59858 Federal Register / Vol. 65, No. 195 / Friday, October 6, 2000 / Notices

in justifying an exception request to

their composite rate for outpatient

dialysis services.; Frequency: On

occasion; Affected Public: Business or

other for-profit, Not-for-profit

institutions and Federal Government;

Number of Respondents: 291; Total

Annual Responses: 291; Total Annual

Hours: 14,000.

To obtain copies of the supporting

statement and any related forms for the

proposed paperwork collections

referenced above, access HCFA’s Web

Site address at http://www.hcfa.gov/

regs/prdact95.htm, or E-mail your

request, including your address, phone

number, OMB number, and HCFA

document identifier, to

Paperwork@hcfa.gov, or call the Reports

Clearance Office on (410) 786–1326.

Written comments and

recommendations for the proposed

information collections must be mailed

within 60 days of this notice directly to

the HCFA Paperwork Clearance Officer

designated at the following address:

HCFA, Office of Information Services,

Security and Standards Group, Division

of HCFA Enterprise Standards,

Attention: Melissa Musotto, HCFA–9044

Room N2–14–26, 7500 Security

Boulevard, Baltimore, Maryland 21244–

1850.

Dated: September 28, 2000.

John P. Burke III,

HCFA Reports Clearance Officer, HCFA Office

of Information Services, Security and

Standards Group, Division of HCFA

Enterprise Standards

[FR Doc. 00–25762 Filed 10–5–00; 8:45 am]

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

[Document Identifiers: HCFA–R–296 (OMB

# 0938–0781)]

Notice of Extension of Emergency

Office of Management and Budget

Clearance of Agency Information

Collection Activities

AGENCY: Health Care Financing

Administration, DHHS.

The Health Care Financing

Administration (HCFA), Department of

Health and Human Services, is

publishing this Notice to inform the

public that the Office of Management

and Budget (OMB) has approved our

request for an extension of the OMB

clearance on model advance beneficiary

notices (ABNs), for which we first

requested emergency clearance by

Federal Register notice dated

September 22, 1999 (HCFA–R–296,

OMB # 0938–0781). Clearance of these

model ABNs (referred to as HHABNs)

for use by home health agencies (HHAs)

has been extended through January 31,

2001. These model notices, together

with the instructions in Program

Memorandum Transmittals A–99–52

and A–99–54, remain in effect following

the implementation of the prospective

payment system (PPS) for home health

agencies on October 1, 2000. HCFA also

has published a Federal Register notice

on September 26, 2000, 65 FR 57821,

seeking emergency OMB clearance,

pursuant to the Paperwork Reduction

Act, of a revised uniform Home Health

Advance Beneficiary Notice (HHABN),

which we expect to make mandatory in

January 2001.

Use: The purpose of this Notice is to

clarify, for Medicare beneficiaries, for

HHAs, and for other interested members

of the public that existing requirements

regarding notice and demand bills, as

set forth in Program Memorandum

Transmittals A–99–52 and A–99–54,

and as reflected in the model notices for

which OMB has extended the

emergency clearance, remain in effect

following the implementation of the

prospective payment system for HHAs

on October 1, 2000. Thus, in accordance

with the instructions in PMs A–99–52

and A–99–54, HHAs continue to be

responsible for providing proper ABNs

and for submitting demand bills to

Regional Home Health Intermediaries

(RHHIs) when requested to do so by a

beneficiary or by a person acting on the

beneficiary’s behalf. Moreover, the

transition to PPS does not change

HHAs’ responsibility to follow ABN and

demand bill procedures for plans of care

in which the physician’s order spans the

transition.

HHAs must give a Medicare

beneficiary a proper ABN before

reducing or terminating home health

care the beneficiary already is receiving,

if the physician’s order for such care

would still continue the care, and an

HHA believes that the services do not

meet Medicare coverage criteria. In

instances where care has not yet been

initiated and an HHA believes services

ordered by the physician do not meet

Medicare coverage criteria, it must also

provide a proper ABN. Currently, HHAs

may use the model HHABNs designed

by HCFA (Form No. HCFA–R–0296) or

forms of the HHA’s own design to meet

the beneficiary notification requirement.

Continued Use of Demand Billing

Procedures and Meaning of ‘‘Prompt’’

Submission Under HHA PPS

With respect to the instructions

regarding demand bills in Transmittals

A–99–52 and A–99–54, we want to

emphasize that the demand bill process

remains in effect following the

implementation of HHA PPS, and must

be used by HHAs to ensure continuation

of beneficiary rights to obtain an official

Medicare initial determination.

Beginning in June, HCFA has been

assessing the operational feasibility and

impact of options for integrating the

initial determination process into HHA

PPS. In the HHA PPS final rule

published on July 3, 2000, we stated, in

response to public comment, that HCFA

was reviewing demand billing

procedures to determine whether they

must be modified to account for the

differences between HHA reasonable

cost billing and HHA PPS. 65 FR 41128,

41169 (July 3, 2000) (Medicare Program;

Prospective Payment System for Home

Health Agencies, Final Rule). As a result

of our assessment of the feasibility of

various options, HCFA decided to

continue to use the demand bill process

as the mechanism by which Medicare

beneficiaries obtain an official Medicare

initial determination when an HHA

believes, under HHA PPS, that Medicare

will not, or will no longer, cover

services ordered by a physician.

When a beneficiary agrees to be fully

and personally responsible for payment

for the services if Medicare decides the

services are not covered, and has

requested that a claim be submitted to

Medicare, HHAs must ‘‘promptly’’

submit a claim to the RHHI and report,

on the claim submitted, condition code

20 (demand-beneficiary requested

billing) to indicate the beneficiary

believes the services are covered (see

PM A–99–52 sec. I–2A). Under HHA

PPS, HHAs may submit only one claim

for payment at the end of each episode

of care. See 65 FR at 41141. Thus, under

HHA PPS, ‘‘prompt submission’’ of a

claim with the demand bill code

requires that the claim (i.e., the demand

bill) be submitted at the end of the

episode in question, at the same time

the claim for final payment for the

episode is submitted. Pursuant to the

HHA PPS Final Rule, where an HHA

has received a ‘‘request for anticipated

payment’’ (RAP) for an episode, the RAP

will be canceled and recovered unless

the claim for the episode (with the

condition code 20 to indicate that the

claim is a demand bill when requested

by the beneficiary in the circumstances

described in PM A–99–52) is submitted

within the greater of 60 days from the

end of the episode or 60 days from the

issuance of the anticipated payment. 65

FR at 41141.

Future Plans

As noted above, on September 26,

2000, HCFA published a Federal

Federal Register / Vol. 65, No. 195 / Friday, October 6, 2000 / Notices 59859

Register notice seeking emergency OMB

clearance, pursuant to the Paperwork

Reduction Act, of a revised uniform

mandatory Home Health Advance

Beneficiary Notice (HHABN). (The

Federal Register notice, which includes

procedures for submitting comments on

the revised HHABN, the revised

uniform HHABN and related

documents, including a Supporting

Statement, are posted on HCFA’s

website at http://www.hcfa.gov/regs/

prdact95htm, and are also available via

an e-mail request sent to

Paperwork@hcfa.gov). HCFA has

requested that OMB issue an emergency

clearance of the proposed uniform

HHABN by October 12, 2000, and HCFA

intends to make mandatory the use of

the HHABN not later than 90 days

following OMB approval. (See the

Supporting Statement for HCFA–R–

0296). The instructions and

requirements of PMs A–99–52 and A–

99–54 will remain in effect until a

further instruction with a new

mandatory implementation date is

issued. HCFA expects to issue these

instructions as soon as it receives

emergency approval by the Office of

Management and Budget (OMB). HCFA

strongly advises that HHAs use the new

notice (the HHABN) once it is approved

and instructions are issued, rather than

waiting until its use becomes mandatory

in January 2001.

Dated: October 4, 2000.

John P. Burke III,

HCFA Reports Clearance Officer, HCFA,

Office of Information Services Security and

Standards Group Division of HCFA Enterprise

Standards.

[FR Doc. 00–25936 Filed 10–6–00; 8:45 am]

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA–R–64]

Agency Information Collection

Activities: Submission for OMB

Review; Comment Request

In compliance with the requirement

of section 3506(c)(2)(A) of the

Paperwork Reduction Act of 1995, the

Health Care Financing Administration

(HCFA), Department of Health and

Human Services, has submitted to the

Office of Management and Budget

(OMB) the following proposal for the

collection of information. Interested

persons are invited to send comments

regarding the 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.

Type of Information Collection

Request: Extension of a currently

approved collection;

Title of Information Collection:

Indirect Medical Education (IME) and

Supporting Regulations in 42 CFR

412.105;

Form No.: HCFA–R–64 (OMB# 0938–

0456);

Use: This collection of information on

interns and residents (IR) is needed to

properly calculate Medicare program

payments to hospitals that incur

indirect costs for medical education.

The agency’s Intern and Resident

Information System uses the

information for producing automated

reports of duplicate full-time equivalent

IRs for IME. The reports provide

contractors with information to ensure

that hospitals are properly reimbursed

for IME, and help eliminate duplicate

reporting of IR counts which inflate

payments. The collection of this

information affects 1,350 hospitals

which participate in approved medical

education programs.;

Frequency: Annually;

Affected Public: Not-for-profit

institutions, and Business or other forprofit;

Number of Respondents: 1,350;

Total Annual Responses: 1,350;

Total Annual Hours: 2,700.

To obtain copies of the supporting

statement for the proposed paperwork

collections referenced above, access

HCFA’s Web Site Address at http://

www.hcfa.gov/regs/prdact95.htm, or Email your request, including your

address and phone number, to

Paperwork@hcfa.gov, or call the Reports

Clearance Office on (410) 786–1326.

Written comments and

recommendations for the proposed

information collections must be mailed

within 30 days of this notice directly to

the OMB Desk Officer designated at the

following address: OMB Human

Resources and Housing Branch,

Attention: Allison Eydt, New Executive

Office Building, Room 10235,

Washington, DC 20503.

Dated: September 11, 2000.

John P. Burke III,

HCFA Reports Clearance Officer, HCFA,

Office of Information Services, Security and

Standards Group, Division of HCFA

Enterprise Standards.

[FR Doc. 00–25760 Filed 10–5–00; 8:45 am]

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Substance Abuse and Mental Health

Services Administration

Agency Information Collection

Activities: Proposed Collection;

Comment Request

In compliance with section

3506(c)(2)(A) of the Paperwork

Reduction Act of 1995 concerning

opportunity for public comment on

proposed collections of information, the

Substance Abuse and Mental Health

Services Administration will publish

periodic summaries of proposed

projects. To request more information

on the proposed projects or to obtain a

copy of the information collection

plans, call the SAMHSA Reports

Clearance Officer on (301) 443–7978.

Comments are invited on: (a) Whether

the proposed collections of information

are necessary for the proper

performance of the functions of the

agency, including whether the

information shall have practical utility;

(b) the accuracy of the agency’s estimate

of the burden of the proposed collection

of information; (c) ways to enhance the

quality, utility, and clarity of the

information to be collected; and (d)

ways to minimize the burden of the

collection of information on

respondents, including through the use

of automated collection techniques or

other forms of information technology.

Proposed Project: Obligated Service

for Mental Health Traineeships:

Regulations (42 CFR part 62a) and

Forms—(Extension, no change; OMB

No. 0930–0074)—SAMHSA’s Center for

Mental Health Services (CMHS) awards

grants to institutions for training

instruction and traineeships in mental

health and related disciplines. Graduate

student recipients of these clinical

traineeships must perform service, as

determined by the Secretary to be

appropriate in terms of the individual’s

training and experience, for a length of

time equal to the period of support. The

clinical trainees are required to submit

SAMHSA Form SMA 111, a payback

agreement, SAMHSA Form 111–1,

which ensures agency receipt of a

termination notice prior to the end of

support, and the SAMHSA Form SMA