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[Federal Register Volume 77, Number 49 (Tuesday, March 13, 2012)]
[Notices]
[Pages 14806-14807]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-6036]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-1880 and -1882; CMS-10393; and CMS-R-245]

Agency Information Collection Activities: Submission for OMB 
Review; 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), 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: Extension without change 
of a currently approved collection. Title of Information Collection: 
Certification as a Supplier of Portable X-Ray and Portable X-Ray Survey 
Report Form and Supporting Regulations at 42 CFR Part 486.100-486.110. 
Use: CMS-1880 is initially completed by suppliers of portable X-ray 
services, expressing an interest in and requesting participation in the 
Medicare program. This form initiates the process of obtaining a 
decision as to whether the conditions of coverage are met as a portable 
X-ray supplier. It also promotes data reduction or introduction to, and 
retrieval from, the Certification and Survey Provider Enhanced 
Reporting (CASPER) by the CMS Regional Offices (ROs).
    CMS-1882 is used by the State survey agency to provide data 
collected during an on-site survey of a supplier of portable X-ray 
services to determine compliance with the applicable conditions of 
participation and to report this information to the Federal Government. 
The form is primarily a coding worksheet designed to facilitate data 
reduction and retrieval into the ASPEN system at the CMS ROs. The form 
includes basic information on compliance (i.e., met, not met, 
explanatory statements) and does not require any descriptive 
information regarding the survey activity itself. CMS has the 
responsibility and authority for certification decisions which are 
based on supplier compliance with the applicable conditions of 
participation. The information needed to make these decisions is 
available to CMS only through the use of information abstracted from 
the survey report form.
    Subsequent to the publication of the 60-day Federal Register notice 
(December 23, 2011; 76 FR 80372), the Supporting Statement has been 
revised by making editorial changes and by adding clarifying language. 
The requirements and burden estimates have not changed. Form Numbers: 
CMS-1880 (Request for Certification as a Supplier of Portable X-Ray 
Services), CMS-1882 (Medicare/Medicaid Portable X-Ray Survey Report), 
and OCN 0938-0027. Frequency: Occasionally. Affected Public: State, 
Local, or Tribal Governments. Number of Respondents: 579. Total Annual 
Responses: 86. Total Annual Hours: 151. (For policy questions regarding 
this collection contact Georgia Johnson at 410-786-6859. For all other 
issues call 410-786-1326.)
    2. Type of Information Collection Request: Existing collection in 
use without an OMB control number; Title of Information Collection: 
Medicare Beneficiary and Family-Centered Satisfaction Survey; Use: The 
data collection methodology used to determine Beneficiary Satisfaction 
flows from the proposed sampling approach. While it was feasible to 
conduct the 9th SOW via telephone data collection only, with a 
quarterly sample size for the 10th SOW estimated to be 2,664, it does 
not seem efficient to maintain a telephone only data collection 
approach. Based on recent literature on survey methodology and response 
rates by mode, we recommend using a data collection that is done 
primarily by mail. A mail-based methodology will achieve the goals of 
being efficient, effective, and minimally burdensome for beneficiary 
respondents.
    As previously described, we anticipate that a mail-based 
methodology could yield a response rate

[[Page 14807]]

of approximately 60 percent. In order to achieve this response rate, we 
would recommend a 3-staged approach to data collection:
    (1) Mailout of a covering letter, the paper survey questionnaire, 
and a postage-paid return envelope.
    (2) Mailout of a postcard that thanks respondents and reminds the 
non-respondents to please return their survey.
    (3) Mailout of a follow-up covering letter, the paper survey 
questionnaire, and a postage-paid return envelope.
    Through the pilot test, we will determine the response rate that 
can be achieved using this approach. If it is deemed necessary, 
additional mailout reminders can be added to the protocol, or a 
telephone non-response step can be added to the protocol.
    Using the 3-step mail approach described above, we anticipate that 
data collection would occur over an 8 to 10 weeks. This is to say, if 
the first survey mailing were dropped on May 1, we would anticipate 
completing data collection at the end of June or early July. Data would 
then be cleaned, scores would be generated, and data would be delivered 
to CMS. Through the pilot test, we will determine the precise timing 
required to achieve an acceptable response rate, but we are aiming to 
complete sampling, data collection, and scoring within a 12-week 
period.
    Subsequent to the publication of the 60-day Federal Register notice 
(June 10, 2011; 76 FR 34076), the survey instrument has been separated 
into two surveys. Prior to this action, there was one survey proposed 
for the Quality of Care and Appeals review types. Once approved by OMB, 
there will be two survey instruments that will request similar 
information: one for Quality of Care and one for Appeals. Form Number: 
CMS-10393 (OCN 0938-New); Frequency: Once; Affected Public: Individuals 
or households; Number of Respondents: 16,010; Number of Responses: 
16,010; Total Annual Hours: 4,002. (For policy questions regarding this 
collection, contact Coles Mercier at 410-786-2112. For all other issues 
call (410) 786-1326.)
    3. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Medicare and Medicaid Programs OASIS Collection Requirements as Part of 
the CoPs for HHAs and Supp. Regs. in 42 CFR 48.55, 484.205, 484.245, 
484.250; Use: This data set is currently mandated for use by Home 
Health Agencies (HHAs) as a condition of participation (CoP) in the 
Medicare program. Since 1999, the Medicare CoPs have mandated that HHAs 
use the OASIS data set when evaluating adult non-maternity patients 
receiving skilled services. The OASIS is a core standard assessment 
data set that agencies integrate into their own patient-specific, 
comprehensive assessment to identify each patient's need for home care 
that meets the patient's medical, nursing, rehabilitative, social, and 
discharge planning needs. There have not been any changes to the PRA 
package that is associated with the 60-day Federal Register notice that 
published on December 16, 2011 (76 FR 78264); Form Number: CMS-R-245 
(OCN 0938-0760); Frequency: Occasionally; Affected Public: Private 
Sector (Business or other for-profit and Not-for-profit institutions); 
Number of Respondents: 11,495; Total Annual Responses: 16,476,008; 
Total Annual Hours: 16,567,968. (For policy questions regarding this 
collection contact Robin Dowell at 410-786-0060. 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.
    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 April 12, 2012.

OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-6974, Email: OIRA_submission@omb.eop.gov.

    Dated: March 6, 2012.
Martique Jones,
Director, Regulations Development Group, Division-B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-6036 Filed 3-12-12; 8:45 am]
BILLING CODE 4120-01-P
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