OMB applauds HCFA for its superior professionalism, policy, analysis, and responsiveness to commenters' concerns in its PRA review and revision of the Durable Medical Equipment Certificates of Medical Necessity. HCFA's participation in the PRA process has been exemplary. However, during the OMB review process, commenters have raised several outstanding concerns that OMB believes deserve HCFA's further consideration and resolution. OMB understands that many of these concerns will require amend- ments to the National Standard Format (NSF) and perhaps to DMERC operations. The NSF electronic file structures are covered under this clearance action along with the hard copy forms. HCFA invested in the National Standard Format in January 1991 before submitting the requirements for OMB review. Therefore, revisions of the NSF shall be made consistent with the objectives of the Paperwork Reduction Act of 1995. OMB approves for use the revised CMNs through 4/97 under the following conditions: 1) No later than 12/96, HCFA develops a third one page wheelchair CMN to cover "standard" wheelchairs. "Standard" wheelchairs are defined as manual wheelchairs in HCPCS codes K0001, K0002, K0003, and K0004 and with 3 or less accessories; 2) HCFA allows for private sector automation of the CMNs (in particular sections B and C on the form) when the CMN information has been electronically submitted to the DMERC and the hard copy CMN is used solely for recordkeeping purposes. Without exception, the computerized versions of the form must contain identical questions/wording to the OMB-approved form in the same sequence, with the same pagination, and identical instructions/ definitions printed on the back of page one. CMN question sets may not be combined. Within these constraints, flexibility will be allowed in the computer font as articulated in OMB's later technical remarks; 3) The mandated NSF reflects the revised hardcopy CMNs and in the future HCFA better coordinates PRA oversight of the hardcopy forms and related electronic file structures; and 4) The revised CMNs and DMERC computer screens for electronic transmission display the OMB clearance number and disclosure statements as required by the Paperwork Reduction Act of 1995 and 5 CFR 1320. Technical Comments . To ensure that the programmatic objectives of CMNs are met, CMNs may be computer generated if: 1) without exception, they meet the requirements of item 2 above; and 2) are printed within the font specifications recommended by commenters (see DEZINE HEALTHCARE SOLUTIONS letter to NAMES dated 4/10/96, forwarded to OMB on 4/11/96) and agreed to by HCFA. In addition, to ensure adequate industry reproduction, the computer generated CMNs should meet the enclosed HCFA specifications; and . Computer generated instructions appropriate for a particular CMN may appear in entirety on the back side of the first page consistent with the above format specifications. Finally, as suggested by public commenters, OMB recommends that HCFA consider the following amendments: . In the enteral nutrition CMNs, HCFA will consider providing respondents the choice between specifying the HCPCS code or a narrative description with the appropriate level of detail (e.g. dosage, frequency, etc.) HCFA will discuss its decision on this matter and its basis in the next submission for OMB clearance; . Redesign of the CMN's Part B to include check-off blocks for "yes" and "no"; and . To allow for additional space in Part C, consolidation of questions 5-7 in the wheelchair CMNs. Pending implementation of the third streamlined wheelchair CMN, HCFA will implement all of its revised CMNs including the two page forms for manual and motorized wheelchair CMNs. HCFA actively should educate the physician/supplier community in the use of these forms and inform them that an additional streamlined wheelchair form (similar in format but on one page) will be available in the next few months.
Inventory as of this Action
Requested
Previously Approved
05/31/1997
05/31/1997
04/30/1996
6,800,000
0
6,800,000
1,130,000
0
1,130,000
0
0
0
This information is needed to correctly process claims and insure that claims are properly paid. These forms contain medical information necessary to make an appropriate claims determination. Suppliers and physicians will complete these forms.
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.
Durable Medical Equipment Regional Carrier, Certificates of Medical Necessity