View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0679	ICR Reference No: 201303-0938-018
Status: Historical Active	Previous ICR Reference No: 201001-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: 19199
Title: Durable Medical Equipment Medicare Administrative Contractors (MAC) Regional Carrier, Certificate of Medical Necessity and Supporting Documentation
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/10/2013
	Date Received in OIRA: 03/29/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2016	36 Months From Approved
Responses	462,000	0	0
Time Burden (Hours)	92,400	0	0
Cost Burden (Dollars)	0	0	0

Authorizing Statute(s): US Code: 42 USC 1395y(a) Name of Law: Items or Services Specifically Excluded
   US Code: 42 USC 1395x(n) Name of Law: Durable medical equipment
   US Code: 42 USC 1395j(5) Name of Law: Special Payment Rules for Particular Items and Services
   US Code: 42 USC 1395l(e) Name of Law: Information for Determination of Amounts Due
   US Code: 42 USC 1395m(j)(2) Name of Law: Certificates of Medical Necessity
   US Code: 42 USC 1395m(j)(2)(A)(iii) Name of Law: Penalty
   US Code: 42 USC 1395y(a)(1)(A) Name of Law: Items or Services Specifically Excluded

Citations for New Statutory Requirements: None

ICR Summary of Burden

	Total Approved	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	462,000	-6,018,000	6,480,000
Annual Time Burden (Hours)	92,400	-1,203,600	1,296,000
Annual Cost Burden (Dollars)	0	0	0

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: Burden has decreased for the CMN forms. Suppliers are better educated on submission of CMNs/DIFs and only submit these when needed. Additionally, the current data suggests that the burden was incorrectly estimated in 2009. CMS is not renewing CMN Form 10269, which has never been used.

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