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:
201812-0938-004
Status:
Historical Active
Previous ICR Reference No:
201807-0938-009
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CMS/CM
Title:
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program
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:
12/07/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/06/2018
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2021
36 Months From Approved
05/07/2018
Responses
18,000
0
19,053
Time Burden (Hours)
56,675
0
18,870
Cost Burden (Dollars)
0
0
0
Abstract:
CMS is seeking approval to reinstate the Information Collection Request (ICR) and to update our burden estimates to Forms A and B in preparation for the next round. CMS will publish a slightly modified version of Form A so that bidders will be better able to identify and understand the new requirement related to bid surety bonds (Section 1847(a)(1)(G) of the Act, added by section 522(a) of the Medicare Access and CHIP Reauthorization Act of 2015 (Pub. L. 114-10) (MACRA). We have made changes to Form B to remove the expansion plan section and to include the bidding methodology proposed in CMS-1691-P (83 FR 34304).
Authorizing Statute(s):
PL:
Pub.L. 110 - 275 154
Name of Law: Delay in and Reform of Medicare DMEPOS Competitive Acquisition Program
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. 111 - 148 6410
Name of Law: Adjustments to the Medicare DMEPOS competitive acquisition program
PL:
Pub.L. 114 - 10 522
Name of Law: Requiring bid surety bonds for bidding entities
Citations for New Statutory Requirements:
PL: Pub.L. 111 - 148 6410 Name of Law: Adjustments to the Medicare DMEPOS competitive acquisition program
PL: Pub.L. 114 - 10 522 Name of Law: Requiring bid surety bonds for bidding entities
PL: Pub.L. 110 - 275 154 Name of Law: Delay in and Reform of Medicare DMEPOS Competitive Acquisition Program
PL: Pub.L. 108 - 173 302(b)(1) Name of Law: Payment for durable medical equipment; competitive acquisition of certain items and services
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AT28
Final or interim final rulemaking
83 FR 56922
11/14/2018
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Application for DMEPOS Competitve Bidding Program (Form A)
CMS-10169
Form A
Bidding Form (Form B)
CMS-10169
Form B _ Bidding Form
Change of Ownership (CHOW) - Purchaser Form
CMS-10169
Change of Ownership - Purchaser Form - 30-day notice
Change of Ownership (CHOW) Contract Supplier Notification Form
CMS-10169
Change of Ownership - Contract Supplier Notificaiton Form - 60-day Notice
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Quarterly Reporting Form (Form C)
CMS-10169
Quarterly Report
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Subcontracting Disclosure
CMS-10169
Contract Suppliers Disclosure of Subcontractors
Form A: Application for DMEPOS Competitve Bidding Program
CMS-10169
Form A: Application for DMEPOS Competitve Bidding Program
Round 1 Re-Compete for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Beneficiary Survey (Form D)
CMS-10169, CMS-10169
Beneficiary Survey (English Language Version)
,
Beneficiary Survey (Spanish Language Version)
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
18,000
19,053
0
-1,053
0
0
Annual Time Burden (Hours)
56,675
18,870
0
37,805
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:
Miscellaneous Actions
Short Statement:
While the total number of annual responses has slightly decreased, the overall burden has increased. Round consolidation (multiple rounds to single round), more accurate estimates based on our experience from prior rounds of competition, more bidders who are experienced with the Program, information technology efficiencies in the bidding process (DBidS), the bidding methodology finalized in CMS-1691-F, and the exclusion of other forms for the Program that will be included in a subsequent PRA information collection request are the reasons for the changes in burden.
Annual Cost to Federal Government:
$1,500,000
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
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:
William Parham 4107864669
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:
12/06/2018
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