Agency Information Collection Activities: Submission for OMB Review; Comment Request
| Published date | 29 November 2019 |
| Citation | 84 FR 65817 |
| Record Number | 2019-25861 |
| Section | Notices |
| Court | Centers For Medicare & Medicaid Services,Health And Human Services Department |
Federal Register, Volume 84 Issue 230 (Friday, November 29, 2019)
[Federal Register Volume 84, Number 230 (Friday, November 29, 2019)]
[Notices]
[Pages 65817-65818]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-25861]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier CMS-1500/1490S, CMS-10704 and CMS-10338]
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 December 30, 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 website address at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
1. Email your request, including your address, phone number, OMB
number, and CMS document identifier, to [email protected].
2. 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. 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 without change
of a currently approved collection; Title of Information Collection:
Health Insurance Common Claims Form and Supporting Regulations at 42
CFR part 424, subpart C (CMS-1500 and CMS-1490S); Use: Social Security
ACT, Part E, Section 1861(s) provides definition of services and
institutions covered under the Act. The CMS-1500 is used to bill for
services covered under section 1861(a)(1) by persons entitled to
payment for such services. Benefits are paid either to the physician/
supplier under an agreement, the beneficiary on the basis of an
itemized bill per section 1842(b)(3)(B)(i) and (ii) of the Social
Security Act, or to an organization authorized to receive payment per
1842(b)(6).
The CMS-1500 and the CMS-1490S forms are used to deliver
information to CMS in order for CMS to reimburse for provided services.
Medicare Administrative Contractors use the data collected on the CMS-
1500 and the CMS-1490S to determine the proper amount of reimbursement
for Part B medical and other health services (as listed in section
1861(s) of the Social Security Act) provided by physicians and
suppliers to beneficiaries. The CMS-1500 is submitted by physicians/
suppliers for all Part B Medicare. Serving as a common claim form, the
CMS-1500 can be used by other third-party payers (commercial and
nonprofit health insurers) and other Federal programs (e.g., TRICARE,
RRB, and Medicaid). As the CMS-1500 displays data items required for
other third-party payers in addition to Medicare, the form is
considered too complex for use by beneficiaries when they file their
own claims. Therefore, the CMS-1490S (Patient's Request for Medical
Payment) was explicitly developed for easy use by beneficiaries who
file their own claims. The English and Spanish version CMS-1490S form
(version 01/18) can be obtained from a Medicare Administrative
Contractor or online. Form Number: CMS-1500/1490S (OMB control number:
0938-1197); Frequency: Yearly; Affected Public: State, Local, or
[[Page 65818]]
Tribal Governments; Number of Respondents: 2,029,505; Total Annual
Responses: 1,033,839,906; Total Annual Hours: 18,847,500. (For policy
questions regarding this collection contact Charlene Parks at 410-786-
8684.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Health
Reimbursement Arrangements and Other Account-Based Group Health Plans;
Use: On June 20, 2019, the Department of the Treasury, the Department
of Labor, and the Department of Health and Human Services
(collectively, the Departments) issued final regulations titled
``Health Reimbursement Arrangements and Other Account-Based Group
Health Plans'' (84 FR 28888) under section 2711 of the PHS Act and the
health nondiscrimination provisions of HIPAA, Public Law 104-191 (HIPAA
nondiscrimination provisions). The regulations expand the use of health
reimbursement arrangements and other account-based group health plans
(collectively referred to as HRAs). In general, the regulations expand
the use of HRAs by eliminating the current prohibition on integrating
HRAs with individual health insurance coverage, thereby permitting
employers to offer individual coverage HRAs to employees that can be
integrated with individual health insurance coverage or Medicare. Under
the regulations employees will be permitted to use amounts in an
individual coverage HRA to pay expenses for medical care (including
premiums for individual health insurance coverage and Medicare),
subject to certain requirements. This information collection includes
provisions related to substantiation of individual health insurance
coverage (45 CFR 146.123(c)(5)), the notice requirement for individual
coverage HRAs (45 CFR 146.123(c)(6)), and notification of termination
of coverage (45 CFR 146.123(c)(1)(iii)). Form Number: CMS-10704 (OMB
Control Number 0938-1361); Frequency: Annually; Affected Public:
Private Sector, State Governments; Number of Respondents: 2,005; Total
Annual Responses: 273,492; Total Annual Hours: 6,016. (For policy
questions regarding this collection contact Usree Bandyopadhyay at 410-
786-6650.)
3. Type of Information Collection Request: Extension without change
of a currently approved collection; Title of Information Collection:
Affordable Care Act Internal Claims and Appeals and External Review
Procedures for Non-grandfathered Group Health Plans and Issuers and
Individual Market Issuers; Use: The information collection requirements
ensure that claimants receive adequate information regarding the plan's
claims procedures and the plan's handling of specific benefit claims.
Claimants need to understand plan procedures and plan decisions in
order to appropriately request benefits and/or appeal benefit denials.
The information collected in connection with the HHS-administered
federal external review process is collected by HHS, and is used to
provide claimants with an independent external review. Form Number:
CMS-10338 (OMB control number: 0938-1099); Frequency: Occasionally;
Affected Public: State, Local, or Tribal Governments; Number of
Respondents: 109,653; Total Annual Responses: 4,711; Total Annual
Hours: 1,195,626. (For policy questions regarding this collection
contact Laura Byabazaire at 410-786-6650.)
Dated: November 25, 2019.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2019-25861 Filed 11-27-19; 8:45 am]
BILLING CODE 4120-01-P
