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Federal forms, ICRs, and supporting documents

Information Collection Request

Medicare Program/Home Health Prospective Payment System Rate Update for Calendar Year 2010: Physician Narrative Requirement and Supporting Regulation in 42 CFR 424.22

ICR 201002-0938-001 · OMB 0938-1083 · Historical Active

Forms and Documents
Document
Name
Status
Supporting Statement A
2010-01-22
IC Document Collections
IC ID
Document
Title
Status
191961
New
ICR Details
0938-1083 201002-0938-001
Historical Active
HHS/CMS
Medicare Program/Home Health Prospective Payment System Rate Update for Calendar Year 2010: Physician Narrative Requirement and Supporting Regulation in 42 CFR 424.22
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 02/26/2010
Retrieve Notice of Action (NOA) 02/03/2010
  Inventory as of this Action Requested Previously Approved
02/28/2013 36 Months From Approved
345,600 0 0
28,800 0 0
0 0 0
The Centers for Medicare and Medicaid Services (CMS) require that a physician sign every patient's individual plan of care certifying or recertifying that the patient is homebound and the planned services are medically necessary in order for the home health agency to be reimbursed for Medicare covered services as stipulated in 42 CFR 424.22. CMS is relying on physicians to fulfill a role that is sometimes thought of as a "gatekeeper" by requiring the physician to provide a narrative located within the home health certification or recertification when skilled nursing management & evaluation of the plan of care, (PoC) is ordered. The physician's narrative is required when a patient's underlying condition or complication requires a registered nurse to ensure that essential non-skilled care is achieving its purpose, The narrative must be located immediately prior to the physician's signature. If the narrative exists as an addendum to the certification or recertification form, in addition to the physician's signature on the certification or recertification form, the physician must sign immediately following the narrative in the addendum. This change supports Medicare's home health coverage criteria for skilled services as stipulated in the CFR, (see 42 CFR 409.42).
US Code: 42 USC 1395x Name of Law: Definitions
  
None
0938-AP55 Final or interim final rulemaking 74 FR 58078 11/09/2009
  74 FR 58078 11/09/2009
75 FR 2548 01/15/2010
No
1
IC Title Form No. Form Name
Requirement in 42 CFR 424.22
  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 345,600 0 0 345,600 0 0
Annual Time Burden (Hours) 28,800 0 0 28,800 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Changing Regulations
No
This is a new ifnormation collection requirement contained in 42 CFR 424.22.
$0
No
No
Uncollected
Uncollected
No
Uncollected
William Parham 4107864669
  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.
02/03/2010