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:
0938-0984
ICR Reference No:
202103-0938-006
Status:
Historical Active
Previous ICR Reference No:
201705-0938-009
Agency/Subagency:
HHS/CMS
Agency Tracking No:
20493
Title:
Certification Statement for Electronic File Interchange Organizations that Submit NPI Data to the National Plan and Provider Enumeration System (CMS-10175)
Type of Information Collection:
Reinstatement without change of a previously approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/15/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/05/2021
Terms of Clearance:
CMS will work to merge all NPI and NPPES information collections into one OMB control number before the next renewal request.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2025
36 Months From Approved
Responses
32
0
0
Time Burden (Hours)
8
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
Health care providers can currently obtain a National Provider Identifier (NPI) via a paper application or over the Internet through the National Plan and Provider Enumeration System (NPPES). These applications must be submitted individually, on a per-provider basis. The Electronic File Interchange (EFI) process allows provider-designated organizations (EFIOs) to capture multiple providers' NPI application information on a single electronic file for submission to NPPES. (This process is also referred to as "bulk enumeration.") To ensure that the EFIO has the authority to act on behalf of each provider and complies with other Federal requirements, an authorized official of the EFIO must sign a certification statement and mail it to the Centers for Medicare and Medicaid Services (CMS).
Authorizing Statute(s):
PL:
Pub.L. 104 - 191 Title II
Name of Law: Health Insurance Portability and Accountability Act
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:
85 FR 60170
09/24/2020
30-day Notice:
Federal Register Citation:
Citation Date:
86 FR 12191
03/02/2021
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Certification Statement for Electronic File Interchange Organizations that Submit NPI Data to the National Plan and Provider Enumeration System
CMS-10175
EFI Certification Statement
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
32
0
0
0
11
21
Annual Time Burden (Hours)
8
0
0
0
3
5
Annual Cost Burden (Dollars)
0
0
0
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:
CMS is using more accurate data from NPPES to estimate respondents who use the Certification Statement for Electronic File Interchange Organizations (EFIOs). By doing so, we were able to accurately estimate the number of respondents from 21 to 32 respondents (+11). NPPES currently reports that the CMS-10175 is usually completed, signed and submitted by a professional, such as a chief member of the organization acting as the Authorized Representative for the organization. The CMS-10175 form is comprised of 3 pages, only one of which has minimal data fields to be completed and a certification statement to be signed. NPPES now estimates that completion of those data fields and their submission takes 15 minutes to complete. That increases the burden hour estimate by 2.75 hours (from 5.25 to 8.0 hours). Combined, the annual increase in burden hours is 2.75 (from 5.25 to 8.0 hours) and the increase in cost is $552.92 (from $938.28 to $1,491.20.). The increase in the number of respondents is 11 (from 21 to 32).
Annual Cost to Federal Government:
$0
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]?
No
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?
No
Agency Contact:
Jamaa Hill 301 492-4190
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:
03/05/2021
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