[Federal Register Volume 85, Number 57 (Tuesday, March 24, 2020)]
[Notices]
[Pages 16631-16633]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-06077]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10468, CMS-10418, CMS-10488, CMS-R-290 and
CMS-10525]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
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 (the 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,
[[Page 16632]]
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 May 26, 2020.
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, you may make
your request using one of following:
1. Access CMS' website address at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing.html.
2. Email your request, including your address, phone number, OMB
number, and CMS document identifier, to [email protected].
3. Call the Reports Clearance Office at (410) 786-1326.
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).
CMS-10468 Essential Health Benefits in Alternative Benefit Plans,
Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums
and Cost Sharing; Exchanges: Eligibility and Enrollment
CMS-10418 Annual MLR and Rebate Calculation Report and MLR Rebate
Notices
CMS-10488 Consumer Experience Survey Data Collection
CMS-R-290 Medicare Program: Procedures for Making National Coverage
Decisions
CMS-10525 PACE Quality Data Monitoring and Reporting
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: Extension without change
of a currently approved collection; Title of Information Collection:
Essential Health Benefits in Alternative Benefit Plans, Eligibility
Notices, Fair Hearing and Appeal Processes, and Premiums and Cost
Sharing; Exchanges: Eligibility and Enrollment; Use: The Exchanges,
which became operational on January 1, 2014, enhanced competition in
the health insurance market, expanded access to affordable health
insurance for millions of Americans, and provided consumers with a
place to easily compare and shop for health insurance coverage. The
reporting requirements and data collection in Medicaid, Children's
Health Insurance Programs, and Exchanges: Essential Health Benefits in
Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal
Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and
Enrollment (CMS-2334-F) address: (1) Standards related to notices, (2)
procedures for the verification of enrollment in an eligible employer-
sponsored plan and eligibility for qualifying coverage in an eligible
employer-sponsored plan; and (3) other eligibility and enrollment
provisions to provide detail necessary for state implementation. The
submission seeks OMB approval of the information collection
requirements associated with selected provisions in 45 CFR parts 155,
156 and 157. Form Number: CMS-10468 (OMB control number: 0938-1207);
Frequency: Annually; Affected Public: Individuals, Households and
Private Sector; Number of Respondents: 1,522; Total Annual Responses:
9,533; Total Annual Hours: 103,710. For policy questions regarding this
collection contact Anne Pesto at 443-844-9966.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Annual MLR and
Rebate Calculation Report and MLR Rebate Notices; Use: Under Section
2718 of the Affordable Care Act and implementing regulation at 45 CFR
part 158, a health insurance issuer (issuer) offering group or
individual health insurance coverage must submit a report to the
Secretary concerning the amount the issuer spends each year on claims,
quality improvement expenses, non-claims costs, Federal and State taxes
and licensing and regulatory fees, the amount of earned premium, and
beginning with the 2014 reporting year, the amounts related to the
transitional reinsurance, risk corridors, and risk adjustment programs
established under sections 1341, 1342, and 1343, respectively, of the
Affordable Care Act. An issuer must provide an annual rebate if the
amount it spends on certain costs compared to its premium revenue
(excluding Federal and States taxes and licensing and regulatory fees)
does not meet a certain ratio, referred to as the medical loss ratio
(MLR). Each issuer is required to submit annually MLR data, including
information about any rebates it must provide, on a form prescribed by
CMS, for each State in which the issuer conducts business. Each issuer
is also required to provide a rebate notice to each policyholder that
is owed a rebate and each subscriber of policyholders that are owed a
rebate for any given MLR reporting year. Additionally, each issuer is
required to maintain for a period of seven years all documents, records
and other evidence that support the data included in each issuer's
annual report to the Secretary.
Based upon CMS' experience in the MLR data collection and
evaluation process, CMS is updating its annual burden hour estimates to
reflect the actual numbers of submissions, rebates and rebate notices.
The 2019 MLR Reporting Form and Instructions reflect changes for
the 2018 reporting year and beyond. The 2019 MLR Reporting Form and
instructions are also modified to eliminate the reporting elements that
were required under the risk corridors data submission
[[Page 16633]]
requirements in 45 CFR 153.530 for the 2014 through 2016 benefit years.
For 2019, it is expected that issuers will submit fewer reports and on
average, send fewer notices and rebate checks in the mail to
policyholders and subscribers, which will reduce burden on issuers. In
addition, issuers of qualified health plans will no longer have to
submit on the annual report the data for the risk corridors program
established under section 1342 of the Patient Protection and Affordable
Care Act. Form Number: CMS-10418 (OMB control number: 0938-1164);
Frequency: Annually; Affected Public: Private Sector, Business or other
for-profit and not-for-profit institutions; Number of Respondents: 494;
Number of Responses: 1,896; Total Annual Hours: 232,427. For policy
questions regarding this collection contact Stephanie Watson at 301-
492-4238.
3. Type of Information Collection Request: Renewal of a currently
approved collection; Title of Information Collection: Consumer
Experience Survey Data Collection; Use: Section 1311(c)(4) of the
Affordable Care Act requires the Department of Health and Human
Services (HHS) to develop an enrollee satisfaction survey system that
assesses consumer experience with qualified health plans (QHPs) offered
through an Exchange. It also requires public display of enrollee
satisfaction information by the Exchange to allow individuals to easily
compare enrollee satisfaction levels between comparable plans. HHS
established the QHP Enrollee Experience Survey (QHP Enrollee Survey) to
assess consumer experience with the QHPs offered through the
Marketplaces. The survey includes topics to assess consumer experience
with the health care system such as communication skills of providers
and ease of access to health care services. CMS developed the survey
using the Consumer Assessment of Health Providers and Systems
(CAHPS[supreg]) principles (https://www.ahrq.gov/cahps/about-cahps/principles/index.html) and established an application and approval
process for survey vendors who want to participate in collecting QHP
enrollee experience data.
The QHP Enrollee Survey, which is based on the CAHPS[supreg] Health
Plan Survey, will be used to (1) help consumers choose among competing
health plans, (2) provide actionable information that the QHPs can use
to improve performance, (3) provide information that regulatory and
accreditation organizations can use to regulate and accredit plans, and
(4) provide a longitudinal database for consumer research. Based on the
requirements for the QHP Enrollee Survey, CMS developed this survey to
capture information about enrollees' experience with QHPs offered
through an Exchange. CMS conducted in-depth formative research
including: A comprehensive literature review, review of existing CMS
survey instruments, consumer focus groups, stakeholder discussions, and
input from a Technical Expert Panel (TEP). CMS performed a psychometric
test and beta test in 2014 and 2015, respectively. CMS began fielding
the QHP Enrollee Survey nationwide in 2016 and this request is to
continue nationwide collection and administration of the statutorily-
required survey in 2021 through 2023. These activities are necessary to
ensure that CMS fulfills legislative mandates established by section
1311(c)(4) of the Affordable Care Act to develop an ``enrollee
satisfaction survey system'' and provide such information on Exchange
websites. Form Number: CMS-10488 (OMB Control Number: 0938-1221);
Frequency: Annually; Affected Public: Public sector (Individuals and
Households), Private sector (Business or other for-profits and Not-for-
profit institutions); Number of Respondents: 285; Total Annual
Responses: 82,510; Total Annual Hours: 15,141. For policy questions
regarding this collection contact Nidhi Singh Shah at 301-492-5110.
4. Type of Information Collection Request: Reinstatement without
change of a previously approved collection; Title: Medicare Program:
Procedures for Making National Coverage Decisions; Use: This collection
is required by a notice (78 FR 48164-69) published on August 7, 2013
which delineates the process for making a national coverage
determination (NCD) including information for external parties to
submit a formal request for a new NCD or a reconsideration of an
existing NCD. An NCD is defined in 1862(l) of the Social Security Act
(the Act) as ``a determination by the Secretary with respect to whether
or not a particular item or service is covered nationally under this
title.'' This information collection will assist us in obtaining the
information we require to make a national coverage determination in a
timely manner and ensuring that the Medicare program continues to meet
the needs of its beneficiaries. Form Number: CMS-R-290 (OMB control
number: 0938-0776); Frequency: Annual; Affected Public: Private Sector:
Business or other for-profits; Number of Respondents: 30; Total Annual
Responses: 30; Total Annual Hours: 1,200. (For policy questions
regarding this collection contact Lori M. Ashby at 410-786-6322.)
6. Type of Information Collection Request: Revision with change of
a previously approved collection; Title: PACE Quality Data Monitoring
and Reporting; Use: The Programs of All-Inclusive Care for the Elderly
(PACE) program is a unique model of managed care service delivery for
the frail elderly, most of whom are dually-eligible for Medicare and
Medicaid benefits. To be eligible to enroll in PACE, an individual
must: Be 55 or older, live in the service area of a PACE organization
(PO), need a nursing home-level of care (as certified by the state in
which he or she lives), and be able to live safely in the community
with assistance from PACE.
PACE organizations are responsible for providing all required
Medicare and Medicaid covered services, and any other service that the
interdisciplinary team (IDT) determines necessary to improve and
maintain a participant's overall health condition (42 CFR 460.92). POs
must also comply with the quality monitoring and reporting requirements
outlined in Sec. Sec. 460.140, 460.200(b)(1), 460.200(c) and 460.202.
POs are also required to report certain unusual incidents to other
Federal and State agencies consistent with applicable statutory or
regulatory requirements (see 42 CFR 460.136(a)(5)). Form Number: CMS-R-
10525 (OMB control number: 0938-1264); Frequency: Annual; Affected
Public: Private Sector: Business or other for-profits; Number of
Respondents: 131; Total Annual Responses: 1,143; Total Annual Hours:
156,414. (For policy questions regarding this collection contact Donna
Williamson at 410-786-4647.)
Dated: March 18, 2020.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2020-06077 Filed 3-23-20; 8:45 am]
BILLING CODE 4120-01-P