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 ).

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 Collections

1. Type of Information Collection Request: Reinstatement with change of a previously approved collection; Title of Information Collection: Inpatient Psychiatric Unit Criteria Work Sheet; Use: We request a reinstatement with change of the OMB approval for the CMS form approved under OMB Control number 0938-0358. We have made non-substantive formatting changes to section 1 of the CMS-437 form including providing separate data field for the name, street address, city, state and zip code for the Inpatient Psychiatric Unit (IPU). We also added new data fields for the CCN number and telephone number for the IPU. In section 2 we have updated the text of several CFR code sections for accuracy.

Medicare has several types of schedules with which payments are made to inpatient hospitals. Acute care hospitals are paid by Medicare using the Inpatient Prospective Payment System (IPPS). Hospital outpatient services are paid by Medicare using the Medicare Hospital Outpatient Prospective Payment System (HOPPS). Inpatient Psychiatric Facilities (IPFs) and Inpatient Psychiatric Units (IPUs) are paid by Medicare using the Inpatient Psychiatric Facility Prospective Payment System (IPU PPS).

For IPFs and IPUs to be paid by Medicare under the higher paying Inpatient Psychiatric Facility Prospective Payment System (IPF PPU), they must prove that they meet the requirements to be exempt from receiving payment from Medicare under the lower paying hospital IPPS. The CMS-437 form is used by IPUs to attest that they meet the necessary requirements that make them exempt from receiving Medicare payments under the lower hospital rate provided by the IPPS and instead are eligible to receive a higher payment rate under the IPU PPS.

New IPUs must submit an initial CMS-437 to CMS when they apply for participation in the Medicare program to request new IPPS excluded status. Thereafter, the existing IPUs are required to submit completed CMS-437 forms annually to maintain their IPPS exclusion status, as required by 42 CFR 412.25. The IPUs submit their completed CMS-437 form to the CMS Locations (formerly named CMS Regional Offices) via the applicable SAs. ( printed page 68962)

Prior to November 2007, SA surveyors conducted onsite IPPS exclusion surveys to verify that the IPPS exclusion criteria were met by the facility. The SA surveyor completed the CMS-437 form prior to placing an IPU into IPPS excluded status. However, on November 5, 2007, CMS suspended the requirement for onsite IPPS exclusion surveys and instead began allowing IPUs to self-attest to meeting the IPPS exclusion criteria by completing and submitting the CMS-437 form. (See: Survey & Certification Memo 08-03, dated 11/05/2007). As a result, instead of having the SAs perform IPPS exclusion surveys, the IPUs are now required to complete the CMS-437 form annually as a self-attestation indicating they continue to meet the IPPS exclusion criteria. Form Number: CMS-437 (OMB control number: 0938-0358); Frequency: Annually; Affected Public: Private sector—Business or other for-profits; Number of Respondents: 1,534; Total Annual Responses: 1,534; Total Annual Hours: 1,551. (For policy questions regarding this collection contact Caroline Gallaher at 410-786-8705.)

91 FR 68961