Indirect Medical Education (IME) and Supporting Regulations 42 CFR 412.105

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-R-64.Supporting_Statement-07-12-16.docx	Supporting Statement A	Uploaded 2016-12-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8078	Indirect Medical Education (IME) and Supporting Regulations 42 CFR 412.105	Instruction	Modified

ICR Details

OMB Control No: 0938-0456	ICR Reference No: 201612-0938-015
Status: Historical Active	Previous ICR Reference No: 201611-0938-017
Agency/Subagency: HHS/CMS	Agency Tracking No: CMS-R-64
Title: Indirect Medical Education (IME) and Supporting Regulations 42 CFR 412.105
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/15/2017
	Date Received in OIRA: 12/15/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved
Responses	1,245	0	0
Time Burden (Hours)	2,490	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The collection of information on interns and residents (IR) is needed to properly calculate Medicare program payments to hospitals that incur indirect costs for medical education. The agency's Intern and Resident Information System and similar contractor systems use the information for producing reports of duplicate full-time equivalent IR counts for IME. The contractors also use this information to ensure that hospitals are properly reimbursed for IME, and help eliminate duplicate reporting of IR counts which inflate payments.

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Authorizing Statute(s): US Code: 42 USC 1395ww Name of Law: PAYMENT TO HOSPITALS FOR INPATIENT HOSPITAL SERVICES
  

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:
	81 FR 46926	07/19/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 75409	10/31/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Indirect Medical Education (IME) and Supporting Regulations 42 CFR 412.105

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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	1,245	0	0	0	55	1,190
Annual Time Burden (Hours)	2,490	0	0	0	110	2,380
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: The increase in burden from 2,150 hours as shown on CMS' previous Request for OMB Review, to 2,490 hours shown above, directly reflects an increase in the number of hospitals.

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Annual Cost to Federal Government: $6,652

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: 12/15/2016

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