[Federal Register Volume 84, Number 209 (Tuesday, October 29, 2019)]
[Notices]
[Page 57875]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-23584]



[[Page 57875]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10708]


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 the necessity and utility of the 
proposed information collection for the proper performance of the 
agency's functions, the accuracy of the estimated burden, ways to 
enhance the quality, utility, and clarity of the information to be 
collected, and the use of automated collection techniques or other 
forms of information technology to minimize the information collection 
burden.

DATES: Comments must be received by December 30, 2019.

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' website address at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
    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: William N. Parham at (410) 786-4669.

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-10708 Proposed Repetitive, Scheduled Non-Emergent Ambulance 
Transport (RSNAT) Prior Authorization Process and Requirements for a 
Potential National Model

    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.

Information Collection

    1. Type of Information Collection Request: New collection (Request 
for a new OMB control number); Title of Information Collection: 
Proposed Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) 
Prior Authorization Process and Requirements for a Potential National 
Model; Use: CMS is pursuing approval to potentially expand the RSNAT 
Prior Authorization Model nationally if the Secretary determines that 
the expansion criteria are met. The potential national model would 
follow the same design as the current RSNAT Prior Authorization Model, 
as described in the September 16, 2019, Federal Register (84 FR 48620) 
and may be implemented in multiple phases. If such a national model 
moves forward, the information that would be required under this 
collection would be used to determine proper payment for repetitive, 
scheduled non-emergent ambulance transports. The information required 
in a prior authorization request package would include all medical 
documents and information to show that the number and level of 
transports requested are reasonable and necessary for the beneficiary 
and meet other Medicare requirements. If an ambulance supplier does not 
submit a prior authorization request by the fourth round trip in a 30-
day period, and the claim is submitted to the Medicare Administrator 
Contractor (MAC) for payment, then the claim would be stopped for 
prepayment review and medical documentation will be requested.
    Trained nurse reviewers from the MAC would review the information 
from the ambulance supplier to determine if the beneficiary meets 
Medicare's requirements for the transport and if the beneficiary needs 
the level of care requested. The MAC would also use the information to 
determine if the number of trips requested is reasonable and necessary. 
Form Number: CMS-10708 (OMB control number: 0938-NEW); Frequency: 
Occasionally; Affected Public: Private Sector (Business or other for-
profits, Not-for-profit institutions); Number of Respondents: 1,745; 
Number of Responses: 216,941; Total Annual Hours: 113,706. (For 
questions regarding this collection contact Angela Gaston at 410-786-
7409.)

    Dated: October 24, 2019.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2019-23584 Filed 10-25-19; 8:45 am]
 BILLING CODE 4120-01-P