[Federal Register Volume 89, Number 168 (Thursday, August 29, 2024)]
[Notices]
[Pages 70191-70192]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-19404]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-18F5 and CMS-287-22]


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

AGENCY: Centers for Medicare & Medicaid Services, Health and Human 
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 (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 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 on the collection(s) of information must be received by 
the OMB desk officer by September 30, 2024.

ADDRESSES: Written comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function.

[[Page 70192]]

    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, please access 
the CMS PRA website by copying and pasting the following web address 
into your web browser: https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.

FOR FURTHER INFORMATION CONTACT: William Parham at (410) 786-4669.

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: Reinstatement with 
change of a currently approved collection; Title of Information 
Collection: Application for Enrollment in Medicare Part A internet 
Claim (iClaim) Application Screen Modernized Claims System and 
Consolidated Claim Experience Screens; Use: The Centers for Medicare 
and Medicaid Services (CMS) Form ``Application for Hospital Insurance'' 
supports sections 1818 and 1818A of the Social Security Act (the Act) 
and corresponding regulations at 42 CFR 406.6 and 406.7.
    The CMS-18-F5 is used to establish entitlement to Part A and 
enrollment in Part B for claimants who must file an application. The 
application follows the questions and requirements used by SSA on the 
electronic application. This is done not only for consistency purposes 
but because certain requirements under titles II and XVIII of the act 
must be met in order to qualify for Part A and Part B; including 
insured status, relationship and residency. The form is owned by CMS 
but is not utilized by CMS staff. SSA uses the form to collect 
information and make Part A and Part B entitlement determinations on 
behalf of CMS. Form Number: CMS-18F5 (OMB control number: 0938-0251); 
Frequency: Once; Affected Public: Individuals and Households; Number of 
Respondents: 1,042,263; Total Annual Responses: 1,042,263; Total Annual 
Hours: 260,566. (For policy questions regarding this collection contact 
Carla Patterson at 410-786-8911 or [email protected]).
    2. Type of Information Collection Request: Extension without change 
of a previously approved collection; Title of Information Collection: 
Home Office Cost Statement; Use: A home office/chain organization (HO/
CO) submits the home office cost statement annually as the documentary 
support required for a provider that is a member of the HO/CO to be 
reimbursed for HO/CO costs claimed in the provider's cost report (see 
42 CFR 413.24(f)(5)(i)(E)(1) and (2)).
    The relationship of the HO/CO is that of a related organization to 
a provider (see 42 CFR 413.17). A HO/CO usually furnishes central 
management and administrative services, e.g., centralized accounting, 
purchasing, personnel services, management direction and control, and 
other services. To the extent that the HO/CO furnishes services related 
to patient care to a provider, the reasonable costs of such services 
are included in the provider's cost report and are reimbursable as part 
of the provider's costs.
    CMS requires the form to determine a HO/CO's reasonable cost 
incurred in furnishing management and administrative services to 
Medicare providers, each of which includes the costs in their cost 
report for reimbursement. A Medicare-certified provider includes costs 
allocated from the home office cost statement in the provider's costs 
used by CMS for rate setting; payment refinement activities, including 
developing a market basket; and Medicare Trust Fund projections; and to 
support program operations. Additionally, the Medicare Payment Advisory 
Commission (MedPAC) uses the cost report data to calculate Medicare 
margins (a measure of the relationship between Medicare's payments and 
providers' Medicare costs) and analyze data to formulate Medicare 
Program recommendations to Congress. Form Number: CMS-287-22 (OMB 
control number: 0938-0202); Frequency: Yearly; Affected Public: Private 
Sector; Business or other for-profits, Not-for-profit institutions; 
Number of Respondents: 1,646; Total Annual Responses: 1,646; Total 
Annual Hours: 767,036. (For policy questions regarding this collection 
contact Gail S. Duncan at (410) 786-7278.)

William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts, 
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2024-19404 Filed 8-28-24; 8:45 am]
BILLING CODE 4120-01-P