Transitional Pass through payments related to Drugs, Biologicals, and Radiopharmaceuticals to determine eligibility under the Outpatient Prospective Payment System(CMS-10008)
ICR 201810-0938-003
OMB: 0938-0802
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0802 can be found here:
Transitional Pass through
payments related to Drugs, Biologicals, and Radiopharmaceuticals to
determine eligibility under the Outpatient Prospective Payment
System(CMS-10008)
Reinstatement with change of a previously approved collection
Section 1833(t)(6) of the Act provides
for temporary additional payments or “transitional pass-through
payments” for certain drugs and biological agents. As originally
enacted by the Balanced Budget Refinement Act (BBRA), this
provision required the Secretary to make additional payments to
hospitals for current orphan drugs, as designated under section 526
of the Federal Food, Drug, and Cosmetic Act (Pub. L. 107-186);
current drugs and biological agents and brachytherapy used for the
treatment of cancer; and current radiopharmaceutical drugs and
biological products. For those drugs and biological agents referred
to as “current,” the transitional pass-through payment began on the
first date the hospital OPPS was implemented (before enactment of
Benefits Improvement and Protections Act (BIPA) (Pub. L. 106-554),
on December 21, 2000). Transitional pass-through payments are also
required for certain “new” drugs, devices and biological agents
that were not being paid for as a hospital outpatient department
(OPD) service as of December 31, 1996, and whose cost is “not
insignificant” in relation to the outpatient perspective payment
system (OPPS) payment for the procedures or services associated
with the new drug, device, or biological. Under the statute,
transitional pass- through payments can be made for at least 2
years but not more than 3 years.
Statute at
Large: 18
Stat. 1833 Name of Statute: null
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.