Detailed Explanation of Non-Coverage (42 CFR 422.626(e)(1)), and Notice of Medicare Non-Coverage (42 CFR 422.624(b)(1))

ICR 201008-0938-004

OMB: 0938-0910

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2010-07-30
Supplementary Document
2010-07-30
Supplementary Document
2010-07-30
Supplementary Document
2010-07-30
Supplementary Document
2010-07-30
Supplementary Document
2010-07-30
Supporting Statement A
2010-07-30
IC Document Collections
IC ID
Document
Title
Status
8750 Modified
179179 Modified
ICR Details
0938-0910 201008-0938-004
Historical Active 200902-0938-003
HHS/CMS
Detailed Explanation of Non-Coverage (42 CFR 422.626(e)(1)), and Notice of Medicare Non-Coverage (42 CFR 422.624(b)(1))
Revision of a currently approved collection   No
Regular
Approved without change 10/29/2010
Retrieve Notice of Action (NOA) 08/10/2010
  Inventory as of this Action Requested Previously Approved
10/31/2013 36 Months From Approved 10/31/2010
100,785 0 47,558
45,353 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.
US Code: 42 USC 1395-21 Name of Law: Implementation of Medicare Advantage Program
   PL: Pub.L. 108 - 173 234 Name of Law: Medicare Prescription Drug, Improvement, and Modernization Act of 2003
  
None
Not associated with rulemaking
  75 FR 22810 04/30/2010
75 FR 43168 07/23/2010
Yes
  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 100,785 47,558 0 42,582 10,645 0
Annual Time Burden (Hours) 45,353 23,780 0 10,645 10,928 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Our revised methodology for calculating the total burden is responsible, in part, for the increase in burden for this package. We now include the total number of affected providers in our estimates, whereas we previously only included the total number of Medicare health plans. Additionally, the number of Medicare health plans has grown from 376 to 740 plans, the number of Medicare enrollees has increased from 6.1 million to 10.9 million, and the hourly wage for a GS-12, Step 1 employees has increased from $26.53 to $28.88. Please see Supporting Statement for further details concerning the increase in burden for this package.
$0
No
No
No
No
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.
08/10/2010
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