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###### Department of Health and Human Services

###### Centers for Medicare and Medicaid Services

          - [Document Identifier CMS-10373]

# AGENCY:

Center for Medicare and 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 and 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 functions; (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.

We are, however, requesting an emergency review of the information collection referenced below. In compliance with the requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, we have submitted to the Office of Management and Budget (OMB) the following requirements for emergency review. We are requesting an emergency review because the collection of this information is needed before the expiration of the normal time limits under OMB's regulations at 5 CFR 1320(a)(2)(ii). This is necessary to ensure compliance with an initiative of the Administration.

                    1.                     *Type of Information Collection Request:*                     New collection;                     *Title of Information Collection:*                     Medical Loss Ratio Quarterly Reporting;                     *Use:*                     Under Section 2718 of the Affordable Care Act and implementing regulations at 45 CFR part 158 (75 FR 74865, December 1, 2010), 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 or regulatory fees, and the amount of earned premium. An issuer must provide an annual rebate to enrollees if the amount it spends on certain costs compared to its premium revenue (excluding Federal and States taxes and licensing or regulatory fees) does not meet a certain ratio, referred to as the medical loss ratio (MLR). An interim final rule (IFR) implementing the MLR was published on December 1, 2010 (75 FR 74865), which added part 158 to Title 45 of the Code of Federal Regulations. The IFR is effective January 1, 2011. Issuers are required to submit annual MLR reporting data for each large group market, small group market, and individual market within each State in which the issuer conducts business. For policies that have a total annual limit of $250,000 or less (sometimes referred to as “mini-med plans”) and for policies that primarily cover employees working outside the United States (referred to as “expatriate plans”), the IFR applies a special circumstance adjustment to the MLR data for the 2011 MLR reporting year. In order to evaluate the appropriateness of this special circumstance adjustment for years 2012 and beyond, issuers that provide such policies are required to submit quarterly MLR data to the Secretary for the 2011 MLR reporting year.                     *Form Number:*                     CMS-10373;                     *Frequency:*                     Quarterly submissions for each respondent;                     *Affected Public:*                     Private Sector: Business or other for-profits and Not-for-profit institutions;                     *Number of Respondents:*                     75;                     *Number of Responses:*                     1,125;                     *Total Annual Hours:*                     70,200. (For policy questions regarding this collection, contact Carol Jimenez at (301) 492-4109. For all other issues call (410) 786-1326.)                

                    CMS is requesting OMB review and approval of this collection by                     *May 1, 2011,*                     with a 180-day approval period. Written comments and recommendations will be considered from the public if received by the individuals designated below by                     *April 25, 2011.*

                    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/​regulations/​pra*                     or E-mail 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.                

                    Interested persons are invited to send comments regarding the burden or any other aspect of these collections of information requirements. However, as noted above, comments on these                           ( print page 16790)                        information collection and recordkeeping requirements must be mailed and/or faxed to the designees referenced below by April 25, 2011.                

                    1.                     *Electronically.*                     You may submit 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) 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.                

                    3.                     *By Facsimile or E-mail to OMB.*                     OMB, Office of Information and Regulatory Affairs,                     *Attention:*                     CMS Desk Officer,                     *Fax Number:*                     (202) 395-6974,                     *E-mail: OIRA_submission@omb.eop.gov.*

Dated: March 18, 2011.

Martique Jones,

Director, Regulations Development Group, Division B, Office of Strategic Operations and Regulatory Affairs.

[FR Doc. 2011-7106 Filed 3-24-11; 8:45 am]

BILLING CODE 4120-01-P