31556 Federal Register / Vol. 78, No. 101 / Friday, May 24, 2013 / Notices 

Number: CMS–10295 (OCN: 0938– 

1073). Frequency: Quarterly; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

50; Total Annual Responses: 200; Total 

Annual Hours: 400. (For policy 

questions regarding this collection 

contact Rhonda Simms at 410–786– 

1200. For all other issues call 410–786– 

1326.) 

3. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Standards 

Related to Reinsurance, Risk Corridors 

and Risk Adjustment; Use: Section 1341 

of the Affordable Care Act provides that 

each state must establish a transitional 

reinsurance program to help stabilize 

premiums for coverage in the individual 

market during the first three years of 

Exchange operation. Section 1342 

provides for the establishment of a 

temporary risk corridors program that 

will apply to qualified health plans in 

the individual and small group markets 

for the first three years of Exchange 

operation. Section 1343 provides for a 

program of risk adjustment for all nongrandfathered plans in the individual 

and small group market both inside and 

outside of the Exchange. These riskspreading programs, which will be 

implemented by HHS, states, or both 

HHS and states, are designed to mitigate 

adverse selection and provide stability 

for health insurance issuers in the 

individual and small group markets as 

market reforms and Exchanges are 

implemented. Section 1321(a) also 

provides broad authority for the 

Secretary to establish standards and 

regulations to implement the statutory 

requirements related to Exchanges, 

reinsurance, risk adjustment, and other 

components of title I of the Affordable 

Care Act. The data collection and 

reporting requirements described in this 

information collection request will 

enable states, HHS, or both states and 

HHS to implement the aforementioned 

programs, which will mitigate the 

impact of adverse selection in the 

individual and small group markets 

both inside and outside the Exchange. 

Form Number: CMS–10401 (OCN: 

0938–1155); Frequency: Occasionally; 

Affected Public: Private Sector (business 

or other for-profit and not-for-profit 

institutions); Number of Respondents: 

24,171; Total Annual Responses: 

584,042; Total Annual Hours: 1,013,293. 

(For policy questions regarding this 

collection contact Jaya Ghildiyal at 301– 

492–5149. 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 June 24, 2013. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS Desk 

Officer, Fax Number: (202) 395–6974, 

Email: OIRA _submission@omb.eop.gov. 

Dated: May 21, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–12465 Filed 5–23–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10293] 

Agency Information Collection 

Activities: Proposed Collection; 

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) 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. 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; 

Title of Information Collection: Tribal 

Consultation State Plan Amendment 

Template; Use: Effective July 1, 2009, 

section 5006 of the American Recovery 

and Reinvestment Act of 2009 (Recovery 

Act) amended section 1902(a)(73) of the 

Act to require that certain states utilize 

a process for the state to seek advice on 

a regular, ongoing basis from designees 

of the Indian Health Service (IHS) and 

Urban Indian Organizations concerning 

Medicaid and Children’s Health 

Insurance Program (CHIP) matters 

having a direct effect on them. The 

consultation process is required for the 

37 States in which 1 or more Indian 

Health Programs or Urban Indian 

Organizations furnish health care 

services. The State Medicaid agency for 

each of these States will complete the 

template page and submit it for approval 

as part of a State plan amendment, to 

document how it meets the 

requirements for tribal consultation. 

Form Number: CMS–10293 (OCN: 

0938–1098); Frequency: Reporting— 

Occasionally; Affected Public: State, 

Local, or Tribal Governments; Number 

of Respondents: 37; Total Annual 

Responses: 37; Total Annual Hours: 37. 

(For policy questions regarding this 

collection contact Lane Terwilliger at 

410–786–6618. 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. 

In commenting on the proposed 

information collections please reference 

the document identifier or OMB control 

number. To be assured consideration, 

comments and recommendations must 

be submitted in one of the following 

ways by July 23, 2013: 

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. 

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Federal Register / Vol. 78, No. 101 / Friday, May 24, 2013 / Notices 31557 

Dated: May 20, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–12370 Filed 5–23–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers CMS–R–137, CMS– 

10371 and CMS–10471] 

Agency Information Collection 

Activities: Proposed Collection; 

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) 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. 

1. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection; 

Title of Information Collection: Internal 

Revenue Service (IRS)/Social Security 

Administration (SSA)/Centers for 

Medicare and Medicaid Services (CMS) 

Data Match and Supporting Regulations 

in 42 CFR 411.20–491.206 Use: 

Medicare Secondary Payer (MSP) is 

essentially the same concept known in 

the private insurance industry as 

coordination of benefits; it refers to 

those situations where Medicare 

assumes a secondary payer role to 

certain types of private insurance for 

covered services provided to a Medicare 

beneficiary. 

Congress sought to reduce the losses 

to the Medicare program by requiring in 

42 U.S.C. 1395y(b)(5) that the Internal 

Revenue Service (IRS), the Social 

Security Administration (SSA), and 

CMS perform an annual data match (the 

IRS/SSA/CMS Data Match, or ‘‘Data 

Match’’ for short). We use the 

information obtained through Data 

Match to contact employers concerning 

possible application of the MSP 

provisions by requesting information 

about specifically identified employees 

(either a Medicare beneficiary or the 

working spouse of a Medicare 

beneficiary). This statutory data match 

and employer information collection 

activity enhances our ability to identify 

both past and present MSP situations. 

Form Number: CMS–R–137 (OCN: 

0938–0565); Frequency: Annually; 

Affected Public: Business or other forprofit, Not-for-profit institutions, Farms, 

State, Local or Tribal Governments; 

Number of Respondents: 280,028; Total 

Annual Responses: 280,028; Total 

Annual Hours: 1,629,763. (For policy 

questions regarding this collection 

contact Rick Mazur at 410–786–1418. 

For all other issues call 410–786–1326.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Cooperative 

Agreement to Support Establishment of 

State-Operated Health Insurance 

Exchanges; Use: All States (including 

the 50 states, consortia of states, 

territories, and the District of Columbia 

herein referred to as states) that received 

a State Planning and Establishment 

Grant for Affordable Care Act’s (ACA) 

Exchanges are eligible for the 

Cooperative Agreement to Support 

Establishment of State Operated 

Insurance Exchanges. Section 1311 of 

the Affordable Care Act offers the 

opportunity for each state to establish 

an Exchange [now referred to as 

Marketplace], and provides for grants to 

states for the planning and 

establishment of these Exchanges. Given 

the innovative nature of Exchanges and 

the statutorily-prescribed relationship 

between the Secretary and states in their 

development and operation, it is critical 

that the Secretary work closely with 

states to provide necessary guidance 

and technical assistance to ensure that 

states can meet the prescribed timelines, 

federal requirements, and goals of the 

statute. 

In order to provide appropriate and 

timely guidance and technical 

assistance, the Secretary must have 

access to timely, periodic information 

regarding state progress. Consequently, 

the information collection associated 

with these grants is essential to 

facilitating reasonable and appropriate 

federal monitoring of funds, providing 

statutorily-mandated assistance to states 

to implement Exchanges in accordance 

with federal requirements, and to ensure 

that states have all necessary 

information required to proceed, such 

that retrospective corrective action can 

be minimized. 

The submitted revision adds sets of 

Outcomes and Operational Metrics to 

States’ data collection requirements; we 

will use the resulting data to evaluate 

Marketplace performance and overall 

effectiveness of the ACA. Key areas of 

measurement are the effectiveness of 

eligibility determination and enrollment 

processes, impact on affordability for 

consumers, and the effect of 

Marketplace participation on health 

insurances markets. Furthermore, these 

metrics facilitate actionable feedback 

and technical assistance to states for 

quality improvement efforts during the 

critical early period of operations. This 

funding opportunity was first released 

on January 20, 2011. Form Number: 

CMS–10371; Frequency: Occasionally; 

Affected Public: State, Local, or Tribal 

governments; Number of Respondents: 

40; Total Annual Responses: 1475; Total 

Annual Hours: 64,695. (For policy 

questions regarding this collection 

contact Christina Daw at 301–492–4181. 

For all other issues call 410–786–1326.) 

3. Type of Information Collection 

Request: New collection (Request for a 

new OMB control number); Title of 

Information Collection: Medicare Prior 

Authorization of Power Mobility 

Devices (PMDs) Demonstration; Use: 

The purpose of the Medicare Prior 

Authorization of Power Mobility 

Devices Demonstration (the 

Demonstration) is to ensure that 

payments for PMDs are appropriate 

before the claims are paid, thereby 

preventing the fraud, waste, and abuse 

in the seven states participating in the 

Demonstration: California, Florida, 

Illinois, Michigan, New York, North 

Carolina and Texas. Additional benefits 

of the Demonstration include ensuring 

that a beneficiary’s medical condition 

warrants their medical equipment under 

existing coverage guidelines and 

preserving their ability to receive 

quality products from accredited 

suppliers. In order to gather qualitative 

information for analysis, the evaluation 

team will use semi-structured interview 

guides that focus on the direct impact of 

the Demonstration on stakeholder 

groups. Stakeholders will be drawn 

from advocacy organizations, power 

mobility device supply companies, state 

and local government, and healthcare 

practitioners. This information 

collection request explains the research 

methodology and data collection 

strategies designed to minimize the 

burden placed on research participants, 

while effectively gathering the data 

needed for the evaluation of the 

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