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: 0938-1311	ICR Reference No: 202205-0938-011
Status: Active	Previous ICR Reference No: 201810-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: CPI - 10599
Title: Pre-Claim Review Demonstration For Home Health Services (CMS-10599)
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 with change	Conclusion Date: 12/07/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/10/2022
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2025	36 Months From Approved
Responses	2,688,139	0	0
Time Burden (Hours)	1,357,224	0	0
Cost Burden (Dollars)	2,675,200	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,688,139	0	482,702	2,205,437
Annual Time Burden (Hours)	1,357,224	1	221,451	1,135,772
Annual Cost Burden (Dollars)	2,675,200	0	-978,495	3,653,695

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: With the implementation of the Home Health Patient-Driven Groupings Model (PDGM), effective on January 1, 2020, claims are now submitted every 30 days instead of 60 days. Providers now submit two claims for each of the 30- day billing periods, where they previously submitted one for the whole 60-day episode of care. This has led to a significant increase in the number of claims submitted. While providers in Choice 1- Pre-Claim Review, may request more than one billing period at once to limit the number of reviews, providers may still request each billing period separately. In addition, there are more claims to review under the other review options. The overall burden has increased as a result of the change to submitting claims every 30 days instead of 60 days (from 1,132,772 to 1,357,224 for all 16 states).

Annual Cost to Federal Government: $443,500,000

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]? 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