Agency Information Collection Activities: Submission for OMB Review; Comment Request
| Citation | 84 FR 26877 |
| Record Number | 2019-12118 |
| Published date | 10 June 2019 |
| Section | Notices |
| Court | Centers For Medicare & Medicaid Services |
Federal Register, Volume 84 Issue 111 (Monday, June 10, 2019)
[Federal Register Volume 84, Number 111 (Monday, June 10, 2019)]
[Notices]
[Pages 26877-26878]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-12118]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier CMS-855R]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
ACTION: Notice.
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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 (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 a second opportunity
for public comment on the notice. Interested persons are invited to
send comments regarding the burden estimate 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 on the collection(s) of information must be received by
the OMB desk officer by July 10, 2019.
ADDRESSES: When commenting on the proposed information collections,
please reference the document identifier or OMB control number. To be
assured consideration, comments and recommendations must be received by
the OMB desk officer via one of the following transmissions: OMB,
Office of Information and Regulatory Affairs, Attention: CMS Desk
Officer, Fax Number: (202) 395-5806 OR Email:
[email protected].
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 https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
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: 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.
[[Page 26878]]
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 information collection request; Title of Information
Collection: Reassignment of Medicare Benefits; Use: The reassignment
application is submitted at the time the provider/supplier first
reassigns of his/her Medicare benefits to a group practice, as well as
any subsequent reassignments, changes to current reassignment
information or terminations of established reassignments as requested
by the provider/supplier or group. The application is used by the
Medicare Administrative Contractor (MAC) to collect data to assure the
applicant has the necessary information that allows the MAC to
correctly establish, change, or terminate the reassignment.
The collection and verification of reassignment information defends
and protects our beneficiaries from illegitimate providers/suppliers.
These procedures also protect the Medicare Trust Fund against fraud. It
gathers information that allow Medicare contractors to ensure that the
provider/supplier is not sanctioned from the Medicare and/or Medicaid
program(s), or debarred, or excluded from any other Federal agency or
program. The data (e.g., Social Security Numbers, Employer
Identification Numbers) collected also ensures that the applicant has
the necessary credentials to provide the health care services for which
they intend to bill Medicare through the reassignment. This is sole
instrument implemented for this purpose. Form Number: CMS-855R (OMB
control number: 0938-1179); Frequency: Occasionally; Affected Public:
Private Sector; Businesses or other for-profits, Not-for-profit
institutions; Number of Respondents: 357,628; Number of Responses:
357,628; Total Annual Hours: 89,407. For policy questions regarding
this collection, contact Kimberly McPhillips at 410-786-5374.
Dated: June 5, 2019.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2019-12118 Filed 6-7-19; 8:45 am]
BILLING CODE 4120-01-P
