Summary of Changes

Summary of Changes to Form CMS-1696

1. Our estimate of the burden has changed slightly due to the number of claims in our data which is used to compute the burden (the previous collection used FY 2007 appeals data and for this submission we use FY 2010 appeals data).  The time it takes to complete the form has not changed. 

2. The dollar amount used to compute the wage burden associated with the form has changed.  On the previous collection, we used the 2007 hourly base wage for a GS-09, while for this collection, we are using 2010 GS-09 hourly base wage salary.

3. Another item that has changed is the associated rulemaking information related to this form.  The previous collection cited an interim final rule and in 2009, a final rule was published. 

4. Finally, the specific changes to the form itself:

• The font on the original form that you had sent me was changed in order to make the form 508 compliant and meet space limitations.   We believe the font that we used should meet requirements. 

• Also, the Roman numerals in each section heading were changed to regular numbers so when read aloud under 508, listener does not hear, “i, i, i” or “i,v”.

  • Other formatting changes due to 508 compliance needs were: removal of some lines in the form that separated sections, and changing some titles from all capital letters to first letter in each word capitalized. 

  • Section 1, first sentence: Delete the colon and replace it with a comma. (Grammatical correction)

  • Section 4, throughout section.  We removed an acronym.  In four places in this section, the Medicare Appeals Council is referred to as “MAC” – We are leaving in the term “Medicare Appeals Council” but removing the acronym and using the full name instead.  (Technical correction)

  • Section 4, fourth paragraph, second sentence.  Add a period at the end of the sentence. (Grammatical correction)

  • Section 4, sixth paragraph, second sentence.  Add the word “will” following “Medicare Appeals Council”; Delete the “S” at the end of the word “considers”, and; replace the word “performed” with “rendered”. (Technical correction)

  • Section 4, eighth paragraph, first sentence.  Add numbering to items in list for clarity (technical correction).