The publication of the Patient
Protection and Affordable Care Act (PPACA), section 6405 -
"Physicians Who Order Items or Services Required to be Medicare
Enrolled Physicians or Eligible Professionals" (regulation CMS
6010-F), contains a requirement for certain physicians and
non-physician practitioners to enroll in the Medicare program for
the sole purpose of ordering or referring items or services for
Medicare beneficiaries. The PPACA has an effective date applicable
to written orders and certifications made on or after July 1, 2010.
The CMS 855O allows a physician to receive a Medicare
identification number (without being approved for billing
privileges) for the sole purpose of ordering and referring Medicare
beneficiaries to Medicare approved providers and suppliers. This
new Medicare application form allows physicians who do not provide
services to Medicare beneficiaries to be given a Medicare
identification number without having to supply all the data
required for the submission of Medicare claims. It also allows the
Medicare program to identify ordering and referring physicians
without having to validate the amount of data necessary to
determine claims payment eligibility (such as banking information),
while continuing to identify the physician's credentials as valid
for ordering and referring purposes.
The burden increase is based
the new burden amounts of data compiled from PECOS. The new
estimates for completing the CMS-855O Medicare enrollment
application form for initial enrollment, reporting changes in
enrollment information, and voluntarily withdrawal of enrollment
information are taken directly from the actual applications
processed for calendar year 2014 in PECOS. These numbers are for
estimated providers completing the CMS-855O solely for the purpose
of ordering and/or referring Medicare beneficiaries to Medicare
enrolled providers/suppliers. The new figures are from PECOS and
therefore more accurate than the prior estimates. In addition, CMS
assessed (via PECOS) how many providers are currently prescribing
based on their NPI and PDE data but are not currently enrolled in
PECOS and therefore will complete and submit the revised CMS-855O
as new providers enrolling solely for the purpose of prescribing
Part D drugs. Those assessed new providers were added to the burden
estimates. Furthermore, according to the most recent wage data
provided by the Bureau of Labor Statistics (BLS) for May 2014 (see
http://www.bls.gov/oes/current/oes_nat.htm#43-0000), the mean
hourly wage for the general categories of "Office and
Administrative Support Occupations" and "Physicians and Surgeons"
and has greatly increased since the last revision of this form in
2012. Overall the burden hours and costs have increased. Combined,
the increase in burden hours is 219,475 and the increase in cost is
$6,494,160. The increase in the number of respondents is 408,000
(from 40,000 to 448,000). The burden has increased for two reasons.
The first is we are using more accurate data from PECOS to estimate
enrollees who use the CMS-855O to enroll in Medicare to solely to
order and refer Medicare beneficiaries to Medicare enrolled
providers and suppliers. By doing so, we have decreased the first
part of our estimate by 12,000, from 40,000 respondents to 28,000.
This means our burden cost is now $458,010 for these respondents.
The second is we are now requiring providers who are prescribing
Part D drugs to enroll as providers/suppliers. This increases the
number of applications by 420,000 and increases our burden cost by
$6,870,150. Combined, the changes are 243,600 hours and
$7,328,160.
$0
No
No
Yes
No
No
Uncollected
Jamaa Hill 301 492-4190
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.
Form CMS-855O Reporting Voluntary Withdrawal of Registration Information
CMS 855O - Supporting Statement 1517.docx
Reporting Voluntary Withdrawal of Registration Information