[Federal Register Volume 79, Number 249 (Tuesday, December 30, 2014)]
[Notices]
[Pages 78438-78439]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-30468]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10421]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

ACTION: Notice.

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SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is 
announcing an opportunity for the public to comment on CMS' intention 
to collect information from the public. Under the Paperwork Reduction 
Act of 1995 (PRA), federal agencies are required to publish notice in 
the Federal Register concerning each proposed collection of 
information, including each proposed extension or reinstatement of an 
existing collection of information, and to allow a second opportunity 
for public comment on the notice. Interested persons are invited to 
send comments regarding the 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.

DATES: Comments on the collection(s) of information must be received by 
the OMB desk officer by January 29, 2015.

ADDRESSES: When commenting on the proposed information collections, 
please reference the document identifier or OMB control number. To be 
assured consideration, comments and recommendations must be received by 
the OMB desk officer via one of the following transmissions:
    OMB, Office of Information and Regulatory Affairs, Attention: CMS 
Desk Officer, Fax Number: (202) 395-5806 or Email: 
[email protected].
    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, you may make 
your request using one of following:
    1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to [email protected].
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. The term ``collection of 
information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and 
includes agency requests or requirements that members of the public 
submit reports, keep records, or provide information to a third party. 
Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires 
federal agencies to publish a 30-day notice in the Federal Register 
concerning each proposed collection of information, including each 
proposed extension or reinstatement of an existing collection of 
information, before submitting the collection to OMB for approval. To 
comply with this requirement, CMS is publishing this notice that 
summarizes the following proposed collection(s) of information for 
public comment:
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Fee-for-Service 
Recovery Audit Prepayment Review Demonstration and Prior Authorization 
Demonstration; Use: On July 23, 2012, the Office of Management and 
Budget approved the collections required for two demonstrations of 
prepayment review and prior authorization. The first demonstration 
allows Medicare Recovery Auditors to review claims on a pre-payment 
basis in certain States. The second demonstration established a prior 
authorization program for Power Mobility Device claims in certain 
States.
    For the Recovery Audit Prepayment Review Demonstration, CMS and its 
agents 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, we are piloting prior authorization for PMDs. 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, Texas, Pennsylvania, Ohio, Louisiana, Missouri, 
Maryland, New Jersey, Indiana, Kentucky, Georgia, Tennessee, 
Washington, and Arizona based on beneficiary address as reported to the 
Social Security Administration and recorded in the Common Working File 
(CWF). For the demonstration, a prior

[[Page 78439]]

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. Form 
Number: CMS-10421 (OMB control number: 0938-1169); Frequency: 
Occasionally; Affected Public: State, Local or Tribal Governments; 
Number of Respondents: 333,750; Total Annual Responses: 333,750; Total 
Annual Hours: 170,060. (For policy questions regarding this collection 
contact Daniel Schwartz at 410-786-4197.)

    Dated: December 23, 2014.
Martique Jones,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 2014-30468 Filed 12-29-14; 8:45 am]
BILLING CODE 4120-01-P