41328 Federal Register / Vol. 72, No. 144 / Friday, July 27, 2007 / Notices 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–R–249, CMS–

10238, CMS–102, 105, CMS–10243 and 

CMS–10244] 

Agency Information Collection 

Activities: Proposed Collection; 

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) 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 functions; 

(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: Hospice Cost 

and Data Report and supporting 

regulations 42 CFR 413.20 and 42 CFR 

413.24; Use: In accordance with sections 

1815(a), 1833(e), 1861(v)(A)(ii) and 

1881(b)(2)(B) of the Social Security Act, 

providers of services in the Medicare 

program are required to submit annual 

information to receive reimbursement 

for health care services provided to 

Medicare beneficiaries. In addition, 42 

CFR 413.20(b) requires that cost reports 

be filed with the provider’s fiscal 

intermediary/Medicare Administrative 

Contractor (FI/MAC). The functions of 

the FI/MAC are described in section 

1816 of the Social Security Act. The 

Center for Medicare and Medicaid 

Services will use the information from 

providers for rate evaluations for the 

Prospective Payment System. Form 

Number: CMS–R–249 (OMB#: 0938–

0758); Frequency: Reporting: Yearly; 

Affected Public: Business or other forprofit; Number of Respondents: 1938; 

Total Annual Responses: 1938; Total 

Annual Hours: 341,088. 

2. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Testing of 

Revised OASIS Instrument for Home 

Health Quality Measures & Data 

Analysis; Use: Medicare-certified home 

health agencies (HHAs) must meet the 

Conditions of Participation (COPs) as set 

forth at 42 CFR part 484 and 488. Since 

1999, the COPs have mandated that 

HHAs use the ‘‘Outcome and 

Assessment Information Set’’ (OASIS) 

data set when evaluating adult, nonmaternity patients receiving skilled 

services. The OASIS is a patientspecific, comprehensive assessment that 

identifies each patient’s need for home 

care and that meets the patient’s 

medical, nursing, rehabilitative, social 

and discharge planning needs. 

Since OASIS data collection was 

mandated in 1999, CMS has been 

systematically collecting input on ways 

to improve the OASIS instrument and 

reduce the burden of the collection 

effort. In 2002, CMS introduced the 

‘‘reduced-burden’’ OASIS that was a 

product of the Secretary’s Regulatory 

Reform Advisory Committee to help 

guide HHS’ broader efforts to streamline 

unnecessarily burdensome or inefficient 

regulations that interfere with the 

quality of health care. Since the 2002 

revision, CMS has continued to solicit 

input on potential refinements and 

enhancements of the OASIS instrument 

from HHAs, industry associations, 

consumer representatives, researchers 

and other stakeholders. 

Abt Associates and their 

subcontractor UCHSC were awarded a 

contract by CMS in September 2006 to 

continue the process of refining the 

OASIS data set, as well as for the testing 

of the instrument and analysis of the 

impact of proposed changes. Under this 

contract, researchers from Abt 

Associates, University of Colorado 

Health Sciences Center (UCHSC), and 

Case Western Reserve University have 

assisted CMS in carrying out the 

revisions based on the input described 

in the previous section. Changes to the 

OASIS instrument include the following 

removal and revision of items: 

• Elimination of 7 original OASIS 

items not required for payment, quality 

or risk adjustment; 

• Replacement of 44 original OASIS 

items with items that are revised and/ 

or simplified to respond to industry 

concerns by increasing clarity and userfriendliness, and/or reducing 

complexity and burden (e.g., removal of 

‘‘prior status’’ assessment for all 

Activity of Daily Living (ADL) and 

Instrumental Activity of Daily Living 

(IADL) items). 

The revised OASIS also includes the 

addition of the following process items 

to support evidence-based practices: 

• A total of 7 process items to be 

collected only at Start of Care/ 

Resumption of Care, 4 of which are to 

be asked seasonally (e.g.; flu vaccine); 

• A total of 10 process items to be 

collected only at Follow-up, Transfer or 

Discharge, either seasonally or on a 

small subpopulation; 

• A total of 13 process items to be 

collected at all OASIS time points, 6 of 

which are to be collected on a small 

subpopulation. 

We estimate the elimination, 

simplification and revision of existing 

OASIS items will have a burden impact 

equivalent to the complete elimination 

of 19 items. Since many of the process 

items will be collected only on small 

subpopulations or during specific 

months of the year, we estimate the 

impact of the addition of these items on 

burden to be equivalent to the addition 

of 20 items. Therefore, total impact of 

proposed OASIS revisions, including 

the elimination, revision and addition of 

items, changes the estimated burden of 

the OASIS very little while 

incorporating process measures needed 

to support evidence-based practices 

across the post-acute care spectrum. 

Form Number: CMS–10238 (OMB#: 

0938–NEW); Frequency: Reporting: Onetime; Affected Public: Private Sector—

Business or other for-profit and Not-forprofit institutions; Number of 

Respondents: 11; Total Annual 

Responses: 11; Total Annual Hours: 

173.58. 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Clinical 

Laboratory Improvement Amendment 

(CLIA) Budget Workload Reports and 

Supporting Regulations Contained in 42 

CFR 493.1–.2001; Use: Information 

collected will be used by CMS in 

determining the amount of Federal 

Reimbursement for compliance surveys. 

Use of the information includes program 

evaluation, audit, budget formulation 

and budget approval; Form Number: 

CMS–102, 105 (OMB#: 0938–0599); 

Frequency: Reporting: Quarterly; 

Affected Public: State, Local or Tribal 

Governments; Number of Respondents: 

50; Total Annual Responses: 550; Total 

Annual Hours: 4,500. 

4. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Data Collection 

for Administering the Medicare 

Continuity Assessment Record and 

Evaluation (CARE) Instrument; Use: The 

Medicare Continuity Assessment Record 

and Evaluation (CARE) is a uniform 


jlentini on PROD1PC65 with NOTICES
Federal Register / Vol. 72, No. 144 / Friday, July 27, 2007 / Notices 41329 

patient assessment instrument designed 

to measure differences in patient 

severity, resource utilization, and 

outcomes for patients in acute and postacute care settings. This tool will be 

used to (1) Standardize program 

information on Medicare beneficiaries’

acuity at discharge from acute hospitals, 

(2) document medical severity, 

functional status and other factors 

related to outcomes and resource 

utilization at admission, discharge, and 

interim times during post acute 

treatment, and (3) understand the 

relationship between severity of illness, 

functional status, social support factors, 

and resource utilization. The CARE 

instrument will be used in the PostAcute Care (PAC) Payment Reform 

Demonstration program mandated by 

Section 5008 of the Deficit Reduction 

Act of 2005 to develop payment groups 

that reflect patient severity and related 

cost and resource use across post acute 

settings. Specifically, the data collected 

using the CARE instrument during the 

Post-Acute Care Payment Demonstration 

will be used by CMS to develop a 

setting neutral post-acute care payment 

model as mandated by Congress. The 

data will be used to characterize patient 

severity of illness and level of function 

in order to predict resource use, postacute care discharge placement, and 

beneficiary outcomes. CMS will use the 

data from the CARE instrument to 

examine the degree to which the items 

on the instrument can be used to predict 

beneficiary resource use and outcomes. 

Form Number: CMS–10243 (OMB#: 

0938–NEW); Frequency: Reporting—

Daily; Affected Public: Private Sector—

Business or other for-profit and Not-forprofit institutions; Number of 

Respondents: 388; Total Annual 

Responses: 244,292; Total Annual 

Hours: 179,341. 

5. Type of Information Collection 

Request: New Collection; Title of 

Information Collection: Medicaid State 

Program Integrity Assessment (SPIA); 

Use: Under the provisions of the Deficit 

Reduction Act (DRA) of 2005, Congress 

directed CMS to establish the Medicaid 

Integrity Program (MIP), CMS’ first 

national strategy to combat Medicaid 

fraud, waste, and abuse. CMS has two 

broad responsibilities under the MIP: 

(1) Reviewing the actions of 

individuals or entities providing 

services or furnishing items under 

Medicaid; conducting audits of claims 

submitted for payment; identifying 

overpayments; and educating providers 

and others on payment integrity and 

quality of care; and 

(2) Providing effective support and 

assistance to States to combat Medicaid 

fraud, waste, and abuse. 

In order to fulfill the second of these 

requirements, CMS plans to develop a 

Medicaid State Program Integrity 

Assessment (SPIA) system. CMS is 

seeking approval from the Office of 

Management and Budget (OMB) to 

collect information from the States on 

an annual basis for input into a national 

SPIA system. Through the SPIA system, 

CMS will identify current Medicaid 

program integrity (PI) information, 

develop profiles for each State based on 

these data, determine areas to provide 

States with technical support and 

assistance, and use the data to develop 

performance measures to assess States’

performance in an ongoing manner; 

Form Number: CMS–10244 (OMB#: 

0938–NEW); Frequency: Reporting: 

Yearly; Affected Public: State, Local or 

Tribal Governments; Number of 

Respondents: 56; Total Annual 

Responses: 56; Total Annual Hours: 

1,400. 

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 

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 at the address below, no 

later than 5 p.m. on September 25, 2007. 

CMS, Office of Strategic Operations 

and Regulatory Affairs, Division of 

Regulations Development—C, Attention: 

Bonnie L. Harkless, Room C4–26–05, 

7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: July 18, 2007. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 07–3647 Filed 7–26–07; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–R–312] 

Agency Information Collection 

Activities: Proposed Collection; 

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) 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 functions; 

(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: Conflict of 

Interest and Ownership and Control 

Information Use: The Conflict of Interest 

and Ownership and Control Information 

Statement (COI Statement) is sent to all 

Medicare Fiscal Intermediaries (FIs) and 

Carriers to collect full and complete 

information on any entity’s or 

individual’s ownership interest (defined 

as a 5 per centum or more) in an 

organization that may present a 

potential conflict of interest in their role 

as a Medicare FI or Carrier. 

The information gathered in the 

survey is used to ensure that all 

potential, apparent and actual conflicts 

of interest involving Medicare 

contractors are appropriately mitigated 

and that employees of the contractors, 

including officers, directors, trustees 

and members of their immediate 

families, do not utilize their positions 

with the contractor for their own private 

business interest to the detriment of the 

Medicare program. Information is also 

requested on potential organizational 

conflicts of interest involving Medicare 

contractors’ ownership of other entities 

in the health care industry. If a response 

has indicated that a potential conflict of 

interest exists, the contractor is 

contacted and asked to address how the 

conflict can be avoided or mitigated. 

Form Number: CMS–R–312 (OMB#: 

0938–0795); Frequency: Reporting—

Annually; Affected Public: Private 

Sector—Business or other for-profit and 

Not-for-profit institutions; Number of 

Respondents: 37; Total Annual 

Responses: 37; Total Annual Hours: 

11,100. 

To obtain copies of the supporting 

statement and any related forms for the 


jlentini on PROD1PC65 with NOTICES