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OMB Control No: 0938-1083	ICR Reference No: 201007-0938-012
Status: Historical Inactive	Previous ICR Reference No: 201002-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare program/Home Health Prospective Payment System Rate Update for CY2010:Physician Narrative Requirement, CY2011 Proposed Physician Face-to-Face Encounter
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 08/29/2010
	Date Received in OIRA: 07/23/2010
Terms of Clearance: OMB files this comment in accordance with 5 CFR 1320.11(c). This OMB action is not an approval to conduct or sponsor an information collection under the Paperwork Reduction Act of 1995. This action has no effect on any current approvals. For future submissions of this information collection, reference the OMB Control Number provided. In accordance with 5 CFR 1320, the agency should resubmit this ICR at the final rule stage.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2013	36 Months From Approved	02/28/2013
Responses	345,600	0	345,600
Time Burden (Hours)	28,800	0	28,800
Cost Burden (Dollars)	0	0	0

Abstract: 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).The Home Health Prospective Payment System Rate Update for Calendar Year 2011 changes the certification requirements for Home Health Agencies. In the case of a certification made by a physician after January 1, 2010, prior to making such certification, the physician must document that the physician himself or herself or specified non-physician practitioner has had a face-to-face encounter with the patient incident to the services involved

Authorizing Statute(s): US Code: 42 USC 1395x Name of Law: Definitions
   PL: Pub.L. 111 - 148 6407(a) Name of Law: Patient Protection and Affordable Care Act
   US Code: 42 USC 1395x Name of Law: Definitions
   Statute at Large: 18 Stat. 1814
   Statute at Large: 18 Stat. 1835
   Statute at Large: 18 Stat. 1834
   Statute at Large: 18 Stat. 1861

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 6407 Name of Law: Patient Protection and Affordable Care Act

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AP88	Proposed rulemaking	75 FR 43236	07/23/2010

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: the Patient Protection and Affordable Care Act (PPACA) of 2010 (Pub. L. 111-148) was enacted. Section 6407 (a) (amended by section 10605) of the PPACA amends the requirements for physician certification of home health services contained in Section 1814 (a)(2)(C ) and 1835 (a) (2)(A) by requiring that, "In the case of a certification made by a physician after January 1, 2010, prior to making such certification, the physician must document that the physician himself or herself or specified non-physician practitioner has had a face-to-face encounter (including through the use of telehealth, subject to the requirements in section 1834 (m) of the Act)", with the patient incident to the services involved

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Bonnie Harkless 4107865666

View ICR - OIRA Conclusion