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[Federal Register Volume 78, Number 46 (Friday, March 8, 2013)]
[Notices]
[Pages 15015-15016]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-05388]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-846-849, 10125 and 10126]

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

AGENCY: Centers for Medicare & Medicaid Services, HHS.

    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid 
Services (CMS), Department of Health

[[Page 15016]]

and Human Services, is publishing the following summary of proposed 
collections for public comment. Interested persons are invited to send 
comments regarding this burden estimate 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 function; (2) the accuracy of 
the estimated burden; (3) ways to enhance the quality, 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.
    1. Type of Information Collection Request: Reinstatement without 
change of previously approved collection; Title: Durable Medical 
Equipment Medicare Administrative Contractor Certificate of Medical 
Necessity and Supporting Documentation Requirements; Use: The 
certificates of medical necessity (CMNs) collect information required 
to help determine the medical necessity of certain items. The CMS 
requires CMNs where there may be a vulnerability to the Medicare 
program. Each initial claim for these items must have an associated CMN 
for the beneficiary. Suppliers (those who bill for the items) complete 
the administrative information (e.g., patient's name and address, items 
ordered, etc.) on each CMN. The 1994 Amendments to the Social Security 
Act require that the supplier also provide a narrative description of 
the items ordered and all related accessories, their charge for each of 
these items, and the Medicare fee schedule allowance (where 
applicable). The supplier then sends the CMN to the treating physician 
or other clinicians (e.g., physician assistant, LPN, etc.) who 
completes questions pertaining to the beneficiary's medical condition 
and signs the CMN. The physician or other clinician returns the CMN to 
the supplier who has the option to maintain a copy and then submits the 
CMN (paper or electronic) to CMS, along with a claim for reimbursement. 
Form Numbers: CMS-846, 847, 848, 849, 10125, 10126 (OCN: 0938-0679); 
Frequency: Occasionally; Affected Public: Individuals or Households; 
Number of Respondents: 462,000; Total Annual Responses: 462,000; Total 
Annual Hours: 92,400. (For policy questions regarding this collection 
contact Amanda Burd at 410-786-2074. For all other issues call 410-786-
1326.)
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS' 
Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995, 
or Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to Paperwork@cms.hhs.gov, or call 
the Reports Clearance Office on (410) 786-1326.
    To be assured consideration, comments and recommendations for the 
proposed information collections must be received by the OMB desk 
officer at the address below, no later than 5 p.m. on April 8, 2013.

OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-6974, Email: OIRA_submission@omb.eop.gov.

    Dated: February 26, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2013-05388 Filed 3-7-13; 8:45 am]
BILLING CODE 4120-01-P
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