5118 Federal Register / Vol. 80, No. 20 / Friday, January 30, 2015 / Notices 

Prevention and the Agency for Toxic 

Substances and Disease Registry. 

Elaine L. Baker, 

Director, Management Analysis and Services 

Office, Centers for Disease Control and 

Prevention. 

[FR Doc. 2015–01768 Filed 1–29–15; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–R–306, CMS– 

10371, CMS–10392, CMS–10418, CMS– 

10472, CMS–10494 and CMS–10549] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 (the 

PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information (including each proposed 

extension or reinstatement of an existing 

collection of information) and to allow 

60 days for public comment on the 

proposed action. Interested persons are 

invited to send comments regarding our 

burden estimates 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. 

DATES: Comments must be received by 

March 31, 2015. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number (OCN). To be 

assured consideration, comments and 

recommendations must be submitted in 

any one of the following ways: 

1. Electronically. You may send 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) that are 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 lll, Room C4–26– 

05, 7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

http://www.cms.hhs.gov/

PaperworkReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326. 

SUPPLEMENTARY INFORMATION: 

Contents 

This notice sets out a summary of the 

use and burden associated with the 

following information collections. More 

detailed information can be found in 

each collection’s supporting statement 

and associated materials (see 

ADDRESSES). 

CMS–R–306 Use of Restraint and 

Seclusion in Psychiatric Residential 

Treatment Facilities (PRTFs) for 

Individuals Under Age 21 and 

Supporting Regulations 

CMS–10371 Cooperative Agreements 

to Support Establishment of StateOperated Health Insurance Exchanges 

CMS–10392 Consumer Operated and 

Oriented (CO–OP) Program 

CMS–10418 Annual MLR and Rebate 

Calculation Report and MLR Rebate 

Notices 

CMS–10472 Exchange Functions: 

Standards for Navigators and NonNavigator Assistance 

CMS–10494 Standards for Navigators 

and Non-Navigator Assistance 

Personnel; Consumer Assistance 

Tools and Programs of an Exchange 

and Certified Application Counselors 

CMS–10549 Generic Clearance for 

Questionnaire Testing and 

Methodological Research for the 

Medicare Current Beneficiary Survey 

(MCBS) 

Under the PRA (44 U.S.C. 3501– 

3520), federal agencies must obtain 

approval from the Office of Management 

and Budget (OMB) for each collection of 

information they conduct or sponsor. 

The term ‘‘collection of information’’ is 

defined in 44 U.S.C. 3502(3) and 5 CFR 

1320.3(c) and includes agency requests 

or requirements that members of the 

public submit reports, keep records, or 

provide information to a third party. 

Section 3506(c)(2)(A) of the PRA 

requires federal agencies to publish a 

60-day notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, before 

submitting the collection to OMB for 

approval. To comply with this 

requirement, CMS is publishing this 

notice. 

Information Collection 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Use of Restraint 

and Seclusion in Psychiatric Residential 

Treatment Facilities (PRTFs) for 

Individuals Under Age 21 and 

Supporting Regulations; Use: 

Psychiatric residential treatment 

facilities are required to report deaths, 

serious injuries and attempted suicides 

to the State Medicaid Agency and the 

Protection and Advocacy Organization. 

They are also required to provide 

residents the restraint and seclusion 

policy in writing, and to document in 

the residents’ records all activities 

involving the use of restraint and 

seclusion. Form Number: CMS–R–306 

(OMB Control Number 0938–0833); 

Frequency: Occasionally; Affected 

Public: Private sector (Business or other 

for-profits); Number of Respondents: 

390; Total Annual Responses: 

1,466,795; Total Annual Hours: 431,062. 

(For policy questions regarding this 

collection contact Cindy Ruff at 410– 

786–5916). 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Cooperative 

Agreements to Support Establishment of 

State-Operated Health Insurance 

Exchanges; Use: All States (including 

the 50 States, consortia of States, and 

the District of Columbia herein referred 

to as States) had the opportunity under 

Section 1311(b) of the Affordable Care 

to apply for three types of grants: (1) 

Planning grants; (2) Early Innovator 

grants for early development of 

information technology; and (3) 

Establishment grants to develop, 

implement and start-up Marketplaces. 

As of January 1st, 2015, the Secretary 

has disbursed over $5.4 billion under 


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Federal Register / Vol. 80, No. 20 / Friday, January 30, 2015 / Notices 5119 

this grant program and, as of that date, 

there were 79 active establishment 

grants awarded to 28 states. As the 

State-Based Marketplaces (SBM) and 

Small Business Health Options Program 

(SHOP) have matured and moved from 

the developmental phases to fulloperation, the reporting requirements 

for the states have been modified and 

streamlined to insure only information 

necessary to provide effective oversight 

of their operations by CMS is collected. 

Given the innovative nature of 

Exchanges and the statutorilyprescribed 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 and the grants 

awarded to them. Form Number: CMS– 

10371 (OMB Control Number: 0938– 

1119); Frequency: Once; Affected 

Public: State Government agencies, nonprofit entities; Number of Respondents: 

28; Number of Responses: 48; Total 

Annual Hours: 31,404. (For policy 

questions regarding this collection 

contact Dena Pushkin at 301–492–4342.) 

3. Type of Information Collection 

Request: Revision of a currently 

approved information collection; Title 

of Information Collection: Consumer 

Operated and Oriented (CO–OP) 

Program; Use: The Consumer Operated 

and Oriented Plan (CO–OP) program 

was established by Section 1322 of the 

Affordable Care Act. This program 

provides for loans to establish at least 

one consumer-operated, qualified 

nonprofit health insurance issuer in 

each State. Issuers supported by the 

CO–OP program will offer at least one 

qualified health plan at the silver level 

of benefits and one at the gold level of 

benefits in the individual market State 

Health Benefit Exchanges (Exchanges). 

At least two-thirds of policies or 

contracts offered by a CO–OP will be 

open to individuals and small 

employers. Profits generated by the 

nonprofit CO–OPs will be used to lower 

premiums, improve benefits, improve 

the quality of health care delivered to 

their members, expand enrollment, or 

otherwise contribute to the stability of 

coverage offered by the CO–OP. By 

increasing competition in the health 

insurance market and operating with a 

strong consumer focus, the CO–OP 

program will provide consumers more 

choices, greater plan accountability, 

increased competition to lower prices, 

and better models of care, benefiting all 

consumers, not just CO–OP members. 

The CO–OP program will provide 

nonprofits with loans to fund start-up 

costs and State reserve requirements, in 

the form of Start-up Loans and Solvency 

Loans. An applicant may apply for (1) 

joint Start-up and Solvency Loans; or (3) 

only a Solvency Loan. Planning Loans 

are intended to help loan recipients 

determine the feasibility of operating a 

CO–OP in a target market. Start-up 

Loans are intended to assist loan 

recipients with the many start-up costs 

associated with establishing a new 

health insurance issuer. Solvency Loans 

are intended to assist loan recipients 

with meeting the solvency requirements 

of States in which the applicant seeks to 

be licensed to issue qualified health 

plans. Form Number: CMS–10392 (OMB 

control number: 0938–1139); Frequency: 

Occasionally; Affected Public: Private 

sector (Not-for-profit institutions); 

Number of Respondents: 23; Total 

Annual Responses: 675; Total Annual 

Hours: 93,220. (For policy questions 

regarding this collection contact Deepti 

Loharikar 301–492–4126). 

4. Type of Information Collection 

Request: Revision of a currently 

approved information collection; Title 

of Information Collection: Annual MLR 

and Rebate Calculation Report and MLR 

Rebate Notices; Use: Under Section 

2718 of the Affordable Care Act and 

implementing regulation at 45 CFR part 

158, 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, nonclaims costs, Federal and State taxes 

and licensing and regulatory fees, the 

amount of earned premium, and 

beginning with the 2014 reporting year, 

the amounts related to the transitional 

reinsurance, risk adjustment, and risk 

corridors. An issuer must provide an 

annual rebate if the amount it spends on 

certain costs compared to its premium 

revenue (excluding Federal and States 

taxes and licensing and 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) and modified by 

technical corrections on December 30, 

2010 (75 FR 82277), which added Part 

158 to Title 45 of the Code of Federal 

Regulations. The IFR is effective January 

1, 2011. A final rule regarding selected 

provisions of the IFR was published on 

December 7, 2011 (76 FR 76574, CMS– 

9998–FC) and an interim final rule 

regarding an issue not included in 

issuers’ reporting obligations 

(disbursement of rebates by non-federal 

governmental plans) was also published 

December 7, 2011 (76 FR 76596, CMS– 

9998–IFC2). Both rules published on 

December 7, 2011 are effective January 

1, 2012. Each issuer is required to 

submit annually MLR data, including 

information about any rebates it must 

provide, on a form prescribed by CMS, 

for each State in which the issuer 

conducts business. Each issuer is also 

required to provide a rebate notice to 

each policyholder that is owed a rebate 

and each subscriber of policyholders 

that are owed a rebate for any given 

MLR reporting year. Additionally, each 

issuer is required to maintain for a 

period of seven years all documents, 

records and other evidence that support 

the data included in each issuer’s 

annual report to the Secretary. Under 

Section 1342 of the Patient Protection 

and Affordable Care Act and 

implementing regulation at 45 CFR part 

153, issuers of qualified health plans 

(QHPs) must participate in a risk 

corridors program. A QHP issuer is 

required to pay charges to or receive 

payments from CMS based on the ratio 

of the issuer’s allowable costs to the 

target amount. A final rule (Premium 

Stabilization Rule) implementing the 

risk corridors program was published on 

March 23, 2012 (77 FR 17220), which 

added Part 153 to Title 45 of the Code 

of Federal Regulations. The Premium 

Stabilization Rule is effective May 22, 

2012. Final rules (2014 and 2015 

Payment Notices) outlining the risk 

corridors benefit and payment 

parameters for the 2014 and 2015 

benefit years were published on March 

11, 2013 (78 FR 15410) and March 11, 

2014 (79 FR 13744), respectively. The 

2014 and 2015 Payment Notices are 

effective April 30, 2013 and May 12, 

2014, respectively. Each QHP issuer is 

required to submit an annual report to 

CMS concerning the issuer’s allowable 

costs, allowable administrative costs, 

and the amount of premium. 

Based upon our experience in the 

MLR data collection and evaluation 

process, we are updating its annual 

burden hour estimates to reflect the 

actual numbers of submissions, rebates 

and rebate notices. In addition, we are 

updating its annual burden hour 

estimates to reflect the additional 

burden (published in the 2015 Payment 

Notice) related to the risk corridors data 

submission requirements. 

The 2014 MLR Reporting Form and 

instructions reflect changes for the 2014 

reporting year and beyond that are set 

forth in the March 2013 update to 45 

CFR part 158 regarding the MLR 

reporting and rebate distribution 

deadlines and the accounting for the 

transitional reinsurance, risk 


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5120 Federal Register / Vol. 80, No. 20 / Friday, January 30, 2015 / Notices 

adjustment, and risk corridors. The 2014 

MLR Reporting Form and instructions 

are also modified to include the 

reporting elements required under the 

risk corridors data submission 

requirements in 45 CFR 153.530. In 

2015, it is expected that issuers will 

send fewer notices and rebate checks to 

policyholders and subscribers, which 

will reduce burden on issuers. On the 

other hand, the requirement to report 

the risk corridors data will increase 

burden for QHP issuers. It is estimated 

that there will be a net reduction in total 

burden from 294,911 to 271,600. Form 

Number: CMS–10418 (OMB control 

number: 0938–1164); Frequency: 

Annually; Affected Public: Private 

Sector, Business or other for-profits and 

not-for-profit institutions; Number of 

Respondents: 517; Number of 

Responses: 3,307; Total Annual Hours: 

271,600. (For policy questions regarding 

this collection, contact Julie McCune at 

(301) 492–4196.) 

5. Type of Information Collection 

Request: Revision of a previously 

approved information collection; Title 

of Information Collection: Patient 

Protection and Affordable Care Act; 

Consumer Assistance Tools and 

Programs of an Exchange and Certified 

Application Counselors; Exchange and 

Insurance Market Standards for 2015; 

Use: Section 1321(a)(1) of the Affordable 

Care Act directs and authorizes the 

Secretary to issue regulations setting 

standards for meeting the requirements 

under title I of the Affordable Care Act, 

with respect to, among other things, the 

establishment and operation of 

Exchanges. Pursuant to this authority, 

regulations have been finalized at 45 

CFR 155.215(b)(1) to require Navigators, 

as well as those non-Navigator 

personnel to whom 45 CFR 155.215 

applies, requires completion of HHS 

approved training for initial certification 

and annual recertification prior to 

providing application and enrollment 

assistance. The training will include an 

optional training quality questionnaire 

providing Navigators and non-Navigator 

assistance personnel to whom 45 CFR 

155.215 applies, an opportunity to 

provide feedback to CMS regarding the 

training and any improvements that can 

be made in the future. Form Number: 

CMS–10472 (OMB Control Number: 

0938–1220); Frequency: On Occasion; 

Affected Public: State, Local, or Tribal 

Governments, Private Sector (not-forprofit institutions); individuals or 

households; Number of Respondents: 

5,610; Number of Responses: 5,610; 

Total Annual Hours: 37,036. (For policy 

questions regarding this collection, 

contact Heather Raeburn at 301–492– 

4224.) 

6. Type of Information Collection 

Request: Revision of a previously 

approved information collection; Title 

of Information Collection: Patient 

Protection and Affordable Care Act; 

Consumer Assistance Tools and 

Programs of an Exchange and Certified 

Application Counselors; Exchange and 

Insurance Market Standards for 2015; 

Use: Section 1321(a)(1) of the Affordable 

Care Act directs and authorizes the 

Secretary to issue regulations setting 

standards for meeting the requirements 

under title I of the Affordable Care Act, 

with respect to, among other things, the 

establishment and operation of 

Exchanges. Pursuant to this authority, 

regulations establishing the certified 

application counselor program have 

been finalized at 45 CFR 155.225. In 

accordance with 155.225(d)(1) and (7), 

certified application counselors in all 

Exchanges are required to be initially 

certified and recertified on at least an 

annual basis and successfully complete 

Exchange-required training. Form 

Number: CMS–10494 (OMB Control 

Number: 0938–1205); Frequency: On 

Occasion; Affected Public: State, Local, 

or Tribal Governments, Private Sector 

(Not-for-profit institutions); Individuals 

or Households; Number of Respondents: 

30,000; Number of Responses: 30,000; 

Total Annual Hours: 7,500. (For policy 

questions regarding this collection, 

contact Tricia Beckmann at 301–492– 

4328.) 

7. Type of Information Collection 

Request: New collection (Request for a 

new OMB control number); Title of 

Information Collection: Generic 

Clearance for Questionnaire Testing and 

Methodological Research for the 

Medicare Current Beneficiary Survey 

(MCBS); Use: The purpose of this OMB 

clearance package is to clear a Generic 

Clearance to support an effort to 

evaluate the operations and content of 

the Medicare Current Beneficiary 

Survey (MCBS). The MCBS is a 

continuous, multipurpose survey of a 

nationally representative sample of 

aged, disabled, and institutionalized 

Medicare beneficiaries. The MCBS, 

which is sponsored by the Centers for 

Medicare & Medicaid Services (CMS), is 

the only comprehensive source of 

information on the health status, health 

care use and expenditures, health 

insurance coverage, and socioeconomic 

and demographic characteristics of the 

entire spectrum of Medicare 

beneficiaries. 

The core of the MCBS is a series of 

interviews with a stratified random 

sample of the Medicare population, 

including aged and disabled enrollees, 

residing in the community or in 

institutions. Questions are asked about 

enrollees’ patterns of health care use, 

charges, insurance coverage, and 

payments over time. Respondents are 

asked about their sources of health care 

coverage and payment, their 

demographic characteristics, their 

health and work history, and their 

family living circumstances. In addition 

to collecting information through the 

core questionnaire, the MCBS collects 

information on special topics through 

supplements. For example, questions 

are asked about enrollees’ income and 

assets, access to health care, health and 

functional status and satisfaction with 

care. Special supplements also focus on 

emerging trends in health care. Form 

Number: CMS–10549 (OMB control 

number 0938–New); Frequency: 

Occasionally; Affected Public: 

Individuals or Households; Number of 

Respondents: 1,500; Total Annual 

Responses: 1,500; Total Annual Hours: 

1,117. (For policy questions regarding 

this collection contact William Long at 

410–786–7927.) 

Dated: January 27, 2015. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2015–01790 Filed 1–29–15; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10530, CMS– 

1880 and CMS–1882] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 

(PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, and to allow 

a second opportunity for public 

comment on the notice. Interested 

persons are invited to send comments 

regarding the burden estimate or any 

other aspect of this collection of 

information, including any of the 


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