Notification of FIs and CMS of co-located Medicare providers and Supporting Regulations in 42 CFR 412.22 and 412.533

ICR 201307-0938-028

OMB: 0938-0897

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2013-07-26
IC Document Collections
ICR Details
0938-0897 201307-0938-028
Historical Active 201006-0938-007
HHS/CMS 20164
Notification of FIs and CMS of co-located Medicare providers and Supporting Regulations in 42 CFR 412.22 and 412.533
Extension without change of a currently approved collection   No
Regular
Approved without change 09/26/2013
Retrieve Notice of Action (NOA) 07/30/2013
  Inventory as of this Action Requested Previously Approved
09/30/2016 36 Months From Approved 09/30/2013
25 0 25
6 0 6
0 0 0

Many long-term care hospitals (LTCHs) are co-located with other Medicare providers (acute care hospitals, IRFs, SNFs, psychiatric facilities), which leads to potential gaming of the Medicare system based on patient shifting. CMS is requiring LTCHs to notify fiscal intermediaries K (FIs), Medicare Administrative Contractors (MACs) and CMS of co-located providers in order to establish policies to limit payment abuse that will be based on FIs tracking patient movement among these co-located providers.

PL: Pub.L. 90 - 603 307(b) Name of Law: Balanced Budget Refinement Act
  
None

Not associated with rulemaking

  78 FR 29173 05/17/2013
78 FR 45203 07/26/2013
No

1
IC Title Form No. Form Name
Notification of FIs and CMS of co-Located Medicare Providers and Supporting Regulations

  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 25 25 0 0 0 0
Annual Time Burden (Hours) 6 6 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
No
No
No
Uncollected
Mitch Bryman 410 786-5258 [email protected]

  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.
07/30/2013


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