CMS Requests OMB Approval for Fraud Measurement Pilot, Exemption From Public Access Requirements

In a Notice to be published in tomorrow’s Federal Register, attached below, CMS is requesting OMB approval under the Paperwork Reduction Act (PRA) for a “Probable Fraud Measurement Pilot.” According to CMS,

The probable fraud measurement pilot would establish a baseline estimate of probable fraud in payments for home health care services in the fee-for-service Medicare program. CMS and its agents will collect information from home health agencies, the referring physicians and Medicare beneficiaries selected in a national random sample of home health claims. The pilot will rely on the information collected along with a summary of the service history of the HHA, the referring provider, and the beneficiary to estimate the percentage of total payments that are associated with probable fraud and the percentage of all claims that are associated with probable fraud for Medicare fee-for-service home health.

The agency also stated,

CMS is requesting an exemption from the Paperwork Reduction Act under 5 CFR 1320.14A. [sic] However, CMS is providing information related to the purpose and need for this data collection in Supporting Statement Part A.

The section of the Code of Federal Regulations referenced by CMS states:

§ 1320.14   Public access.

(a) In order to enable the public to participate in and provide comments during the clearance process, OMB will ordinarily make its paperwork docket files available for public inspection during normal business hours. Notwithstanding other provisions of this Part, and to the extent permitted by law, requirements to publish public notices or to provide materials to the public may be modified or waived by the Director to the extent that such public participation in the approval process would defeat the purpose of the collection of information; jeopardize the confidentiality of proprietary, trade secret, or other confidential information; violate State or Federal law; or substantially interfere with an agency’s ability to perform its statutory obligations.

Comments are due to the OMB Desk Officer in 30 days.

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