Agency Information Collection Activities: Submission for OMB Review; Comment Request
| Published date | 08 September 2021 |
| Citation | 86 FR 50360 |
| Record Number | 2021-19476 |
| Section | Notices |
| Court | Centers For Medicare & Medicaid Services,Health And Human Services Department |
Federal Register, Volume 86 Issue 171 (Wednesday, September 8, 2021)
[Federal Register Volume 86, Number 171 (Wednesday, September 8, 2021)]
[Notices]
[Page 50360]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-19476]
[[Page 50360]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10765]
Agency Information Collection Activities: Submission for OMB
Review; 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 (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 October 8, 2021.
ADDRESSES: Written comments and recommendations for the proposed
information collection should be sent within 30 days of publication of
this notice to www.reginfo.gov/public/do/PRAMain . Find this particular
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function.
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.
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: 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: September 3, 2021.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2021-19476 Filed 9-7-21; 8:45 am]
BILLING CODE 4120-01-P
