[Federal Register Volume 72, Number 81 (Friday, April 27, 2007)]
[Notices]
[Pages 21024-21025]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-7955]


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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<greek-i>: 
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-for-profit 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<greek-i>: 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 power-operated 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

[[Page 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<greek-i>: 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<greek-i>: 
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 third-party 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 E-mail your request, including your address, phone number, OMB 
number, and CMS document identifier, to <a href="/cdn-cgi/l/email-protection#7727160712050018051c37141a04591f1f0459101801"><span class="__cf_email__" data-cfemail="316150415443465e435a71525c421f5959421f565e47">[email protected]</span></a>, 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


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