21956 Federal Register / Vol. 78, No. 71 / Friday, April 12, 2013 / Notices 

CARE Data Set V1.01. Form Number: 

CMS–10409 (OCN: 0938–1163); 

Frequency: Occasionally; Affected 

Public: Private Sector: Business or other 

for-profit and not-for-profit institutions; 

Number of Respondents: 442; Total 

Annual Responses: 403,988; Total 

Annual Hours: 212,160. (For policy 

questions regarding this collection 

contact Charles Padgett at 410–786– 

2811. 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: Emergency 

Department Patient Experience of Care 

Survey. Use: This survey supports the 

six national priorities for improving care 

from the National Quality Strategy 

developed by the U.S. Department of 

Health and Human Services (HHS) that 

was called for under the Affordable Care 

Act to create national aims and 

priorities to guide local, state, and 

national efforts to improve the quality of 

health care. The priorities support a 

three-part aim focusing on better care, 

better health, and lower costs through 

improvement. In this regard, this survey 

will provide patient experiences with 

care data that enables making 

comparisons of emergency departments 

across the nation and promoting 

effective communication and 

coordination. Form Number: CMS– 

10461 (OCN: 0938—New). Frequency: 

Once. Affected Public: Individuals and 

households. Number of Respondents: 

Total Annual Responses: 3,360. Total 

Annual Hours: 799. (For policy 

questions regarding this collection 

contact Sai Ma at 410–786–1479. 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 May 13, 2013. OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–6974, Email: 

OIRA_submission@omb.eop.gov. 

Dated: April 9, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–08677 Filed 4–11–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–460 and CMS– 

10469] 

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: Medicare 

Participating Physician or Supplier 

Agreement. Use: Section 1842(h) of the 

Social Security Act permits physicians 

and suppliers to voluntarily participate 

in Medicare Part B by agreeing to take 

assignment on all claims for services to 

Medicare beneficiaries. The law also 

requires that the Secretary provide 

specific benefits to the physicians, 

suppliers and other persons who choose 

to participate. The CMS–460 is the 

agreement by which the physician or 

supplier elects to participate in 

Medicare. The information is used by: 

Medicare contractors to provide the 

benefits the law provides for 

participating entities and to enable 

contractors to enforce the Medicare 

limiting charge for physicians, suppliers 

and other persons who do not 

participate; Medicare beneficiaries to 

assist them in locating physicians who 

will accept Medicare assignment on 

claims for services and therefore save 

them money; and CMS to gauge the 

effectiveness of our and contractors 

efforts to increase participation in 

Medicare. Form Number: CMS–460 

(OCN: 0938–0373). Frequency: Yearly. 

Affected Public: Private sector (business 

or other for-profits). Number of 

Respondents: 120,000. Total Annual 

Responses: 120,000. Total Annual 

Hours: 30,000. (For policy questions 

regarding this collection contact April 

Billingsley at 410–786–0140. For all 

other issues call 410–786–1326.) 

2. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Issuer Reporting 

Requirements for Selecting a CostSharing Reductions Reconciliation 

Methodology; Use: Under established 

Department of Health and Human 

Services (HHS) regulations, qualified 

health plan (QHP) issuers will receive 

advance payments of the cost-sharing 

reductions throughout the year. Each 

issuer will then be subject to one of two 

reconciliation processes after the year to 

ensure that HHS reimbursed each issuer 

the correct advance cost-sharing 

amount. This information collection 

request establishes the data collection 

requirements for a QHP issuer to report 

to HHS which reconciliation reporting 

option the issuer will be subject to for 

a given benefit year. 

On March 23, 2010, the President 

signed into law H.R. 3590, the Patient 

Protection and Affordable Care Act 

(Affordable Care Act), Public Law 111– 

148. Sections 1402 and 1412 of the 

Affordable Care Act provide for 

reductions in cost sharing on essential 

health benefits for low- and moderateincome enrollees in silver level 

qualified health plans on individual 

market Exchanges. It also provides for 

reductions in cost sharing for Indians 

enrolled in QHPs at any metal level. 

These cost-sharing reductions will help 

eligible individuals and families afford 

the out-of-pocket spending associated 

with health care services provided 

through Exchange-based QHP coverage. 

The law directs QHP issuers to notify 

the Secretary of HHS of cost-sharing 

reductions made under the statute for 

qualified individuals, and directs the 

Secretary to make periodic and timely 

payments to the QHP issuer equal to the 

value of those reductions. Further, the 

law permits advance payment of the 

cost-sharing reduction amounts to QHP 

issuers based upon amounts specified 

by the Secretary. 

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Federal Register / Vol. 78, No. 71 / Friday, April 12, 2013 / Notices 21957 

On December 7, 2012, HHS published 

a proposed rule (77 FR 73118) entitled 

‘‘HHS Notice of Benefit and Payment 

Parameters for 2014.’’ This rule 

proposed a payment approach under 

which CMS would make monthly 

advance payments to issuers to cover 

projected cost-sharing reduction 

amounts, and then reconcile those 

advance payments after the end of the 

benefit year to the actual cost-sharing 

reduction amounts. The reconciliation 

process described in the rule would 

require that QHP issuers provide CMS 

the amount of cost-sharing paid by each 

enrollee, as well as the level of costsharing that enrollee would have paid 

under a standard plan without costsharing reductions. To determine the 

amount of cost-sharing an enrollee 

receiving cost-sharing reductions would 

have paid under a standard plan, QHP 

issuers would need to re-adjudicate 

each claim for these enrollees under a 

standard plan structure. HHS finalized 

the proposed notice of benefit and 

payment parameters for 2014 and this 

approach on March 11, 2013 (78 FR 

15410). 

During the comment period to the 

proposed rule, HHS received numerous 

comments suggesting that the reporting 

requirements of the reconciliation 

process for QHP issuers would be 

operationally challenging for some 

issuers. In response to these comments, 

HHS issued an interim final rule (CMS– 

9964–IFC) with comment period on 

March 11, 2013 (78 FR 15541) entitled 

‘‘Amendments to the HHS Notice of 

Benefit and Payment Parameters for 

2014,’’ which laid out an alternative 

approach that QHP issuers may elect to 

pursue with respect to the reporting 

requirements. This alternative approach 

would allow a QHP issuer to estimate 

the amount of cost-sharing an enrollee 

receiving cost-sharing reductions would 

have paid under a standard plan in the 

Exchange, rather than re-adjudicating 

each of the enrollee’s claims. This 

approach is intended to permit a 

reasonable transitional period in which 

QHP issuers will be allowed to choose 

the methodology that best aligns with 

their operational practices, which 

should reduce the administrative 

burden on issuers in the initial years of 

the Exchanges. The interim final rule 

describes the estimation methodology in 

sufficient detail to allow QHP issuers to 

make an informed decision of which 

reporting approach to pursue. 

Prior to the start of each coverage 

year, QHP issuers must notify HHS of 

the methodology it is selecting for the 

benefit year. QHP issuers will provide 

information on which option they 

choose via the Health Insurance 

Oversight System (HIOS), a web-based 

data collection system that is already 

being used by issuers to provide 

information for the healthcare.gov Web 

site. All submissions will be made 

electronically and no paper submissions 

are required. The QHP issuer must 

select the same methodology for all plan 

variations it offers on the Exchange for 

a benefit year. Moreover, as the 

estimated methodology is intended as a 

transition to the actual methodology, the 

QHP issuer may not select the estimated 

methodology if it selected the actual 

methodology for the prior benefit year. 

Form Number: CMS–10469 (OCN: 

0938–NEW); Frequency: Annually; 

Affected Public: Private Sector (business 

or other for-profits); Number of 

Respondents: 1,200; Total Annual 

Responses: 1,200; Total Annual Hours: 

13,200. (For policy questions regarding 

this collection contact Chris Weiser at 

410–786–0650. 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 June 11, 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. 

Dated: April 9, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–08676 Filed 4–11–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10463] 

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: New collection; Title of 

Information Collection: Cooperative 

Agreement to Support Navigators in 

Federally-facilitated and State 

Partnership Exchanges; Use: Section 

1311(i) of the Affordable Care Act 

requires Exchanges to establish a 

Navigator grant program as part of its 

function to provide consumers with 

assistance when they need it. Navigators 

will assist consumers by providing 

education about and facilitating 

selection of qualified health plans 

(QHPs) within Exchanges, as well as 

other required duties. Section 1311(i) 

requires that an Exchange operating as 

of January 1, 2014, must establish a 

Navigator Program under which it 

awards grants to eligible individuals or 

entities who satisfy the requirements to 

be Exchange Navigators. For Federallyfacilitated Exchanges (FFE) and State 

Partnership Exchanges (SPEs), CMS will 

be awarding these grants. Navigator 

awardees must provide quarterly, biannual, and an annual progress report to 

CMS on the activities performed during 

the grant period and any sub-awardees 

receiving funds. Form Number: CMS– 

10463 (OMB#: 0938–NEW); Frequency: 

Annually; Quarterly; Affected Public: 

Private sector Number of Respondents: 

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