(CMS-10282) Comprehensive Outpatient Rehabilitation Facilites (CORFs) Conditions of Participation (CoP) and Supporting Regulations

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-10282 Supporting Statement 11-5-19 clean.docx	Supporting Statement A	Uploaded 2019-11-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
192450	42 CFR 485.66(b)(1), (2), and 3(i),(ii) Untilization review plan		Unchanged

ICR Details

OMB Control No: 0938-1091	ICR Reference No: 201911-0938-004
Status: Active	Previous ICR Reference No: 201810-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No: 20940
Title: (CMS-10282) Comprehensive Outpatient Rehabilitation Facilites (CORFs) Conditions of Participation (CoP) and Supporting Regulations
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/29/2019
	Date Received in OIRA: 11/20/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2022	36 Months From Approved	08/31/2020
Responses	188	0	235
Time Burden (Hours)	1,504	0	3,055
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this package is to request Office of Management and Budget (OMB) approval of the collection of information requirements for the conditions of participation (CoPs) that comprehensive outpatient rehabilitation facilities (CORFS) must meet to participate in the Medicare Program.

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Authorizing Statute(s): US Code: 42 USC 1395x(cc) Name of Law: Comprehensive Outpatient Rehabilitation Facility (CORFs) Services
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT23	Final or interim final rulemaking	84 FR 51732	09/30/2019

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Federal Register Notices & Comments

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
42 CFR 485.66(b)(1), (2), and 3(i),(ii) Untilization review plan

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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	188	235	0	-47	0	0
Annual Time Burden (Hours)	1,504	3,055	0	-1,551	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: These burden estimates are unchanged from what was estimated for the proposed rule, which was an annual burden of 1,504 hours.

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Annual Cost to Federal Government: $0

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: 11/20/2019

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