Ambulatory Surgical Centers Conditions of Coverage (CMS-10279)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Response to Comments.docx	Supplementary Document	Uploaded 2024-06-06	Repair queued
CMS-10279 Ambulatory Surgical Centers - Supporting Statement - 508 01-25-24.docx	Supporting Statement A	Uploaded 2024-06-03	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
233417	Ambulatory Surgical Centers Conditions of Coverage 416.52(a)		Modified
189557	Ambulatory Surgical Centers Conditions of Coverage (416.50)(a)(3)		Modified
189556	Ambulatory Surgical Centers Conditions of Coverage (416.50)(a)(1)		Modified
189555	Ambulatory Surgical Centers Conditions of Coverage (416.43)		Modified
189554	Ambulatory Surgical Centers Conditions of Coverage (416.41)		Removed

ICR Details

OMB Control No: 0938-1071	ICR Reference No: 202405-0938-029
Status: Active	Previous ICR Reference No: 201911-0938-005
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Ambulatory Surgical Centers Conditions of Coverage (CMS-10279)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/31/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/06/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2027	36 Months From Approved
Responses	12,739	0	0
Time Burden (Hours)	97,527	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection package is a request for extension of information collection requirements. With this submission, we have updated the current number of Ambulatory Surgical Centers and wages/salary figures. The information collection requirements, as discussed in the supporting statement, are needed to implement the Medicare and Medicaid Conditions for Coverage for 5557 Ambulatory Surgical Centers.

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Authorizing Statute(s): PL: Pub.L. 96 - 499 934 Name of Law: Outpatient Surgery
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 18411	03/13/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 47153	05/31/2024
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Ambulatory Surgical Centers Conditions of Coverage (416.41)
Ambulatory Surgical Centers Conditions of Coverage (416.43)
Ambulatory Surgical Centers Conditions of Coverage (416.50)(a)(1)
Ambulatory Surgical Centers Conditions of Coverage (416.50)(a)(3)
Ambulatory Surgical Centers Conditions of Coverage 416.52(a)

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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	12,739	0	0	-9,546	0	22,285
Annual Time Burden (Hours)	97,527	0	0	-165,419	0	262,946
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Changes to the burden are a reflection of three changes: 1) A correction in the assumption in the previous iteration that development (IC-1) of notifications and draft policy (IC-3) occur more than a one-time basis and 2) an increase in the number of affected ASCs from 5,557 to 6,227. These changes and updates result in a 170 percent net decrease in annual burden hours, from 262,946 to 97,527 and a 154 percent net decrease in annual cost, from $28,144,370 to $11,089,427.

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Annual Cost to Federal Government: $2,008,208

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? No

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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: 06/06/2024

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