# Emergency Clearance: Public Information Collection Requirements Submitted to the Office of Management and Budget (OMB) > Briefs, arguments, decisions, and more. URL: https://www.frixlaw.com/law-library/documents/fr%3A99-24845 ## Record - **Collection:** Federal Register - **Document type:** Notice - **Published:** September 22, 1999 - **Citation:** 64 FR 51328 ## Text DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Care Financing Administration [Document Identifier: HCFA-R-0296] Emergency Clearance: Public Information Collection Requirements Submitted to the Office of Management and Budget (OMB) AGENCY: Health Care Financing Administration, HHS. 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, is publishing the following summary of proposed collections for public comment. Interested persons are invited to send comments regarding this burden estimate or any other aspect of this collection of information, including any of the following subjects: (1) The necessity and utility of the proposed information collection for the proper performance of the agency's functions; (2) the accuracy of the estimated burden; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) the use of automated collection techniques or other forms of information technology to minimize the information collection burden. We are, however, requesting an emergency review of the Information collections referenced below. In compliance with the requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, we have submitted to the Office of Management and Budget (OMB) the following requirements for emergency review. We [[Page 51329]] 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 CFR, part 1320. The Agency cannot reasonably comply with the normal clearance procedures because public harm is likely to result because beneficiaries may not receive timely, accurate, complete, and useful notices which will enable them to make informed consumer decisions, with a proper understanding of their rights to a Medicare initial determination, their appeal rights in the case of payment denial, and how these rights are waived if they refuse to allow their medical information to be sent to Medicare. This information collection standardizes the requirements set forth under 42 CFR 484.10, currently approved under OMB number 0938-0365. HCFA is requesting OMB review and approval of this collection by close of business 09/30/1999, with a 180-day approval period. Written comments and recommendations will be accepted from the public if received by the individuals designated below by close of business 9/29/ 1999. During this 180-day period, we will publish a separate Federal Register notice announcing the initiation of an extensive 60-day agency review and public comment period on these requirements. We will submit the requirements for OMB review and an extension of this emergency approval. Type of Information Collection Request: New Collection; Title of Information Collection: Home Health Advance Beneficiary Notices (HHABNs) and Supporting Regulations in 42 CFR 484.10; Form No.: HCFA-R-0296 (OMB #0938-NEW); Use: This program memorandum (PM) is intended to instruct Home Health Agencies (HHAs) with respect to their responsibility for providing proper written notice to beneficiaries in advance of furnishing what they believe to be noncovered care or of reducing or terminating ongoing care. These new instructions and notices apply where a physician has ordered home health care for a beneficiary but the HHA believes that Medicare will not pay for that care. They do not apply to situations where the physician will not order care, or where care is reduced or terminated in accordance with a physician's order. Medicare never pays for home health care that is not ordered by a physician. The instructions in the PM supersede current instructions in Medicare Intermediary Manual, Part 3 (MIM) Sec. 3730.2 and in Home Health Agency Manual Sec. 270. These new instructions are designed to ensure that beneficiaries receive timely, accurate, complete, and useful notices which will enable them to make informed consumer decisions, with a proper understanding of their rights to a Medicare initial determination, their appeal rights in the case of payment denial, and how these rights are waived if they refuse to allow their medical information to be sent to Medicare. It is essential that such notice be timely, readable and comprehensible, provide clear directions, and provide accurate and complete information about the services affected and the reason that Medicare denial of payment for those services is expected by the HHA. For this reason, new notices (the HHABNs) with very specific content and graphic design have been prepared and are attached as Exhibits 2-4 hereto, and must be used by all HHAs furnishing services to Medicare beneficiaries. The model notices attached to the memorandum are designed to ensure HHAs inform beneficiaries in writing, in a timely fashion, about changes to their home health care, the fact that they may have to pay for care themselves if Medicare does not pay, the process they must follow in order to obtain an initial determination by Medicare and, if payment is denied, to file an appeal, and the fact that they waive those rights if they refuse to allow their medical information to be sent to Medicare. If the HHA expects payment for the home health services to be denied by Medicare, a beneficiary must be advised before home health care is initiated or continued, that in the HHA's opinion, payment probably will be required from him or her personally. These notices must be issued by the HHA each time, and as soon as the HHA makes the assessment that it believes Medicare payment will not be made. The HHABNs must be provided by HHAs according to these instructions in any case where a reduction or termination of services is to occur, or where services are to be denied before being initiated, except in any case in which a physician concurs in the reduction, termination, or denial of services. Failure to do so is a violation of the HHA Conditions of Participation in the Medicare Program, which are currently approved PRA requirements approved under OMB number 0938- 0365, and may result in the HHA being held liable under the Limitation on Liability (LOL) provision. These instructions for completion, provision, and effectuation of advance beneficiary notices by HHAs are to be used by RHHIs effective September 30, 1999. The model notices (HHABNs) must be used by providers and as required by the MIM, Part 3, Sec. 3440 Establishing When Beneficiary is on Notice of Noncoverage. Completion of Model Home Health Advance Beneficiary Notices (HHABNs) Model Notice Exhibit 1 of the PM is for instructional purposes only and includes guidance on the notice form. Model HHABNs, Exhibits 2-4, serve as notice to the beneficiary that the HHA believes that home health services are not covered in different situations. HHABN-1, Termination, is used when all home health services will be terminated. HHABN-2, Initiation, is used when the HHA expects that Medicare will not pay, even before services have been initiated. HHABN-3, Reduction, is used when ongoing home health services will be reduced (e.g., reduced in number, frequency, or for a particular subset of services, or otherwise). For any particular HHABN, the provider makes an original and two copies. (If you require a copy, one more will be made.) The provider gives, or where this is not possible mails, the original to the beneficiary (or the person acting on his or her behalf), sends the first copy to the beneficiary's physician, and keeps the second. When the beneficiary (or person acting on his or her behalf) is given a copy, he or she will return it to the provider with his or her signature and the date he or she signed the notice. If the beneficiary or the person acting on behalf of the beneficiary refused to sign the HHABN, the provider's copy should be annotated accordingly, indicating the circumstances and persons involved; Frequency: On occasion; Affected Public: Individuals or Households, Business or other for- profit, Not-for-profit institutions; Number of Respondents: 188,326; Total Annual Responses: 360,000; Total Annual Hours: 60,000. To obtain copies of the supporting statement and any related forms for the proposed paperwork collections referenced above, access HCFA's Web Site address at http://www.hcfa.gov/regs/prdact95.htm, or E-mail your request, including your address, phone number, 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 and recordkeeping requirements must be mailed and/or faxed to the designees referenced below, by close of business 09/29/1999: [[Page 51330]] Health Care Financing Administration, Office of Information Services, Security and Standards Group, Division of HCFA Enterprise Standards, Attention: Dawn Willinghan, Room N2-14-26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850. and Office of Information and Regulatory Affairs, Office of Management and Budget, Room 10235, New Executive Office Building, Washington, DC 20503, Fax Number: (202) 395-6974 or (202) 395-5167, Attn: Allison Herron Eydt, HCFA Desk Officer. Dated: September 20, 1999. John P. Burke III, HCFA Reports Clearance Officer, HCFA Office of Information Services, Security and Standards Group, Division of HCFA Enterprise Standards. [FR Doc. 99-24845 Filed 9-20-99; 2:40 pm] BILLING CODE 4120-03-P --- Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/fr%3A99-24845. Public record. Not legal advice.