[Federal Register Volume 71, Number 170 (Friday, September 1, 2006)]
[Notices]
[Pages 52079-52080]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-7291]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-143, CMS-R-247, CMS-10199, and CMS-10184]


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 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: Extension of a currently 
approved collection.
    Title of Information Collection: Medicare Physician Fee Schedule 
Geographic Practice Expense Index (GPCI).
    Use: This information collection is a survey of State insurance 
commissioners and malpractice insurers to acquire premium data for use 
in computing the malpractice component of the geographic practice cost 
index, a component of the geographic cost index as set forth in the 
Omnibus Reconciliation Act of 1989. The data collected in this 
information collection request will be used by CMS staff and outside 
contractors to update the Medicare physician fee schedule geographic 
practice expense index (MGPCI), the malpractice relative value units 
(MRVUs), and to supplement the updating of the malpractice component of 
the Medicare Economic Index (MEI). The MGPCI is one of the components 
of the GPCI, the others being physician work (net income), employee 
wages, office rents, medical equipment and supplies, and miscellaneous 
expenses. The MRVUs are one of the three components of the fee 
schedule, the others being physician work RVUs and practice expense 
RVUs. The GPCIs and fee schedule RVUs also used by other Federal 
agencies such as the Veteran's Administration and the Department of 
Labor. Form Number: CMS-R-143 (OMB<greek-i>: 0938-0575).
    Frequency: Reporting--Every three years.
    Affected Public: State, Local or Tribal governments, Business or 
other for-profit and Not-for-profit institutions.
    Number of Respondents: 150.
    Total Annual Responses: 50.
    Total Annual Hours: 150.
    2. Type of Information Collection Request: Extension of a currently 
approved collection.
    Title of Information Collection: Expanded Coverage for Diabetes 
Outpatient Self-Management Training Services and Supporting Regulations 
Contained in 42 CFR 410.141, 410.142, 410.143, 410.144, 410.145, 
410.146, 414.63.
    Use: According to the National Health and Nutrition Examination 
Survey (NHANES), as many as 18.7 percent of Americans over age 65 are 
at risk for developing diabetes. The goals in the management of 
diabetes are to achieve normal metabolic control and reduce the risk of 
micro- and macro-vascular complications. Numerous epidemiologic and 
interventional studies point to the necessity of maintaining good 
glycemic control to reduce the risk of the complications of diabetes. 
In expanding the Medicare program to include diabetes outpatient self-
management training services, the Congress intended to empower Medicare 
beneficiaries with diabetes to better manage and control their 
conditions. The Conference Report indicates that the conferees believed 
that ``this provision will provide significant Medicare savings over 
time due to reduced hospitalizations and complications arising from 
diabetes.'' (H.R. Conf. Rep. No. 105-217, at 701 (1997)).
    Form Number: CMS-R-247 (OMB<greek-i>: 0938-818).
    Frequency: Recordkeeping and Reporting--On occasion.
    Affected Public: Business or other for-profit institutions.
    Number of Respondents: 2008.
    Total Annual Responses: 8,032; Total Annual Hours: 88,519.
    3. Type of Information Collection Request: New collection.
    Title of Information Collection: Data Collection for Medicare 
Facilities Performing Carotid Artery Stenting with Embolic Protection 
in Patients at High Risk for Carotid Endarterectomy.
    Use: CMS provides coverage for carotid artery stenting (CAS) with 
embolic protection for patients at high risk for carotid endarterectomy 
and who also have symptomatic carotid artery stenosis between 50% and 
70% or have asymptomatic carotid artery stenosis >= 80% in accordance 
with the Category B IDE clinical trials regulation (42 CFR 405.201), a 
trial under the CMS Clinical Trial Policy (NCD Manual Sec.  310.1, or 
in accordance with the National Coverage Determination on CAS post 
approval studies (Medicare NCD Manual 20.7). Accordingly, CMS considers 
coverage for CAS reasonable and necessary {section 1862 (A)(1)(a) of 
the Social Security Act{time} . However, evidence for use of CAS with 
embolic protection for patients at high risk for carotid endarterectomy 
and who also have symptomatic carotid artery stenosis >= 70% who are 
not enrolled in a study or trial is less compelling. To encourage 
responsible and appropriate use of CAS with embolic protection, CMS 
issued a Decision Memo for Carotid Artery Stenting on March 17, 2005, 
indicating that CAS with embolic protection for patients at high risk 
for carotid endarterectomy and who also have symptomatic carotid artery 
stenosis >= 70% will be covered only if performed in facilities that 
have been determined to be competent. In accordance with this criteria 
CMS considers coverage for CAS reasonable and necessary (section 
1862(A)(1)(a) of the Social Security Act).
    Form Number: CMS-10199 (OMB<greek-i>: 0938-NEW).
    Frequency: Reporting--On.
    Affected Public: Business or other for-profit, Not-for-profit 
institutions.
    Number of Respondents: 1,000.
    Total Annual Responses: 1,000.
    Total Annual Hours: 500.
    4. Type of Information Collection Request: New collection.
    Title of Information Collection: Payment Error Rate Measurement 
(PERM) of Eligibility in Medicaid and the State Children's Health 
Insurance Program (SCHIP).
    Use: The Improper Payments Information Act (IPIA) of 2002 requires 
CMS to produce national error rates for Medicaid and the State 
Children's Health Insurance Program (SCHIP). To comply with the IPIA, 
CMS will use a national contracting strategy in part to

[[Page 52080]]

produce error rates for Medicaid and SCHIP fee-for-service and managed 
care improper payments. The Federal contractor will review states on a 
rotational basis so that each state will be measured for improper 
payments, in each program, once and only once every three years.
    Subsequent to the first publication, we determined that we will 
measure Medicaid and SCHIP in the same State. Therefore, states will 
measure Medicaid and SCHIP eligibility in the same year measured for 
fee-for-service and managed care. We believe this approach will 
advantage States through economies of scale (e.g. administrative ease 
and shared staffing for both programs reviews). We also determined that 
interim case completion timeframes and reporting are critical to the 
integrity of the reviews and to keep the reviews on schedule to produce 
a timely error rate. An additional revision is that the sample sizes 
were increased slightly in order to produce an equal sample size per 
strata each month. Finally, this information collection request does, 
to a certain extent, duplicate Medicaid eligibility reviews under the 
Medicaid Eligibility Quality Control (MEQC) as required by section 
1903(u) of the Social Security Act (of the Act) and we proposed this 
option in the first publication of this information request.
    However, CMS has not finalized its analysis of the associated legal 
and policy matters regarding the option to use the payment error rate 
measurement (PERM) reviews to satisfy MEQC statutory and regulatory 
requirements. We are concerned that using the PERM eligibility reviews 
to satisfy requirements for the MEQC program under 1903(u) of the Act 
would necessarily require that the data derived from the reviews be 
used to determine potential disallowances of Federal funds under the 
MEQC program. Therefore, we are still considering whether or not to 
make this option available to States. We expect to make a final 
decision before the start of the eligibility reviews in FY 2007. 
However, in response to State resource concerns, CMS will provide 
States the option to contract out the PERM eligibility reviews to 
entities not actively involved in the state's eligibility determination 
and enrollment activities. The supporting statement reflects those 
changes.
    As outlined in the October 5, 2005, interim final rule (70 FR 
58260), CMS convened an eligibility workgroup comprised of the 
Department of Health and Human Services, the Office of Management and 
Budget (OMB) and representatives from two states. The Office of 
Inspector General (OIG) participated in an advisory capacity. The 
workgroup was charged to make recommendations for measuring Medicaid 
and SCHIP improper payments based on eligibility errors within the 
confines of current statute, with minimal impact on States' resources 
and considering public comments on the August 27, 2004, proposed rule 
and the October 5, 2005, interim final rule. Based on the eligibility 
workgroup's recommendations and public comments, we developed an 
eligibility review methodology that we expect will provide consistency 
in the reviews of active (i.e., beneficiaries receiving Medicaid or 
SCHIP) and negative cases (i.e., beneficiaries whose benefits were 
denied or terminated) as well as achieve the confidence and precision 
requirements at the national level required by the IPIA.
    Form Number: CMS-10184 (OMB<greek-i>: 0938-NEW).
    Frequency: Reporting--On occasion and Monthly.
    Affected Public: Business or other for-profit, Not-for-profit 
institutions.
    Number of Respondents: 34.
    Total Annual Responses: 1,326.
    Total Annual Hours: 535,670.
    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 
e-mail your request, including your address, phone number, OMB number, 
and CMS document identifier, to <a href="/cdn-cgi/l/email-protection#d282b3a2b7a0a5bda0b992b1bfa1fcbabaa1fcb5bda4"><span class="__cf_email__" data-cfemail="92c2f3e2f7e0e5fde0f9d2f1ffe1bcfafae1bcf5fde4">[email protected]</span></a>, or call the 
Reports Clearance Office on (410) 786-1326.
    Written comments and recommendations for the proposed information 
collections must be mailed or faxed within 30 days of this notice 
directly to the OMB desk officer: OMB Human Resources and Housing 
Branch, Attention: Carolyn Lovett, New Executive Office Building, Room 
10235, Washington, DC 20503. Fax Number: (202) 395-6974.

    Dated: August 25, 2006.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 06-7291 Filed 8-31-06; 8:45 am]
BILLING CODE 4120-01-P


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