To: Jamie Wilson
Office of Information and Regulatory Affairs (OIRA)
Office of Management and Budget (OMB)
From: William N. Parham III
Office of Strategic Operations and Regulatory Affairs (OSORA)
Centers for Medicare and Medicaid Services (CMS)
Date: November 22, 2023
Subject: Non-Substantive Change Request – End Stage Renal Disease Medical Evidence Report Medicare Entitlement and/or Patient Registration (OMB No: 0938-0046; CMS-2728)
This memo requests approval of a non-substantive change to the approved information collection titled End Stage Renal Disease Medical Evidence Report Medicare Entitlement and/or Patient Registration (OMB No: 0938-0046; CMS-2728)
Background
The End Stage Renal Disease (ESRD) Medical Evidence (CMS-2728) is completed for all ESRD patients either by the first treatment facility or by a Medicare-approved ESRD facility when it is determined by a physician that the patient’s condition has reached that stage of renal impairment that a regular course of kidney dialysis or a kidney transplant is necessary to maintain life. The data reported on the CMS-2728 is used by the Federal Government, ESRD Networks, treatment facilities, researchers and others to monitor and assess the quality and type of care provided to end stage renal disease beneficiaries. The data collection captures the specific medical information required to determine the Medicare medical eligibility of End Stage Renal Disease claimants. It also collects data for research and policy on this population.
While working to incorporate the recently approved CMS-2728 into the ESRD Quality Reporting System (EQRS), several formatting issues were identified and must be remediated for the system to function properly.
Overview of Requested Changes
The Division of Kidney Health (DKH) in the Center for Clinical Standards and Quality (CCSQ) is requesting to make the following non-substantive edits to the currently approved information collection request. Please see the attached redline document for a visual illustration of the non-substantive edits to form CMS-2728. The following changes have no impact on the currently approved burden for this information collection. No data elements have been added or removed.
Section A #19: correct lettering co-morbidities- from i to bbb.
Section A #70-76: correct numbering to 62-68
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Jones, Molly (ACF) |
| File Modified | 0000-00-00 |
| File Created | 2023-12-12 |