Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-10207.Final Supporting Statement-5-17-07.doc	Supporting Statement A	Uploaded 2007-07-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
45541	Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)		Modified
45540	Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)		Modified
45539	Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)		Modified
45538	Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)		Modified
181366	Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)		New

ICR Details

OMB Control No: 0938-1009	ICR Reference No: 200707-0938-013
Status: Historical Active	Previous ICR Reference No: 200610-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/17/2008
	Date Received in OIRA: 07/30/2007
Terms of Clearance: Upon resubmission, CMS will update the burden and number of respondents to reflect physician usage of electronic health information technology.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2011	36 Months From Approved	01/31/2008
Responses	54,730	0	49,402
Time Burden (Hours)	17,545	0	13,393
Cost Burden (Dollars)	0	0	0

---

Abstract: As required by section 101 of the Medicare Prescription Drug, Improvement, and Modernization Improvement Act of 2003, this final rule creates an exception to the physician self-referral prohibition for certain arrangements in which a physician receives non-monetary remuneration in the form of items or services that is necessary and used solely to receive and transmit electronic prescription information. Also, this rule creates a regulatory exception for certain arrangements involving the provision of non-monetary remuneration in the form of electronic health records software or information technology and training services necessary and used predominantly to create, maintain, transmit, and receive electronic health records.

---

Authorizing Statute(s): PL: Pub.L. 109 - 171 101 Name of Law: Deficit Reduction Act of 2005
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AN69	Final or interim final rulemaking	71 FR 45140	08/08/2006

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 29323	05/25/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 40299	07/24/2007
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)
Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)
Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)
Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)
Physician Self-Referral Exceptions for Electronic Prescribing and Electronic Health Records (CMS-1303-F)

---

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	54,730	49,402	0	0	5,328	0
Annual Time Burden (Hours)	17,545	13,393	0	0	4,152	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

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

---

Common Form ICR:  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:

(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: 07/30/2007

---