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

Document Name	Status
Comments received on the proposed COI - AUC.docx Supplementary Document	2017-11-27
CMS-10654 - Supporting Statement A - Passback2 sf CLEAN.doc Supporting Statement A	2018-05-18

IC Document Collections

IC ID	Document Title	Status
229146	Voluntary Consultations	New
227638	Mandatory Consultations	Modified

ICR Details

OMB Control No: 0938-1345	ICR Reference No: 201711-0938-008
Status: Historical Active	Previous ICR Reference No: 201707-0938-009
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: Approved with change	Conclusion Date: 05/18/2018
	Date Received in OIRA: 11/28/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2021	36 Months From Approved
Responses	46,591,818	0	0
Time Burden (Hours)	1,537,530	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information will be used by Medicare claims processing systems to determine payment for advanced diagnostic imaging services. In the future, we expect the consultation information to be used in the identification of outlier ordering professionals to apply prior authorization for applicable imaging services that are ordered by such professionals. We expect details on this component to be addressed in future rulemaking.

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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	Final or interim final rulemaking	82 FR 52976	11/15/2017

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 33950	07/21/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 52976	11/15/2017
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Voluntary Consultations
Mandatory Consultations

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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	46,591,818	0	47,728,485	-1,136,667	0	0
Annual Time Burden (Hours)	1,537,530	0	1,575,040	-37,510	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There are no changes to burden as this is a new collection.

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Annual Cost to Federal Government: $3,514,000,000

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: 11/28/2017

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