"Detailed Explanation of Non-Coverage and Notice of Medicare Non-Coverage" and Supporting Regulations in 42 CFR 422.626(e)(1) and 42 CFR 422.624(b)(1)

ICR 200902-0938-003

OMB: 0938-0910

Federal Form Document

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2009-01-14
ICR Details
0938-0910 200902-0938-003
Historical Active 200808-0938-002
HHS/CMS
"Detailed Explanation of Non-Coverage and Notice of Medicare Non-Coverage" and Supporting Regulations in 42 CFR 422.626(e)(1) and 42 CFR 422.624(b)(1)
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 02/06/2009
Retrieve Notice of Action (NOA) 02/06/2009
  Inventory as of this Action Requested Previously Approved
08/31/2010 08/31/2010 08/31/2010
47,558 0 47,558
23,780 0 23,780
0 0 0

Pursuant to 42 CFR 422.624(b)(1), providers in skilled nursing facilities, home health agencies and comprehensive outpatient rehabilitation facilities must deliver to MA enrollees a 2-day advance notice of termination of services. Per requirements at 42 CFR 422.626(e)(1), MA organizations must deliver detailed notices to the QIO and enrollees upon request for appeal of the termination of services. These notices fulfill the regulatory requirement. 42 CFR 417.600(b) provides that cost plans must follow these same fast track appeal notification procedures for their enrollees in SNFs HHAs and CORFs.

PL: Pub.L. 108 - 173 234 Name of Law: Medicare Prescription Drug, Improvement, and Modernization Act of 2003
   US Code: 42 USC 1395-21 Name of Law: Implementation of Medicare Advantage Program
  
None

Not associated with rulemaking

  72 FR 1536 01/12/2007
72 FR 13793 03/23/2007
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 47,558 47,558 0 0 0 0
Annual Time Burden (Hours) 23,780 23,780 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Bonnie Harkless 4107865666

  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.
02/06/2009


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