Notice2024-21055
Agency Information Collection Activities: Proposed Collection; Comment Request
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
September 17, 2024
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
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 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.
Full Text
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<title>Federal Register, Volume 89 Issue 180 (Tuesday, September 17, 2024)</title>
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[Federal Register Volume 89, Number 180 (Tuesday, September 17, 2024)]
[Notices]
[Pages 76115-76116]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-21055]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers: CMS-R-297/CMS-L564 and CMS-2088-17]
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 (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 November 18, 2024.
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
<a href="http://www.regulations.gov">http://www.regulations.gov</a>. 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.
To obtain copies of a supporting statement and any related forms
for the proposed collection(s) summarized in this notice, please access
the CMS PRA website by copying and pasting the following web address
into your web browser: <a href="https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing">https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing</a>.
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-R-297/CMS-L564 Medicare Request for Employment Information
CMS-2088-17 The Community Mental Health Center Cost Report
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 Collections
1. Type of Information Collection Request: Extension of a currently
approved information collection; Title of Information Collection:
Medicare Request for Employment Information; Use: Section 1837(i) of
the Social Security Act (the Act) provides for a SEP for individuals
who delay enrolling in Medicare Part B because they are covered by a
group health plan based on their own or a spouse's current employment
status. Disabled individuals with Medicare may also delay enrollment
because they have large group health plan coverage based on their own
or a family member's current employment status. When these individuals
apply for Medicare Part B, they must provide proof that the group
health plan coverage is (or was) based on current employment status.
Form CMS L564 provides this proof so that SSA can determine eligibility
for the SEP. Individuals eligible for the SEP can enroll in Part B
without incurring a late enrollment penalty (LEP). Individuals may also
use this form to prove that their group health plan coverage is based
on current employment status and to have the assessed Medicare LEP
reduced. Form Number: CMS-R-297/CMS-L564 (OMB control number: 0938-
0787); Frequency: Annually; Affected Public: Individuals or households,
Business or other for-profits and Not-for-profit institutions; Number
of Respondents: 594,998; Total Annual Responses: 594,998; Total Annual
Hours: 243,949. (For policy questions regarding this collection contact
Candace Carter at 410-786-8466 or <a href="/cdn-cgi/l/email-protection#df9cbeb1bbbebcbaf19cbeadabbaad9fbcb2acf1b7b7acf1b8b0a9"><span class="__cf_email__" data-cfemail="bdfedcd3d9dcded893fedccfc9d8cffdded0ce93d5d5ce93dad2cb">[email protected]</span></a>.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Community Mental
Health Center Cost Report Use: CMS requires the Form CMS-2088-17 to
determine a provider's reasonable cost incurred in furnishing medical
services to Medicare beneficiaries and reimbursement due to or from a
provider. In addition, CMHCs may receive reimbursement through the cost
report for Medicare reimbursable bad debts. CMS uses the Form CMS-2088-
17 for rate setting; payment refinement activities, including market
basket analysis; Medicare Trust Fund projections; and to support
program operations. The primary function of the cost report is to
determine provider reimbursement for services rendered to Medicare
beneficiaries. Each CMHC submits the cost report to its contractor for
reimbursement determination.
Section 1874A of the Act describes the functions of the contractor.
CMHCs must follow the principles of cost reimbursement, which require
they maintain sufficient financial records and statistical data for
proper determination of costs. The S series of worksheets collects the
provider's location, CBSA, date of certification, operations, and
unduplicated census
[[Page 76116]]
days. The A series of worksheets collects the provider's trial balance
of expenses for overhead costs, direct patient care services, and non-
revenue generating cost centers. The B series of worksheets allocates
the overhead costs to the direct patient care and non-revenue
generating cost centers using functional statistical bases. The
Worksheet C computes the apportionment of costs between Medicare
beneficiaries and other patients. The D series of worksheets are
Medicare specific and calculate the reimbursement settlement for
services rendered to Medicare beneficiaries. The Worksheet F collects
the provider's revenues and expenses data from the provider's income
statement. Form Number: CMS-2088-17 (OMB control number: 0938-0378);
Frequency: Annually; Affected Public: Private Sector, Business or other
for-profits, Not-for-profits institutions; Number of Respondents: 191;
Total Annual Responses: 191; Total Annual Hours: 17,190. (For policy
questions regarding this collection contact Jill Keplinger at 410-786-
4550.)
William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts,
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2024-21055 Filed 9-16-24; 8:45 am]
BILLING CODE 4120-01-P
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