[Federal Register Volume 84, Number 202 (Friday, October 18, 2019)]
[Notices]
[Pages 55966-55968]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-22718]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifiers CMS-10227, CMS-10243, CMS-10316 and CMS-10716]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
ACTION: Notice.
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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, 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 December 17, 2019.
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 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:
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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-10227 PACE State Plan Amendment Preprint
CMS-10243 Testing Experience and Functional Tools: Functional
Assessment Standardized Items (FASI) Based on the CARE Tool
CMS-10316 Implementation of the Medicare Prescription Drug Plan (PDP)
and Medicare Advantage (MA) Plan Disenrollment Reasons Survey
CMS-10716 Applicable Integrated Plan Coverage Decision Letter
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: PACE State Plan
Amendment Preprint; Use: If a state elects to offer PACE as an optional
Medicaid benefit, it must complete a state plan amendment preprint
packet described as ``Enclosures 3, 4, 5, 6, and 7.'' CMS will review
the information provided in order to determine if the state has
properly elected to cover PACE services as a state plan option. In the
event that the state changes something in the state plan, only the
affected page must be updated. Form Number: CMS-10227 (OMB control
number: 0938-1027); Frequency: Once and occasionally; Affected Public:
State, Local, or Tribal Governments; Number of Respondents: 7; Total
Annual Responses: 2; Total Annual Hours: 140. (For policy questions
regarding this collection contact Angela Cimino at 410-786-2638.)
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Testing
Experience and Functional Tools: Functional Assessment Standardized
Items (FASI) Based on the CARE Tool; Use: In 2012, CMS funded a project
entitled, Technical Assistance to States for Testing Experience and
Functional Tools (TEFT) Grants. One component of this demonstration is
to amend and test the reliability of a setting-agnostic, interoperable
set of data elements, called ``items,'' that can support standardized
assessment of individuals across the continuum of care. Items that were
created for use in post-acute care settings using the Continuity
Assessment Record and Evaluation (CARE) tool have been adopted,
modified, or supplemented for use in community-based long-term services
and supports (CB-LTSS) programs. This project will test the reliability
and validity of the function-related assessment items, now referred to
as Functional Assessment Standardized Items (FASI), when applied in
community settings, and in various populations: Elders (65 years and
older); younger adults (18-64) with physical disabilities; and adults
of any age with intellectual or developmental disabilities, with severe
mental illness, or with traumatic brain injury.
Individual-level data will be collected two times using the TEFT
FASI Item Set. The first data collection effort will collect data that
can be analyzed to evaluate the reliability and validity of the FASI
items when used with the five waiver populations. Assessors will
conduct functional assessments in client homes using the TEFT FASI Item
Set. Changes may be recommended to individual TEFT FASI items, to be
made prior to releasing the TEFT FASI items for use by the states. The
FASI Field Test Report will be released to the public.
The second data collection will be conducted by the states to
demonstrate their use of the FASI data elements. The assessment data
could be used by the states for multiple purposes. They may use the
standardized items to determine individual eligibility for state
programs, or to help determine levels of care within which people can
receive services, or other purposes. In the second round of data
collection, states will demonstrate their proposed uses, manage their
FASI data collection and conduct their own analysis, to the extent they
propose to do such tasks. The states have been funded under the
demonstration grant to conduct the round 2 data collection and
analysis. These states will submit reports to CMS describing their
experience in the Round 2 data collection, including the items they
collected, how they planned to use the data, and the types of
challenges and successes they encountered in doing so. The reports may
be used by CMS in their evaluation of the TEFT grants. Form Number:
CMS-10243 (OMB control number: 0938-1037); Frequency: On occasion;
Affected Public: Individuals and Households; Number of Respondents:
5,650; Total Annual Responses: 5,650; Total Annual Hours: 2,825. (For
policy questions regarding this collection contact Kerry Lida at 410-
786-4826.)
3. Type of Information Collection Request: Revision of a currently
approved collection; Title of Information Collection: Implementation of
the Medicare Prescription Drug Plan (PDP) and Medicare Advantage (MA)
Plan Disenrollment Reasons Survey; Use: The Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (MMA) provides a requirement
to collect and report performance data for Part D prescription drug
plans. Specifically, the MMA under Sec. 1860D-4 (Information to
Facilitate Enrollment) requires CMS to conduct consumer satisfaction
surveys regarding the PDP and MA contracts pursuant to section 1860D-
4(d).
The Centers for Medicare & Medicaid Services (CMS) developed the
Disenrollment Survey to capture the reasons for disenrollment at a time
that is as close as possible to the actual date of disenrollment.
Through this survey, CMS seeks to: (1) Obtain information about
beneficiaries' expectations relative to provided benefits and services
(for both MA and PDPs) and (2) determine the reasons that prompt
beneficiaries to voluntarily disenroll. It is important to include such
information from disenrollees as CMS assesses plan performance, because
plan disenrollment can be a broad indicator of beneficiary
dissatisfaction with some aspect of plan services, such as access to
care, customer service, cost, benefits provided, or quality of care.
Information obtained from the Disenrollment Survey also supports the
quality improvement efforts of individual plans and provides data to
assist consumer choice through use of the Medicare Plan Finder website.
The survey results are an important plan monitoring tool for CMS to
ensure that Medicare beneficiaries are receiving high quality services
from contracted providers. CMS uses information from the survey to
track changes in the
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reasons Medicare beneficiaries cite for disenrolling to monitor
improvements/declines over time nationally and at the plan level. CMS
also uses the disenrollment survey results to support the quality
improvement efforts of individual plans, by providing plans with a
detailed, annual report showing the reasons disenrollees cited for
voluntarily leaving the plan and comparing the plan's scores to
regional and national benchmarks. Additionally, CMS uses the plan-
specific results of the survey to provide Medicare beneficiaries with
information (i.e., reasons cited for disenrolling from a plan and the
frequency with which disenrollees cite each of the reasons) to assist
beneficiaries with their annual consumer choice of plans. Form Number:
CMS-10316 (OMB control number: 0938-1113); Frequency: Yearly; Affected
Public: State, Local, or Tribal Governments; Number of Respondents:
43,872; Total Annual Responses: 43,872; Total Annual Hours: 8,774. (For
policy questions regarding this collection contact Beth Simon at 415-
744-3780.)
4. Type of Information Collection Request: New Collection (Request
for a new OMB control number); Title of Information Collection:
Applicable Integrated Plan Coverage Decision Letter; Use: The
Bipartisan Budget Act (BBA) of 2018 directed the establishment of
procedures to unify Medicare and Medicaid grievance and appeals
procedures to the extent feasible for dual eligible special needs plans
(D-SNPs) beginning in 2021. On April 16, 2019, CMS finalized rules
(hereafter referred to as the April 2019 final rule) to implement these
new statutory provisions.[1] As a result of these regulations, starting
in 2021, a subset of full integrated dual special needs plans (FIDE
SNPs) and highly integrated dual special needs plans (HIDE SNPs) will
need to unify and update appeals and grievance procedures, including
how enrollees are notified of their appeal rights.
Applicable integrated plans as defined at Sec. 422.561 are
required to issue form CMS-10716 when a request for either a medical
service or payment covered under the Medicare or Medicaid benefit is
denied in whole or in part. The notice explains why the plan denied the
service or payment and informs the plan enrollees of their appeal
rights.
The ``Applicable Integrated Plan Coverage Decision Letter'' or the
``coverage decision letter'', which will be issued as a result of an
integrated organization determination under 42 CFR 422.631 when an
applicable integrated plan reduces, stops, suspends, or denies, in
whole or in part, a request for a service/item (including a Part B
drug) or a request for payment of a service/item (including a Part B
drug) the member has already received. ``Applicable integrated plans,''
hereinafter referred to as ``plans'', are defined at 42 CFR 422.561 as
FIDE SNPs or HIDE SNPs with exclusively aligned enrollment, where state
policy limits the D-SNP's membership to a Medicaid managed care plan
offered by the same organization. Applicable integrated plans will
issue the coverage decision letter starting in CY 2021 in place of the
Notice of Denial of Medical Coverage (or Payment) (NDMCP) form (CMS-
10003) as part of requirements to unify appeals and grievance
processes. All other Medicare Advantage (MA) plans will continue to use
the NDMCP form (CMS-10003). Form Number: CMS-10716 (OMB control number:
0938-New); Frequency: Yearly; Affected Public: State, Local, or Tribal
Governments; Number of Respondents: 693; Total Annual Responses: 693;
Total Annual Hours: 116. (For policy questions regarding this
collection contact Marna Metcalf Akbar at 410-786-8251.)
Dated: October 11, 2019.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 2019-22718 Filed 10-17-19; 8:45 am]
BILLING CODE 4120-01-P