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[Federal Register Volume 77, Number 246 (Friday, December 21, 2012)]
[Notices]
[Pages 75634-75635]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-30749]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-906 and CMS-855B]

Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid 
Services (CMS), Department of Health and Human Services, is publishing 
the following summary of proposed collections for public comment. 
Interested persons are invited to send comments regarding this burden 
estimate or any other aspect of this collection of information, 
including any of the following subjects: (1) The necessity and utility 
of the proposed information collection for the proper performance of 
the Agency's function; (2) the accuracy of the estimated burden; (3) 
ways to enhance the quality, utility, and clarity of the information to 
be collected; and (4) the use of automated collection techniques or 
other forms of information technology to minimize the information 
collection burden.
    1. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: The Fiscal 
Soundness Reporting Requirements; Use: The Centers for Medicare and 
Medicaid Services (CMS) is assigned responsibility for overseeing the 
on-going financial performance for all Medicare Advantage Organizations 
(MAO), Prescription Drug Plan (PDP) sponsors and Program of All-
Inclusive Care for the Elderly (PACE) organizations. Specifically, CMS 
needs the requested collection of information to establish that 
contracting entities within those programs maintain fiscally sound 
organizations. The revised fiscal soundness reporting form combines 
MAO, PDP, 1876 Cost Plans, Demonstration Plans and PACE organizations. 
Entities contracting in

[[Page 75635]]

these programs currently submit all documentation being requested. 
Specifically, all contracting organizations must submit annual 
independently audited financial statements one time per year. The MAOs 
with a net loss, a negative net worth or both must file three quarterly 
statements. Currently there are approximately 44 MAOs filing quarterly 
financial statements. The PDPs must also file three unaudited quarterly 
financial statements. The PACE organizations are required to file 3 
quarterly financial statements for the first three years in the 
program. Additionally, PACE organizations with a net loss, a negative 
net worth or both must file statements as well.
    The information collection request is being revised to include one 
additional data element for PACE organizations only, Total Subordinated 
Liabilities. The addition of the new data element will actually reduce 
the time to analyze the financial standing of PACE organizations 
because we will no longer have to contact the PACE organizations to 
establish whether or not the organization's total liabilities 
calculation includes subordinated debt. Form Number: CMS-906 (OCN: 
0938-0469); Frequency: Annually, Quarterly; Affected Public: Private 
Sector: Business or other for-profits and Not-for-profit institutions; 
Number of Respondents: 648; Total Annual Responses: 1,281; Total Annual 
Hours: 428. (For policy questions regarding this collection contact Joe 
Esposito at 410-786-1129. For all other issues call 410-786-1326.)
    2. Type of Information Collection Request: New collection; Title of 
Information Collection: Medicare Enrollment Application for Clinics/
Group Practice and Certain Other Suppliers; Use: The primary function 
of the CMS-855B enrollment application for Clinics, Group Practices and 
Certain Other Suppliers is to gather information from the organization 
that tells us what it is, whether it meets certain qualifications to be 
a health care supplier, where it renders services and information 
necessary to establish the correct claims payment. The goal of 
evaluating and revising the CMS-855B enrollment application is to 
simplify and clarify the information collection without jeopardizing 
our need to collect specific information. The majority of the revisions 
are very minor in nature such as spelling and formatting corrections, 
removal of duplicate fields and instruction clarification for the 
organization/group. The Sections and Sub-Sections within the form are 
also being re-numbered and re-sequenced to create a more logical flow 
of the data collection. In addition, CMS is adding a data collection 
for an address to mail the periodic request for the revalidation of 
enrollment information (only if it differs from other addresses 
currently collected). Other than the revalidation mailing address 
described above, new data being collected in this revision package is a 
checkbox indicating whether or not an organization is wholly owned or 
operated by a hospital, the inclusion of a new supplier type 
(Centralized Flu Biller) and information on, if applicable, where the 
supplier stores its patient records electronically. While the CMS-855B 
is not a new form, this is considered a new information collection 
request because we are submitting it to OMB for approval under its own 
OMB control number. Form Number: CMS-855B (OCN: 0938-New); Frequency: 
Yearly; Affected Public: Individuals and households; Number of 
Respondents: 31,000; Total Annual Responses: 31,000; Total Annual 
Hours: 103,000 (For policy questions regarding this collection contact 
Kim McPhillips at 410-786-5374. For all other issues call 410-786-
1326.)
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS Web 
site address at http://www.cms.hhs.gov/PaperworkReductionActof1995, or 
Email your request, including your address, phone number, OMB number, 
and CMS document identifier, to Paperwork@cms.hhs.gov, or call the 
Reports Clearance Office on (410) 786-1326.
    To be assured consideration, comments and recommendations for the 
proposed information collections must be received by the OMB desk 
officer at the address below, no later than 5 p.m. on January 22, 2013.
    OMB, Office of Information and Regulatory Affairs, Attention: CMS 
Desk Officer, Fax Number: (202) 395-6974, Email: OIRA_submission@omb.eop.gov.

    Dated: December 17, 2012.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2012-30749 Filed 12-20-12; 8:45 am]
BILLING CODE 4120-01-P
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