55846 Federal Register / Vol. 73, No. 188 / Friday, September 26, 2008 / Notices 

have an associated CMN for the 

beneficiary. Suppliers (those who bill 

for the items) complete the 

administrative information (e.g., 

patient’s name and address, items 

ordered, etc.) on each CMN. The 1994 

Amendments to the Social Security Act 

require that the supplier also provide a 

narrative description of the items 

ordered and all related accessories, their 

charge for each of these items, and the 

Medicare fee schedule allowance (where 

applicable). The supplier then sends the 

CMN to the treating physician or other 

clinicians (e.g., physician assistant, 

LPN, etc.) who completes questions 

pertaining to the beneficiary’s medical 

condition and signs the CMN. The 

physician or other clinician returns the 

CMN to the supplier who has the option 

to maintain a copy and then submits the 

CMN (paper or electronic) to CMS, 

along with a claim for reimbursement. 

Form Number: CMS–846–849, 854, 

10125, 10126, 10269 (OMB# 0938– 

0679); Frequency: Occasionally; 

Affected Public: Business or other forprofit and Not-for-profit institutions; 

Number of Respondents: 59,200; Total 

Annual Responses: 6,480,000; Total 

Annual Hours: 1,296,000. 

3. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Withholding 

Medicare Payments to Recover 

Medicaid Overpayments and 

Supporting Regulations in 42 CFR 

44.31; Use: Overpayments may occur in 

either the Medicare and Medicaid 

program, at times resulting in a situation 

where an institution or person that 

provides services owes a repayment to 

one program while still receiving 

reimbursement from the other. Certain 

Medicaid providers which are subject to 

offsets for the collection of Medicaid 

overpayments may terminate or 

substantially reduce their participation 

in Medicaid, leaving the State Medicaid 

Agency unable to recover the amounts 

due. These information collection 

requirements give CMS the authority to 

recover Medicaid overpayments by 

offsetting payments due to a provider 

under the program. Form Number: 

CMS–R–21 (OMB# 0938–0287); 

Frequency: On occasion; Affected 

Public: State, Local or Tribal 

Governments; Number of Respondents: 

54; Total Annual Responses: 27; Total 

Annual Hours: 81. 

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. 

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 27, 2008: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, New 

Executive Office Building, Room 10235, 

Washington, DC 20503, Fax Number: 

(202) 395–6974. 

Dated: September 18, 2008. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E8–22582 Filed 9–25–08; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–372 and CMS– 

R–54] 

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: Revision of a currently 

approved collection; Title of 

Information Collection: Annual Report 

on Home and Community Based 

Services Waivers and Supporting 

Regulations in 42 CFR 440.180 and 

441.300–310.; Use: States within an 

approved waiver under section 1915(c) 

of the act are required to submit a report 

annually in order for CMS to: (1) Verify 

that State assurances regarding waiver 

cost-neutrality are met; and (2) 

Determine the waiver’s impact on the 

type, amount, and cost of services 

provided under the State Plan and 

health welfare of recipients. Form 

Number: CMS–372 (OMB# 0938–0272); 

Frequency: Yearly; Affected Public: 

State, Local, or Tribal Governments; 

Number of Respondents: 49; Total 

Annual Responses: 305; Total Annual 

Hours: 13,115. 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: National 

Medicare & You Education Program 

(NMEP) Survey of Medicare 

Beneficiaries Use: The Centers for 

Medicare and Medicaid Services is 

requesting a revision of this information 

collection request to continue to collect 

information from Medicare 

beneficiaries, caregivers, health care 

providers, and health information 

providers. It is critical for this agency to 

obtain feedback from the 

aforementioned groups so that the 

agency can accurately assess the needs 

of the Medicare audience. Using random 

digit dial and/or an administrative 

sample, members of the Medicare 

audience will be called and asked to 

complete the survey via telephone. The 

results of this survey will be compiled 

and studied so that communication may 

be amended to benefit Medicare’s 

audience. The survey has the following 

objectives: To assess satisfaction with 

and knowledge of the Medicare 

program; to gather information on 

health behaviors and quality of health 

care; to determine the most used source 

for Medicare information; and to gather 

information from health care provider 

and health information providers. Form 

Number: CMS–R–54 (OMB# 0938– 

0738); Frequency: Once; Affected 

Public: Individuals and Households, 

Private Sector—Business or other forprofits; Number of Respondents: 7,000; 

Total Annual Responses: 7,000; Total 

Annual Hours: 1,750. 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS’ Web site 

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 


jlentini on PROD1PC65 with NOTICES
Federal Register / Vol. 73, No. 188 / Friday, September 26, 2008 / Notices 55847 

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 November 25, 2008: 

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 lllll, Room C4– 

26–05, 7500 Security Boulevard, 

Baltimore, Maryland 21244–1850. 

Dated: September 18, 2008. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E8–22584 Filed 9–25–08; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–4136–N] 

Medicare Program; Medicare Appeals; 

Adjustment to the Amount in 

Controversy Threshold Amounts for 

Calendar Year 2009 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

annual adjustment in the amount in 

controversy (AIC) threshold amounts for 

Administrative Law Judge (ALJ) 

hearings and judicial review under the 

Medicare appeals process. The 

adjustment to the AIC threshold 

amounts will be effective for requests 

for ALJ hearings and judicial review 

filed on or after January 1, 2009. The 

2009 AIC threshold amounts are $120 

for ALJ hearings and $1,220 for judicial 

review. 

DATES: Effective Date: This notice is 

effective on January 1, 2009. 

FOR FURTHER INFORMATION CONTACT: Liz 

Hosna, (410) 786–4993. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Section 1869(b)(1)(E) of the Social 

Security Act (the Act), as amended by 

section 521 of the Medicare, Medicaid, 

and SCHIP Benefits Improvement and 

Protection Act of 2000 (BIPA), 

established the AIC threshold amounts 

for ALJ hearing requests and judicial 

review at $100 and $1000, respectively, 

for Medicare Part A and Part B appeals. 

Section 940 of the Medicare 

Prescription Drug, Improvement, and 

Modernization Act of 2003 (MMA), 

amended section 1869(b)(1)(E) of the 

Act to require the AIC threshold 

amounts for ALJ hearings and judicial 

review to be adjusted annually. The AIC 

threshold amounts are to be adjusted, as 

of January 2005, by the percentage 

increase in the medical care component 

of the consumer price index for all 

urban consumers (U.S. city average) for 

July 2003 to July of the year preceding 

the year involved and rounded to the 

nearest multiple of $10. Section 

940(b)(2) of the MMA provided 

conforming amendments to apply the 

AIC adjustment requirement to 

Medicare Part C (Medicare Advantage 

‘‘MA’’) appeals and certain health 

maintenance organization and 

competitive health plan appeals. Health 

care prepayment plans are also subject 

to MA appeals rules, including the AIC 

adjustment requirement. Section 101 of 

the MMA provides for the application of 

the AIC adjustment requirement to 

Medicare Part D appeals. 

A. Medicare Part A and Part B Appeals 

The statutory formula for the annual 

adjustment to the AIC threshold 

amounts for ALJ hearings and judicial 

review of Medicare Part A and Part B 

appeals, set forth at section 

1869(b)(1)(E) of the Act, is included in 

the applicable implementing 

regulations, 42 CFR Part 405, Subpart I, 

at § 405.1006(b). The regulations require 

the Secretary of the Department of 

Health and Human Services (the 

Secretary) to publish changes to the AIC 

threshold amounts in the Federal 

Register (§ 405.1006(b)(2)). In order to 

be entitled to a hearing before an ALJ, 

a party to a proceeding must meet the 

AIC requirements at § 405.1006(b). 

Similarly, a party must meet the AIC 

requirement at § 405.1006(c) at the time 

judicial review is requested for the court 

to have jurisdiction over the appeal 

(§ 405.1136(a)). 

B. Medicare Part C (Medicare 

Advantage) Appeals 

Section 940(b)(2) of the MMA applies 

the AIC adjustment requirement to Part 

C (MA) appeals by amending section 

1852(g)(5) of the Act. The implementing 

regulations for Medicare Part C appeals 

are found at 42 CFR Part 422, Subpart 

M. Specifically, § 422.600 and § 422.612 

discuss the AIC threshold amounts for 

ALJ hearings and judicial review. 

Section 422.600 grants any party to 

the reconsideration, except the MA 

organization, a right to an ALJ hearing 

as long as the amount remaining in 

controversy after reconsideration meets 

the threshold requirement established 

annually by the Secretary. Section 

422.612 states that any party, including 

the MA organization, may request 

judicial review if the amount in 

controversy meets the threshold 

requirement established annually by the 

Secretary. 

C. Health Maintenance Organizations, 

Competitive Medical Plans, and Health 

Care Prepayment Plans 

Section 1876(c)(5)(B) of the Act states 

that the annual adjustment to the AIC 

dollar amounts set forth in section 

1869(b)(1)(E) of the Act applies to 

certain beneficiary appeals within the 

context of health maintenance 

organizations and competitive medical 

plans. The applicable implementing 

regulations for Medicare Part C appeals 

are set forth in 42 CFR Part 422, Subpart 

M, and as discussed above, apply to 

these appeals. The Medicare Part C 

appeals rules also apply to health care 

prepayment plan appeals. 

D. Medicare Part D (Prescription Drug 

Plan) Appeals 

The annually adjusted AIC threshold 

amounts for ALJ hearings and judicial 

review that apply to Medicare Parts A, 

B, and C appeals also apply to Medicare 

Part D appeals. Section 101 of the MMA 

added section 1860D–4(h)(1) of the Act 

regarding Part D appeals. This statutory 

provision requires a prescription drug 

plan sponsor to meet the requirements 

set forth in sections 1852(g)(4) and (g)(5) 

of the Act, in a similar manner as MA 

organizations. As noted above, the 

annually adjusted AIC threshold 

requirement was added to section 

1852(g)(5) of the Act by section 

940(b)(2)(A) of the MMA. The 

implementing regulations for Medicare 

Part D appeals can be found at 42 CFR 

Part 423, Subpart M. The regulations 

impart at § 423.562(c) that unless the 

Part D appeals rules provide otherwise, 

the Part C appeals rules (including the 

annually adjusted AIC threshold 

amount) apply to Part D appeals to the 

extent they are appropriate. More 

specifically, § 423.610 and § 423.630 of 

the Part D appeals rules discuss the AIC 

threshold amounts for ALJ hearings and 

judicial review. Section 423.610(a) 


jlentini on PROD1PC65 with NOTICES