final ABN 2nd comment

June 19, 2007 OMB Human Resources and Housing Branch Attention: Carolyn Lovett New Executive Office Building, Room 10235 Washington, DC 20503 Re: CMS-R-131 Dear Ms. Lovett, I am writing on behalf of the American Academy of Family Physicians (AAFP), which represents nearly 94,000 family physicians and medical students nationwide. Specifically, I am writing to offer our comments in response to the request for information on the Advance Beneficiary Notice of Noncoverage (ABN) as published in the Federal Register on May 25, 2007. Estimated BurdenAs we noted in the previous comment period, the estimated burden appears to be seriously underestimated. The Centers for Medicare and Medicaid Services (CMS) noted that comments to this effect were anecdotal only. This is true because it is CMS which has the data to substantiate a better estimate of this burden. CMS has in the past indicated the ability to track modifier usage from claims data when investigating the use of modifiers such as 25 and 59. This same data should be available to indicate the number of claims by unique physician and provider identifier which contained the GA modifier indicating that an ABN was on file. This number of claims should then be increased by approximately one-third to account for those beneficiaries who elect to not receive the service or to not have a claim filed. Division of this number by the number of unique physician and provider identifiers should ...