Medicare and Medicaid Programs OASIS Collection Requirements as Part of the CoPs for HHAs and Supp. Regs. in 42 CFR 48.55, 484.205, 484.245, 484.250

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-R-245 Outcome and Assessment Information Set (OASIS-B1)	Form and Instruction	Modified	Available
Form CMS-R-245 Outcome and Assessment Information Set (OASIS-B1)	Form and Instruction	Modified	Available
Form CMS-R-245 Outcome and Assessment Information Set (OASIS-B1)	Form and Instruction	New	Available
Form CMS-R-245 Outcome and Assessment Information Set (OASIS-B1)	Form and Instruction	New	Available
OASIS_Changes_for_2008_ver_2007 - CROSSWALK.doc	Supplementary Document	Uploaded 2007-09-07	Available
CMS-R-245. Supporting Statement - REDLINE.doc	Supporting Statement A	Uploaded 2007-09-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43666	Medicare and Medicaid Programs OASIS Collection Requirements as Part of the CoPs for HHAs and Supp. Regs. in 42 CFR 48.55, 484.205, 484.245, 484.250	Form and Instruction	Modified	Outcome and Assessment Information Set (OASIS-B1)
43666	Medicare and Medicaid Programs OASIS Collection Requirements as Part of the CoPs for HHAs and Supp. Regs. in 42 CFR 48.55, 484.205, 484.245, 484.250	Form and Instruction	Modified	Outcome and Assessment Information Set (OASIS-B1)
180130	Medicare and Medicaid Programs OASIS Collection Requirements as Part of the CoPs for HHAs and Supp. Regs. in 42 CFR 48.55, 484.205, 484.245, 484.250	Form and Instruction	New	Outcome and Assessment Information Set (OASIS-B1)
180130	Medicare and Medicaid Programs OASIS Collection Requirements as Part of the CoPs for HHAs and Supp. Regs. in 42 CFR 48.55, 484.205, 484.245, 484.250	Form and Instruction	New	Outcome and Assessment Information Set (OASIS-B1)

ICR Details

OMB Control No: 0938-0760	ICR Reference No: 200705-0938-002
Status: Historical Active	Previous ICR Reference No: 200605-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare and Medicaid Programs OASIS Collection Requirements as Part of the CoPs for HHAs and Supp. Regs. in 42 CFR 48.55, 484.205, 484.245, 484.250
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/12/2007
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/14/2007
Terms of Clearance: This collection is approved under the following terms of clearance: Upon publishing a new 60-day and 30-day Federal Register Notice, CMS will provide the public and OMB with a supplemental document that crosswalks all changes (technical and substantive) made to the revised ICR. The document should include an explanation of each change from the previous approval, the reason why the change is necessary and the citation or reference to the statute, regulation or guidance document that support the need for the change. The crosswalk should also address an increase or decrease in burden for each change.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2010	36 Months From Approved	09/30/2007
Responses	11,986,053	0	11,087,565
Time Burden (Hours)	9,050,817	0	9,339,184
Cost Burden (Dollars)	0	0	0

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Abstract: This collection requires HHAs to use a standard core assessment data set, the OASIS, to collect information and to evaluate adult non-maternity patients. In addition, data from the OASIS will be used for purposes of case mix adjusting patients under home health PPS and will facilitate the production of necessary case mix information at relevant time points in the patient's home health stay. Modifications were previously made to the OASIS forms to allow for the preservation of masking of personally identifiable information for the non-Medicare/non-Medicaid individuals.

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Authorizing Statute(s): US Code: 42 USC 1395x Name of Law: Home Health Agency
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AO32	Final or interim final rulemaking	72 FR 25356	05/04/2007

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 5055	02/02/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 25319	05/04/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Medicare and Medicaid Programs OASIS Collection Requirements as Part of the CoPs for HHAs and Supp. Regs. in 42 CFR 48.55, 484.205, 484.245, 484.250	CMS-R-245, CMS-R-245	Outcome and Assessment Information Set (OASIS-B1) ,   Outcome and Assessment Information Set (OASIS-B1)
Medicare and Medicaid Programs OASIS Collection Requirements as Part of the CoPs for HHAs and Supp. Regs. in 42 CFR 48.55, 484.205, 484.245, 484.250	CMS-R-245, CMS-R-245	Outcome and Assessment Information Set (OASIS-B1) ,   Outcome and Assessment Information Set (OASIS-B1)

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ICR Summary of Burden

table that charts list of burden

	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	11,986,053	11,087,565	0	898,488	0	0
Annual Time Burden (Hours)	9,050,817	9,339,184	0	-288,367	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The burden associated with these proposed changes includes possible training of staff, the time and effort associated with downloading a new form and replacing previously pre-printed versions of the OASIS, and utilizing updated vendor software. However, CMS will be removing or modifying existing questions in the OASIS data set to accommodate the requirements referenced above. In addition, as a result of the proposed changes of CMS-1541-P, we expect that the claims processing system is expected to automatically adjust the therapy visits, upward and downward on the final claim, according to the information on the final claim. Consequently, the HHA will no longer have to withdraw and resubmit a revised claim when the number of therapy visits delivered to the patient is higher than the level report on the RAP. Therefore, CMS believes the burden increase associated with these changes is negated by the removal or modification of several current data items. The overall burden to OASIS was decreased by 28% in the OASIS data set. The burden has increased since the last submission due to an increase in the number of respondents.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/14/2007

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