[Federal Register Volume 70, Number 179 (Friday, September 16, 2005)]
[Notices]
[Pages 54749-54750]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-18052]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-138, CMS-339, CMS-1450]


Agency Information Collection Activities: Submission for OMB 
Review; 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), 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 of a currently 
approved collection; Title of Information Collection: Medicare 
Geographic Classification Review Board (MGCRB) Procedures and 
Supporting Regulations in 42 CFR 412.256 and 412.230; Form Nos.: CMS-R-
138 (OMB <greek-i> 0938-0573); Use: Section 1886(d)(10) of the Social 
Security Act established the Medicare Geographic Classification Review 
Board (MGCRB), an entity with the authority to accept short-term 
hospital inpatient prospective payment system applications from 
hospitals requesting geographic reclassification for wage index or 
standardized payment amounts and to issue decisions on these requests. 
This regulation sets up the application process for prospective payment 
system hospitals that choose to appeal their geographic status to the 
MGCRB. This regulation also establishes procedural guidelines for the 
MGCRB; Frequency: Reporting--Annually; Affected Public: Business or 
other for-profit, Not-for-profit institutions; Number of Respondents: 
500; Total Annual Responses: 500; Total Annual Hours: 500.
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Medicare Provider 
Cost Report Reimbursement Questionnaire and Supporting Regulations in 
42 CFR 413.20, 413.24, and 415.60; Form Nos.: CMS-339 (OMB <greek-i> 
0938-0301); Use: The purpose of Form CMS-339 is to assist the provider 
in preparing an acceptable cost report and to minimize subsequent 
contact between the provider and its intermediary. Form CMS-339 
provides the basic data necessary to support the information in the 
cost report. This includes information the provider uses to develop the 
provider and professional components of physician compensation so that 
compensation can be properly allocated between the Part A and the Part 
B trust funds. CMS is currently working on eliminating Form CMS-339 and 
including the applicable questions on the individual cost report forms. 
Because of the time required to include the applicable questions in 
each of the individual cost reports, CMS is revising the currently 
approved information collection; Frequency: Annually; Affected Public: 
Business or other for-profit, not-for-profit institutions, State, Local 
or Tribal Governments; Number of Respondents: 35,904; Total Annual 
Responses: 35,904; Total Annual Hours: 618,210.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare Uniform 
Institutional Provider Bill and Supporting Regulations in 42 CFR 424.5; 
Form No.: CMS-1450 (OMB <greek-i>0938-0279); Use: Section 42 CFR 
424.5(a)(5) requires providers of services to submit claims prior to 
Medicare reimbursement. Charges are coded by revenue codes. The bill 
specifies diagnoses according to the International Classification of 
Diseases, Ninth Edition (ICD-9-CM) codes. Inpatient procedures are 
identified by ICD-9-CM codes, and outpatient procedures are described 
using the Healthcare Common Procedure Coding System (HCPCS). These are 
standard systems of identification for all major health insurance 
claims payers. Submission of information on the CMS-1450 permits 
Medicare intermediaries to receive consistent data for proper payment;

[[Page 54750]]

Frequency: On occasion; Affected Public: Not-for-profit institutions, 
business or other for profit; Number of Respondents: 51,629; Total 
Annual Responses: 174,461,278; Total Annual Hours: 1,997,581.
    To obtain copies of the supporting statement and any related forms 
for these paperwork collections referenced above, access CMS Web site 
address at http://www.cms.hhs.gov/regulations/pra/, or E-mail your 
request, including your address, phone number, OMB number, and CMS 
document identifier, to <a href="/cdn-cgi/l/email-protection#0656677663747169746d46656b75286e6e7528616970"><span class="__cf_email__" data-cfemail="134372637661647c617853707e603d7b7b603d747c65">[email protected]</span></a>, 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 October 17, 2005. 
OMB Human Resources and Housing Branch, Attention: Christopher Martin, 
New Executive Office Building, Room 10235, Washington, DC 20503.

    Dated: September 1, 2005.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. 05-18052 Filed 9-15-05; 8:45 am]
BILLING CODE 4120-01-P


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