Emergency Clearance: Public Information Collection Requirements Submitted to the Office of Management and Budget (OMB)

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Collection # HCFA-R-265]

Emergency Clearance: Public Information Collection Requirements

Submitted to the Office of Management and Budget (OMB)

In compliance with the requirement of section 3506(c)(2)(A) of the

Paperwork Reduction Act of 1995, the Health Care Financing

Administration (HCFA), Department of Health and Human Services (DHSS),

has submitted to the Office of Management and Budget (OMB) the

following request for Emergency review. We are requesting an emergency

review because the collection of this information is needed prior to

the expiration of the normal time limits under OMB's regulations at 5

C.F.R. Part 1320. We cannot reasonably comply with the normal clearance

procedures because of the statutory requirement to implement section

4016 of Balanced Budget Act of 1997.

We are requesting OMB review and approval of this collection within

11 working days, with a 180-day approval period. Written comments and

recommendations will be accepted from the public if received by the

individual designated below, within 10 working days of the publication

of this notice in the Federal Register. During this 180-day period HCFA

will pursue OMB clearance of this collection as stipulated by 5 C.F.R.

section 1320.5.

In order to fairly evaluate whether an information collection

should be approved by OMB, section 3506(c)(2)(A) of the PRA requires

that we solicit comments on the following issues:

The need for the information collection and its usefulness

in carrying out the proper functions of our agency.

The accuracy of our estimate of the information collection

burden.

The quality, utility, and clarity of the information to be

collected.

Recommendations to minimize the information collection

burden on the affected public, including automated collection

techniques.

Therefore, we are soliciting public comment on each of these issues

for the information collection summarized and discussed below.

Type of Information Collection Request: New collection;

Title of Information Collection: Medicare Coordinated Care

Demonstration Project and Request for Information on Potential Best

Practices of Coordinated Care;

Form/Collection No.: HCFA-R-265;

Use: Section 4016 of the Balanced Budget Act of 1997 (Public Law

105-33) requires the Secretary of Health and Human Services (the

Secretary) to evaluate best practices in the private sector for methods

of coordinated care. The statute also directs the Secretary to design a

demonstration project for the Medicare fee-for-service population based

on such evaluation.

The purpose of the demonstration is to evaluate models of

coordinated care that improve the quality of services provided to

beneficiaries who have a chronic illness and reduce expenditures under

Parts A and B of the Medicare program.

We competitively awarded a task order to Mathematica Policy

Research, Inc. (MPR) to conduct a review of best practices in

coordinating care and provide a recommendation of demonstration design

options. We will perform the final assessment of best practices and

select the demonstration design.

We will publish a notice to announce our intent to conduct the

Medicare Coordinated Care Demonstration and inform interested parties

of the opportunity to submit information on potential best practices of

coordinated care, as well as comment on potential aspects of the

overall demonstration. We will solicit information on successful models

of coordinated care, disease management, or case management that are

appropriate for the Medicare fee-for-service population.

In the notice we will request that any person or organization

submit information about successful programs; however, the information

must provide evidence of success in sufficient detail to be useful.

Thus, operators of programs may be in the best position to submit

information regarding their approach. We are interested in the

following items of information:

[[Page 59796]]

The name and address of the program.

The name, address, telephone number, facsimile number, and

E-mail address of a contact person.

Background information on the program (including goals,

history, relationship to larger organization(s), number of clients

served, and length of time the program has been in operation).

Special or innovative features of the program.

Size and composition of the staff (number of registered

nurses and number of social workers performing case management).

Referral sources, targeting criteria, and selection

criteria, if any, for participants.

Information on the patients the program serves, including

age ranges, diagnoses or conditions, and/or functional impairments.

Program intervention and how services differ from the

usual care the patient would have received.

How care plans are developed and monitored for each

patient.

Patient education efforts, if any.

Patient monitoring efforts, if any.

Feedback to providers, if any.

Average length of time patient is in program.

Funding source(s) for the program.

Financial incentives, if any, for providers and patients

to participate.

Outcome measures by which the program's performance is

evaluated (including clinical, utilization, client-reported, and

financial measures used).

Program impacts on these measures.

Cost savings due to the program (total and per person

served per month).

How the program impacts and cost savings were calculated

(i.e., method of estimating reduction in use and costs, such as

comparison to control group or prior year experience).

Costs of operating the program (average per patient, per

month costs).

Adaptability of the program to the Medicare fee-for-

service setting.

Program brochures or published articles, if any.

We are also interested in comments on potential aspects of the

overall demonstration. Specifically, we are interested in comments that

discuss and distinguish program characteristics known to be essential

for positive outcomes in a fee-for-service setting from characteristics

of lesser or unknown importance. Commenters may also wish to address

the types of providers, organizations, or entities that are capable of,

and qualified to provide, coordinated care or case management services.

Other topics of importance include, but are not limited to:

The relationship of the case management entity with other

providers.

The potential role of the case manager in authorizing and/

or providing services beyond coordinating and educational activities.

Appropriate incentives for the case management entity,

beneficiaries, and other providers.

Appropriate payment methodology.

Potential risk bearing arrangements for the case

management entity.

In addition, we will seek comments regarding challenges to, and

potential solutions for, implementing a coordinated care demonstration

in rural sites.

Frequency: One time;

Affected Public: Business or other for-profit, not-for-profit

institutions;

Number of Respondents: 1,000;

Total Annual Responses: 1,000;

Total Annual Hours: 10,000.

To obtain copies of the supporting statement and any related forms

for the proposed paperwork collections referenced above, E-mail your

request, including your address, phone number, and HCFA form number

referenced above, to P[email protected], or call the Reports Clearance

Office on (410) 786-1326.

Interested persons are invited to send comments regarding the

burden or any other aspect of these collections of information

requirements. However, as noted above, comments on these information

collection requirements must be mailed and/or faxed within 10 working

days of the publication of this notice in the Federal Register to the

designee referenced below:

Health Care Financing Administration, Office of Information

Services, Standards and Security Group, Division of HCFA Enterprise

Standards, Room N2-14-26, 7500 Security Boulevard, Baltimore, MD 21244-

1850.

Attn: Dawn Willinghan, HCFA-R-265, Fax Number: (410) 786-0262 and,

Office of Information and Regulatory Affairs, Office of Management and

Budget, Room 10235, New Executive Office Building, Washington, DC

20503, Attn: Allison Eydt, HCFA Desk Officer. Fax Number: (202) 395-

6974 or (202) 395-5167.

Datedd: October 30, 1998.

John P. Burke III,

HCFA Reports Clearance Officer, HCFA, Office of Information Services,

Security and Standards Group, Division of HCFA Enterprise Standards.

[FR Doc. 98-29677 Filed 11-4-98; 8:45 am]

BILLING CODE 4120-03-P