Appropriate Use Criteria (AUC) for Diagnostic Imaging Services: Consultation of Specified Applicable AUC through a Qualified Clinical Decision Support Mechanism (CDMS) (CMS-10654)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-10654 - Supporting Statement A (rev 07-21-2017 by OSORA PRA).pdf	Supporting Statement A	Uploaded 2017-07-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
227638	Consultation of Specified Applicable AUC through a Qualified Clinical Decision Support Mechanism (CDSM)		New

ICR Details

OMB Control No: 0938-1345	ICR Reference No: 201707-0938-009
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Appropriate Use Criteria (AUC) for Diagnostic Imaging Services: Consultation of Specified Applicable AUC through a Qualified Clinical Decision Support Mechanism (CDMS) (CMS-10654)
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: Comment filed on proposed rule	Conclusion Date: 11/17/2017
	Date Received in OIRA: 07/21/2017
Terms of Clearance: OMB files this comment in accordance with 5 CFR 1320.11( c ). This OMB action is not an approval to conduct or sponsor an information collection under the Paperwork Reduction Act of 1995. This action has no effect on any current approvals. If OMB has assigned this ICR a new OMB Control Number, the OMB Control Number will not appear in the active inventory. For future submissions of this information collection, reference the OMB Control Number provided. OMB is withholding approval at this time. Prior to publication of the final rule, the agency should provide a summary of any comments related to the information collection and their response, including any changes made to the ICR as a result of comments. In addition, the agency must enter the correct burden estimates.

table that charts list comparision

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

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Abstract: For CMS to ensure that ordering professionals are consulting specified applicable AUC using a qualified clinical decision support mechanism (CDSM), reporting professionals are including this information on the Medicare claim form as required under section 1834(q)(4)(A) and (B) of the Act. Therefore, we are proposing in the CY 2018 Physician Fee Schedule proposed rule (CMS-1676-P) under §414.94(j) and §414.94(k) to require consultation and reporting to begin for specified applicable imaging services furnished in an applicable setting, paid for under an applicable payment system and ordered on and after January 1, 2019. The proposed reporting requirement would not have any impact on any Medicare claim forms because the forms’ data fields, instructions, and burden are not expected to require any changes. Consequently, this collection of information request reflects the proposed consultation requirement and does not include the reporting requirement.

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Authorizing Statute(s): US Code: 42 USC 834(q)(4)(A) and (B) Name of Law: Social Security Act
   US Code: 42 USC 218(b) Name of Law: Protecting Access to Medicare Act of 2014 (PAMA)
  

Citations for New Statutory Requirements: US Code: 42 USC 218(b) Name of Law: Protecting Access to Medicare Act of 2014 (PAMA)
US Code: 42 USC 834(q)(4)(A) and (B) Name of Law: Social Security Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT02	Proposed rulemaking	82 FR 33950	07/21/2017

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 33950	07/21/2017
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
Consultation of Specified Applicable AUC through a Qualified Clinical Decision Support Mechanism (CDSM)

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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: $16,841,024

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 07/21/2017

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