Federal Register / Vol. 86, No. 103 / Tuesday, June 1, 2021 / Notices 29265 

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: Extension of a currently 

approved collection; Title of 

Information Collection: Verification of 

Clinic Data—Rural Health Clinic Form 

and Supporting Regulations; Use: The 

form is utilized as an application to be 

completed by suppliers of Rural Health 

Clinic (RHC) services requesting 

participation in the Medicare program. 

This form initiates the process of 

obtaining a decision as to whether the 

conditions for certification are met as a 

supplier of RHC services. It also 

promotes data reduction or introduction 

to and retrieval from the Automated 

Survey Process Environment (ASPEN) 

and related survey and certification 

databases by the CMS Regional Offices. 

Should any question arise regarding the 

structure of the organization, this 

information is readily available. Form 

Number: CMS–29 (OMB control number 

0938–0074); Frequency: Occasionally 

(initially and then every six years); 

Affected Public: Private Sector (Business 

or other for-profit and Not-for-profit 

institutions); Number of Respondents: 

1,887; Total Annual Responses: 5,661; 

Total Annual Hours: 1,269. (For policy 

questions regarding this collection 

contact Shonte Carter at 410–786–3532.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Psychiatric Unit 

Criteria Work Sheet; Use: Certain 

specialty hospitals and hospital 

specialty distinct-part units may be 

excluded from the Inpatient Medicare 

Prospective Payment System (IPPS) and 

be paid at a different rate. These 

specialty hospitals and distinct-part 

units of hospitals include Inpatient 

Rehabilitation Facilities (IRFs) units, 

Inpatient Rehabilitation Facilities (IRFs) 

hospitals and Inpatient Psychiatric 

Facilities (IPFs). 

CMS regulations at 42 CFR 412.20 

through 412.29 describe the criteria 

under which these specialty hospitals 

and specialty distinct-part hospital units 

are excluded from the IPPS. Form CMS– 

437 is used by Inpatient Psychiatric 

Facilities (IPFs) to attest to meeting the 

necessary requirements that make them 

exempt for receiving payment from 

Medicare under the IPPS. These IPFs 

must use CMS–437 to attest that they 

meet the requirements for IPPS exempt 

status prior to being placed into 

excluded status. The IPFs must re-attest 

to meeting the exclusion criteria 

annually. Form Number: CMS–437 

(OMB control number: 0938–0358); 

Frequency: Annually; Affected Public: 

Private sector—Business or other forprofits; Number of Respondents: 1,598; 

Total Annual Responses: 1,598; Total 

Annual Hours: 1,732. (For policy 

questions regarding this collection 

contact Caroline Gallaher at 410–786– 

8705.) 

3. Type of Information Collection 

Request: Extension of a previously 

approved collection; Title of 

Information Collection: CMS Identity 

Management (IDM) System; Use: HIPAA 

regulations require covered entities to 

verify the identity of the person 

requesting Personal Health Information 

(PHI) and the person’s authority to have 

access to that information. Per the 

HIPAA Security Rule, covered entities, 

regardless of their size, are required 

under Section 164.312(a)(2)(i) to ‘‘assign 

a unique name and/or number for 

identifying and tracking user identity.’’ 

A ‘user’ is defined in Section 164.304 as 

a ‘‘person or entity with authorized 

access’’. Accordingly, the Security Rule 

requires covered entities to assign a 

unique name and/or number to each 

employee or workforce member who 

uses a system that receives, maintains or 

transmits electronic PHI, so that system 

access and activity can be identified and 

tracked by user. This pertains to 

workforce members within health plans, 

group health plans, small or large 

provider offices, clearinghouses and 

beneficiaries. 

The information collected will be 

gathered and used solely by CMS, 

approved contractor(s), and state health 

insurance exchanges to prove the 

identity of an individual requesting 

electronic access to CMS protected 

information or services. Information 

confidentiality will conform to the 

Health Insurance Portability and 

Accountability Act (HIPAA) of 1996 and 

the Federal Information Security 

Management Act (FISMA) requirements. 

Respondents may also access CMS’ 

Terms of Service and Privacy Statement 

on the CMS Portal and IDM websites. 

CMS has moved from this centralized 

on premise model for enterprise identity 

management to a cloud-based solution, 

IDM, with multiple products providing 

specialized services: Okta Identity as a 

Service (IDaaS), which includes MultiFactor Authentication (MFA) services; 

Experian Remote Identity Proofing 

(RIDP) services; and Cloud Computing 

Services-Amazon Web Services/ 

Information Technology Operations 

(CCS–AWS/ITOps) Hub Hosting. In 

order to prove the identity of an 

individual requesting electronic access 

to CMS protected information or 

services, IDM (leveraging Experian 

Precise ID RIDP services) will collect a 

core set of attributes about that 

individual. Form Number: CMS–10452 

(OMB control number: 0938–1236); 

Frequency: Yearly; Affected Public: 

Individuals and Households; Number of 

Respondents: 560,000; Total Annual 

Responses: 560,000; Total Annual 

Hours: 186,667. (For policy questions 

regarding this collection contact 

Malachi Robinson at 410–786–1849). 

Dated: May 26, 2021. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2021–11491 Filed 5–28–21; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–179 and CMS– 

10775] 

Agency Information Collection 

Activities: Proposed Collection; 

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 (the 

PRA), federal agencies are required to 

publish notice in the Federal Register 


jbell on DSKJLSW7X2PROD with NOTICES
29266 Federal Register / Vol. 86, No. 103 / Tuesday, June 1, 2021 / Notices 

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 

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 must be received by 

August 2, 2021. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number. 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: ll, 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’ website address at 

website address at https://www.cms.gov/ 

Regulations-and-Guidance/Legislation/ 

PaperworkReductionActof1995/PRAListing.html. 

FOR FURTHER INFORMATION CONTACT: 

William N. Parham at (410) 786–4669. 

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–179—Medicaid State Plan Base 

Plan Pages 

CMS–10775—Medicare Severity 

Diagnosis Related Groups 

Reclassification Request (MS–DRGs) 

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: Revision of a currently 

approved collection; Title of 

Information Collection: Medicaid State 

Plan Base Plan Pages; Use: State 

Medicaid agencies complete the plan 

pages while we review the information 

to determine if the state has met all of 

the requirements of the provisions the 

states choose to implement. If the 

requirements are met, we will approve 

the amendments to the state’s Medicaid 

plan giving the state the authority to 

implement the flexibilities. For a state to 

receive Medicaid Title XIX funding, 

there must be an approved Title XIX 

state plan. Form Number: CMS–179 

(OMB control number 0938–0193); 

Frequency: Occasionally; Affected 

Public: State, Local, and Tribal 

Governments; Number of Respondents: 

56; Total Annual Responses: 1,120; 

Total Annual Hours: 22,400. (For policy 

questions regarding this collection 

contact Gary Knight at 304–347–5723.) 

2. Type of Information Collection 

Request: New Collection; Title of 

Information Collection: Medicare 

Severity Diagnosis Related Groups 

Reclassification Request (MS–DRGs); 

Use: Section 1886(d)(4) of the Act 

establishes a classification system, 

referred to as DRGs, for inpatient 

discharges and adjusts payments under 

the IPPS based on appropriate weighting 

factors assigned to each MS–DRG. 

Section 1886(d)(4)(C)(i) of the Act 

specifies adjustments to the 

classification and weighting factors 

shall occur ‘‘at least annually to reflect 

changes in treatment patterns, 

technology, and other factors which 

may change the relative use of hospital 

resources.’’ 

The requests are evaluated in the 

Division of Coding and DRGs (DCDRG) 

by the DRG and Coding Team and the 

clinical advisors (medical officers) in 

both the Technology, Coding and 

Pricing Group (TCPG) and the Hospital 

and Ambulatory Policy Group (HAPG), 

along with the CMS contractor(s). This 

team participates via conference calls in 

the review of MedPAR claims data to 

analyze and perform clinical review of 

the requested changes. Based on the 

examination of claims data and clinical 

judgment, the team provides 

recommendations to CMS and HHS 

leadership for proposed changes. Per the 

statue, proposed MS–DRG changes and 

payment adjustments must go through 

notice and comment rulemaking giving 

the opportunity for the public to 

comment. Finalized MS–DRG changes 

are effective with discharges on and 

after October 1, consistent with the 

beginning of the fiscal year. CMS makes 

the updated MS–DRG Grouper software 

and related materials that reflects the 

changes available to the public for free 

via download at: https://www.cms.gov/ 

Medicare/Medicare-Fee-for-ServicePayment/AcuteInpatientPPS/MS-DRGClassifications-and-Software. 

When an application is submitted in 

MEARISTM, the DRG and Coding Team 

in DCDRG will have instant access to 

the application request and 

accompanying materials to facilitate a 

more timely review of the request, 

including the ability to efficiently 

inform other team members involved in 

the process that information is available 

for their review and input. Form 

Number: CMS–10775 (OMB control 

number 0938-New); Frequency: 

Occasionally; Affected Public: Private 

Sector, Business or other for-profits, 

Not-for-profits institutions; Number of 

Respondents: 50; Total Annual 

Responses: 50; Total Annual Hours: 

48,000. (For policy questions regarding 

this collection contact Marilu Hue at 

410–786–4510.) 

Dated: May 26, 2021. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2021–11490 Filed 5–28–21; 8:45 am] 

BILLING CODE 4120–01–P 


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