Federal Register / Vol. 78, No. 105 / Friday, May 31, 2013 / Notices 32659 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–367, CMS– 

10279, CMS–10483, CMS–301, CMS–317, 

CMS–319, CMS–10178 and CMS–10307] 

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: 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. 

1. Type of Information Collection 

Request: Extension without change of a 

currently approved collection. Title of 

Information Collection: Medicaid Drug 

Program Monthly and Quarterly Drug 

Reporting Format; Use: Labelers 

transmit drug data to CMS within 30 

days after the end of each calendar 

month and quarter. We calculate the 

unit rebate amount (URA) for each 

National Drug Code and distribute to all 

state Medicaid agencies. States use the 

URA to invoice the labeler for rebates. 

The monthly data is used to calculate 

Federal Upper Limit prices for 

applicable drugs and for states that opt 

to use this data to establish their 

pharmacy reimbursement methodology. 

Form Number: CMS–367 (OCN: 0938– 

0578); Frequency: Monthly and 

quarterly; Affected Public: Private sector 

(business or other for-profits); Number 

of Respondents: 590; Total Annual 

Responses: 9,440; Total Annual Hours: 

139,712. (For policy questions regarding 

this collection contact Cindy Bergin at 

410–786–1176. For all other issues call 

410–786–1326.) 

2. Type of Information Collection 

Request: Reinstatement with change of a 

previously approved collection; Title of 

Information Collection: Ambulatory 

Surgical Center Conditions for Coverage; 

Use: The Ambulatory Surgical Center 

(ASC) Conditions for Coverage (CfCs) 

focus on a patient-centered, outcomeoriented, and transparent processes that 

promote quality patient care. The CfCs 

are designed to ensure that each facility 

has properly trained staff to provide the 

appropriate type and level of care for 

that facility and provide a safe physical 

environment for patients. The CfCs are 

used by federal or state surveyors as a 

basis for determining whether an ASC 

qualifies for approval or re-approval 

under Medicare. We, along with the 

healthcare industry, believe that the 

availability to the facility of the type of 

records and general content of records, 

which this regulation specifies, is 

standard medical practice and is 

necessary in order to ensure the wellbeing and safety of patients and 

professional treatment accountability. 

Form Number: CMS–10279 (OCN: 

0938–1071); Frequency: Annual; 

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

Number of Respondents: 5,300; Total 

Annual Responses: 5,300; Total Annual 

Hours: 206,700. (For policy questions 

regarding this collection contact 

Jacqueline Leach at 410–786–4282. For 

all other issues call 410–786–1326.) 

3. Type of Information Collection 

Request: New Collection (Request for a 

new control number); Title of 

Information Collection: Evaluation of 

the Multi-Payer Advanced Primary Care 

Practice (MAPCP) Demonstration: 

Conduct Beneficiary Experience with 

Care Surveys; Use: On September 16, 

2009, the Department of Health and 

Human Services announced the 

establishment of the Multi-payer 

Advanced Primary Care Practice 

(MAPCP) Demonstration, under which 

Medicare joined Medicaid and private 

insurers as a payer participant in statesponsored patient-centered medical 

home (PCMH) initiatives. We selected 

eight states to participate in this 

demonstration: Maine, Vermont, Rhode 

Island, New York, Pennsylvania, North 

Carolina, Michigan, and Minnesota. 

We are conducting a survey to assess 

the care experiences of beneficiaries 

involved in the MAPCP Demonstration. 

We have chosen to measure patient 

experience using a validated, 

standardized survey questionnaire, the 

PCMH version of the Consumer 

Assessment of Healthcare Providers and 

Systems (PCMH–CAHPS). The PCMH– 

CAHPS is a validated, federally 

developed instrument that measures 

patient experience in 6 domains (access 

to care, provider communication, office 

staff interactions, attention to medical/ 

emotional health, health care support, 

and medication decisions). Form 

Number: CMS–10483 (OCN: 0938– 

NEW); Frequency: Annually; Affected 

Public: Individuals and households; 

Number of Respondents: 10,038; Total 

Annual Responses: 10,038; Total 

Annual Hours: 3,313. (For policy 

questions regarding this collection 

contact Suzanne Goodwin at 410–786– 

0226. For all other issues call 410–786– 

1326.) 

4. Type of Information Collection 

Request: Reinstatement of a previously 

approved collection; Title of 

Information Collection: Certification of 

Medicaid Eligibility Quality Control 

(MEQC) Payment Error Rates; Use: We 

conduct these to determine whether or 

not the sampled cases meet applicable 

state Title XIX or XXI eligibility 

requirements when applicable. The 

reviews are also used to assess 

beneficiary liability, if any, and to 

determine the amounts paid to provide 

Medicaid services for these cases. In the 

Medicaid Eligibility Quality Control 

(MEQC) system, sampling is the only 

practical method of validating eligibility 

of the total caseload and determining 

the dollar value of eligibility liability 

errors. Any attempt to make such 

validations and determinations by 

reviewing every case would be an 

enormous and unwieldy undertaking. 

During each 6-month review period 

states are required to collect data on 

eligibility payment error dollars and 

paid claims dollars for each case in the 

sample. States must also identify cases 

for which a review cannot be 

conducted. At the conclusion of the 6- 

month review period, states must 

complete the Payment Error Rate form 

which contains aggregate data on 

sample size, number of sampled cases 

dropped, and number of sampled cases 

listed in error. These data, along with 

the calculated eligibility payment error 

rate and lower limit are certified by the 

State Medicaid Director (or designee) 

and submitted to the Regional Office. 

The collection of information is also 

necessary to implement provisions from 

the Children’s Health Insurance 

Program Reauthorization Act of 2009 

(CHIPRA) (Pub. L. 111–3) with regard to 

the MEQC and Payment Error Rate 

Measurement (PERM) programs. Form 

Number: CMS–301 (OCN: 0938–0246); 

Frequency: Semi-Annually; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

51; Total Annual Responses: 102; Total 

Annual Hours: 16,446. (For policy 

questions regarding this collection 

contact Monetha Dockery at 410–786– 

0155. For all other issues call 410–786– 

1326.) 


tkelley on DSK3SPTVN1PROD with NOTICES
32660 Federal Register / Vol. 78, No. 105 / Friday, May 31, 2013 / Notices 

5. Type of Information Collection 

Request: Reinstatement of previously 

approved collection; Title of 

Information Collection: State Medicaid 

Eligibility Quality Control (MEQC) 

Sample Plans; Use: The Medicaid 

Eligibility Quality Control (MEQC) 

system is based on monthly state 

reviews of Medicaid and Medicaid 

expansion under Title XXI cases by 

states performing the traditional 

sampling process identified through 

statistically reliable statewide samples 

of cases selected from the eligibility 

files. These reviews are conducted to 

determine whether or not the sampled 

cases meet applicable state Title XIX or 

XXI eligibility requirements when 

applicable. The reviews are also used to 

assess beneficiary liability, if any, and to 

determine the amounts paid to provide 

Medicaid services for these cases. In the 

MEQC system, sampling is the only 

practical method of validating eligibility 

of the total caseload and determining 

the dollar value of eligibility liability 

errors. Any attempt to make such 

validations and determinations by 

reviewing every case would be an 

enormous and unwieldy undertaking. In 

1993, CMS implemented MEQC pilots 

in which states could focus on special 

studies, targeted populations, 

geographic areas or other forms of 

oversight with CMS approval. States 

must submit a sampling plan, or pilot 

proposal to be approved by CMS before 

implementing their pilot program. The 

Children’s Health Insurance Program 

Reauthorization Act (CHIPRA) was 

enacted February 4, 2009. Sections 203 

and 601 of the CHIPRA relate to MEQC. 

Section 203 of the CHIPRA establishes 

an error rate measurement with respect 

to the enrollment of children under the 

express lane eligibility option. The law 

directs states not to include children 

enrolled using the express lane 

eligibility option in data or samples 

used for purposes of complying with the 

MEQC requirements. Section 601 of the 

CHIPRA, among other things, requires a 

new final rule for the Payment Error 

Rate Measurement (PERM) program and 

aims to harmonize the PERM and MEQC 

programs and provides states with the 

option to apply PERM data resulting 

from its eligibility reviews for meeting 

MEQC requirements and vice versa, 

with certain conditions. CMS reviews, 

either directly or through its contractors, 

of the sampling plans helps to ensure 

states are using valid statistical methods 

for sample selection. The collection of 

information is also necessary to 

implement provisions from the 

Children’s Health Insurance Program 

Reauthorization Act of 2009 (CHIPRA) 

(Pub. L. 111–3) with regard to the MEQC 

and Payment Error Rate Measurement 

(PERM) programs. Form Number: CMS– 

317 (OCN: 0938–0148); Frequency: 

Semi-Annually; Affected Public: State, 

Local, or Tribal Governments; Number 

of Respondents: 10; Total Annual 

Responses: 20; Total Annual Hours: 

480. (For policy questions regarding this 

collection contact Monetha Dockery at 

410–786–0155. For all other issues call 

410–786–1326.) 

6. Type of Information Collection 

Request: Reinstatement of a previously 

approved collection; Title of 

Information Collection: State Medicaid 

Eligibility Quality Control (MEQC) 

Sample Selection Lists; Use: The 

Medicaid Eligibility Quality Control 

MEQC system is based on monthly state 

reviews of Medicaid and Medicaid 

expansion under Title XXI cases by 

states performing the traditional 

sampling process identified through 

statistically reliable statewide samples 

of cases selected from the eligibility 

files. These reviews are conducted to 

determine whether or not the sampled 

cases meet applicable state Title XIX or 

XXI eligibility requirements when 

applicable. The reviews are also used to 

assess beneficiary liability, if any, and to 

determine the amounts paid to provide 

Medicaid services for these cases. In the 

MEQC system, sampling is the only 

practical method of validating eligibility 

of the total caseload and determining 

the dollar value of eligibility liability 

errors. Any attempt to make such 

validations and determinations by 

reviewing every case would be an 

enormous and unwieldy undertaking. 

At the beginning of each month, state 

agencies still performing the traditional 

sample are required to submit sample 

selection lists which identify all of the 

cases selected for review in the states’ 

samples. The sample selection lists 

contain identifying information on 

Medicaid beneficiaries such as: State 

agency review number, beneficiary’s 

name and address, the name of the 

county where the beneficiary resides, 

Medicaid case number, etc. The 

submittal of the sample selection lists is 

necessary for regional office validation 

of state reviews. Without these lists, the 

integrity of the sampling results would 

be suspect and the regional offices 

would have no data on the adequacy of 

the states’ monthly sample draw or 

review completion status. The authority 

for collecting this information is Section 

1903(u) of the Social Security Act. The 

specific requirement for submitting 

sample selection lists is described in 

regulations at 42 CFR 431.814(h). 

Regional Office staff review the sample 

selection lists to determine that states 

are sampling a sufficient number of 

cases for review. Form Number: CMS– 

319 (OCN: 0938–0147); Frequency: 

Monthly; Affected Public: State, Local, 

or Tribal Governments; Number of 

Respondents: 10; Total Annual 

Responses: 120; Total Annual Hours: 

960. (For policy questions regarding this 

collection contact Monetha Dockery at 

410–786–0155. For all other issues call 

410–786–1326.) 

7. Type of Information Collection 

Request: Reinstatement of a previously 

approved collection; Title of 

Information Collection: Medicaid and 

Children’s Health Insurance (CHIP) 

Managed Care Claims and Related 

Information; Use: The Payment Error 

Rate Measurement (PERM) program 

measures improper payments for 

Medicaid and the State Children’s 

Health Insurance Program (SCHIP). The 

program was designed to comply with 

the Improper Payments Information Act 

(IPIA) of 2002 and the Office of 

Management and Budget (OMB) 

guidance. Although OMB guidance 

requires error rate measurement for 

SCHIP, 2009 SCHIP legislation 

temporarily suspended PERM 

measurement for this program and 

changed to Children’s Health Insurance 

Program (CHIP) effective April 01, 2009. 

Please see Children’s Health Insurance 

Program Reauthorization Act of 2009 

(CHIPRA) Public Law 111–3 for more 

details. There are two phases of the 

PERM program, the measurement phase 

and the corrective action phase. The 

PERM measures improper payments in 

Medicaid and CHIP and produces state 

and national-level error rates for each 

program. The error rates are based on 

reviews of Medicaid and CHIP fee-forservice (FFS) and managed care 

payments made in the federal fiscal year 

under review. States conduct eligibility 

reviews and report eligibility related 

payment error rates also used in the 

national error rate calculation. We 

created a 17 state rotation cycle so that 

each state will participate in PERM once 

every three years. Following is the list 

of states in which CMS will measure 

improper payments over the next three 

years in Medicaid. We need to collect 

capitation payment information from 

the selected states so that the federal 

contractor can draw a sample and 

review the managed care capitation 

payments. We will also collect state 

managed care contracts, rate schedules 

and updates to the contracts and rate 

schedules. This information will be 

used by the federal contractor when 

conducting the managed care claims 

reviews. Sections 1902(a)(6) and 


tkelley on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 105 / Friday, May 31, 2013 / Notices 32661 

2107(b)(1) of the Social Security Act 

grants CMS authority to collect 

information from the States. The IPIA 

requires CMS to produce national error 

rates in Medicaid and CHIP fee-forservice, including the managed care 

component. The state-specific Medicaid 

managed care and CHIP managed care 

error rates will be based on reviews of 

managed care capitation payments in 

each program and will be used to 

produce national Medicaid managed 

care and CHIP managed care error rates. 

Form Number: CMS–10178 (OCN: 

0938–0994); Frequency: Occasionally; 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

34; Total Annual Responses: 2040; Total 

Annual Hours: 28,050. (For policy 

questions regarding this collection 

contact Monetha Dockery at 410–786– 

0155. For all other issues call 410–786– 

1326.) 

8. Type of Information Collection 

Request: Reinstatement with change of a 

previously approved information 

collection; Title of Information 

Collection: Medical Necessity and 

Claims Denial Disclosures under 

MHPAEA; Use: The Paul Wellstone and 

Pete Domenici Mental Health Parity and 

Addiction Equity Act of 2008 

(MHPAEA) (P.L.110–343) requires that 

group health plans and group health 

insurance issuers offering mental health 

or substance use disorder (MH/SUD) 

benefits in addition to medical and 

surgical (med/surg) benefits ensure that 

that they do not apply any more 

restrictive financial requirements (e.g., 

co-pays, deductibles) and/or treatment 

limitations (e.g., visit limits) to MH/SUD 

benefits than those requirements and/or 

limitations applied to substantially all 

med/surg benefits. 

Medical Necessity Disclosure Under 

MHPAEA 

The MHPAEA section 512(b) 

specifically amends the Public Health 

Service (PHS) Act to require plan 

administrators or health insurance 

issuers to provide, upon request, the 

criteria for medical necessity 

determinations made with respect to 

MH/SUD benefits to current or potential 

participants, beneficiaries, or 

contracting providers. The interim final 

rules Under the Paul Wellstone and Pete 

Domenici Mental Health Parity and 

Addiction Equity Act of 2008 (75 FR 

5410, February 2, 2010) set forth rules 

for providing criteria for medical 

necessity determinations. CMS oversees 

non-federal governmental plans or 

related health insurance. 

Claims Denial Disclosure Under 

MHPAEA 

The MHPAEA section 512(b) 

specifically amends the Public Health 

Service (PHS) Act to require plan 

administrators or health insurance 

issuers to supply, upon request, the 

reason for any denial of payment for 

MH/SUD services to the participant or 

beneficiary involved in the case. The 

interim final rules Under the Paul 

Wellstone and Pete Domenici Mental 

Health Parity and Addiction Equity Act 

of 2008 (75 FR 5410, February 2, 2010) 

implement 45 CFR 146.136(d)(2), which 

sets forth rules for providing reasons for 

denial of payment. We oversee nonfederal governmental plans or related 

health insurance, and the regulation 

provides a safe harbor such that plans 

or issuers are deemed to comply with 

requirements of paragraph (d)(2) of 45 

CFR 166.136 if they provide the notice 

in a form and manner consistent with 

ERISA requirements found in 29 CFR 

2560.503–1. Form Number: CMS–10307 

(OMB Control No. 0938–1080); 

Frequency: On Occasion; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

20,300; Number of Responses: 509,600; 

Total Annual Hours: 2,200. (For policy 

questions regarding this collection, 

contact Usree Bandyopadhyay at 410– 

786–6650. 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 30, 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 llll, Room C4–26– 

05, 7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: May 28, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–12950 Filed 5–30–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–7028–N] 

Medicare, Medicaid, and Children’s 

Health Insurance Programs; Renewal 

of the Advisory Panel on Outreach and 

Education (APOE) and Request for 

Nominations 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice announces that 

the charter of the Advisory Panel on 

Outreach and Education (APOE) has 

been renewed. It also requests 

nominations for individuals to serve on 

the APOE. 

DATES: Nominations will be considered 

if we receive them at the appropriate 

address, provided in the ADDRESSES

section of this notice, no later than 5 

p.m., Eastern Daylight Time (e.d.t.) on 

July 1, 2013. 

ADDRESSES: Mail or deliver nominations 

to the following address: Kirsten 

Knutson, Acting Designated Federal 

Official, Office of Communications, 

CMS, 7500 Security Boulevard, Mail 

Stop S1–13–05, Baltimore, MD 21244– 

1850 or email to 

Kirsten.Knutson@cms.hhs.gov. 

FOR FURTHER INFORMATION CONTACT: 

Kirsten Knutson, Acting Designated 

Federal Official, Office of 

Communications, CMS, 7500 Security 

Boulevard, Mail Stop S1–13–05, 

Baltimore, MD 21244, 410–786–5886, 

email kirsten.knutson@cms.hhs.gov or 

visit the Web site at http:// 

www.cms.gov/Regulations-andGuidance/Guidance/FACA/APOE.html. 

Press inquiries are handled through the 

CMS Press Office at (202) 690–6145. 

SUPPLEMENTARY INFORMATION:

I. Background 

The Advisory Panel on Medicare 

Education (the predecessor to the 

APOE) was created in 1999 to advise 

and make recommendations to the 


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