OASIS Collection Requirements as Part of the CoPs for HHAs and Supporting Regulations

Forms and Documents

Document	Type	Status	Availability
Form CMS-R-245 Medicare and Medicaid OASIS Collection Requirements (Data collection)	Form and Instruction	Modified	Available
Form CMS-R-245 Medicare and Medicaid Programs OASIS Collection Requirements (Training)	Form and Instruction	Modified	Available
OASIS C1 ICD 9 Emergency Justification Memo 8-21-14.docx	Supplementary Document	Uploaded 2014-09-03	Available
Revised Supporting Statement A OASIS-C1 ICD-9 11_7_14.doc	Supporting Statement A	Uploaded 2015-02-12	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
43666	Medicare and Medicaid OASIS Collection Requirements (Data collection)	Form and Instruction	Modified
180130	Medicare and Medicaid Programs OASIS Collection Requirements (Training)	Form and Instruction	Modified

ICR Details

OMB Control No: 0938-0760	ICR Reference No: 201502-0938-004
Status: Historical Active	Previous ICR Reference No: 201409-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: 21017
Title: OASIS Collection Requirements as Part of the CoPs for HHAs and Supporting Regulations
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: 03/18/2015
	Date Received in OIRA: 02/12/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2018	36 Months From Approved	04/30/2015
Responses	17,280,904	0	17,280,904
Time Burden (Hours)	15,320,253	0	15,320,253
Cost Burden (Dollars)	0	0	0

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Abstract: This request is for extension of OMB PRA approval of the Outcome and Assessment Information Set (OASIS-C1/ICD-9) data set. This data set is currently mandated for use by Home Health Agencies (HHAs) as a condition of participation (CoP) in the Medicare program. There are no proposed revisions to the OASIS-C1/ICD-9 data set. The current OMB PRA approval of the OASIS-C1/ICD-9 data set will expire on April 30, 2015.

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Authorizing Statute(s): PL: Pub.L. 105 - 33 4601(e) Name of Law: Balanced Budget Act of 1997 (authority for collecting data required for casemix system)
   US Code: 42 USC 1395x Name of Law: DEFINITIONS OF SERVICES, INSTITUTIONS, ETC; Home Health Agency
   PL: Pub.L. 109 - 171 5201(c)(2) Name of Law: Deficit Reduction Act of 2005: Home health - pay for reporting of quality information
   US Code: 42 USC 1395bbb Name of Law: Conditions of participation for home health agencies; home health quality
  

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:
	79 FR 69854	11/24/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 6724	02/06/2015
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Medicare and Medicaid Programs OASIS Collection Requirements (Training)	CMS-R-245	OASIS-C1/ICD-9
Medicare and Medicaid OASIS Collection Requirements (Data collection)	CMS-R-245	OASIS-C1 ICD-9

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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	17,280,904	17,280,904	0	0	0	0
Annual Time Burden (Hours)	15,320,253	15,320,253	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: $1,500,000

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: 02/12/2015

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