Proposed Prior Authorization
Process and Requirements for Certain Hospital Outpatient Department
(OPD) Services (CMS-10711)
Revision of a currently approved collection
No
Regular
08/02/2022
Requested
Previously Approved
36 Months From Approved
07/31/2024
564,010
151,451
289,926
108,108
0
0
The Centers for Medicare &
Medicaid Services (CMS) is requesting the Office of Management and
Budget (OMB) approval for establishing a new prior authorization
process and requirements for certain outpatient department (OPD)
services. This process will be under the authority of
§1833(t)(2)(F) which authorizes the Secretary to develop a method
for controlling unnecessary increases in the volume of covered OPD
services. It will establish criteria for identifying a list of
outpatient department services requiring prior authorization and
will focus on five groups of OPD services – Blepharoplasty,
Botulinum Toxin Injections, Panniculectomy, Rhinoplasty, Vein
Ablation, and their related services. CMS recently completed an
analysis of the volume of covered OPD services furnished and
recognized significant increases in the utilization volume of these
services. CMS believes a prior authorization process for OPD
services would ensure beneficiaries receive medically necessary
care while protecting the Medicare Trust Funds from improper
payments and unnecessary utilization
US Code:
42
USC 1895I Name of Law: Social Security Act
The burden has increased to
account for an increased number of respondents as well as the
addition of a new service category to the prior authorization
process.
$9,300,000
No
No
No
No
No
No
No
William Parham
4107864669
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.
CMS-10711.Supporting Statement Part A.docx
Prior Authorization Process (One New Service Category - Facet Joint Interventions)