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:
0938-1067
ICR Reference No:
202104-0938-008
Status:
Historical Inactive
Previous ICR Reference No:
202103-0938-005
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CCSQ
Title:
Hospice Conditions of Participation (CMS-10277)
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Comment filed on proposed rule and continue
Conclusion Date:
06/15/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/16/2021
Terms of Clearance:
In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2024
36 Months From Approved
03/31/2024
Responses
18,725,653
0
18,725,653
Time Burden (Hours)
3,639,215
0
3,639,215
Cost Burden (Dollars)
0
0
0
Abstract:
The CoPs and accompanying requirements specified in the regulations are used by Federal or State surveyors as a basis for determining whether a hospice qualifies for approval or re-approval under Medicare. CMS and the healthcare industry believe that the availability to the hospice of the type of records and general content of records, which this regulation specifies, is standard medical practice, and is necessary in order to ensure the well-being and safety of patients and professional treatment accountability.
Authorizing Statute(s):
PL:
Pub.L. 97 - 248 122
Name of Law: Tax Equity & Fiscal Responsibility Act
PL:
Pub.L. 101 - 239 6005(b)
Name of Law: Omnibus Reconciliation Act of 1989
US Code:
42 USC 1395x
Name of Law: Hospice Care; Hospice Program
PL:
Pub.L. 105 - 33 Title IV, Chapter 4
Name of Law: BBA of 1997
PL:
Pub.L. 108 - 173 946
Name of Law: Medicare Prescription Drug, Improvement, & Modernization Act of 2003
Citations for New Statutory Requirements:
US Code: 42 USC 418.24(b) Name of Law: Election of hospice care
US Code: 42 USC 418.24(c) Name of Law: Election of hospice care
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AU41
Proposed rulemaking
86 FR 19700
04/14/2021
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
30
IC Title
Form No.
Form Name
Hospice Condition of Participation (418.22(b)(4) and (b)(5)
Hospice Condition of Participation 418.58 Phase 2 data entry
Hospice Conditions of Participation (418.110 (n) new hospice training program
Hospice Conditions of Participation (418.52(a)(3)
Hospice Conditions of Participation 418.100(e)
Hospice Conditions of Participation 418.106 (e)
Hospice Conditions of Participation 418.108(c)
Hospice Conditions of Participation 418.108(c)(3)
Hospice Conditions of Participation 418.110(m)
Hospice Conditions of Participation 418.110(n) documentation
Hospice Conditions of Participation 418.110(n) training
Hospice Conditions of Participation 418.112(e)(3)
Hospice Conditions of Participation 418.114 (b)
Hospice Conditions of Participation 418.114 (d)
Hospice Conditions of Participation 418.22(b)
Hospice Conditions of Participation 418.22(b)(3)
Hospice Conditions of Participation 418.24 explain election form
Hospice Conditions of Participation 418.28 develop revocation form
Hospice Conditions of Participation 418.28 explain revocation form
Hospice Conditions of Participation 418.52(b)
Hospice Conditions of Participation 418.56(b) and (c)
Hospice Conditions of Participation 418.58 Phase 1
Hospice Conditions of Participation 418.58 Phase 2 aggregate/data analysis
Hospice Conditions of Participation 418.58 Phase 3
Hospice Conditions of Participation 418.76(c) and (d)
Hospice Conditions of Participation 418.78(a)(c)(d) and (e)
Hospice Conditons of Participation 418.24 develop election form
Hospice Condtions of Participation 418.52(a)
§418.24(b) Modification
§418.24(c) Addendum
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
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?
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:
04/16/2021
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