Data Collection for Developing Outpatient Therapy Payment Alternatives (DOTPA)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Summary of Changes to CARE C and F_11 10 10.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2010-11-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
192931	Data Collection for Developing Outpatient Therapy Payment Alternatives (DOTPA): Data Collection in Facility-Based Settings	Other-Admission Intake Questionnaire	Modified
192930	Data Collection for Developing Outpatient Therapy Payment Alternatives (DOTPA): Data Collection in Community-Based Settings (CMS-10298)	Other-Care C Admossion Questionnaire:updated	Modified

ICR Details

OMB Control No: 0938-1096	ICR Reference No: 201012-0938-004
Status: Historical Active	Previous ICR Reference No: 201005-0938-011
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Data Collection for Developing Outpatient Therapy Payment Alternatives (DOTPA)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/16/2011
	Date Received in OIRA: 12/06/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2013	07/31/2013	07/31/2013
Responses	38,632	0	38,632
Time Burden (Hours)	20,774	0	14,271
Cost Burden (Dollars)	0	0	0

---

Abstract: CMS has awarded a five year contract to RTI International (RTI) to collect data, conduct analyses, and report the results. To complete the contract, RTI will: (1) develop a data collection strategy, including the recruitment of therapy providers to participate in data collection, (2) analyze the resulting data to identify payment alternatives to therapy caps, and (3) engage with the stakeholder community closely throughout the project. Outpatient therapy services are furnished in such diverse settings as hospital outpatient facilities, skilled nursing facilities (SNF), comprehensive outpatient rehabilitation facilities (CORF), and outpatient rehabilitation facilities (ORF). In addition, outpatient therapy services may be furnished by individual practitioners including physical therapists in private practice (PTPP), occupational therapists in private practice (OTPP), physicians, and specified non-physician practitioners (NPP) as permissible by state law. In order to compare beneficiary needs across these settings, it is important to collect these data using similar items across settings and disciplines. Although there currently exist assessment instruments for outpatient therapy, the item definitions and rating scales differ across these instruments and these instruments have not been tested in the full range of Medicare patients and therapy settings. These differences in the existing assessment instruments make it difficult to compare patient function and clinical characteristics across them.

---

Authorizing Statute(s): PL: Pub.L. 106 - 554 1 Name of Law: Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act (BIPA)
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Data Collection for Developing Outpatient Therapy Payment Alternatives (DOTPA): Data Collection in Community-Based Settings (CMS-10298)
Data Collection for Developing Outpatient Therapy Payment Alternatives (DOTPA): Data Collection in Facility-Based Settings

---

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	38,632	38,632	0	0	0	0
Annual Time Burden (Hours)	20,774	14,271	0	0	6,503	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: $841,194

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

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: 12/06/2010

---