Agency Information Collection Activities: Proposed Collection; Comment Request

Issuing agencies

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 91 Issue 210 (Monday, November 2, 2026)</title>
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[Federal Register Volume 91, Number 210 (Monday, November 2, 2026)]
[Notices]
[Pages 68961-68962]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-22326]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-437]


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 January 4, 2027.

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).
    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: Reinstatement with 
change of a previously approved collection; Title of Information 
Collection: Inpatient Psychiatric Unit Criteria Work Sheet; Use: We 
request a reinstatement with change of the OMB approval for the CMS 
form approved under OMB Control number 0938-0358. We have made non-
substantive formatting changes to section 1 of the CMS-437 form 
including providing separate data field for the name, street address, 
city, state and zip code for the Inpatient Psychiatric Unit (IPU). We 
also added new data fields for the CCN number and telephone number for 
the IPU. In section 2 we have updated the text of several CFR code 
sections for accuracy.
    Medicare has several types of schedules with which payments are 
made to inpatient hospitals. Acute care hospitals are paid by Medicare 
using the Inpatient Prospective Payment System (IPPS). Hospital 
outpatient services are paid by Medicare using the Medicare Hospital 
Outpatient Prospective Payment System (HOPPS). Inpatient Psychiatric 
Facilities (IPFs) and Inpatient Psychiatric Units (IPUs) are paid by 
Medicare using the Inpatient Psychiatric Facility Prospective Payment 
System (IPU PPS).
    For IPFs and IPUs to be paid by Medicare under the higher paying 
Inpatient Psychiatric Facility Prospective Payment System (IPF PPU), 
they must prove that they meet the requirements to be exempt from 
receiving payment from Medicare under the lower paying hospital IPPS. 
The CMS-437 form is used by IPUs to attest that they meet the necessary 
requirements that make them exempt from receiving Medicare payments 
under the lower hospital rate provided by the IPPS and instead are 
eligible to receive a higher payment rate under the IPU PPS.
    New IPUs must submit an initial CMS-437 to CMS when they apply for 
participation in the Medicare program to request new IPPS excluded 
status. Thereafter, the existing IPUs are required to submit completed 
CMS-437 forms annually to maintain their IPPS exclusion status, as 
required by 42 CFR 412.25. The IPUs submit their completed CMS-437 form 
to the CMS Locations (formerly named CMS Regional Offices) via the 
applicable SAs.

[[Page 68962]]

    Prior to November 2007, SA surveyors conducted onsite IPPS 
exclusion surveys to verify that the IPPS exclusion criteria were met 
by the facility. The SA surveyor completed the CMS-437 form prior to 
placing an IPU into IPPS excluded status. However, on November 5, 2007, 
CMS suspended the requirement for onsite IPPS exclusion surveys and 
instead began allowing IPUs to self-attest to meeting the IPPS 
exclusion criteria by completing and submitting the CMS-437 form. (See: 
Survey & Certification Memo 08-03, dated 11/05/2007). As a result, 
instead of having the SAs perform IPPS exclusion surveys, the IPUs are 
now required to complete the CMS-437 form annually as a self-
attestation indicating they continue to meet the IPPS exclusion 
criteria. Form Number: CMS-437 (OMB control number: 0938-0358); 
Frequency: Annually; Affected Public: Private sector--Business or other 
for-profits; Number of Respondents: 1,534; Total Annual Responses: 
1,534; Total Annual Hours: 1,551. (For policy questions regarding this 
collection contact Caroline Gallaher at 410-786-8705.)

William N. Parham III,
Director, Division of Information Collections and Regulatory Impacts, 
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2026-22326 Filed 10-30-26; 8:45 am]
BILLING CODE 4169-69-P


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