Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410, 405.430, 405.435, 405.440, 405.445, 405.455, 410.61, 415.110, and 424.24

Forms and Documents

Document Name	Status
CMS-R-234 Supporting Statement [rev 6-10-2013 by OSORA PRA].docx Supporting Statement A	2013-06-10

IC Document Collections

IC ID	Document Title	Status
8395	Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410 (a)	Modified
178718	Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.455(a)	Modified
178717	Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.455(b)(4)	Modified
178716	Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.445(b)(2)	Modified
178715	Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410 (b)	Modified
178714	Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410(a)	Modified

ICR Details

OMB Control No: 0938-0730	ICR Reference No: 201306-0938-007
Status: Historical Active	Previous ICR Reference No: 201006-0938-018
Agency/Subagency: HHS/CMS	Agency Tracking No: 19764
Title: Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410, 405.430, 405.435, 405.440, 405.445, 405.455, 410.61, 415.110, and 424.24
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/26/2013
	Date Received in OIRA: 06/13/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2016	36 Months From Approved	08/31/2013
Responses	26,820	0	26,820
Time Burden (Hours)	7,197	0	7,197
Cost Burden (Dollars)	0	0	0

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Abstract: Section 4507 of BBA 1997 amended section 1802 of the Social Security Act to permit certain physicians and practitioners to opt-out of Medicare and to provide through private contracts services that would otherwise be covered by Medicare. Under such contracts the mandatory claims submission and limiting charge rules of section 1848(g) of the Act would not apply. Subpart D and the Supporting Regulations contained in 42 CFR 405.410, 405.430, 405.435, 405.440, 405.445, and 405.455, counters the effect of certain provisions of Medicare law that, absent section 4507 of BBA 1997, preclude physicians and practitioners from contracting privately with Medicare beneficiaries to pay without regard to Medicare limits.

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Authorizing Statute(s): PL: Pub.L. 105 - 33 4507 Name of Law: Use of Private Medicare Beneficaries
   Statute at Large: 42 Stat. 4507 Name of Statute: null
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 20323	04/04/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 34390	06/07/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410 (a)
Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410(a)
Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.410 (b)
Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.445(b)(2)
Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.455(b)(4)
Subpart D-Private Contracts and Supporting Regulations in 42 CFR 405.455(a)

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ICR Summary 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	26,820	26,820	0	0	0	0
Annual Time Burden (Hours)	7,197	7,197	0	0	0	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:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

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

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Common Form ICR:  No

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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: 06/13/2013

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