[Federal Register Volume 81, Number 24 (Friday, February 5, 2016)]
[Notices]
[Pages 6275-6276]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-02277]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10406 and CMS-10599]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

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 (the 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 60 days for public 
comment on the proposed action. Interested persons are invited to send 
comments regarding our burden estimates 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,

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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 must be received by April 5, 2016.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number. To be assured consideration, comments and 
recommendations must be submitted in any one of the following ways:
    1. Electronically. You may send your comments electronically to 
http://www.regulations.gov. Follow the instructions for ``Comment or 
Submission'' or ``More Search Options'' to find the information 
collection document(s) that are accepting comments.
    2. By regular mail. You may mail written comments to the following 
address: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: Document Identifier/OMB 
Control Number__, Room C4-26-05, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.
    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:

Contents

    This notice sets out a summary of the use and burden associated 
with the following information collections. More detailed information 
can be found in each collection's supporting statement and associated 
materials (see ADDRESSES).

CMS-10406 Medicare Probable Fraud Measurement Pilot; CMS-10599 Medicare 
Prior Authorization of Home Health Services Demonstration

    Under the 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 requires federal agencies 
to publish a 60-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.
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare Probable 
Fraud Measurement Pilot; Use: The Centers for Medicare & Medicaid 
Services (CMS) is seeking Office of Management and Budget (OMB) 
approval of the collections required for a probable fraud measurement 
pilot. The probable fraud measurement pilot would establish a baseline 
estimate of probable fraud in payments for home health care services in 
the fee-for-service Medicare program. CMS and its agents will collect 
information from home health agencies, the referring physicians and 
Medicare beneficiaries selected in a national random sample of home 
health claims. The pilot will rely on the information collected along 
with a summary of the service history of the HHA, the referring 
provider, and the beneficiary to estimate the percentage of total 
payments that are associated with probable fraud and the percentage of 
all claims that are associated with probable fraud for Medicare fee-
for-service home health. Form Number: CMS-10406 (OMB Control Number 
0938-1192); Frequency: Annually; Affected Public: Individual and 
Private Sector (Business or other for-profits); Number of Respondents: 
6,000; Total Annual Responses: 6,000; Total Annual Hours: 7,500. (For 
policy questions regarding this collection contact Cecelia Franco at 
(786) 313-0737).
    2. Type of Information Collection Request: New Collection; Title of 
Information Collection: Medicare Prior Authorization of Home Health 
Services Demonstration; Use: Section 402(a)(1)(J) of the Social 
Security Amendments of 1967 (42 U.S.C. 1395b-1(a)(1)(J)) authorizes the 
Secretary to ``develop or 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 Act).'' In accordance with this authority, we seek to develop 
and implement a Medicare demonstration project, which we believe will 
help assist in developing improved procedures for the identification, 
investigation, and prosecution of Medicare fraud occurring among HHAs 
providing services to Medicare beneficiaries.
    This demonstration would help assure that payments for home health 
services are appropriate before the claims are paid, thereby preventing 
fraud, waste, and abuse. As part of this demonstration, we propose 
performing prior authorization before processing claims for home health 
services in: Florida, Texas, Illinois, Michigan, and Massachusetts. We 
would establish a prior authorization procedure that is similar to the 
Prior Authorization of Power Mobility Device (PMD) Demonstration, which 
was implemented by CMS in 2012. This demonstration would also follow 
and adopt prior authorization processes that currently exist in other 
health care programs such as TRICARE, certain state Medicaid programs, 
and in private insurance.
    The information required under this collection is requested by 
Medicare contractors to determine proper payment or if there is a 
suspicion of fraud. Medicare contractors will request the information 
from HHA providers submitting claims for payment from the Medicare 
program in advance to determine appropriate payment. Form Number: CMS-
10599 (OMB Control Number: 0938-NEW); Frequency: Occasionally; Affected 
Public: Private sector (Business or other for-profits and Not-for-
profits); Number of Respondents: 908,740; Number of Responses: 1; Total 
Annual Hours: 454,370. (For questions regarding this collection contact 
Carla David (410) 786-4799.)

    Dated: February 2, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2016-02277 Filed 2-4-16; 8:45 am]
 BILLING CODE 4120-01-P