50360 Federal Register / Vol. 86, No. 171 / Wednesday, September 8, 2021 / Notices 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10765] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, Health and Human 

Services (HHS). 

ACTION: Notice. 

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 

(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 

a second opportunity for public 

comment on the notice. Interested 

persons are invited to send comments 

regarding the burden estimate or any 

other aspect of this collection of 

information, including the necessity and 

utility of the proposed information 

collection for the proper performance of 

the agency’s functions, the accuracy of 

the estimated burden, ways to enhance 

the quality, utility, and clarity of the 

information to be collected, and the use 

of automated collection techniques or 

other forms of information technology to 

minimize the information collection 

burden. 

DATES: Comments on the collection(s) of 

information must be received by the 

OMB desk officer by October 8, 2021. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain . Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. 

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’ website address at 

website address at: https://

www.cms.gov/Regulations-andGuidance/Legislation/ 

PaperworkReductionActof1995/PRAListing.html. 

FOR FURTHER INFORMATION CONTACT: 

William Parham at (410) 786–4669. 

SUPPLEMENTARY INFORMATION: Under the 

Paperwork Reduction Act of 1995 (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 (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-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 that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: New collection (Request for a 

new OMB control number); Title of 

Information Collection: Review Choice 

Demonstration for Inpatient 

Rehabilitation Facility (IRF) Services; 

Use: Section 402(a)(1)(J) of the Social 

Security Amendments of 1967 (42 

U.S.C. 1395b–1(a)(1)(J)) authorizes the 

Secretary to ‘‘develop or demonstrate 

improved methods for the investigation 

and prosecution of fraud in the 

provision of care or services under the 

health programs established by the 

Social Security Act (the Act).’’ Pursuant 

to this authority, the CMS seeks to 

develop and implement a Medicare 

demonstration project, which CMS 

believes will help assist in developing 

improved procedures for the 

identification, investigation, and 

prosecution of Medicare fraud occurring 

among IRFs providing services to 

Medicare beneficiaries. 

This demonstration will assist in 

developing improved procedures for the 

identification, investigation, and 

prosecution of potential Medicare fraud. 

The demonstration will ensure that 

payments for IRF services are 

appropriate through either pre-claim or 

postpayment review, thereby working 

towards the prevention and 

identification of potential fraud, waste, 

and abuse, as well as protecting the 

Medicare Trust Funds from improper 

payments while reducing Medicare 

appeals. CMS proposes implementing 

the demonstration in Alabama, then 

expand to Pennsylvania, Texas, and 

California. After the initial four states, 

CMS will expand the demonstration to 

include the IRFs in any state that bill to 

Medicare Administrative Contractor 

(MAC) jurisdictions JJ, JL, JH, and JE. 

Under this demonstration, CMS 

proposes to offer choices for providers 

to demonstrate their compliance with 

CMS’ IRF policies. Providers in the 

demonstration states may participate in 

either 100 percent pre-claim review, or 

100 percent postpayment review. These 

providers will continue to be subject to 

the selected review method until the 

IRF reaches the target affirmation or 

claim approval rate (90 percent, based 

on a minimum of 10 pre-claim requests 

or claims submitted). Once an IRF 

reaches the target pre-claim review 

affirmation or postpayment review 

claim approval rate, it may choose to be 

relieved from claim reviews under the 

demonstration, except for a spot check 

of five percent of their claims to ensure 

continued compliance. 

The information required under this 

collection is required by Medicare 

contractors to determine proper 

payment or if there is a suspicion of 

fraud. Under the pre-claim review 

choice, IRFs will send the pre-claim 

review request along with all required 

documentation to the Medicare 

contractor for review prior to submitting 

the final claim for payment. If a claim 

is submitted without a pre-claim review 

decision on file, the Medicare contractor 

will request the information from the 

IRF to determine if payment is 

appropriate. For the postpayment 

review option, the Medicare contractor 

will also request the information from 

the IRF provider who submitted the 

claim for payment from the Medicare 

program to determine if payment was 

appropriate. Form Number: CMS–10765 

(OMB Control Number: 0938–NEW); 

Frequency: Occasionally; Affected 

Public: Private Sector (Business or other 

for-profits and Not-for-profits); Number 

of Respondents: 526; Number of 

Responses: 179,910; Total Annual 

Hours: 89,955. (For questions regarding 

this collection contact Jaclyn Gray (410) 

786–3744.) 

Dated: September 3, 2021. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2021–19476 Filed 9–7–21; 8:45 am] 

BILLING CODE 4120–01–P 


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