Medicare program/Home Health Prospective Payment System Rate Update for CY2010:Physician Narrative Requirement, CY2011 Proposed Physician Face-to-Face Encounter

ICR 201007-0938-012

OMB: 0938-1083

Federal Form Document

Forms and Documents
ICR Details
0938-1083 201007-0938-012
Historical Inactive 201002-0938-001
HHS/CMS
Medicare program/Home Health Prospective Payment System Rate Update for CY2010:Physician Narrative Requirement, CY2011 Proposed Physician Face-to-Face Encounter
Revision of a currently approved collection   No
Regular
Comment filed on proposed rule and continue 08/29/2010
Retrieve Notice of Action (NOA) 07/23/2010
OMB files this comment in accordance with 5 CFR 1320.11(c). This OMB action is not an approval to conduct or sponsor an information collection under the Paperwork Reduction Act of 1995. This action has no effect on any current approvals. For future submissions of this information collection, reference the OMB Control Number provided. In accordance with 5 CFR 1320, the agency should resubmit this ICR at the final rule stage.
  Inventory as of this Action Requested Previously Approved
02/28/2013 36 Months From Approved 02/28/2013
345,600 0 345,600
28,800 0 28,800
0 0 0

The Centers for Medicare and Medicaid Services (CMS) require that a physician sign every patient's individual plan of care certifying or recertifying that the patient is homebound and the planned services are medically necessary in order for the home health agency to be reimbursed for Medicare covered services as stipulated in 42 CFR 424.22. CMS is relying on physicians to fulfill a role that is sometimes thought of as a "gatekeeper" by requiring the physician to provide a narrative located within the home health certification or recertification when skilled nursing management & evaluation of the plan of care, (PoC) is ordered. The physician's narrative is required when a patient's underlying condition or complication requires a registered nurse to ensure that essential non-skilled care is achieving its purpose, The narrative must be located immediately prior to the physician's signature. If the narrative exists as an addendum to the certification or recertification form, in addition to the physician's signature on the certification or recertification form, the physician must sign immediately following the narrative in the addendum. This change supports Medicare's home health coverage criteria for skilled services as stipulated in the CFR, (see 42 CFR 409.42).The Home Health Prospective Payment System Rate Update for Calendar Year 2011 changes the certification requirements for Home Health Agencies. In the case of a certification made by a physician after January 1, 2010, prior to making such certification, the physician must document that the physician himself or herself or specified non-physician practitioner has had a face-to-face encounter with the patient incident to the services involved

US Code: 42 USC 1395x Name of Law: Definitions
   PL: Pub.L. 111 - 148 6407(a) Name of Law: Patient Protection and Affordable Care Act
   US Code: 42 USC 1395x Name of Law: Definitions
   Statute at Large: 18 Stat. 1814 Name of Statute: null
   Statute at Large: 18 Stat. 1835 Name of Statute: null
   Statute at Large: 18 Stat. 1834 Name of Statute: null
   Statute at Large: 18 Stat. 1861 Name of Statute: null
  
PL: Pub.L. 111 - 148 6407 Name of Law: Patient Protection and Affordable Care Act

0938-AP88 Proposed rulemaking 75 FR 43236 07/23/2010

No

No
No
the Patient Protection and Affordable Care Act (PPACA) of 2010 (Pub. L. 111-148) was enacted. Section 6407 (a) (amended by section 10605) of the PPACA amends the requirements for physician certification of home health services contained in Section 1814 (a)(2)(C ) and 1835 (a) (2)(A) by requiring that, "In the case of a certification made by a physician after January 1, 2010, prior to making such certification, the physician must document that the physician himself or herself or specified non-physician practitioner has had a face-to-face encounter (including through the use of telehealth, subject to the requirements in section 1834 (m) of the Act)", with the patient incident to the services involved

$0
No
No
Yes
Uncollected
No
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.
07/23/2010


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