Pre-Claim Review Demonstration for Inpatient Rehabilitation Facility Services (CMS-10765)

ICR 202109-0938-007

OMB: 0938-1420

Federal Form Document

Forms and Documents
Form and Instruction
Supporting Statement A
Supplementary Document
Supplementary Document
ICR Details
Received in OIRA
HHS/CMS CPI - 10765
Pre-Claim Review Demonstration for Inpatient Rehabilitation Facility Services (CMS-10765)
New collection (Request for a new OMB Control Number)   No
Regular 09/08/2021
  Requested Previously Approved
36 Months From Approved
179,910 0
91,533 0
5,983,807 0

The Centers for Medicare & Medicaid Services (CMS) is requesting the Office of Management and Budget (OMB) approval for the Review Choice Demonstration for Inpatient Rehabilitation Facility (IRF) Services. This demonstration will assist in developing improved procedures for the identification, investigation, and prosecution of potential Medicare fraud. By ensuring that payments for IRF services are appropriate through either pre-claim or postpayment review, this demonstration also works toward the prevention and identification of potential fraud, waste, and abuse, as well as protecting the Medicare Trust Funds from improper payments while reducing Medicare appeals. CMS proposes performing the demonstration in Alabama, Pennsylvania, Texas, and California, as well as IRFs in any state that bill to the Medicare Administrative Contractor (MAC) jurisdictions JJ, JL, JH, and JE.

US Code: 42 USC 602 Name of Law: Social Security Laws
US Code: 42 USC 402(a)(1)(J) Name of Law: Social Security Act

Not associated with rulemaking

  85 FR 81208 12/15/2020
86 FR 50360 09/08/2021

  Total Request 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 179,910 0 179,910 0 0 0
Annual Time Burden (Hours) 91,533 0 91,533 0 0 0
Annual Cost Burden (Dollars) 5,983,807 0 5,983,807 0 0 0
This is a new collection of information.

Jamaa Hill 301 492-4190


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.

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