient's medical records. 
When conducting complex medical review, the contractor specifies 
documentation they require in accordance with Medicare's rules and 
policies. In addition, providers and suppliers may supply additional 
documentation not explicitly listed by the contractor. This supporting 
information may be requested by CMS and its agents on a routine basis 
in instances where diagnoses on a claim do not clearly indicate medical 
necessity, or if there is a suspicion of fraud.
    For the Prior Authorization of Power Mobility Devices (PMDs) 
Demonstration, CMS will pilot prior authorization for Power Mobility 
Devices. Prior authorization will allow the applicable documentation 
that supports a claim to be submitted before the item is delivered. For 
prior authorization, relevant documentation for review is submitted 
before the item is delivered or the service is rendered. CMS will 
conduct this demonstration in California, Florida, Illinois, Michigan, 
New York, North Carolina and Texas based on beneficiary address as 
reported to the Social Security Administration and recorded in the 
Common Working File (CWF). For the demonstration, a prior authorization 
request can be completed by the (ordering) physician or treating 
practitioner and submitted to the appropriate DME MAC for an initial 
decision. The supplier may also submit the request on behalf of the 
physician or treating practitioner. The physician, treating 
practitioner or supplier who submits the request on behalf of the 
physician or treating practitioner, is referred to as the 
``submitter.'' Under this demonstration, the submitter will submit to 
the DME MAC a request for prior authorization and all relevant 
documentation to support Medicare coverage of the PMD item.
    CMS has decided to amend the requirement when subsequent prior 
authorization requests are submitted. Currently, CMS or its agents have 
up to 30 business days in which to conduct a review and communicate a 
decision. CMS now proposes to allow up to 20 business days to provide 
suppliers and the Medicare beneficiaries' quality services within 
reasonable time period to facilitate the delivery of necessary 
equipment which enhances mobility related activities of daily living 
and supports independence.
    These demonstrations have been designed to develop and demonstrate 
improved methods for the investigation and prosecution of fraud in the 
provision of care or services under the health programs established by 
the Social Security Act. The information required under this 
information collection request is requested by Medicare contractors to 
determine proper payment or if there is a suspicion of fraud. For the 
RAC demonstration, Medicare contractors may request the information 
from providers or suppliers submitting claims for payment from the 
Medicare program when data analysis indicates aberrant billing patterns 
or other information which may present a vulnerability to the Medicare 
program. Under the prior authorization demonstration, for certain PMDs, 
with a history of aberrant billing patterns, this information is 
requested in advance to determine appropriate payment or if there is a 
suspicion of fraud. Form Number: CMS-10421 (OCN 0938--New); Frequency: 
Occasionally; Affected Public: State, Local or Tribal Governments; 
Number of Respondents: 479,750; Total Annual Responses: 479,750; Total 
Annual Hours: 243,060. (For policy questions regarding this collection 
contact Debbie Skinner at 410-786-7480. For all other issues call 410-
786-1326.)
    3. Type of Information Collection Request: New collection; Title of 
Information Collection: Generic Clearance for the Collection Customer 
Satisfaction Surveys; Use: This collection of information is necessary 
to enable the Agency to garner customer and stakeholder feedback in an 
efficient, timely manner, in accordance with our commitment to 
improving service delivery. The information collected from our 
customers and stakeholders will help ensure that users have an 
effective, efficient, and satisfying experience with the Agency's 
programs. This feedback will provide insights into customer or 
stakeholder perceptions, experiences and expectations, provide an early 
warning of issues with service, or focus attention on areas where 
communication, training or changes in operations might improve delivery 
of products or services. These collections will allow for ongoing, 
collaborative and actionable communications between the

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Agency and its customers and stakeholders. It will also allow feedback 
to contribute directly to the improvement of program management.
    Collecting voluntary customer feedback is the least burdensome, 
most effective way for the Agency to determine whether or not its 
public Web sites are useful to and used by its customers. Generic 
clearance is needed to ensure that the Agency can continuously improve 
its Web sites though regular surveys developed from these pre-defined 
questions. Surveying the Agency Web sites on a regular, ongoing basis 
will help ensure that users have an effective, efficient, and 
satisfying experience on any of the Web sites, maximizing the impact of 
the information and resulting in optimum benefit for the public. The 
surveys will ensure that this communication channel meets customer and 
partner priorities, builds the Agency's brands, and contributes to the 
Agency's health and human services impact goals. Form Number: CMS-10415 
(OCN 0938--New); Frequency: Occasionally; Affected Public: Individuals 
and Households, Business or other for-profits and Not-for-profit 
institutions, State, Local or Tribal Governments; Number of 
Respondents: 1,000,000; Total Annual Responses: 1,000,000; Total Annual 
Hours: 67,000. (For policy questions regarding this collection contact 
John Booth at 410-786-6577. For all other issues call 410-786-1326.)
    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 
Email 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 June 28, 2012. 
OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-6974, Email: [email protected].

    Dated: May 22, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-12811 Filed 5-25-12; 8:45 am]
BILLING CODE 4120-01-P