Supporting Statement for Accepting New Patients Indicator – UPIN (Unique Physician Identification Number) / PPD Participating Physicians Directory
A. Background
In November of 2000, CMS launched the Participating Physicians Directory (PPD) on Medicare.gov. This particular directory was created to provide beneficiaries with the names, addresses, and specialties of Medicare participating physicians who have agreed to accept assignment on all Medicare claims and covered services. Currently the information posted on PPD comes from the Unique Physician Identifier Number (UPIN) Directory. The UPIN currently provides data elements such as: physician name, address, specialty, education, board certification and credentials.
CMS has received numerous complaints from users via www.medicare.gov’s feedback tool regarding the limited physician information available. Users have stated that once they find a physician’s listing, they have to look for the physician’s phone number in the yellow pages. In many cases, when the user contacts the physician, the physician indicates that they are no longer accepting any new Medicare patients. In addition, users would like more information about physicians to help them make an informed choice. To address user needs, CMS is adding new data elements in 2003. This includes phone numbers, sanction data, training, year of graduation, foreign language, and hospital affiliation. CMS is licensing these data from an existing data source. However, there is no existing data source for information as to whether a physician is accepting new Medicare patients.
Physicians have expressed frustration at receiving calls from beneficiaries when they were not taking new patients and beneficiaries have expressed frustration at having to call numerous physicians to find one who is taking new Medicare patients. We are proposing to collect a new data element, “Accepting New Medicare Patients”. This new data element will serve to address the concerns of physicians and will provide a benefit to patients as well. A physician will have the option, should he/she desire, to enter the “accepting new Medicare patient” information and to update it when his/her practice of “accepting new patients” changes.
B. Justification
1. Need and Legal Basis
CMS was mandated to develop unique identifiers (UPINs) for Medicare physicians under the authority of §§ 1842 (r) of Pub. L. 101-508. It requires a unique identifier for each physician who provides services for which Medicare payment is made. Section 9332(e) of COBRA 1986 requires CMS to develop a Participating Physician Directory that Carriers will furnish upon request and keep updated. CMS updated the UPIN Registry system of notice in the Federal Register to provide beneficiaries and other individuals with the identification of each physician or non-physician practitioner assigned a unique identification number and who are participating in the Medicare program.
We are expanding PPD to provide additional information about physicians who participate in Medicare. With the exception of the “accepting new Medicare patients” element, we will use existing data sources. The new data element “accepting new Medicare patients” will provide beneficiaries and other users with much needed information about the physicians who participate in the Medicare program. It will also provide a service to physicians who are either seeking new Medicare patients or who wish to reduce the burden of responding to callers when they are no longer accepting new Medicare patients. There is anecdotal information indicating that there is an increase in the number of physicians who are not taking new patients.
The Participating Physicians Directory is currently the third most popular site on www.medicare.gov, averaging approximately 313,685 page views per month.
2. Information Users
This information will be used by CMS to post on the PPD section of www.medicare.gov, for Medicare beneficiaries and caregivers to obtain specific information on participating Medicare Physicians in their surrounding area. This information will also be offered to beneficiaries in print.
Improved Information Technology
The data collection will occur via the UPIN Registry, a web tool designed and developed by a current CMS contractor. This tool will enable physicians to update their own information on an as needed basis. More importantly this will allow CMS to ensure data accuracy, with the “accepting new Medicare patients” indicator.
4. Duplication of Similar Information
No Duplication.
5. Small Businesses
Small businesses are not affected by this collection.
6. Less Frequent Collection
Physicians only need to change their “accepting new Medicare patients” indicator when applicable and only if they choose to provide this information. CMS refreshes the data on the www.medicare.gov website monthly.
7. Special Circumstances
There are no special circumstances.
8. Federal Register Notice/Outside Consultation
A 60-day Federal Register Notice was published on January 19, 2007 attached. No outside consultation has been obtained. We feel that the Federal Register notice will allow for the public to express their ideas and thoughts.
9. Payments/Gifts to Respondents
There are no payments/gifts to respondents.
10. Confidentiality
The data collection will occur through a secure website, the UPIN Registry, to be developed for sensitive data collection and transmission.
11. Sensitive Questions
There are no sensitive questions.
12. Burden Estimate (Total Hours & Wages)
We estimate that 15% of the 732,000 Participating Physicians will opt to provide this information, or 109,880 respondents. Respondents will be able to make changes to their information on an as needed basis. We estimate that ten percent of the respondents may make changes to the data collection on an annual basis. It is anticipated that 100% of the data will be collected electronically. Each respondent may take up to five minutes to change data, resulting in 915 hours annually (10,980 respondents x 5 minutes per response). We estimate that the cost of this data collection to be $9,150 (915 hours annually per estimated data entry cost of $10.00 per hour).
13. Capital Costs
There are no capital costs.
14. Cost to the Federal Government
Will provide upon submission of contractor bids.
15. Program Changes
There are no program or burden changes.
16. Publication and Tabulation Dates
There are no publication and tabulation dates.
17. Expiration Date
This information collection requirement does not lend itself to displaying an expiration date.
18. Certification Statement
There are no exceptions to the certification statement.
C. Collections of Information Employing Statistical Methods
This data collection will not employ statistical methods.
| File Type | application/msword |
| File Title | Supporting Statement For Participating Physicians Directory |
| Author | CMS |
| Last Modified By | CMS |
| File Modified | 2007-03-15 |
| File Created | 2007-01-09 |