21024 Federal Register / Vol. 72, No. 81 / Friday April 27, 2007 / Notices 

satisfaction, attitudes and perceptions 

regarding the services provided by 

Medicare Fee-for-Service (FFS) Carriers, 

Fiscal Intermediaries, Durable Medical 

Equipment Suppliers, and Regional 

Home Health Intermediaries and 

Medicare Administrative Contractors. 

The survey focuses on basic business 

functions provided by the Medicare 

Contractors such as inquiries, provider 

communications, claims processing, 

appeals, provider enrollment, medical 

review and provider audit & 

reimbursement. Providers will receive a 

notice requesting they use a specially 

constructed web site to respond to a set 

of questions customized for their 

contractor’s responsibilities. The survey 

will be conducted yearly and annual 

reports of the survey results will be 

available via an online reporting system 

for use by CMS, Medicare Contractors, 

and the general public. 

Due to changes in CMS’ reporting 

needs, CMS is requesting a potential 

increase in the number of completed 

surveys. This increase will allow CMS 

to have not only Contractor-specific, but 

also jurisdiction and state-specific data 

which, in turn, will enable Contractors 

to increase and implement performance 

improvement activities within their 

organizations. This increase will affect 

the 2008 and 2009 administrations of 

the survey. Frequency: Reporting—

Annually; Affected Public: Business or 

other for-profit, Not-for-profit 

institutions; Number of Respondents: 

24,279; Total Annual Responses: 

24,279; Total Annual Hours: 8,346. 

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. 

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: April 20, 2007. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E7–7954 Filed 4–26–07; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10225, CMS–

10116, CMS–R–39, and CMS–1500 (08–05)] 

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: New collection; Title of 

Information Collection: Disclosures to 

Patients by Certain Hospitals and 

Critical Access Hospitals; Form 

Numbers: CMS–10225 (OMB#: 0938–

New); Use: There is no Medicare 

prohibition against physician 

investment in a hospital or critical 

access hospital (CAH). Likewise, there is 

no Medicare requirement that a hospital 

or CAH have a physician on-site at all 

times, although there is a requirement 

that they be able to provide basic 

elements of emergency care to their 

patients. Medicare quality and safety 

standards are designed to provide a 

national framework that is sufficiently 

flexible to apply simultaneously to 

hospitals of varying sizes, offering 

varying ranges of services in differing 

settings across the nation. At the same 

time, however, patients might consider 

an ownership interest by their referring 

physician and/or the presence of a 

physician on-site to be important factors 

in their decisions about where to seek 

hospital care. A well-educated 

consumer is essential to improving the 

quality and efficiency of the healthcare 

system. Accordingly, patients should be 

made aware of the physician ownership 

of a hospital, whether or not a physician 

is present in the hospital at all times, 

and the hospital’s plans to address 

patients’ emergency medical conditions 

when a physician is not present. The 

intent of the proposed disclosures is to 

increase the transparency of the 

hospital’s ownership and operations to 

patients as they make decisions about 

receiving care at the hospital. 

Frequency: Recordkeeping, Third-party 

disclosure—On occasion; Affected 

Public: Business or for-profits, Not-forprofit institutions; Number of 

Respondents: 2,679; Total Annual 

Responses: 2,925,468; Total Annual 

Hours: 59,473. 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicare 

Program; Conditions of Payment of 

Power Mobility Devices, Including 

Power Wheelchairs and Power-Operated 

Vehicles (CMS–3017–F); Form 

Numbers: CMS–10116 (OMB#: 0938–

0971); Use: The CMS is seeking the 

reapproval of the collection 

requirements associated with the final 

rule, CMS–3017–F (71 FR 17021), which 

was published on April 5, 2006, and 

became effective on June 5, 2006. 

Specifically, we are seeking OMB 

approval for the following terms of 

clearance identified in the Notice of 

Action dated October 16, 2006, of which 

OMB has requested CMS to monitor the 

paperwork burden required of providers 

and suppliers to determine if the 

paperwork requirements impose any 

unnecessary burden on the industry 

and/or need to be revised in order to 

improve the utility of the information. 

After analyzing the documentation 

requirements burden, CMS does not 

believe that the documentation 

requirements impose any additional 

unnecessary burden on the durable 

medical equipment (DME) industry. We 

believe that most physicians are already 

conducting a face-to-face examination 

before prescribing a wheelchair. Given 

that physicians and treating 

practitioners can now prescribe poweroperated vehicles (POVs), thereby 

removing the requirement that a 

specialist can order a POV, CMS 

believes that the increased burden of 

48,600 hours for physicians and treating 

practitioners is based on the 


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Federal Register / Vol. 72, No. 81 / Friday April 27, 2007 / Notices 21025 

Congressional decision to allow a 

broader range of physicians and treating 

practitioners to prescribe POVs. This 

increased burden is offset by the new 

payments implemented in connection 

with the Final Rule, which is 

demonstrated by the shift in 

prescriptions from one class of 

equipment, power wheelchairs, to 

another class of equipment, POVs. 

In addition, CMS believes that with 

the recent coverage decision on Mobility 

Assistive Equipment, the implementing 

details in the Final Rule (e.g. improved 

documentation for suppliers; physician 

and treating practitioner payments; 

improved classification of mobility 

equipment; the elimination of the 

certificate of medical necessity (CMN)), 

and the provider outreach and 

education provided by CMS, the DME 

program safeguard contractors (PSCs) 

and DME Medicare administrative 

contractors (MACs), the needs of 

mobility-impaired beneficiaries and the 

needs of suppliers have been better met. 

Frequency: Recordkeeping—On 

occasion; Affected Public: Business or 

for-profits, Not-for-profit institutions, 

and State, Local or Tribal governments; 

Number of Respondents: 38,000; Total 

Annual Responses: 342,000; Total 

Annual Hours: 48,600. 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Home Health 

Conditions of Participation (CoP) 

Information Collection Requirements 

and Supporting Regulations in 42 CFR 

484.10, 484.12, 484.16, 484.18, 484.36, 

484.48, 484.52; Form Numbers: CMS–R–

39 (OMB#: 0938–0365); Use: The 

information collection requirements 

contained in this request are part of the 

requirements classified as the 

conditions of participation (CoPs) which 

are based on criteria prescribed in law 

and are standards designed to ensure 

that each facility has properly trained 

staff to provide the appropriate safe 

physical environment for patients. 

These particular standards reflect 

comparable standards developed by 

industry organizations such as the Joint 

Commission on Accreditation of 

Healthcare Organizations, and the 

Community Health Accreditation 

Program. The primary users of this 

information will be State agency 

surveyors, the regional home health 

intermediaries, CMS and home health 

agencies (HHAs) for the purpose of 

ensuring compliance with Medicare 

CoPs as well as ensuring the quality of 

care provided by HHA patients. 

Frequency: Recordkeeping and 

Reporting—Annually, On occasion; 

Affected Public: Business or for-profits, 

Not-for-profit institutions, and State, 

Local or Tribal governments; Number of 

Respondents: 9,354; Total Annual 

Responses: 9,354; Total Annual Hours: 

1,048,483.5. 

4. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Health 

Insurance Common Claims Form and 

Supporting Regulations at 42 CFR Part 

424, Subpart C; Form Number: CMS–

1500(08–05), CMS–1490–S (OMB#: 

0938–0999); Use: The Form CMS–1500 

answers the needs of many health 

insurers. It is the basic form prescribed 

by CMS for the Medicare program for 

claims from physicians and suppliers. 

The Medicaid State Agencies, 

CHAMPUS/TriCare, Blue Cross/Blue 

Shield Plans, the Federal Employees 

Health Benefit Plan, and several private 

health plans also use it; it is the de facto 

standard ‘‘professional’’ claim form. 

Medicare carriers use the data 

collected on the CMS–1500 and the 

CMS–1490S to determine the proper 

amount of reimbursement for Part B 

medical and other health services (as 

listed in section 1861(s) of the Social 

Security Act) provided by physicians 

and suppliers to beneficiaries. The 

CMS–1500 is submitted by physicians/ 

suppliers for all Part B Medicare. 

Serving as a common claim form, the 

CMS–1500 can be used by other thirdparty payers (commercial and nonprofit 

health insurers) and other Federal 

programs (e.g., CHAMPUS/TriCare, 

Railroad Retirement Board (RRB), and 

Medicaid). 

However, as the CMS–1500 displays 

data items required for other third-party 

payers in addition to Medicare, the form 

is considered too complex for use by 

beneficiaries when they file their own 

claims. Therefore, the CMS–1490S 

(Patient’s Request for Medicare 

Payment) was explicitly developed for 

easy use by beneficiaries who file their 

own claims. The form can be obtained 

from any Social Security office or 

Medicare carrier. 

Since the last submission of this 

information collection request, we 

discontinued form CMS–1490U which 

was used by employers, unions, 

employer-employee organizations that 

pay physicians and suppliers for their 

services to employees, group practice 

prepayment plans, and health 

maintenance organizations. Therefore, 

this collection will no longer contain 

the CMS–1490U. 

In sum, the CMS–1500 and CMS–

1490S result in less paperwork burden 

placed on the public. The CMS–1500 

provides efficiency in office procedures 

for physicians and suppliers; the CMS–

1490S provides beneficiaries with a 

relatively easy form to use when filing 

their claims. Without the collection of 

this information, claims for 

reimbursement relating to the provision 

of Part B medical services/supplies 

could not be acted upon. This would 

result in a nationwide paralysis of the 

operation of the Federal Government’s 

Medicare Part B program, and major 

problems for the other health plans that 

use the CMS–1500, inflicting severe 

physical and financial hardship on 

providers/suppliers as well as 

beneficiaries. Frequency: Reporting—On 

occasion; Affected Public: State, Local, 

or Tribal Government, Business or 

other-for-profit, Not-for-profit 

institutions; Number of Respondents: 

1,048,243; Total Annual Responses: 

970,174,260; Total Annual Hours: 

33,067,757. 

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 at the address below, no 

later than 5 p.m. on June 26, 2007. 

CMS, Office of Strategic Operations 

and Regulatory Affairs, Division of 

Regulations Development—B, Attention: 

William N. Parham, III, Room C4–26–

05, 7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: April 20, 2007. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E7–7955 Filed 4–26–07; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–1387–N] 

Medicare Program; Meeting of the 

Practicing Physicians Advisory 

Council, May 21, 2007 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 


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