### 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 aprogram of risk adjustment for all nongrandfathered plans in the individual and small group market both inside andoutside 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.


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

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