Prior to the re-submission of the information collection âPre-Claim Review Demonstration for Inpatient Rehabilitation Facility Services (CMS-10765)â (0938-1420), the agency will assess its respondent burden and the impact of the demonstration. This assessment will be guided by the principles and priorities set forth in the the Executive Order 14192 title "Unleashing Prosperity Through Deregulation" (January 21, 2025) https://www.whitehouse.gov/presidential-actions/2025/01/unleashing-prosperity-through-deregulation/. The assessment will inform and be integrated in the agencyâs annual rulemaking and revision of this information collection.
Inventory as of this Action
Requested
Previously Approved
10/31/2027
36 Months From Approved
237,419
0
0
120,317
0
0
7,896,556
0
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
Burden hours have increased due to the change in the number of IRFs which increased from 526 to 536. Overall burden hours increased from 91,533 to 120,317 hours. Costs have also increased as a result of the change in IRFs from $3,144,909 to $4,922,031 for all states in the demonstration.
$900,000
No
No
No
No
No
No
No
Jamaa Hill 301 492-4190
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-10765 Review Choice Demonstration for Inpatient Rehabilitation Facility Services
CMS-10765 - Supporting Statement.docx
CMS-10765 - cOMMENTS.pdf
Review Choice Demonstration for Inpatient Rehabilitation Facility Services