Reinstatement with change of a previously approved collection
No
Regular
01/10/2022
table that charts list comparision
Requested
Previously Approved
36 Months From Approved
60,209
0
30,105
0
0
0
The publication of the Patient Protection and Affordable Care Act (PPACA), section 6405 - "Physicians Who Order Items or Services Required to be Medicare Enrolled Physicians or Eligible Professionals" (regulation CMS 6010-F), contains a requirement for certain physicians and non-physician practitioners to enroll in the Medicare program for the sole purpose of ordering or referring items or services for Medicare beneficiaries. The PPACA has an effective date applicable to written orders and certifications made on or after July 1, 2010. The CMS 855O allows a physician to receive a Medicare identification number (without being approved for billing privileges) for the sole purpose of ordering and referring Medicare beneficiaries to Medicare approved providers and suppliers. This new Medicare application form allows physicians who do not provide services to Medicare beneficiaries to be given a Medicare identification number without having to supply all the data required for the submission of Medicare claims. It also allows the Medicare program to identify ordering and referring physicians without having to validate the amount of data necessary to determine claims payment eligibility (such as banking information), while continuing to identify the physician's credentials as valid for ordering and referring purposes.
As previously explained, section 3708 of the CARES Act expands § 424.507(b)(1) to allow NPs, CNSs, and PAs to certify the need for home health services. This will require the completion of the CMS-855O application. This burden is reflected in the burden estimate.
With the use of the PECOS system, updated information technology allows CMS to accurately count the hours per submittal reason and consequently, total annual hours. There are three submission reasons for completion of the CMS-855O enrollment application (initial enrollment, reporting a change of Medicare enrollment information, and voluntary termination of Medicare enrollment). Currently, the burden hours for the entirety of all submission reasons and respondents is 30,105 hours annually (over a three-year period 90,314 hours) with approximately 60,209 respondents. Both the burden hour per submission reason as well as the respondents are valued and calculated in this burden estimate.? Itâs all
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No
No
No
Yes
No
No
No
Jamaa Hill 301 492-4190
Reginfo record details
No
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.
Form CMS-855O Reporting Voluntary Withdrawal of Registration Information
CMS-855O - Supporting Statement - 30-dayOMB.docx
CMS 855O - Revisons Spreadsheet - 11202017.pdf
Reporting Voluntary Withdrawal of Registration Information