Appropriate Use Criteria (AUC) for Diagnostic Imaging Services: Clinical Decision Support Mechanism (CDSM) Application Process (CMS-10624)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
AUC COI Comment response document 10-11-16 SF.docx	Supplementary Document	Uploaded 2016-11-18	Available
CMS-10624 - Supporting Statement A - Passback 03-06-17 (002) CLEAN.doc	Supporting Statement A	Uploaded 2017-03-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
222719	Reapplication		Unchanged
222718	Initial Application		Unchanged

ICR Details

OMB Control No: 0938-1315	ICR Reference No: 201611-0938-011
Status: Historical Active	Previous ICR Reference No: 201607-0938-017
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Appropriate Use Criteria (AUC) for Diagnostic Imaging Services: Clinical Decision Support Mechanism (CDSM) Application Process (CMS-10624)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/06/2017
	Date Received in OIRA: 11/22/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2020	36 Months From Approved
Responses	36	0	0
Time Burden (Hours)	660	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Section 218(b) of the PAMA amended the Medicare Part B statute by adding a new section 1834(q) of the Act entitled, “Recognizing Appropriate Use Criteria for Certain Imaging Services,” which directs us to establish a new program to promote the use of AUC. This new program is located at 42 CFR 414.94. Section 1834(q)(3)(B) specifies that qualified CDSMs must meet specific requirements including: make available to the ordering professional applicable AUC and the documentation supporting the appropriateness of the applicable imaging service that is ordered; where there is more than one applicable appropriate use criterion specified for an applicable imaging service, indicate the criteria it uses for the service; determine the extent to which an applicable imaging service that is ordered is consistent with the applicable AUC; generate and provide to the ordering professional documentation to demonstrate that the qualified CDSM was consulted by the ordering professional; be updated on a timely basis to reflect revisions to the specification of applicable AUC; meet applicable privacy and security standards; and perform such other functions as specified by the Secretary (which may include a requirement to provide aggregate feedback to the ordering professional). Based upon these statutory requirements, we have proposed a qualification process and requirements for qualified CDSMs.

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Authorizing Statute(s): PL: Pub.L. 113 - 93 218(b) Name of Law: Protecting Access to Medicare Act of 2014
  

Citations for New Statutory Requirements: PL: Pub.L. 113 - 93 218(b) Name of Law: Protecting Access to Medicare Act of 2014

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AS81	Final or interim final rulemaking	81 FR 80170	11/15/2016

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 46162	07/15/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 80170	11/15/2016
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Initial Application
Reapplication

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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	36	0	36	0	0	0
Annual Time Burden (Hours)	660	0	660	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: There are no program changes or burden adjustments since this is a new collection.

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Annual Cost to Federal Government: $55,974

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: 11/22/2016

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