Agency Information Collection Activities: Proposed Collection; Comment Request
| Published date | 15 December 2020 |
| Citation | 85 FR 81208 |
| Record Number | 2020-27579 |
| Section | Notices |
| Court | Centers For Medicare & Medicaid Services,Health And Human Services Department |
Federal Register, Volume 85 Issue 241 (Tuesday, December 15, 2020)
[Federal Register Volume 85, Number 241 (Tuesday, December 15, 2020)]
[Notices]
[Pages 81208-81209]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-27579]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10765]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services, Health and Human
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 (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 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 must be received by February 16, 2021.
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.
[[Page 81209]]
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.
2. Call the Reports Clearance Office at (410) 786-1326.
FOR FURTHER INFORMATION CONTACT: William N. Parham at (410) 786-4669.
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-10765 Review Choice Demonstration for Inpatient Rehabilitation
Facility (IRF) Services
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: New collection (Request
for a new OMB control number); Title of Information Collection: Review
Choice Demonstration for Inpatient Rehabilitation Facility (IRF)
Services; Use: Section 402(a)(1)(J) of the Social Security Amendments
of 1967 (42 U.S.C. 1395b-1(a)(1)(J)) authorizes the Secretary to
``develop or demonstrate improved methods for the investigation and
prosecution of fraud in the provision of care or services under the
health programs established by the Social Security Act (the Act).''
Pursuant to this authority, the CMS seeks to develop and implement a
Medicare demonstration project, which CMS believes will help assist in
developing improved procedures for the identification, investigation,
and prosecution of Medicare fraud occurring among IRFs providing
services to Medicare beneficiaries.
This demonstration will assist in developing improved procedures
for the identification, investigation, and prosecution of potential
Medicare fraud. The demonstration will ensure that payments for IRF
services are appropriate through either pre-claim or postpayment
review, thereby working towards the prevention and identification of
potential fraud, waste, and abuse, as well as protecting the Medicare
Trust Funds from improper payments while reducing Medicare appeals. CMS
proposes implementing the demonstration in Alabama, then expand to
Pennsylvania, Texas, and California. After the initial four states, CMS
will expand the demonstration to include the IRFs in any state that
bill to Medicare Administrative Contractor (MAC) jurisdictions JJ, JL,
JH, and JE. Under this demonstration, CMS proposes to offer choices for
providers to demonstrate their compliance with CMS' IRF policies.
Providers in the demonstration states may participate in either 100
percent pre-claim review, or 100 percent postpayment review. These
providers will continue to be subject to the selected review method
until the IRF reaches the target affirmation or claim approval rate (90
percent, based on a minimum of 10 pre-claim requests or claims
submitted). Once an IRF reaches the target pre-claim review affirmation
or postpayment review claim approval rate, it may choose to be relieved
from claim reviews under the demonstration, except for a spot check of
five percent of their claims to ensure continued compliance.
The information required under this collection is required by
Medicare contractors to determine proper payment or if there is a
suspicion of fraud. Under the pre-claim review choice, IRFs will send
the pre-claim review request along with all required documentation to
the Medicare contractor for review prior to submitting the final claim
for payment. If a claim is submitted without a pre-claim review
decision on file, the Medicare contractor will request the information
from the IRF to determine if payment is appropriate. For the
postpayment review option, the Medicare contractor will also request
the information from the IRF provider who submitted the claim for
payment from the Medicare program to determine if payment was
appropriate. Form Number: CMS-10765 (OMB Control Number: 0938-NEW);
Frequency: Occasionally; Affected Public: Private Sector (Business or
other for-profits and Not-for-profits); Number of Respondents: 526;
Number of Responses: 179,910; Total Annual Hours: 89,955. (For
questions regarding this collection contact Jaclyn Gray (410) 786-
3744.)
Dated: December 10, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2020-27579 Filed 12-14-20; 8:45 am]
BILLING CODE 4120-01-P
