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[Federal Register Volume 77, Number 44 (Tuesday, March 6, 2012)]
[Notices]
[Pages 13337-13338]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-5439]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10136, CMS-10116, CMS-10426 and CMS-10406]

Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services.

    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: Reinstatement of a 
previously approved collection; Title of Information Collection: 
Physician Group Practice Transition Demonstration (PGP-TD) Performance 
Assessment Tool (``PAT''); Use: The Physician Group Practice (PGP) 
Demonstration was mandated by section 412 of the Medicare, Medicaid, 
and SCHIP Benefits Improvement and Protection Act of 2000 and is the 
precursor to the Medicare Shared Savings Program. Section 1899(k) of 
the Social Security Act, as added by section 10307(k) of the Affordable 
Care Act (as amended by section 10307 of the Health Care and Education 
Reconciliation Act of 2010), states ``the Secretary may enter into an 
agreement with an ACO under the Demonstration under section 1866A, 
subject to rebasing and other modifications deemed appropriate by the 
Secretary.'' The Demonstration extension is entitled the PGP Transition 
Demonstration (PGP-TD).
    We are seeking reinstatement of the collection of information as it 
was erroneously discontinued. Only a portion of the information 
collection requirements previously approved under 0938-0941 should have 
been discontinued. The collection of information is strictly voluntary 
in nature and was developed in conjunction with the industry and 
Demonstration participants. Only organizations that voluntarily respond 
and elect to participate in the Demonstration will be reporting the 
measures. Moreover, CMS will not be using this information to regulate 
or sanction but rather to provide financial incentives for improving 
the quality of care. The collection of information to be used under 
this extension is being used to test quality data collection systems 
and determine incentive payment levels to participating physician group 
practices participating in the PGP-TD. In addition, this data will be 
used to evaluate the effectiveness of these payment models and provide 
insight into the most appropriate way for the agency to collect 
clinical information. Form Number: CMS-10136 (OCN: 0938-0941); 
Frequency: Yearly; Affected Public: Private Sector--Business or other 
for-profits and not-for-profit institutions. Number of Respondents: 10. 
Number of Responses: 10. Total Annual Hours: 790. (For policy questions 
regarding this collection contact Heather Grimsley at 410-786-1048. For 
all other issues call 410-786-1326.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection;
    Title of Information Collection: Conditions for Payment of Power 
Mobility Devices, including Power Wheelchairs and Power-Operated 
Vehicles; Use: CMS is renewing our request for approval for 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. The regulation CMS-3017-F finalized provisions set forth 
in the interim final regulation (70 FR 50940) published on August 26, 
2005. This final rule conforms our regulations to section 
302(a)(2)(E)(iv) of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003. This rule defines the term power mobility 
devices (PMDs) as power wheelchairs and power operated vehicles (POVs 
or scooters). It sets forth revised conditions for Medicare payment of 
PMDs and defines who may prescribe PMDs. This rule also requires a 
face-to-face examination of the beneficiary by the physician or 
treating practitioner, a written prescription, and receipt of pertinent 
parts of the medical record by the supplier within 45 days after the 
face-to-face examination that the durable medical equipment (DME)

[[Page 13338]]

suppliers maintain in their records and make available to CMS and its 
agents upon request. Finally, this rule discusses CMS' policy on 
documentation that may be requested by CMS and its agents to support a 
Medicare claim for payment. Form Number: CMS-10116 (OCN: 0938-0971); 
Frequency: Yearly; Affected Public: Private Sector--Business or other 
for-profits. Number of Respondents: 90,521. Number of Responses: 
173,810. Total Annual Hours: 34,762. (For policy questions regarding 
this collection contact Susan Miller at 410-786-2118. For all other 
issues call 410-786-1326.)
    3. Type of Information Collection Request: New collection; Title of 
Information Collection: End Stage Renal Disease (ESRD) System Access 
Request Form; Use: Within CMS, the Office of Clinical Standards and 
Quality is developing a new suite of systems to support the End Stage 
Renal Disease (ESRD) program. Due to the sensitivity of the data being 
collected and reported, CMS must ensure that only authorized personnel 
have access to data. Personnel are given access to the ESRD systems 
through the creation of user IDs and passwords within the QualityNet 
Identity Management System (QIMS); however, once within the system, the 
system determines the rights and privileges the personnel has over the 
data within the system.
    The sole purpose the End Stage Renal Disease System (ESRD) System 
Access Request Form is to identify the individual's data access rights 
once within the ESRD system. This function and the associated data 
collection is currently being accomplished under ``Part B'' of the 
QualityNet Identity Management System Account Form (CMS-10267; OCN: 
0938-1050). Once the ESRD System Access Form is approved, the 
QualityNet Identity Management System (QIMS) Account Form will be 
revised to remove Part B from the QIMS data collection. Form Number: 
CMS-10426 (OCN: 0938-New); Frequency: Yearly; Affected Public: Private 
Sector--Business or other for-profits. Number of Respondents: 25,000. 
Number of Responses: 25,000. Total Annual Hours: 6,250. (For policy 
questions regarding this collection contact Michelle Tucker at 410-786-
0736. For all other issues call 410-786-1326.)
    4. Type of Information Collection Request: New collection; Title of 
Information Collection: Probable Fraud Measurement Pilot; Use: The 
Centers for Medicare & Medicaid Services (CMS) is seeking Office of 
Management and Budget (OMB) approval of the collections required for a 
probable fraud measurement pilot. The probable fraud measurement pilot 
would establish a baseline estimate of probable fraud in payments for 
home health care services in the fee-for-service Medicare program. CMS 
and its agents will collect information from home health agencies, the 
referring physicians and Medicare beneficiaries selected in a national 
random sample of home health claims. The pilot will rely on the 
information collected along with a summary of the service history of 
the HHA, the referring provider, and the beneficiary to estimate the 
percentage of total payments that are associated with probable fraud 
and the percentage of all claims that are associated with probable 
fraud for Medicare fee-for-service home health. Form Number: CMS-10406 
(OCN: 0938-New); Frequency: Yearly; Affected Public: Individual and 
Private Sector--Business or other for-profits. Number of Respondents: 
6,000. Number of Responses: 6,000. Total Annual Hours: 10,500. (For 
policy questions regarding this collection contact Kelly Gent at 410-
786-0918. 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 E-mail 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 May 7, 2012:
    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: March 1, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-5439 Filed 3-5-12; 8:45 am]
BILLING CODE 4120-01-P
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