1135 Waiver Request Automated Process PRA Information Collection

Content

ACTION:

Notice.

SUMMARY:

The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention
to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to
publish notice in the
Federal Register
concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection
of information) and to allow 60 days for public comment on the proposed action. Interested persons are invited to send comments
regarding our burden estimates or any other aspect of this collection of information, including the necessity and utility
of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated
burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection
techniques or other forms of information technology to minimize the information collection burden.

DATES:

Comments must be received by June 1, 2026.

ADDRESSES:

When commenting, please reference the document identifier or OMB control number. To be assured consideration, comments and
recommendations must be submitted in any one of the following ways:

1. Electronically. You may send your comments electronically to http://www.regulations.gov. Follow the instructions for “Comment or Submission” or “More Search Options” to find the information collection document(s)
   that are accepting comments.

2. By regular mail. You may mail written comments to the following address: CMS, Office of Strategic Operations and Regulatory Affairs, Division
   of Regulations Development, Attention: Document Identifier: _/OMB Control Number: _, Room C4-26-05, 7500 Security Boulevard,
   Baltimore, Maryland 21244-1850.

To obtain copies of a supporting statement and any related forms for the proposed collection(s) summarized in this notice,
please access the CMS PRA website by copying and pasting the following web address into your web browser: https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.

FOR FURTHER INFORMATION CONTACT:

William N. Parham at (410) 786-4669.

SUPPLEMENTARY INFORMATION:

Contents

This notice sets out a summary of the use and burden associated with the following information collections. More detailed
information can be found in each collection's supporting statement and associated materials (see
ADDRESSES
).

Under the PRA (44 U.S.C. 3501-3520), federal agencies must obtain approval from the Office of Management and Budget (OMB)
for each collection of information they conduct or sponsor. The term “collection of information” is defined in 44 U.S.C. 3502(3)
and 5 CFR 1320.3(c) and includes agency requests or requirements that members of the public submit reports, keep records,
or provide information to a third party. Section 3506(c)(2)(A) of the PRA requires federal agencies to publish a 60-day notice
in the
Federal Register
concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection
of information, before submitting the collection to OMB for approval. To comply with this requirement, CMS is publishing this
notice.

Information Collection

1. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: Submission of 1135 Waiver Request Automated Process; Use: This is a revision of an information collection request approved under Office of Management and Budget (OMB) control number of 0938-1384 with an expiration date of August 31, 2026. The Acute Hospital Care at Home (AHCAH) program will no longer be included in this package.

Waivers under Section 1135 of the Social Security Act (the Act) and certain flexibilities allow the CMS to relax certain requirements,
known as the Conditions of Participation (CoPs) or Conditions of Coverage to promote the health and safety of beneficiaries.
Under Section 1135 of the Act, the Secretary may temporarily waive or modify certain Medicare, Medicaid, and Children's Health
Insurance Program (CHIP) requirements to ensure that sufficient health care services are available to meet the needs of individuals
enrolled in Social Security Act programs in the emergency area and time periods. These waivers ensure that healthcare entities/caregivers
who provide such services in good faith can be reimbursed and exempted from sanctions.

During emergencies, CMS must be able to apply program waivers and flexibilities under section 1135 of the Social Security
Act, in a timely manner to respond quickly to unfolding events. In a disaster or emergency, waivers and flexibilities assist
health care providers/suppliers in providing timely healthcare and services to people who have been affected and enables states,
Federal districts, and U.S. territories to ensure Medicare and/or Medicaid beneficiaries have continued access to care. During
disasters and emergencies, it is not uncommon to evacuate patients in health care facilities to other provider settings or
across state lines, especially, during hurricane, wildfire, and tornado events. CMS must collect relevant information for
which a provider is requesting a waiver or flexibility to

  make proper decisions about approving or denying such requests. Collection of this data aids in the prevention of gaps in
  access to care and services before, during, and after an emergency. CMS must also respond to inquiries related to a Public
  Health Emergency (PHE) from providers. CMS is not collecting information from these inquiries; we are merely responding to
  them.

The collection of the information surrounding 1135 Waiver requests/inquiries is based on a case-by-case basis and not regularly
scheduled (e.g., quarterly, annually, by all providers/suppliers). The collection of information only occurs when the healthcare entity, impacted
by an emergency, is requesting waivers/flexibilities under Section 1135 of the Act or inquiring about PHEs. The collection
of information is also dependent on provider types; therefore, it is not a collection for all Medicare-participating facilities.

In 2021, we implemented a streamlined, automated process to standardize the 1135 waiver requests and inquiries submitted based
on lessons learned during the COVID-19 PHE.

Furthermore, the normal operations of a healthcare provider are disrupted by emergencies or disasters occasionally. When this
occurs, State Survey Agencies (SA) or Health Care Providers deliver a provider/beneficiary tracking report regarding the current
status of all affected healthcare providers and their beneficiaries. This report includes demographic information about the
beneficiary status, provider, their operational status, anticipated needs and planned resumption of normal operations. This
information is provided whether or not a PHE has been declared.

We are enhancing this information collection to better support emergency response by capturing the emergency date, simplifying
ongoing status updates for stakeholders, and providing a more comprehensive view of cybersecurity incidents through expanded
reporting on patient and operational impacts. This automated process will continue to consist of a public facing web form
as well as a process for SAs/Providers to submit data using extracts (CSV or Excel) on emergent events impacting Health Care
Facilities via an automated mail handler system. Both processes (public facing web form and extracts via an automated mail
handler system) are known as the Health Care Facility (HCF) Operational Status. Form Number: CMS-10752 (OMB control number: 0938-1384); Frequency: Occasionally; Affected Public: Private Sector: Business or other for-profits and Not-for-profit institutions and State, Local or Tribal Governments; Number of Respondents: 4,829; Total Annual Responses: 4,829; Total Annual Hours: 4,016. (For policy questions regarding this collection, contact Adriane Saunders at 404-562-7484.)

William N. Parham, III, Director, Division of Information Collections and Regulatory Impacts, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2026-06170 Filed 3-30-26; 8:45 am] BILLING CODE 4120-01-P

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