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Information Collection Request

MEDICARE COLLECTION OF MEDICAL INFORMATION ON HOME HEALTH SERVICES ON FORMS HCFA 485-487 AND INTERMEDIARY REQUEST FOR MEDICAL INFORMATION ON CLAIMS TO BE PROCESSED

ICR 199310-0938-018 · OMB 0938-0357 · Historical Active

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Document
Name
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No forms / supporting documents in this ICR. Check IC Document Collections.
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IC ID
Document
Title
Status
113524 Migrated
ICR Details
0938-0357 199310-0938-018
Historical Active 199307-0938-003
HHS/CMS
MEDICARE COLLECTION OF MEDICAL INFORMATION ON HOME HEALTH SERVICES ON FORMS HCFA 485-487 AND INTERMEDIARY REQUEST FOR MEDICAL INFORMATION ON CLAIMS TO BE PROCESSED
Revision of a currently approved collection   No
Regular
Approved without change 01/12/1994
Retrieve Notice of Action (NOA) 10/14/1993
Approved for use through 6/94 under the following conditions: 1) no later than 2/94, HCFA transmits a program bulletin to its FIs clarifying Manual guidance on the HCFA-485 to:a) clearly articulate those diagnoses for which a range of visits must be allowed by FIs (p. 10-24 of the Manual asks FIs to "encourage HHAs to limit the use of ranges to cases where the beneficiary's condition makes it difficul to project the number of visits that will be needed." This should be amended to ensure uniformity between FIs and should be as inclusive as possible); b) amend the Manual to only require use of HCFA treatment codes to describe "Duties/Treatments" in Locator 21 and to delete the requirement that orders "include all disciplines and treatments, even if they are not billable to Medicare" (unless HCFA can justify that th is mandated by regulation or statute); and c) clarify policy and reduc variation between FIs in how supplies must be reported under the physician order (such policy should be crafted with the objective of minimizing unnecessary burden on HHAs.); 2) no later than 3/94 incorporate these bulletin policies into the Manual guidance and submit these amendments for OMB review pursuant to the Paperwork Reduction Act; and 3) pursue efforts with outside groups to identify new areas for stream lining, e.g. expansion of visit ranges to more diagnosis codes and simplification of treatment codes and categories for Locators 18 and
  Inventory as of this Action Requested Previously Approved
06/30/1994 06/30/1994 04/30/1994
6,115,288 0 6,115,288
2,916,992 0 2,916,992
0 0 0
MEDICARE, MEDICAL SERVICES, HOME HEALTH AGENCIES, MEDICAL INFORMATION THIS INFORMATION IS USED BY FISCAL INTERMEDIARIES TO ASSURE THAT REIMBURSEMENT IS MADE TO HOME HEALTH AGENCIES ONLY FOR SERVICES THAT A IN THE HCFA 485, 486, 487, AND OTHER MEDICAL RECORDS DESCRIBES THE PATIENT AND LEVEL OF MEDICAL NEEDS AND/OR SERVICES PROVIDED. THESE RECORDS ARE SUBMITTED WITH THE CLAIM OR AS REQUESTED.
None
None
No
  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 6,115,288 6,115,288 0 0 0 0
Annual Time Burden (Hours) 2,916,992 2,916,992 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  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.
10/14/1993