CMS-R-142 Crosswalk0938-0667_092109

Crosswalk Document: CMS-R-142; OMB# 0938-0667

Changes made to CMS-R-142; OMB# 0938-0667 since the last submission include the following:

1. Under “A. Background,” expiration date of package changed from 1/31/2007 to 04/30/2010.

2. Under “A. Background,” bullets added to summarize EMTALA related changes made in the FY 2008 Inpatient Prospective Payment System (IPPS) Final Rule, the FY 2009 IPPS Final Rule, and the FY 2010 Final Rule.

3. Under “B. Justification - 1. Need and Legal Basis – we updated the figures through FY 2008 and at section (d), we added a brief description of how section 489.20(r)(2) was amended in the FY 2009 IPPS Final Rule (August 19, 2008 Federal Register). At sections (h) – (m), we corrected the lettering of the sections. We added section (k), which addressed the clarification made to the applicability of EMTALA to hospital inpatients in the FY 2009 IPPS Final Rule. As this change clarifies that EMTALA does not apply after a patient is admitted, we do not believe there is an increased burden associated with this change. We added section (n), which discusses changes made to the regulations in the FY 2009 IPPS Final Rule, specifically, we moved the requirement to maintain an on-call list from 42 CFR section 489.24(j)(1) to section 489.20(r)(2) and we added a provision regarding community call to the regulations at 42 CFR section 489.24(j). We do not believe there is an increased burden due to these changes since prior to the regulatory change, hospitals were required to maintain an on-call list. In addition, the establishment of a formal community call plan is voluntary, it is meant to provide hospitals with increased flexibility in meeting their on-call needs, therefore, we do not believe there is an increased burden associated with this change to the regulations at 42 CFR section 489.24(j).

4. Under “B. Justification – 8. Federal Register Notice/Outside Consultation – History,” we updated the section to include information pertaining to the publication of the Inpatient Prospective Payment System Proposed and Final Rules for fiscal years 2008 through 2010. There is no increased burden associated with these edits because they provide information on the publication dates of the proposed and final rules.

5. Under “B. Justification – 12. Estimate of Burden (Hours and Wages),” we added “Section 489.24(f),” which discusses the applicability of EMTALA to hospital inpatients. As stated above, as this requirement clarifies when EMTALA does not apply, it does not add a paperwork burden. We also added “Removal of section 489.24(j)(1)” and “Section 489.24(j)(2)(iii).” “Removal of section 489.24(j)(1)” discusses the movement of the requirement to maintain an on-call list from the regulations at section 489.24(j)(1) to section 489.20(r)(2). We do not believe there is an increased burden due to these changes since the requirement to maintain an on-call list was in effect prior to the change. “Section 489.24(j)(2)(iii)” discusses the changes to the regulations to include information pertaining to participation in a formal community call arrangement. We do not believe there is an increased burden due to these changes since participation in a formal community call plan is voluntary.

6. Under “B. Justification – 14. Cost to Federal Government,” we updated the cost from calendar year 2006 numbers to calendar year 2009 numbers.