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OMB Control No: 0938-1083	ICR Reference No: 201312-0938-020
Status: Historical Active	Previous ICR Reference No: 201012-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No: 21238
Title: Medicare Program/Home Health Prospective Payment System Rate Update for CY2010: Physician Narrative Requirement, CY2011 Final Physician Face-to-Face Encounter
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/06/2014
	Date Received in OIRA: 12/24/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	36 Months From Approved	03/31/2014
Responses	3,281,452	0	3,281,452
Time Burden (Hours)	277,384	0	277,384
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: Affordable Care Act
   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: None

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 61848	10/04/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 77133	12/20/2013
Did the Agency receive public comments on this ICR? No

ICR Summary of Burden

	Total Approved	Previously Approved
Annual Number of Responses	3,281,452	3,281,452
Annual Time Burden (Hours)	277,384	277,384
Annual Cost Burden (Dollars)	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:

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]? 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

View ICR - OIRA Conclusion