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Federal forms, ICRs, and supporting documents

Information Collection Request

(CMS-R-240) Prospective Payments for Hospital Outpatient Services and Supporting Regulations in 42 CFR 413.24, 413.65

ICR 200701-0938-007 · OMB 0938-0798 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
CMS-R-240.Supporting Statement-8-23-06.doc Supporting Statement A Uploaded 2006-12-12 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
8576 (CMS-R-240) Prospective Payments for Hospital Outpatient Services and Supporting Regulations in 42 CFR 413.24, 413.65 Modified
46622 (CMS-R-240) Prospective Payments for Hospital Outpatient Services and Supporting Regulations in 42 CFR 413.24, 413.65 New
ICR Details
0938-0798 200701-0938-007
Historical Active 200305-0938-004
HHS/CMS
(CMS-R-240) Prospective Payments for Hospital Outpatient Services and Supporting Regulations in 42 CFR 413.24, 413.65
Extension without change of a currently approved collection   No
Regular
Approved without change 06/06/2007
Retrieve Notice of Action (NOA) 01/03/2007
  Inventory as of this Action Requested Previously Approved
06/30/2010 36 Months From Approved 06/30/2007
500,355 0 2,272
26,063 0 41,063
0 0 0
Section 1833(t) of the Social Security Act (of the Act), as amended by section 4523 of the Balanced Budget Act of 1997 (the BBA) requires the Secretary to establish a prospective payment system (PPS) for hospital outpatient services. Successful implementation of an outpatient PPS requires that CMS distinguish facilities or organizations that function as departments of hospitals from those that are freestanding, so that CMS can determine which services should be paid under the PPS. Regulations found at 42 CFR 413.65(b)( 3) and (c) require the submission of the information CMS needs to make the determination of whether an organization functions as a department of a hospital or functions as a freestanding facility. In addition, section 1866(b)(2) of the Act authorizes hospitals and other providers to impose deductible and coinsurance charges for facility services, but does not allow such charges by facilities or organizations which are not provider-based. Implementation of this provision requires that CMS have information from the required reports, so it can determine which facilities are provider-based.
PL: Pub.L. 105 - 33 4523 Name of Law: Prospective Payment System for Hospital Outpatient Services
   US Code: 42 USC 1395cc(b)(2) Name of Law: Agreements with providers of services; enrollment processes
  
None
Not associated with rulemaking
  71 FR 55479 09/22/2006
71 FR 71179 12/08/2006
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 500,355 2,272 0 0 498,083 0
Annual Time Burden (Hours) 26,063 41,063 0 0 -15,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$9,403
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Saleda Perryman
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/14/2006