80 FR 53516 - Agency Information Collection Activities: Proposed Collection; Comment Request
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 80, Issue 172 (September 4, 2015)
Centers for Medicare & Medicaid Services
Federal Register Volume 80, Issue 172 (September 4, 2015)
| Page Range | 53516-53517 | |
| FR Document | 2015-22033 |
[Federal Register Volume 80, Number 172 (Friday, September 4, 2015)] [Notices] [Pages 53516-53517] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-22033] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifiers: CMS-1728-94 and CMS-2567] Agency Information Collection Activities: Proposed Collection; Comment Request AGENCY: Centers for Medicare & Medicaid Services. 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 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 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 [[Page 53517]] minimize the information collection burden. DATES: Comments must be received by November 3, 2015. 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 ____, 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' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995. 2. Email your request, including your address, phone number, OMB number, and CMS document identifier, to [email protected]. 3. Call the Reports Clearance Office at (410) 786-1326. FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786- 1326. 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-10387 Skilled Nursing Facility (SNF) Prospective Payment System and Consolidated Billing CMS-2567 Statement of Deficiencies and Plan of Correction and Supporting Regulations 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: Home Health Agency Cost Report; Use: Providers of Services participating in the Medicare program are required under sections 1815(a), 1833(e) and 1861(v)(1)(A) of the Social Security Act (42 U.S.C. 1395g) to submit annual information to achieve settlement of costs for health care services rendered to Medicare beneficiaries. In addition, regulations at 42 CFR 413.20 and 413.24 require adequate cost data and cost reports from providers on an annual basis. The Form CMS-1728-94 cost report is needed to determine a provider's reasonable cost incurred in furnishing medical services to Medicare beneficiaries and reimbursement due to or from a provider. Form Number: CMS-1728-94 (OMB control number: 0938- 0022); Frequency: Annually; Affected Public: Private sector (Business or other for-profits and Not-for-profit institutions); Number of Respondents: 11,352; Total Annual Responses: 11,352; Total Annual Hours: 2,576,904. (For policy questions regarding this collection contact Angela DiGorgio at 410-786-4516.) 2. Type of Information Collection Request: Extension without change of a currently approved collection; Title of Information Collection: Statement of Deficiencies and Plan of Correction Supporting Regulations; Use: Section 1864(a) of the Social Security Act requires that the Secretary use state survey agencies to conduct surveys to determine whether health care facilities meet Medicare and Clinical Laboratory Improvement Amendments participation requirements. The Form CMS-2567 is the means by which the survey findings are documented. This section of the law further requires that compliance findings resulting from these surveys be made available to the public within 90 days of such surveys. The Form CMS-2567 is the vehicle for this disclosure. The form is also used by health care facilities to document their plan of correction and by CMS, the states, facilities, purchasers, consumers, advocacy groups, and the public as a source of information about quality of care and facility compliance. The regulations at 42 CFR 488.18 require that state survey agencies document all deficiency findings on a statement of deficiencies and plan of correction, which is the CMS-2567. Sections 488.26 and 488.28 further delineate how compliance findings must be recorded and that CMS prescribed forms must be used. Form Number: CMS-2567 (OMB Control Number: 0938-0391); Frequency: Yearly and occasionally; Affected Public: Private Sector (Business or other for-profit and Not-for-profit institutions); Number of Respondents: 64,500; Total Annual Responses: 64,500; Total Annual Hours: 128,083. (For policy questions regarding this collection contact Sharon Lash at 410-786-9457.) Dated: September 1, 2015. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2015-22033 Filed 9-3-15; 8:45 am] BILLING CODE 4120-01-P
![53516 Federal Register / Vol. 80, No. 172 / Friday, September 4, 2015 / Notices
and CMS document identifier, to new OMB control number); Title of and patients) can use the information to
Paperwork@cms.hhs.gov. Information Collection: Generic inform decision making and better
3. Call the Reports Clearance Office at Clearance for the Heath Care Payment understand market dynamics in relation
(410) 786–1326. Learning and Action Network; Use: The to alternative payment models. Form
FOR FURTHER INFORMATION CONTACT: Center for Medicare and Medicaid Number: CMS–10575 (OMB control
Reports Clearance Office at (410) 786– Services (CMS), through the Center for number: 0938–NEW); Frequency:
1326. Medicare and Medicaid Innovation, Occasionally; Affected Public:
SUPPLEMENTARY INFORMATION: Under the
develops and tests innovative new Individuals; Private Sector (Business or
Paperwork Reduction Act of 1995 (PRA) payment and service delivery models in other For-profit and Not-for-profit
accordance with the requirements of institutions), State, Local and Tribal
(44 U.S.C. 3501–3520), federal agencies
section 1115A and in consideration of Governments; Number of Respondents:
must obtain approval from the Office of
the opportunities and factors set forth in 9,570; Total Annual Responses: 20,280;
Management and Budget (OMB) for each
section 1115A(b)(2) of the Act. To date, Total Annual Hours: 49,432. (For policy
collection of information they conduct
CMS has built a portfolio of 26 models questions regarding this collection
or sponsor. The term ‘‘collection of
(in operation or already announced) that contact Dustin Allison at 410–786–
information’’ is defined in 44 U.S.C.
have attracted participation from a 8830.)
3502(3) and 5 CFR 1320.3(c) and
broad array of health care providers,
includes agency requests or Dated: September 1, 2015.
states, payers, and other stakeholders.
requirements that members of the public William N. Parham, III,
During the development of models,
submit reports, keep records, or provide CMS builds on ideas received from Director, Paperwork Reduction Staff, Office
information to a third party. Section stakeholders—consulting with clinical of Strategic Operations and Regulatory
3506(c)(2)(A) of the PRA (44 U.S.C. and analytical experts, as well as with
Affairs.
3506(c)(2)(A)) requires federal agencies representatives of relevant federal and [FR Doc. 2015–22020 Filed 9–3–15; 8:45 am]
to publish a 30-day notice in the state agencies. BILLING CODE 4120–01–P
Federal Register concerning each On January 26, 2015, Secretary
proposed collection of information, Burwell announced the ambitious goal
including each proposed extension or to have 30% of Medicare Fee-For- DEPARTMENT OF HEALTH AND
reinstatement of an existing collection Service payments tied to alternative HUMAN SERVICES
of information, before submitting the payment models (such as Pioneer ACOs
collection to OMB for approval. To Centers for Medicare & Medicaid
or bundled payment arrangements) by
comply with this requirement, CMS is Services
the end of 2016, and 50% of payments
publishing this notice that summarizes by the end of 2018. To reach this goal,
the following proposed collection(s) of [Document Identifiers: CMS–1728–94 and
CMS will continue to partner with CMS–2567]
information for public comment: stakeholders across the health care
1. Type of Information Collection system to catalyze transformation Agency Information Collection
Request: Extension without change of a through the use of alternative payment Activities: Proposed Collection;
currently approved collection; Title of models. To this end, CMS launched the Comment Request
Information Collection: Hospice Survey Health Care Payment Learning and
and Deficiencies Report Form and Action Network, an effort to accelerate AGENCY: Centers for Medicare &
Supporting Regulations; Use: We use the transition to alternative payment Medicaid Services.
the information collected as the basis for models, identify best practices in their ACTION: Notice.
certification decisions for hospices that implementation, collaborate with
wish to obtain or retain participation in payers, providers, consumers, SUMMARY: The Centers for Medicare &
the Medicare and Medicaid programs. purchasers, and other stakeholders, and Medicaid Services (CMS) is announcing
The information is used by CMS monitor the adoption of value-based an opportunity for the public to
regional offices, which have the alternative payment models across the comment on CMS’ intention to collect
delegated authority to certify Medicare health care system. A system wide information from the public. Under the
facilities for participation, and by State transition to alternative payment models Paperwork Reduction Act of 1995 (the
Medicaid agencies, which have will strengthen the ability of CMS to PRA), federal agencies are required to
comparable authority under Medicaid. implement existing models and design publish notice in the Federal Register
The information on the Hospice Survey new models that improve quality and concerning each proposed collection of
and Deficiencies Report Form is coded decrease costs for CMS beneficiaries. information (including each proposed
for entry into the OSCAR system. The The information collected from LAN extension or reinstatement of an existing
data is analyzed by the CMS regional participants will be used by the CMS collection of information) and to allow
offices and by the CMS central office Innovation Center to potentially inform 60 days for public comment on the
components for program evaluation and the design, selection, testing, proposed action. Interested persons are
monitoring purposes. The information is modification, and expansion of invited to send comments regarding our
also available to the public upon innovative payment and service burden estimates or any other aspect of
request. Form Number: CMS–643 (OMB delivery models in accordance with the this collection of information, including
control number: 0938–0379); Frequency: requirements of section 1115A, while any of the following subjects: (1) The
Yearly; Affected Public: State, Local, or monitoring progress towards the necessity and utility of the proposed
mstockstill on DSK4VPTVN1PROD with NOTICES
Tribal Governments; Number of Secretary’s goal to increase the information collection for the proper
Respondents: 3,976; Total Annual percentage of payments tied to performance of the agency’s functions;
Responses: 1,325; Total Annual Hours: alternative payment models across the (2) the accuracy of the estimated
1,325. (For policy questions regarding U.S. health care system. In addition, the burden; (3) ways to enhance the quality,
this collection contact Annette Snyder requested information will be made utility, and clarity of the information to
at 410–786–0807.) publically available so that LAN be collected; and (4) the use of
2. Type of Information Collection participants (payers, providers, automated collection techniques or
Request: New collection (Request for a consumers, employers, state agencies, other forms of information technology to
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![Federal Register / Vol. 80, No. 172 / Friday, September 4, 2015 / Notices 53517
minimize the information collection 1320.3(c) and includes agency requests this disclosure. The form is also used by
burden. or requirements that members of the health care facilities to document their
DATES: Comments must be received by public submit reports, keep records, or plan of correction and by CMS, the
November 3, 2015. provide information to a third party. states, facilities, purchasers, consumers,
Section 3506(c)(2)(A) of the PRA advocacy groups, and the public as a
ADDRESSES: When commenting, please
requires federal agencies to publish a source of information about quality of
reference the document identifier or 60-day notice in the Federal Register care and facility compliance. The
OMB control number. To be assured concerning each proposed collection of regulations at 42 CFR 488.18 require
consideration, comments and information, including each proposed that state survey agencies document all
recommendations must be submitted in extension or reinstatement of an existing deficiency findings on a statement of
any one of the following ways: collection of information, before deficiencies and plan of correction,
1. Electronically. You may send your submitting the collection to OMB for which is the CMS–2567. Sections
comments electronically to http:// approval. To comply with this 488.26 and 488.28 further delineate how
www.regulations.gov. Follow the requirement, CMS is publishing this compliance findings must be recorded
instructions for ‘‘Comment or notice. and that CMS prescribed forms must be
Submission’’ or ‘‘More Search Options’’ used. Form Number: CMS–2567 (OMB
to find the information collection Information Collection
Control Number: 0938–0391);
document(s) that are accepting 1. Type of Information Collection Frequency: Yearly and occasionally;
comments. Request: Revision of a currently Affected Public: Private Sector (Business
2. By regular mail. You may mail approved collection; Title of or other for-profit and Not-for-profit
written comments to the following Information Collection: Home Health institutions); Number of Respondents:
address: CMS, Office of Strategic Agency Cost Report; Use: Providers of 64,500; Total Annual Responses:
Operations and Regulatory Affairs, Services participating in the Medicare 64,500; Total Annual Hours: 128,083.
Division of Regulations Development, program are required under sections (For policy questions regarding this
Attention: Document Identifier/OMB 1815(a), 1833(e) and 1861(v)(1)(A) of the collection contact Sharon Lash at 410–
Control Number ____, Room C4–26–05, Social Security Act (42 U.S.C. 1395g) to 786–9457.)
7500 Security Boulevard, Baltimore, submit annual information to achieve
Maryland 21244–1850. Dated: September 1, 2015.
settlement of costs for health care
To obtain copies of a supporting services rendered to Medicare William N. Parham, III,
statement and any related forms for the beneficiaries. In addition, regulations at Director, Paperwork Reduction Staff, Office
proposed collection(s) summarized in 42 CFR 413.20 and 413.24 require of Strategic Operations and Regulatory
this notice, you may make your request Affairs.
adequate cost data and cost reports from
using one of following: providers on an annual basis. The Form [FR Doc. 2015–22033 Filed 9–3–15; 8:45 am]
1. Access CMS’ Web site address at CMS–1728–94 cost report is needed to BILLING CODE 4120–01–P
http://www.cms.hhs.gov/ determine a provider’s reasonable cost
PaperworkReductionActof1995. incurred in furnishing medical services
2. Email your request, including your to Medicare beneficiaries and DEPARTMENT OF HEALTH AND
address, phone number, OMB number, reimbursement due to or from a HUMAN SERVICES
and CMS document identifier, to provider. Form Number: CMS–1728–94 Administration for Children and
Paperwork@cms.hhs.gov. (OMB control number: 0938–0022); Families
3. Call the Reports Clearance Office at Frequency: Annually; Affected Public:
(410) 786–1326. Private sector (Business or other for- Submission for OMB Review;
FOR FURTHER INFORMATION CONTACT: profits and Not-for-profit institutions); Comment Request
Reports Clearance Office at (410) 786– Number of Respondents: 11,352; Total
1326. Annual Responses: 11,352; Total Title: Assets for Independence (AFI)
Annual Hours: 2,576,904. (For policy Program Evaluation.
SUPPLEMENTARY INFORMATION: OMB No.: 0970–0414.
questions regarding this collection
Contents contact Angela DiGorgio at 410–786– Description: The U.S. Department of
4516.) Health and Human Services,
This notice sets out a summary of the 2. Type of Information Collection Administration for Children and
use and burden associated with the Request: Extension without change of a Families (ACF) is proposing a data
following information collections. More currently approved collection; Title of collection activity as part of an
detailed information can be found in Information Collection: Statement of experimental evaluation of the Assets
each collection’s supporting statement Deficiencies and Plan of Correction for Independence (AFI) Program. The
and associated materials (see Supporting Regulations; Use: Section purpose of this study is to assess the
ADDRESSES). 1864(a) of the Social Security Act impact of participation in AFI-funded
CMS–10387 Skilled Nursing Facility requires that the Secretary use state individual development account (IDA)
(SNF) Prospective Payment System survey agencies to conduct surveys to projects on the savings, asset purchases,
and Consolidated Billing determine whether health care facilities and economic well-being of low-income
CMS–2567 Statement of Deficiencies meet Medicare and Clinical Laboratory individuals and families. While some
and Plan of Correction and Improvement Amendments evaluations suggest that IDAs help low-
Supporting Regulations
mstockstill on DSK4VPTVN1PROD with NOTICES
participation requirements. The Form income families save, rigorous
Under the PRA (44 U.S.C. 3501– CMS–2567 is the means by which the experimental research is limited. Few
3520), federal agencies must obtain survey findings are documented. This studies have focused on AFI-funded
approval from the Office of Management section of the law further requires that IDAs, and few have tested alternative
and Budget (OMB) for each collection of compliance findings resulting from design features. The Assets for
information they conduct or sponsor. these surveys be made available to the Independence Evaluation is the first
The term ‘‘collection of information’’ is public within 90 days of such surveys. experimental evaluation of IDA projects
defined in 44 U.S.C. 3502(3) and 5 CFR The Form CMS–2567 is the vehicle for operating under the Assets for
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Document Created: 2015-12-15 09:58:28
Document Modified: 2015-12-15 09:58:28
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Dates | Comments must be received by November 3, 2015. | |
| Contact | Reports Clearance Office at (410) 786- 1326. | |
| FR Citation | 80 FR 53516 |
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