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[Federal Register Volume 79, Number 65 (Friday, April 4, 2014)]
[Notices]
[Pages 18916-18917]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-07582]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-437 and CMS-10332]

Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

ACTION: Notice.

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SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is 
announcing an opportunity for the public to comment on CMS' intention 
to collect information from the public. Under the Paperwork Reduction 
Act of 1995 (the PRA), federal agencies are required to publish notice 
in the Federal Register concerning each proposed collection of 
information (including each proposed extension or reinstatement of an 
existing collection of information) and to allow 60 days for public 
comment on the proposed action. Interested persons are invited to send 
comments regarding our burden estimates 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.

DATES: Comments must be received by June 3, 2014.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number (OCN). To be assured consideration, comments and 
recommendations must be submitted in any one of the following ways:
    1. Electronically. You may send 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) that are 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.

    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, you may make 
your request using one of following:
    1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to Paperwork@cms.hhs.gov.
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.

SUPPLEMENTARY INFORMATION:

Contents

    This notice sets out a summary of the use and burden associated 
with the following information collections. More detailed information 
can be found in each collection's supporting statement and associated 
materials (see ADDRESSES).

CMS-437 Psychiatric Unit Criteria Work Sheet and Supporting Regulations

CMS-10332 Disclosure for the In-Office Ancillary Services Exception

    Under the PRA (44 U.S.C. 3501-3520), federal agencies must obtain 
approval from the Office of Management and Budget (OMB) for each 
collection of information they conduct or sponsor. The term 
``collection of information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 
1320.3(c) and includes agency requests or requirements that members of 
the public submit reports, keep records, or provide information to a 
third party. Section 3506(c)(2)(A) of the PRA requires federal agencies 
to publish a 60-day notice in the Federal Register concerning each 
proposed collection of information, including each proposed extension 
or reinstatement of an existing collection of information, before 
submitting the collection to OMB for approval. To comply with this 
requirement, CMS is publishing this notice.

Information Collection

    1. Type of Information Collection Request: Reinstatement with 
Change of a currently approved collection; Title of Information 
Collection: Psychiatric Unit Criteria Work Sheet and Supporting 
Regulations; Use: Certain hospital units are excluded from the Medicare 
Prospective Payment System (PPS). The exclusion of units is not 
optional on the part of the provider but is required by section 
1886(d)(1)(B) of the Social Security Act. That section excludes 
psychiatric hospitals, rehabilitation hospitals, hospitals whose 
inpatients are predominantly individuals under 18 years of age 
(children's hospitals), and psychiatric and rehabilitation units which 
are a distinct part of a hospital.
    We propose to continue the current process of performing initial 
verifications and annual reverifications to determine that psychiatric 
units continue to comply with the regulatory criteria at 42 CFR 412.25 
and 42 CFR 412.27 of the PPS regulations. These regulations state the 
criteria that distinct part units must meet for exclusion.
    If, as a result of the regular survey process a hospital is 
certified as a psychiatric hospital by the State survey agency (SA), 
then it automatically satisfies the regulatory criteria for exclusion. 
Thus, no additional

[[Page 18917]]

verification is required for psychiatric hospitals. Some verification 
is needed, however, to ensure that other types of hospitals and units 
meet the criteria for exclusion. Consequently, we instructed the Fiscal 
Intermediaries (FIs) and SAs to perform certain verification 
activities, beginning in October 1983 when PPS was implemented. We 
originally developed the CMS-437 as an SA Worksheet for verifying 
exclusions from PPS for psychiatric units.
    Since April 9, 1994, PPS-excluded psychiatric units already 
excluded from the PPS have met CMS's annual requirement for PPS-
exclusion by self-attesting that they remain in compliance with the PPS 
exclusion criteria. Under the current procedure, all psychiatric units 
applying for first-time exclusion are surveyed by the SAs. The SAs also 
perform surveys to investigate complaint allegations and conduct annual 
sample reverification surveys on 5 percent of all psychiatric units. 
The aforementioned exclusions continue to exist and thus we propose to 
continue to use the Criteria Worksheet, Forms CMS-437, for verifying 
first-time exclusions from the PPS, for complaint surveys, for its 
annual 5 percent validation sample, and for facility self-attestation. 
These forms are related to the survey and certification and Medicare 
approval of the PPS-excluded units. Form Number: CMS-437 (OCN: 0938-
0358); Frequency: Annually; Affected Public: Private sector--Business 
or other for-profits; Number of Respondents: 1,614; Total Annual 
Responses: 1,614; Total Annual Hours: 404. (For policy questions 
regarding this collection contact Donald Howard at 410-786-6764.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Disclosure for 
the In-Office Ancillary Services Exception; Use: Physicians who provide 
certain imaging services (magnetic resonance imaging, computed 
tomography, and positron emission tomography) under the in-office 
ancillary services exception to the physician self-referral prohibition 
are required to create the disclosure notice as well as the list of 
other imaging suppliers to be provided to the patient. The patient will 
then be able to use the disclosure notice and list of suppliers in 
making an informed decision about his or her course of care for the 
imaging service. The physician must maintain a record of the disclosure 
in the patient's medical record. If we were investigating the referrals 
of a physician providing advanced imaging services under the in-office 
ancillary services exception, we would review the written disclosure in 
order to determine if the physician satisfied the requirement. Form 
Number: CMS-10332 (OCN: 0938-1133); Frequency: Occasionally; Affected 
Public: Private sector--Business or other for-profits; Number of 
Respondents: 71,000; Total Annual Responses: 71,106; Total Annual 
Hours: 125,383. (For policy questions regarding this collection contact 
Jacqueline Proctor at 410-786-8852).

    Dated: April 1, 2014.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2014-07582 Filed 4-3-14; 8:45 am]
BILLING CODE 4120-01-P
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