[Federal Register Volume 90, Number 132 (Monday, July 14, 2025)]
[Notices]
[Pages 31207-31209]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-13042]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-P-0015A and CMS-10599]
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 September 12, 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:
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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-P-0015A Medicare Current Beneficiary Survey
CMS-10599 Pre-Claim Review Demonstration For Home Health Services
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: Revision of a currently
approved collection; Title of Information Collection: Medicare Current
Beneficiary Survey; Use: CMS is the largest single payer of health care
in the United States. The agency plays a direct or indirect role in
administering health insurance coverage for more than 150 million
people across the Medicare, Medicaid, CHIP, and Health Insurance
Marketplace populations. A critical aim for CMS is to be an effective
steward, major force, and trustworthy partner in supporting innovative
approaches to improving quality, accessibility, and affordability in
healthcare. CMS also aims to put patients first in the delivery of
their health care needs.
The Medicare Current Beneficiary Survey (MCBS) is the most
comprehensive and complete survey available on the Medicare population
and is essential in capturing information not otherwise collected
through operational or administrative data on the Medicare program. The
MCBS is a nationally-representative, longitudinal survey of Medicare
beneficiaries that is sponsored by CMS and is directed by the Office of
Enterprise Data and Analytics (OEDA). MCBS data collection is primarily
conducted by phone and is supplemented with limited video interviewing
or in-person visits. The survey captures beneficiary information
whether aged or disabled, living in the community or facility, or
serviced by managed care or fee-for-service. Data produced as part of
the MCBS are enhanced with administrative data (e.g., fee-for-service
claims, prescription drug event data, enrollment, etc.) to provide
users with more accurate and complete estimates of total health care
costs and utilization. The MCBS has been continuously fielded for more
than 30 years, encompassing over 1.2 million interviews and more than
140,000 survey participants. Respondents participate in up to 11
interviews over a four-year period. The MCBS provides a holistic view
of Medicare beneficiaries' social and medical risk factors and rich
information on the relationship between these risk factors, healthcare
utilization, and health outcomes, at a point in time and over time.
The MCBS continues to provide unique insight into the Medicare
program and helps CMS and its external stakeholders better understand
and evaluate the impact of existing programs and significant new policy
initiatives. MCBS data are used to assess potential changes to the
Medicare program. For example, MCBS data were instrumental in
supporting the initial implementation of the Medicare prescription drug
benefit and continue providing a means to evaluate prescription drug
costs and out-of-pocket burden for these drugs to Medicare
beneficiaries. Beginning in Fall 2026, this proposed revision to the
clearance will remove questionnaire items that are no longer relevant
for administration. The revisions will result in a net decrease in
respondent burden. Form Number: CMS-P-0015A (OMB control number 0938-
0568); Frequency: Occasionally; Affected Public: Business or other for-
profits and Not-for-profits Institutions; Number of Respondents:
13,568; Number of Responses: 35,015; Total Annual Hours: 32,132. (For
questions regarding this collection, contact William Long at 410-786-
7927).
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Review Choice
Demonstration for Home Health Services; 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).'' Pursuant to this authority, the CMS seeks to
develop and implement a Medicare demonstration project, which CMS
believes will help assist in developing improved procedures for the
identification, investigation, and prosecution of Medicare fraud
occurring among Home Health Agencies (HHA) providing services to
Medicare beneficiaries.
This revised demonstration helps assist in developing improved
procedures for the identification, investigation, and prosecution of
potential Medicare fraud. The demonstration helps make sure that
payments for home health services are appropriate through either pre-
claim or post payment review, thereby working towards the prevention
and identification of potential fraud, waste, and abuse; the protection
of Medicare Trust Funds from improper payments; and the reduction of
Medicare appeals. CMS has implemented the demonstration in Illinois,
Ohio, North Carolina, Florida, and Texas with the option to expand to
other states in the Palmetto/JM jurisdiction. Under this demonstration,
CMS offers choices for providers to demonstrate their compliance with
CMS' home health policies. Providers in the demonstration states may
participate in either 100 percent pre-claim review or 100 percent post
payment review. These providers will continue to be subject to a review
method until the HHA reaches the target affirmation or claim approval
rate. Once an HHA reaches the target pre-claim review affirmation or
post-payment review claim approval rate, it may choose to be relieved
from claim reviews, except for a spot check of their claims to ensure
continued compliance. Providers who do not wish to participate in
either 100 percent pre-claim or post payment reviews have the option to
furnish home health services and submit the associated claim for
payment without undergoing such reviews; however, they will receive a
25 percent payment reduction on all claims submitted for home health
services and may be eligible for review by the Recovery Audit
Contractors.
The information required under this collection is required by
Medicare contractors to determine proper payment or if there is a
suspicion of fraud. Under the pre-claim review option, the HHA sends
the pre-claim review request along with all required documentation to
the Medicare contractor for review prior to submitting the final claim
for payment. If a claim
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is submitted without a pre-claim review decision on one file, the
Medicare contractor will request the information from the HHA to
determine if payment is appropriate. For the post payment review
option, the Medicare contractor will also request the information from
the HHA provider who submitted the claim for payment from the Medicare
program to determine if payment was appropriate. Form Number: CMS-10599
(OMB control number: 0938-1311); Frequency: Frequently, until the HHA
reaches the target affirmation or claim approval threshold and then
occasionally; Affected Public: Private Sector (Business or other for-
profits and Not-for-profits); Number of Respondents: 4,700; Number of
Responses: 3,173,016; Total Annual Hours: 1,600,608. (For questions
regarding this collection contact Jennifer McMullen (410)786-7635.)
William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts,
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2025-13042 Filed 7-11-25; 8:45 am]
BILLING CODE 4120-01-P