Agency Information Collection Activities: Submission for OMB Review; Comment Request

CourtCenters For Medicare & Medicaid Services,Health And Human Services Department
Citation86 FR 50360
Record Number2021-19476
Publication Date08 Sep 2021
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]]
                =======================================================================
                -----------------------------------------------------------------------
                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.
                -----------------------------------------------------------------------
                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
                

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT