Federal Register / Vol. 75, No. 161 / Friday, August 20, 2010 / Notices 51463 

493.1–.2001 Medicare/Medicaid 

Psychiatric Hospital Survey Data; Use: 

The application must be completed by 

entities performing laboratory’s testing 

specimens for diagnostic or treatment 

purposes. This information is vital to 

the certification process. Form Number: 

CMS–116 (OMB#: 0938–0581); 

Frequency: Biennially and Occasionally; 

Affected Public: Private Sector: Business 

or other for-profits and Not-for-profit 

institutions; Number of Respondents: 

219,000; Total Annual Responses: 

31,520; Total Annual Hours: 23,640. 

(For policy questions regarding this 

collection contact Sheila Ward at 410– 

786–3115. For all other issues call 410– 

786–1326.) 

7. Type of Information Collection 

Request: Extension 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. Frequency: 

Reporting—On occasion; Affected 

Public: State, Local, or Tribal 

Government, Business or other-forprofit, Not-for-profit institutions; 

Number of Respondents: 1,048,243; 

Total Annual Responses: 991,160,925; 

Total Annual Hours: 23,815,541. 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS’ Web Site 

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. 

In commenting on the proposed 

information collections please reference 

the document identifier or OMB control 

number. To be assured consideration, 

comments and recommendations must 

be submitted in one of the following 

ways by October 19, 2010: 

1. Electronically. You may submit 

your comments electronically to 

http://www.regulations.gov. Follow the 

instructions for ‘‘Comment or 

Submission’’ or ‘‘More Search Options’’ 

to find the information collection 

document(s) accepting comments. 

2. By regular mail. You may mail 

written comments to the following 

address: 

CMS, Office of Strategic Operations 

and Regulatory Affairs, Division of 

Regulations Development, Attention: 

Document Identifier/OMB Control 

Number, Room C4–26–05, 7500 Security 

Boulevard, Baltimore, Maryland 21244– 

1850. 

Dated: August 13, 2010. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2010–20385 Filed 8–19–10; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10314] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services. 

In compliance with the requirement 

of section 3506I(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: New collection; Title of 

Information Collection: Medicare 

Savings Program Protection from 

Medicaid Estate Recovery—State Plan 

Pre-print under Title XIX. Form No.: 

CMS–10314 (OMB# 0938–New); Use: 

Section 115 of the Medicare 

Improvements for Patients and 

Providers Act (MIPPA)—2008, provides 

new protections from Medicaid estate 

recovery for limited categories of dual 

eligibles age 55 and over. To offer these 

protections, States have to amend their 

Medicaid State plans to reflect these 

new limits on estate recovery. To reduce 

paperwork burden and expedite this 

process, CMS is providing States with a 

pre-printed document (i.e., a State plan 

preprint) which neither needs nor 

requires any insertion of language or 

even completion of a check-off box. As 

Section 115 simply mandates 

compliance (there is no option not to 

comply), States only need return the 

preprint page (as prepared by CMS) to 

CMS, as a requested amendment to their 

State Plan. This is a one-time only 

submission, with little burden 

imposition and complete electronic 

routing to and from States. 

Frequency: Reporting—Once; Affected 

Public: State, Local or Tribal 

Governments; Number of Respondents: 

51; Total Annual Responses: 51; Total 

Annual Hours: 102. (For policy 

questions regarding this collection 

contact Nancy Dieter at 410–786–7219. 

For all other issues call 410–786–1326.) 

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. 


sroberts on DSKD5P82C1PROD with NOTICES
51464 Federal Register / Vol. 75, No. 161 / Friday, August 20, 2010 / Notices 

To be assured consideration, 

comments and recommendations for the 

proposed information collections must 

be received by the OMB desk officer at 

the address below, no later than 5 p.m. 

on September 20, 2010. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS 

Desk Officer. Fax Number: (202) 395– 

6974. E-mail: 

OIRA_submission@omb.eop.gov. 

Dated: August 13, 2010. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2010–20386 Filed 8–19–10; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–2476–FN2] 

Medicare and Medicaid Programs; 

Approval of the American Association 

for Accreditation of Ambulatory 

Surgery Facilities for Continued 

Deeming Authority for Ambulatory 

Surgical Centers 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS). 

ACTION: Final notice. 

SUMMARY: This final notice announces 

our decision to approve without 

condition the American Association for 

Accreditation of Ambulatory Surgery 

Facilities’ (AAAASF) request for 

continued recognition as a national 

accreditation program for ambulatory 

surgical centers (ASC) seeking to 

participate in the Medicare or Medicaid 

programs. 

DATES: Effective Date: This final notice 

is effective on November 27, 2009 

through November 27, 2012. 

FOR FURTHER INFORMATION CONTACT: 

Cindy Melanson (410) 786–0310. 

Patricia Chmielewski (410) 786–6899. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Under the Medicare program, eligible 

beneficiaries may receive covered 

services in an ambulatory surgical 

center (ASC) provided certain 

requirements are met. Section 

1832(a)(2)(F)(i) of the Social Security 

Act (the Act) establishes distinct criteria 

for a facility seeking designation as an 

ASC. Under this authority, the 

minimum requirements that an ASC 

must meet to participate in Medicare are 

set forth in regulations at 42 CFR part 

416, which determine the basis and 

scope of ASC covered services, and the 

conditions for Medicare payment for 

facility services. Regulations concerning 

provider agreements are at 42 CFR part 

489 and those pertaining to activities 

relating to the survey and certification 

of facilities are at 42 CFR part 488. 

Generally, to enter into an agreement, 

an ASC must first be certified by a State 

survey agency as complying with 

conditions or requirements set forth in 

part 416 of our regulations. Then, the 

ASC is subject to regular surveys by a 

State survey agency to determine 

whether it continues to meet those 

requirements. There is an alternative, 

however, to surveys by State agencies. 

Section 1865(a)(1) of the Act provides 

that, if a provider entity demonstrates 

through accreditation by an approved 

national accreditation organization that 

all applicable Medicare conditions are 

met or exceeded, we may ‘‘deem’’ those 

provider entities to have met the 

requirements. Accreditation by an 

accreditation organization is voluntary 

and is not required for Medicare 

participation. 

If an accreditation organization is 

recognized by the Secretary as having 

standards for accreditation that meet or 

exceed Medicare requirements, a 

provider entity accredited by the 

national accrediting body’s approved 

program may be deemed to meet the 

Medicare conditions. A national 

accreditation organization applying for 

approval of deeming authority under 

part 488, subpart A, must provide us 

with reasonable assurance that the 

accreditation organization requires the 

accredited provider entities to meet 

requirements that are at least as 

stringent as the Medicare conditions. 

Our regulations concerning re-approval 

of accrediting organizations are set forth 

at section § 488.4 and § 488.8(d)(3). The 

regulations at § 488.8(d)(3) require 

accreditation organizations to reapply 

for continued approval of deeming 

authority every 6 years, or sooner as 

determined by CMS. The regulation at 

§ 488.8(f)(3)(i) provides CMS the 

authority to grant conditional approval 

of an accreditation organization’s 

deeming authority, with a probationary 

period of up to 180 days, if the 

accreditation organization has not 

adopted comparable standards during 

the reapplication process. 

We received a complete application 

from AAAASF for continued 

recognition as a national accreditation 

organization for ASCs on March 31, 

2009. In accordance with the 

requirements at § 488.4 and 

§ 488.8(d)(3), we published a proposed 

notice on June 26, 2009 (74 FR 30587) 

and a final notice on November 27, 2009 

(74 FR 62330). This final notice 

provides CMS’ final determination in 

response to the conditional approval 

with a 180-day probationary period 

granted to the American Association for 

Accreditation of Ambulatory Surgery 

Facilities on November 27, 2009. 

II. Deeming Applications Approval 

Process 

Section 1865(a)(3)(A) of the Act 

provides a statutory timetable to ensure 

that our review of deeming applications 

is conducted in a timely manner. The 

Act provides us with 210 calendar days 

after the date of receipt of an application 

to complete our survey activities and 

application review process. Within 60 

days of receiving a completed 

application, we must publish a notice in 

the Federal Register that identifies the 

national accreditation body making the 

request, describes the request, and 

provides no less than a 30-day public 

comment period. At the end of the 210- 

day period, we must publish an 

approval or denial of the application. In 

accordance with § 488.8(f)(2), if CMS 

determines following the deeming 

authority review that the organization 

has failed to adopt requirements 

comparable to CMS requirements, the 

accreditation organization may be given 

a conditional approval of its deeming 

authority for a probationary period of up 

to 180 days to adopt comparable 

requirements. Within 60 days after the 

end of this period, we must make a final 

determination as to whether or not the 

AAAASF’s accreditation program for 

ASCs is comparable to CMS 

requirements and issue an appropriate 

notice that includes our reasons for our 

determination. 

III. Provisions of the November 27, 

2009 Final Notice 

Our review of AAAASF’s renewal 

application for ASC deeming authority 

revealed that AAAASF had on-going, 

serious, widespread areas of noncompliance. Specifically, AAAASF’s 

inability to provide accurate and timely 

data on deemed providers; lack of 

complete and accurate deemed facility 

survey files; and, inadequate surveyor 

training and evaluation program. Due to 

the significant number of areas of 

noncompliance identified during the 

review of AAAASF’s renewal 

application for deeming authority, we 

conditionally approved AAAASF’s ASC 

accreditation program for 3 years with a 

180 day probationary period. Under 

section 1865(a)(2) of the Act and our 

regulations at § 488.4 and § 488.8, we 

conducted a comparability review of 


sroberts on DSKD5P82C1PROD with NOTICES