[Federal Register Volume 90, Number 111 (Wednesday, June 11, 2025)]
[Notices]
[Pages 24630-24631]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-10534]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-10775, CMS-10417 and CMS-10524]
Agency Information Collection Activities: Proposed Collection;
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 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 August 11, 2025.
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, 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 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-10775 The Medicare Severity Diagnosis Related Groups
Reclassification Request
CMS-10417 Medicare Fee-for-Service Prepayment Review of Medical Records
CMS-10524 Medicare Program: Prior Authorization Process for Certain
Durable Medical Equipment, Prosthetics, Orthotics and Supplies
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 Collections
1. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare Severity
Diagnosis Related Groups Reclassification Request (MS-DRGs); Use:
Section 1886(d)(4) of the Act establishes a classification system,
referred to as DRGs, for inpatient discharges and adjusts payments
under the IPPS based on appropriate weighting factors assigned to each
MS-DRG. Section 1886(d)(4)(C)(i) of the Act
[[Page 24631]]
specifies adjustments to the classification and weighting factors shall
occur ``at least annually to reflect changes in treatment patterns,
technology, and other factors which may change the relative use of
hospital resources.''
The requests are evaluated in the Division of Coding and DRGs
(DCDRG) by the DRG and Coding Team and the clinical advisors (medical
officers) in both the Technology, Coding and Pricing Group (TCPG) and
the Hospital and Ambulatory Policy Group (HAPG), along with the CMS
contractor(s). This team participates via conference calls in the
review of MedPAR claims data to analyze and perform clinical review of
the requested changes. Based on the examination of claims data and
clinical judgment, the team provides recommendations to CMS and HHS
leadership for proposed changes. Per the statue, proposed MS-DRG
changes and payment adjustments must go through notice and comment
rulemaking giving the opportunity for the public to comment. Finalized
MS-DRG changes are effective with discharges on and after October 1,
consistent with the beginning of the fiscal year. CMS makes the updated
MS-DRG Grouper software and related materials that reflects the changes
available to the public for free via download at: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software.
When an application is submitted in MEARIS\TM\, the DRG and Coding
Team in DCDRG will have instant access to the application request and
accompanying materials to facilitate a more-timely review of the
request, including the ability to efficiently inform other team members
involved in the process that information is available for their review
and input. Form Number: CMS-10775 (OMB control number 0938-1431);
Frequency: Occasionally; Affected Public: Private Sector, Business or
other for-profits, Not-for-profits institutions; Number of Respondents:
50; Total Annual Responses: 50; Total Annual Hours: 48,000. (For policy
questions regarding this collection contact Marilu Hue at 410-786-
4510.)
2. Type of Information Collection Request: Extension of a currently
approved collection: Title of Information Collection: Medicare Fee-for-
Service Prepayment Review of Medical Records; Use: The Medical Review
program is designed to prevent improper payments in the Medicare FFS
program. Whenever possible, Medicare Administrative Contractors (MACs)
are encouraged to automate this process; however, it may require the
evaluation of medical records and related documents to determine
whether Medicare claims are billed in compliance with coverage, coding,
payment, and billing policies. Addressing improper payments in the
Medicare fee-for-service (FFS) program and promoting compliance with
Medicare coverage and coding rules is a top priority for the CMS.
Preventing Medicare improper payments requires the active involvement
of every component of CMS and effective coordination with its partners
including various Medicare contractors and providers. 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 request the information from providers/suppliers submitting
claims for payment when data analysis indicates aberrant billing
patterns or other information which may present a vulnerability to the
Medicare program. Form Number: CMS-10417 (OMB control number: 0938-
0969); Frequency: Occasionally; Affected Public: Private Sector, State,
Business, and Not-for Profits; Number of Respondents: 489,871; Number
of Responses: 489,871; Total Annual Hours: 244,936. (For questions
regarding this collection, contact Olufemi Shodeke at 410-786-1649.)
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Medicare Program;
Prior Authorization Process for Certain Durable Medical Equipment,
Prosthetic, Orthotics, and Supplies (DMEPOS); Use: Section 1834(a)(15)
of the Social Security Act (the Act) authorizes the Secretary to
develop and periodically update a list of DMEPOS that the Secretary
determines, on the basis of prior payment experience, are frequently
subject to unnecessary utilization and to develop a prior authorization
process for these items. Pursuant to this authority, CMS published
final rules CMS-6050-F and CMS-1713-F.
The information required under this collection is used to determine
proper payment and coverage for DMEPOS items. The information requested
includes all documents and information that demonstrate the DMEPOS item
requested is reasonable and necessary for the beneficiary and meets
applicable Medicare requirements. The documentation will be reviewed by
trained registered nurses, therapists, or physician reviewers to
determine if item(s) or service requested meets all applicable Medicare
coverage, coding and payment rules. Form Number: CMS-10524 (OMB control
number: 0938-1293); Frequency: Occasionally; Affected Public: Private
Sector (Business or other for-profits, Not-for-Profit Institutions);
Number of Respondents: ; Total Annual Responses: 190,344; Total Annual
Hours: 95,172. (For policy questions regarding this collection contact
Emily Calvert at (410) 786-4277.)
William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts,
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2025-10534 Filed 6-10-25; 8:45 am]
BILLING CODE 4120-01-P