Under the Paperwork Reduction Act of 1995, we are required to provide 30-day notice in the Federal Register and solicit public comment before a collection of
information requirement is submitted to OMB for review and approval. In order to fairly evaluate whether an information collection should be approved by OMB, section
3506(c)(2)(A) of the Paperwork Reduction Act of 1995 requires that we solicit comment 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.
The following is a discussion of the provisions, as stated in section II. of this final rule, that contain information collection requirements.
B. ICR Estimates in the Proposed Rule
Proposed § 401.305 stated that a provider or supplier must (1) report and return an overpayment to the Secretary, the state, an intermediary, a carrier or a contractor to the correct address by the later of 60 days after the overpayment was identified or the date the corresponding cost report is due, and (2) notify the Secretary, the state, an
burden associated with this requirement was the time and effort necessary to report and return the overpayment in the manner described at § 401.305.
For purposes of § 401.305 only, we estimated that approximately 125,000
providers and suppliers (or roughly 8.5 percent of the total number of Medicare providers and suppliers) would report and return overpayments in a typical year under our
provisions. We estimated this based on the improper payment rate for the Medicare Fee- for-Service program, which was approximately 12 percent in FY 2014 and FY 20154, and we expect that some number of improper payments will be identified by sources other than providers and suppliers themselves. We projected that each of these providers and suppliers would, on average, separately report and return approximately 3 to 5
overpayments. In addition, we estimated that it would take a provider or supplier approximately 2.5 hours to complete the applicable reporting form and return an overpayment.
We are developing an information collection request for OMB review and approval that will authorize the collection of the applicable reporting form. The public will have an opportunity to review the information collection and submit comments. We plan to announce the information collection request under the required 60-day and 30-day Federal Register notice and comment periods. These notices will incorporate the
process described below and the burden calculated in Table 1, among other processes.
4 https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-
We determined that the two main categories of individuals who would most likely complete and submit the applicable reporting form included: (1) accountants and
auditors (external and in-house); and (2) miscellaneous in-house administrative personnel. Each provider's and supplier's individual operations are different and, as a result, it was not possible to break down the percentage of total affected providers or suppliers that would fall within the 2 previously stated categories (for example, percentage of providers that would use an accountant). Consequently, in order to determine the burden cost, we utilized the average hourly wage of these 2 occupational categories based on the most recent wage data provided by the Bureau of Labor Statistics (BLS) data for May 2010. The mean hourly wage for the category of ''accountants and auditors'' was $33.15 (see http://www.bls.gov/oes/current/oes132011.htm ) and the mean hourly wage for the category of ''bookkeeping, accounting, and auditing clerks'' was $16.99 (http://www.bls.gov/oes/current/oes433031.htm ). The average of these 2 figures, including fringe benefits and overhead, was $37.10. This lead to an aggregate annual ICR cost burden--attributable to the impacted 125,000 providers and suppliers, and using the range of 3 to 5 overpayments, of $34.78 million and $57.97 million, respectively. C. Comments Received
We received a number of comments regarding our proposed ICR estimates: Comment: Several commenters suggested that the burden analysis offered by CMS in the proposed rule was inadequate because it only considered two types of
individuals involved in the reporting and returning of overpayments, accountants/auditors and in-house administrative personnel. Commenters suggested that additional and more
costly individuals, such as legal counsel and compliance consultants, would be necessary to comply with this rule.
Response: We disagree. We believe only the rarest of circumstances (such as potential fraud or certain investigations of potential violations of the physician
self-referral law) would necessitate more costly personnel, such as legal counsel, to comply with this final rule. In the overwhelming majority of cases, we expect
overpayment identification and return to be sufficiently handled by accountants, auditors, and in-house administrative personnel.
Comment: Several commenters stated that CMS-- (1) underestimated the administrative burden imposed by this rule; and (2) failed to adequately support the assumptions underlying the regulatory impact analysis.
Response: We understand the commenters' concerns regarding the
underestimation of the administrative burden and the failure to adequately support
assumptions underlying the regulatory impact analysis. Therefore, we have increased the projected "per report" burden--which includes researching, reporting, and returning the overpayment--from 2.5 hours to 6 hours to address these concerns. Our assumptions also include our belief that the majority of these 6 hours will be spent researching and
identifying the overpayment, and that the time burden for reporting and returning the overpayment after it is identified is minimal.
D. Final Estimated ICR Burden
There are two major changes from our projected burden in the proposed rule. First, as noted previously, we are increasing the "per report" hour burden from 2.5 hours to 6 hours. Second, we must use more recent BLS data in calculating the hourly wage.
According to BLS information for May 2014, the national estimated mean hourly wage for the category of ''accountants and auditors'' was $35.42 (see
http://www.bls.gov/oes/current/oes132011.htm ) and the national estimated mean hourly wage for the category of ''bookkeeping, accounting, and auditing clerks'' was $18.30 (http://www.bls.gov/oes/current/oes433031.htm ). The average of these 2 figures, is $26.86. This does not include fringe benefits and overhead which are generally
calculated as being 100% of salary. This means the cost of an hour of work is $53.72. The following table shows the projected annual ICR hour and cost burdens associated with § 401.305: