View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-1016
ICR Reference No:
201305-0938-005
Status:
Historical Active
Previous ICR Reference No:
201207-0938-007
Agency/Subagency:
HHS/CMS
Agency Tracking No:
19556
Title:
Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
06/10/2013
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/10/2013
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2016
36 Months From Approved
10/31/2015
Responses
20,212
0
16,865
Time Burden (Hours)
9,301
0
34,795
Cost Burden (Dollars)
0
0
0
Abstract:
In preparing for the Round 2 and national mail-order competitions, CMS received OMB approval of this collection on November 2, 2011 with no material or non-substantive changes. The collection was modified from prior rounds of competitive bidding in order to make the documents more reader-friendly, to clarify the requirements that suppliers had difficulty in understanding, and to incorporate the Round 2 and national mail order bidding areas and product categories. CMS is currently re-competing the Round 1 Rebid areas. On 10/10/12, we received approval for a revision to a currently approved collection to extend the information collection for an additional three years. We are seeking OMB approval for a revision to this currently approved package as our program expands and increases the population from which we will be collecting information.
Authorizing Statute(s):
PL:
Pub.L. 108 - 173 302(b)(1)
Name of Law: Payment for durable medical equipment; competitive acquisition of certain items and services
PL:
Pub.L. 110 - 275 154
Name of Law: Delay in and Reform of Medicare DMEPOS Competitive Acquisition Program
Citations for New Statutory Requirements:
PL: Pub.L. 110 - 275 154 Name of Law: Delay in and Reform of Medicare DMEPOS Competitive Acquisition Program
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
78 FR 13878
03/31/2013
30-day Notice:
Federal Register Citation:
Citation Date:
78 FR 27399
05/10/2013
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
5
IC Title
Form No.
Form Name
Change of Ownership (CHOW) Contract Supplier Notification Form
CMS-10169
Change of Ownership (CHOW) Contract Supplier Notification Form
Change of Ownership (CHOW) Purchaser Form
CMS-10169
Change of Ownership (CHOW) Purchaser Form
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Application for Suppliers (Form A)
CMS-10169
Application for Suppliers
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Bidding Form (Form B)
CMS-10169
Form B - Bidding Form
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Quarterly Reporting Form (Form C)
CMS-10169
Form C: QUARTERLY REPORT
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Subcontracting Disclosure
CMS-10169
CONTRACT SUPPLIER'S DISCLOSURE OF SUBCONTRACTORS
Round 1 Re-Compete for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Beneficiary Survey (Form D)
CMS-10169
Beneficiary Survey
ICR Summary of Burden
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
20,212
16,865
203
3,144
0
0
Annual Time Burden (Hours)
9,301
34,795
157
-25,651
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Changing Regulations
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Changing Forms
Short Statement:
Total burden associated with this ICR is increasing as the program expands in accordance with statutory mandates. Forms A and B are not part of this package but will be added before their use, upon OMB approval.
Annual Cost to Federal Government:
$1,437,666
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]?
No
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:
Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
05/10/2013
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