Federal Register / Vol. 86, No. 28 / Friday, February 12, 2021 / Notices 9349 

which beneficiaries are electing to 

enroll in the demonstration. Form 

Number: CMS–10518 (OMB control 

number: 0938–1246); Frequency: 

Annually; Affected Public: Individuals 

and Households; Number of 

Respondents: 6,500; Total Annual 

Responses: 6,500; Total Annual Hours: 

1,625. (For policy questions regarding 

this collection contact Debra K. 

Gillespie at 410–786–4631.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Collection of 

Encounter Data from MA Organizations; 

Use: Section 1853(a)(3)(B) of the Act 

directs CMS to require MA 

organizations and eligible organizations 

with risk-sharing contracts under 1876 

to ‘‘submit data regarding inpatient 

hospital services . . . and data 

regarding other services and other 

information as the Secretary deems 

necessary’’ in order to implement a 

methodology for ‘‘risk adjusting’’ 

payments made to MA organizations 

and other entities. Risk adjustments to 

enrollee monthly payments are made in 

order to take into account ‘‘variations in 

per capita costs based on [the] health 

status’’ of the Medicare beneficiaries 

enrolled in an MA plan. 

CMS collects encounter data for 

beneficiaries enrolled in MA 

organizations, section 1876 Cost Health 

Maintenance Organizations (HMOs)/ 

Competitive Medical Plans (CMPs), 

Programs of All-inclusive Care for the 

Elderly (PACE) organizations, and 

MMPs. For PACE organizations and 

MMPs, encounter data serves essentially 

the same purposes as it does for the MA 

program (for Part C and Part D risk 

adjustment). To 1876 Cost Plans that 

offer Part D coverage, CMS makes risk 

adjusted, capitated monthly payments 

for Part D. 

MA organizations, Part D 

organizations, 1876 Cost Plans, MMPs 

and PACE organizations must use a 

CMS approved Network Service Vendor 

to establish connectivity with the CMS 

secure network for operational 

purposes. Once connectivity is 

established, these entities must submit 

required documents to CMS’s front-end 

contractor to obtain security access 

credentials. Form Number: CMS–10340 

(OMB control number: 0938–1152); 

Frequency: Annually; Affected Public: 

Private Sector, Business or other forprofits, Not-for-profits institutions; 

Number of Respondents: 733; Total 

Annual Responses: 1,068,204,429; Total 

Annual Hours: 35,618,366. (For policy 

questions regarding this collection 

contact Michael P. Massimini at 410– 

786–1560.) 

Dated: February 9, 2021. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2021–02944 Filed 2–11–21; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–18F5, CMS– 

10307, CMS–10495 and CMS–10454] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, Health and Human 

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 

(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 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. 

DATES: Comments on the collection(s) of 

information must be received by the 

OMB desk officer by March 15, 2021. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. 

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’ website address at: 

https://www.cms.gov/Regulations-andGuidance/Legislation/ 

PaperworkReductionActof1995/PRAListing.html. 

FOR FURTHER INFORMATION CONTACT: 

William Parham at (410) 786–4669. 

SUPPLEMENTARY INFORMATION: Under the 

Paperwork Reduction Act of 1995 (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 (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-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 that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Application for 

Enrollment in Medicare Part A internet 

Claim (iClaim) Application Screen 

Modernized Claims System and 

Consolidated Claim Experience Screens; 

Use: Individuals who are already 

entitled to retirement or disability 

benefits under Social Security or 

Railroad Retirement Board (RRB) 

benefits are automatically entitled to 

premium-free Medicare Hospital 

Insurance (Part A) when they attain age 

65 or reach the 25th month of disability 

benefit entitlement. These individuals 

do not file a separate application for 

Medicare Part A because their 

application for Social Security or RRB 

benefits is also an application for Part A. 

The form is for individuals who are not 

eligible for Social Security for RRB 

benefits, but may qualify for premiumfree Medicare Part A based on certain 

requirements outlined in § 406.11 and 

406.15 or for certain disabled 

individuals who may enroll in premium 

Medicare Part A based on certain 

requirements outlined in § 406.20. 

Individuals may also choose to enroll in 

9350 Federal Register / Vol. 86, No. 28 / Friday, February 12, 2021 / Notices 

Medicare Part B at the same time they 

apply for Medicare Part A. 

The Application for Enrollment in 

Medicare Part A (CMS–18F5 and CMS– 

18F5–SP) was designed to capture all 

the information needed to make a 

determination of an individual’s 

entitlement to Part A. This Information 

Collection Request (ICR) adds the 

collection instruments SSA uses to 

collect information from individuals 

who are filing an Application for 

Hospital Insurance, updates the burden 

information. CMS will begin reporting 

for additional collection instruments, 

including the internet Claim System 

(iClaim), Modernized Claims System 

(MCS), and the Consolidated Claims 

Experience (CCE). Form Number: CMS– 

18F5 (OMB control number: 0938– 

0251); Frequency: Annually; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

1,394,264; Total Annual Responses: 

1,394,264; Total Annual Hours: 348,566. 

(For policy questions regarding this 

collection contact Carla Patterson at 

410–786–1000.) 

2. Type of Information Collection 

Request: Extension; 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) (Pub. L. 110–343) generally 

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 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. 

The Patient Protection and Affordable 

Care Act, Public Law 111–148, was 

enacted on March 23, 2010, and the 

Health Care and Education 

Reconciliation Act of 2010, Public Law 

111–152, was enacted on March 30, 

2010, collectively known as the 

‘‘Affordable Care Act.’’ The Affordable 

Care Act extended MHPAEA to apply to 

the individual health insurance market. 

Additionally, the Department of Health 

and Human Services (HHS) final 

regulation regarding essential health 

benefits (EHB) requires health insurance 

issuers offering non-grandfathered 

health insurance coverage in the 

individual and small group markets, 

through an Exchange or outside of an 

Exchange, to comply with the 

requirements of the MHPAEA 

regulations in order to satisfy the 

requirement to cover EHB (45 CFR 

147.150 and 156.115). 

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) and the 

Final Rules under the Paul Wellstone 

and Pete Domenici Mental Health Parity 

and Addiction Equity Act of 2008 set 

forth rules for providing criteria for 

medical necessity determinations. CMS 

oversees non-Federal governmental 

plans and health insurance issuers. 

MHPAEA section 512(b) specifically 

amends the PHS Act to require plan 

administrators or health insurance 

issuers to supply, upon request, the 

reason for any denial or reimbursement 

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) and the Final Rules 

under the Paul Wellstone and Pete 

Domenici Mental Health Parity and 

Addiction Equity Act of 2008 

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

sets forth rules for providing reasons for 

claims denial. CMS oversees nonFederal governmental plans and health 

insurance issuers, and the regulation 

provides a safe harbor such that nonFederal governmental plans (and issuers 

offering coverage in connection with 

such plans) are deemed to comply with 

requirements of paragraph (d)(2) of 45 

CFR 146.136 if they provide the reason 

for claims denial in a form and manner 

consistent with ERISA requirements 

found in 29 CFR 2560.503–1. Section 

146.136(d)(3) of the final rule clarifies 

that PHS Act section 2719 governing 

internal claims and appeals and external 

review as implemented by 45 CFR 

147.136, covers MHPAEA claims 

denials and requires that, when a nonquantitative treatment limitation 

(NQTL) is the basis for a claims denial, 

that a non-grandfathered plan or issuer 

must provide the processes, strategies, 

evidentiary standard, and other factors 

used in developing and applying the 

NQTL with respect to med/surg benefits 

and MH/SUD benefits. 

Group health plan participants, 

beneficiaries, covered individuals in the 

individual market, or persons acting on 

their behalf, may use this optional 

model form to request information from 

plans regarding NQTLs that may affect 

patients’ MH/SUD benefits or that may 

have resulted in their coverage being 

denied. Form Number: CMS–10307 

(OMB control number: 0938–1080); 

Frequency: On Occasion; Affected 

Public: State, Local, or Tribal 

Governments, Private Sector, 

Individuals; Number of Respondents: 

250,137; Total Annual Responses: 

987,714; Total Annual Hours: 35,475. 

(For policy questions regarding this 

collection contact Usree 

Bandyopadhyay at 410–786–6650.) 

3. Type of Information Collection 

Request: Extension; Title of Information 

Collection: Data Collection and 

Submission, Registration, Attestation, 

Dispute and Resolution, Record 

Retention, and Assumptions Document 

Submission, for Open Payments; Use: 

Section 6002 of the Affordable Care Act 

added section 1128G to the Social 

Security Act (the Act), which requires 

applicable manufacturers of covered 

drugs, devices, biologicals, or medical 

supplies (as defined at 42 CFR 403.902) 

to report annually to the Secretary 

certain payments or other transfers of 

value to covered recipients. Section 

1128G of the Act also requires 

applicable manufacturers and 

applicable group purchasing 

organizations (GPOs) to report certain 

information regarding the ownership or 

investment interests held by physicians 

or the immediate family members of 

physicians in such entities. 

Specifically, manufacturers of covered 

drugs, devices, biologicals, and medical 

supplies (applicable manufacturers) are 

required to submit on an annual basis 

the information required in section 

1128G(a)(1) of the Act about certain 

payments or other transfers of value 

made to covered recipients during the 

course of the preceding calendar year. 

Similarly, section 1128G(a)(2) of the Act 

requires applicable manufacturers and 

applicable GPOs to disclose any 

ownership or investment interests in 

such entities held by physicians or their 

immediate family members, as well as 

information on any payments or other 

transfers of value provided to such 

physician owners or investors. Form 

Number: CMS–10495 (OMB control 

number: 0938–1237); Frequency: Once; 

Affected Public: Private sector; Business 

or other for-profits; Number of 

Respondents: 34,616; Total Annual 

Responses: 78,812; Total Annual Hours: 

1,897,790. (For policy questions 

regarding this collection contact 

Kathleen Ott 410–786–4246.) 

4. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Federal Register / Vol. 86, No. 28 / Friday, February 12, 2021 / Notices 9351 

Information Collection: Disclosure of 

State Rating Requirements; Use: The 

final rule ‘‘Patient Protection and 

Affordable Care Act; Health Insurance 

Market Rules; Rate Review’’ implements 

sections 2701, 2702, and 2703 of the 

Public Health Service Act (PHS Act), as 

added and amended by the Affordable 

Care Act, and sections 1302(e) and 

1312(c) of the Affordable Care Act. The 

rule directs that states submit to CMS 

certain information about state rating 

and risk pooling requirements for their 

individual, small group, and large group 

markets, as applicable. Specifically, 

states will inform CMS of age rating 

ratios that are narrower than 3:1 for 

adults; tobacco use rating ratios that are 

narrower than 1.5:1; a state-established 

uniform age curve; geographic rating 

areas; whether premiums in the small 

and large group market are required to 

be based on average enrollee amounts 

(also known as composite premiums); 

and, in states that do not permit any 

rating variation based on age or tobacco 

use, uniform family tier structures and 

corresponding multipliers. In addition, 

states that elect to merge their 

individual and small group market risk 

pools into a combined pool will notify 

CMS of such election. This information 

will allow CMS to determine whether 

state-specific rules apply or Federal 

default rules apply. It will also support 

the accuracy of the federal risk 

adjustment methodology. Form Number: 

CMS–10454 (OMB control number: 

0938–1258); Frequency: Occasionally; 

Affected Public: State, Local, or Tribal 

Governments; Number of Respondents: 

3; Total Annual Responses: 3; Total 

Annual Hours: 17. (For policy questions 

regarding this collection contact Russell 

Tipps at 301–869–3502.) 

Dated: February 9, 2021. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2021–02941 Filed 2–11–21; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Expedited OMB Review and Public 

Comment: Planned Use of Child Care 

and Development Fund Coronavirus 

Response and Relief Supplemental 

Appropriations Act, 2021 Funds Report 

AGENCY: Office of Child Care, 

Administration for Children and 

Families, Department of Health and 

Human Services. 

ACTION: Request for public comment. 

SUMMARY: The Office of Child Care 

(OCC), Administration for Children and 

Families (ACF), U.S. Department of 

Health and Human Services (HHS), is 

requesting expedited review of an 

information collection request from the 

Office of Management and Budget 

(OMB). This information collection 

requires states, territories, and tribes to 

submit a one-time report summarizing 

their plans for using supplemental Child 

Care and Development Fund (CCDF) 

appropriations provided by the 

Coronavirus Response and Relief 

Supplemental Appropriations Act 

(CRRSA). Emergency approval is 

requested in order to meet the new 

statutory deadline required by CRRSA. 

ADDRESSES: Copies of the collection of 

information can be obtained from, and 

written comments and 

recommendations related to this 

information collection may be 

submitted to, infocollection@

acf.hhs.gov. All correspondence should 

identify the title of the information 

collection. 

SUPPLEMENTARY INFORMATION: 

Description: ACF is requesting that 

OMB grant a 60-day approval for this 

request under procedures for expedited 

processing. The information collection 

is to meet the requirement in CRRSA for 

states, territories, and tribes to report to 

the Secretary of the Department of 

Health and Human Services how they 

plan to spend supplemental CCDF 

appropriations to prevent, prepare for, 

and respond to the Coronavirus. States, 

territories, and tribes receiving these 

funds will submit a letter to the Director 

of OCC describing how they plan to 

spend funds based on the 

recommendations included in CRRSA. 

This is a one-time report. 

Respondents: All state, territory, and 

tribal CCDF lead agencies. 

ANNUAL BURDEN ESTIMATES

Instrument 

Total 

number of 

respondents 

Total 

number of 

responses per 

respondent 

Average 

burden hours 

per response 

Annual 

burden hours 

Planned Use of CCDF CRRSA Funds Report ................................................ 321 1 2 642 

Estimated Total Annual Burden 

Hours: 642. 

Comments: The Department 

specifically requests comments on (a) 

whether the proposed collection of 

information is necessary for the proper 

performance of the functions of the 

agency, including whether the 

information shall have practical utility; 

(b) the accuracy of the agency’s estimate 

of the burden of the proposed collection 

of information; (c) the quality, utility, 

and clarity of the information to be 

collected; and (d) ways to minimize the 

burden of the collection of information 

on respondents, including through the 

use of automated collection techniques 

or other forms of information 

technology. Consideration will be given 

to comments and suggestions submitted 

within 60 days of this publication. 

Authority: Division M, Title III, Pub. L. 

116–260. 

Mary B. Jones, 

ACF/OPRE Certifying Officer. 

[FR Doc. 2021–02871 Filed 2–9–21; 11:15 am] 

BILLING CODE 4184–43–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Center for Indigenous Innovation and 

Health Equity Supporting Native 

Hawaiian and Pacific Islander and 

American Indian/Alaska Native 

Populations 

AGENCY: Office of Minority Health, U.S. 

Department of Health and Human 

Services (HHS). 

ACTION: Request for information. 

SUMMARY: The U.S. Department of 

Health and Human Services (HHS) 

Office of Minority Health (OMH) seeks 

input from Native Hawaiian and Pacific 

Islander (NHPI) communities and NHPI