OMB control number
Notification of MACs and CMS of Co-Located Medicare Providers
OMB 0938-0897 · HHS/CMS.
OMB 0938-0897
Many long-term care hospitals (LTCHs) are co-located with other Medicare providers (acute care hospitals, inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), inpatient psychiatric facilities (IPFs)), which could lead to potential gaming of the Medicare system based on inappropriate patient shifting. In regulations at 42 CFR 412.22(e)(3) and (h)(6) CMS requires LTCHs to notify Medicare Administrative Contractors (MACs) and CMS of co-located providers.
The latest form for Notification of MACs and CMS of Co-Located Medicare Providers expires 2023-07-31 and is listed under ICR 201912-0938-017.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Supporting Statement - Part A - mlh2.docx | Supporting Statement A |
 Many long-term care hospitals (LTCHs) are co-located with other Medicare providers (acute care hospitals, inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), inpatient psych |
Information collection |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201912-0938-017 | Extension without change of a currently approved collection | 2019-12-20 | Approved without change | |
| 201612-0938-022 | Reinstatement without change of a previously approved collection | 2016-12-28 | Approved without change | |
| 201307-0938-028 | Extension without change of a currently approved collection | 2013-07-30 | Approved without change | |
| 201006-0938-007 | Reinstatement with change of a previously approved collection | 2010-06-15 | Approved without change | |
| 200612-0938-007 | Extension without change of a currently approved collection | 2006-12-15 | Approved without change | |
| 200304-0938-007 | New collection (Request for a new OMB Control Number) | 2003-04-14 | Approved without change |