Notice2025-18219
Agency Information Collection Activities: Submission for OMB Review; 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 19, 2025
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 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.
Full Text
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<title>Federal Register, Volume 90 Issue 180 (Friday, September 19, 2025)</title>
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[Federal Register Volume 90, Number 180 (Friday, September 19, 2025)]
[Notices]
[Pages 45216-45217]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-18219]
[[Page 45216]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10599]
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 20, 2025.
ADDRESSES: Written comments and recommendations for the proposed
information collection should be sent within 30 days of publication of
this notice to <a href="http://www.reginfo.gov/public/do/PRAMain">www.reginfo.gov/public/do/PRAMain</a>. 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, 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 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 of a currently
approved collection; Title of Information Collection: Review Choice
Demonstration for Home Health 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 Home Health Agencies (HHA) providing services to
Medicare beneficiaries.
This revised demonstration helps assist in developing improved
procedures for the identification, investigation, and prosecution of
potential Medicare fraud. The demonstration helps make sure that
payments for home health services are appropriate through either pre-
claim or post payment review, thereby working towards the prevention
and identification of potential fraud, waste, and abuse; the protection
of Medicare Trust Funds from improper payments; and the reduction of
Medicare appeals. CMS has implemented the demonstration in Illinois,
Ohio, North Carolina, Florida, and Texas with the option to expand to
other states in the Palmetto/JM jurisdiction. Under this demonstration,
CMS offers choices for providers to demonstrate their compliance with
CMS' home health policies. Providers in the demonstration states may
participate in either 100 percent pre-claim review or 100 percent post
payment review. These providers will continue to be subject to a review
method until the HHA reaches the target affirmation or claim approval
rate. Once an HHA reaches the target pre-claim review affirmation or
post-payment review claim approval rate, it may choose to be relieved
from claim reviews, except for a spot check of their claims to ensure
continued compliance. Providers who do not wish to participate in
either 100 percent pre-claim or post payment reviews have the option to
furnish home health services and submit the associated claim for
payment without undergoing such reviews; however, they will receive a
25 percent payment reduction on all claims submitted for home health
services and may be eligible for review by the Recovery Audit
Contractors.
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 option, the HHA sends
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 one file, the Medicare contractor will request the
information from the HHA to determine if payment is appropriate. For
the post payment review option, the Medicare contractor will also
request the information from the HHA provider who submitted the claim
for payment from the Medicare program to determine if payment was
appropriate. Form Number: CMS-10599 (OMB control number: 0938-1311);
Frequency: Frequently, until the HHA reaches the target affirmation or
claim approval threshold and then occasionally; Affected Public:
Private Sector (Business or other for-profits and Not-for-profits);
Number of Respondents: 4,700; Number of Responses: 3,173,016; Total
Annual Hours: 1,600,608. (For questions
[[Page 45217]]
regarding this collection contact Jennifer McMullen (410) 786-7635.)
William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts,
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2025-18219 Filed 9-18-25; 8:45 am]
BILLING CODE 4120-01-P
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</html>Indexed from Federal Register on September 19, 2025.
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