8974 Federal Register / Vol. 79, No. 31 / Friday, February 14, 2014 / Notices 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: 1932(a) State 

Plan Amendment Template, State Plan 

Requirements and Supporting 

Regulations; Use: Section 1932(a)(1)(A) 

of the Social Security Act (the Act) 

grants states the authority to enroll 

Medicaid beneficiaries on a mandatory 

basis into managed care entities and 

primary care case managers. Under this 

authority, a state can amend its 

Medicaid state plan to require certain 

categories of Medicaid beneficiaries to 

enroll in managed care entities without 

being out of compliance with provisions 

of section 1902 of the Act on statewideness (42 CFR 431.50), freedom of 

choice (42 CFR 431.51) or comparability 

(42 CFR 440.230). The template may be 

used by states to easily modify their 

state plans if they choose to implement 

the provisions of section 1932(a)(1)(A); 

Form Number: CMS–10120 (OCN: 

0938–0933); Frequency: Once and 

occasionally; Affected Public: State, 

Local, or Tribal Governments; Number 

of Respondents: 56; Total Annual 

Responses: 15; Total Annual Hours: 65. 

(For policy questions regarding this 

collection contact Camille Dobson at 

410–786–7062). 

3. Title of Information Collection: 

Direct Service Workforce (DSW) 

Resource Center (RC) Core 

Competencies (CC) Survey Instrument. 

Form Number: CMS–10512 (OCN: 

0938—New). 

The 30-day PRA notice published in 

the Federal Register on February 7, 

2014, as a correction. While the 

requirements, burden estimates, and 

public comment information that were 

set out in that notice and in the 

associated supporting materials were 

correct, the notice inadvertently 

published as a correction. 

Correction 

In the Federal Register of February 7, 

2014, in FR Doc. 2014–02630, on page 

7462, in the first column, correct the 

document as follows: 

a. Correct the subject heading to read: 

Agency Information Collection 

Activities: Submission for OMB Review; 

Comment Request 

b. Correct the ‘‘Action’’ caption to 

read: ACTION: Notice. 

Dated: February 11, 2014. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2014–03290 Filed 2–13–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–5504–N4] 

Medicare Program; Bundled Payments 

for Care Improvement Models 2, 3, and 

4 2014 Winter Open Period 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice announces an 

open period for additional organizations 

to be considered for participation in 

Models 2, 3, and 4 of the Bundled 

Payments for Care Improvement 

initiative. 

DATES: Submission Deadline: Models 2, 

3, and 4 Open Period intake forms must 

be submitted by April 18, 2014. 

ADDRESSES: Interested organizations 

must submit their Models 2, 3, and 4 

Open Period intake forms via email at 

BundledPayments@cms.hhs.gov. All 

forms must be in a searchable word or 

PDF format. 

FOR FURTHER INFORMATION CONTACT: For 

questions regarding Models 2, 3, and 4 

of the Bundled Payments for Care 

Improvement initiative send an email to 

BundledPayments@cms.hhs.gov. For 

additional information on this initiative 

go to the CMS Center for Medicare and 

Medicaid Innovation (Innovation 

Center) Web site at http://

innovation.cms.gov/initiatives/BundledPayments/Models2-4OpenPeriod.html. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Section 1115A of the Social Security 

Act (the Act), as added by section 3021 

of the Affordable Care Act, authorized 

the Center for Medicare and Medicaid 

Innovation to test innovative payment 

and service delivery models that reduce 

spending under Medicare, Medicaid, or 

CHIP, while preserving or enhancing the 

quality of care. Consistent with that 

authority, we seek to achieve the 

following goals: 

• Improve care coordination, 

beneficiary experience, and 

accountability in a person-centered 

manner. 

• Support and encourage providers 

that are interested in continuously 

reengineering care to deliver better care 

and better health at lower costs through 

continuous improvement. 

• Create a cycle that leads to 

continually decreasing the cost of an 

acute or chronic episode of care while 

fostering quality improvement. 

• Develop and test payment models 

that create extended accountability for 

better care, better health at lower costs 

for the full range of health care services. 

• Shorten the cycle time for adoption 

of evidence-based care. 

• Create environments that stimulate 

rapid development of new evidencebased knowledge. 

We are committed to achieving better 

health, better care, and lower costs 

through continuous improvement for 

Medicare, Medicaid and Children’s 

Health Insurance Program (CHIP) 

beneficiaries. Beneficiaries can 

experience improved health outcomes 

and encounters in the health care 

system when providers work in a 

coordinated and person-centered 

manner. To this end, we are interested 

in partnering with providers that are 

working to redesign care to meet these 

goals. Payment approaches that reward 

providers that assume payment 

accountability for a particular ‘‘episode’’ 

of care are potential mechanisms for 

developing these partnerships. 

The Innovation Center is testing four 

episode payment models through the 

Bundled Payments for Care 

Improvement initiative. The current 

participants in the initiative were 

selected following a review of the 

applications submitted in response to a 

Request for Application, http://

innovation.cms.gov/Files/x/BundledPayment-Request-for-Application.pdf 

released by the Innovation Center in 

August 2011. On January 31, 2013, the 

first set of BPCI Phase 1 participants 

were announced. Phase 2 began either 

on October 1, 2013 or January 1, 2014 

for Awardees that have entered into 

Model 2 Awardee Agreements with 

CMS, at which point Awardees began 

the risk-bearing phase for some or all of 

their episodes. The complete transition 

of all episodes for all episode initiators 

to Phase 2 will be completed by October 

2014. During the transition period, 

Awardees may transition episodes and/ 

or Episode Initiators that have remained 

in Phase 1 to Phase 2 on a quarterly 

basis. 

We began testing Model 1 of the 

initiative in April 2013. Model 1 is a 

retrospective payment model for the 

acute inpatient hospital stay. In the May 

17, 2013 Federal Register (78 FR 

29139), we published a notice 

announcing an open period for 

additional organizations to be 

considered for participation in Model 1 

of the initiative. 

Phase 2 of Models 2 through 4 began 

testing in October 2013. Models 2, 3, 

and 4 are described as follows: 

• Model 2—Retrospective bundled 

payment models for hospitals, 

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Federal Register / Vol. 79, No. 31 / Friday, February 14, 2014 / Notices 8975 

physicians, and post-acute providers for 

an episode of care consisting of an 

inpatient hospital stay followed by postacute care. 

• Model 3—Retrospective bundled 

payment models for post-acute care 

where the episode does not include the 

acute inpatient hospital stay. 

• Model 4—Prospectively 

administered bundled payment models 

for the acute inpatient hospital stay and 

related readmissions. 

II. Provisions of the Notice 

To help us achieve the 

implementation goals noted previously, 

the Innovation Center is announcing a 

2014 winter open period for additional 

organizations to be considered for 

participation in Models 2, 3, and 4 of 

the initiative. We believe that increasing 

the number of Awardees and the types 

of episodes being tested would result in 

an even more robust data set and 

improve our evaluation of the models. 

Interested organizations must submit 

Model 2, 3 or 4 Open Period forms as 

specified in the DATES and ADDRESSES

sections of this notice. Organizations 

may participate in more than one 

model. Organizations who are interested 

in participating in more than one model 

should submit a request to participate in 

each model using separate Open Period 

forms. Interested organizations can find 

information about the intake process, 

eligible organizations and providers, 

and model requirements on the 

Innovation Center Web site as specified 

in the FOR FURTHER INFORMATION

CONTACT section of this notice. 

We will review the submitted intake 

forms and evaluate organizations for 

participation in Models 2, 3, and 4. We 

expect to offer Model 2, 3, or 4 

participation agreements to those 

organizations that demonstrate their 

fitness for participation in the 

applicable Model. For information on 

the screening process go to the CMS 

Center for Medicare and Medicaid 

Innovation Web site as specified at: 

http://innovation.cms.gov/initiatives/

Bundled-Payments/Models2- 

4OpenPeriod.html 

III. Collection of Information 

Requirements 

Section 1115A(d) of the Act waives 

the requirements of the Paperwork 

Reduction Act of 1995 for purposes of 

testing and evaluation of new models or 

expansion of such models under section 

1115A of the Act. 

Authority: Section 1115A of the Social 

Security Act (42 U.S.C. 1315a) 

(Catalog of Federal Domestic Assistance No. 

93.773 Medicare—Hospital Insurance 

Program; and No. 93.774, Medicare— 

Hospital Insurance Program; and No. 93.774, 

Medicare Supplementary Medical Insurance 

Program) 

Dated: February 10, 2014. 

Marilyn Tavenner, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 2014–03311 Filed 2–13–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

[CFDA Numbers: 93.581, 93.587, 93.612] 

Notice of Final Issuance on the 

Adoption of Administration for Native 

Americans (ANA) Program Policies 

and Procedures 

AGENCY: Administration for Native 

Americans (ANA), ACF, HHS. 

ACTION: Issuance of Final Policy Relating 

to Funding Opportunity 

Announcements. 

SUMMARY: The Administration for 

Native Americans (ANA) is issuing final 

interpretive rules, general statements of 

policy, and rules of agency organization, 

procedure, or practice relating to the 

following Funding Opportunity 

Announcements (FOAs): Social and 

Economic Development Strategies 

(hereinafter referred to as SEDS), 

Sustainable Employment and Economic 

Development Strategies (hereinafter 

referred to as SEEDS), Native Language 

Preservation and Maintenance 

(hereinafter referred to as Language 

Preservation), Native Language 

Preservation and Maintenance—Esther 

Martinez Immersion (hereinafter 

referred to as Language—EMI), and 

Environmental Regulatory Enhancement 

(hereinafter referred to as ERE). 

DATES: The policies proposed in the 

Federal Register Notice for Public 

Comment (78 FR 76834, Dec. 19, 2013) 

are final and effective immediately upon 

this publication. 

FOR FURTHER INFORMATION CONTACT: 

Carmelia Strickland, Director, Division 

of Program Operations, ANA (877) 922– 

9262. 

SUPPLEMENTARY INFORMATION: Section 

814 of the Native American Programs 

Act of 1974 (NAPA), as amended, 

requires ANA to provide notice of its 

proposed interpretive rules, general 

statements of policy, and rules of agency 

organization, procedure, or practice. 

The proposed clarifications, 

modifications, and new text will appear 

in the five Fiscal Year (FY) 2014 FOAs: 

SEDS, SEEDS, Language Preservation, 

Language—EMI, and ERE. ANA 

published a Notice of Public Comment 

(NOPC) in the Federal Register (78 FR 

76834, Dec. 19, 2013), with proposed 

policy and program clarifications, 

modifications, and activities governing 

standing FOAs beginning with FY 2014 

FOAs. The public comment period was 

open for 30 days. 

This notice transmits ANA’s final 

policy governing standing FOAs to be 

published in FY 2014. ANA received 20 

comments from entities affected by the 

FOAs including 1 Native Hawaiian 

organization and 4 federally recognized 

Indian tribes. Each comment was fully 

considered. This final notice 

summarizes all comments received and 

ANA’s responses to them. 

A. Comments and Responses 

1. Comment: ANA received two 

comments in reference to ANA’s change 

to the frequency with which program 

progress reports must be submitted. 

Beginning with awards issued under the 

FY 2014 FOAs, program progress 

reports must be submitted semiannually instead of quarterly. One 

commenter disagreed with the proposed 

change and recommended a program 

progress report frequency of no less than 

three times a year in order to ensure that 

grantees had time to analyze the 

progress of project goals and 

demonstrate financial accountability. 

Another commenter expressed support 

for the change to semi-annual reporting, 

expressing the belief that such reporting 

frequency could be just as effective as 

quarterly reporting provided there was 

effective communication between ANA 

and grantees. 

Response: ANA considered 

establishing a requirement for more 

frequent program progress reports but 

determined that semi-annual reporting 

is sufficient to provide grantees with 

opportunities to demonstrate the results 

of their on-going monitoring of project 

progress and provide ANA adequate 

information to maintain project 

accountability. ANA plans to increase 

the interaction it has with grantees 

through means other than reporting, 

including monthly one-on-one 

telephone calls and weekly webinars. 

2. Comment: ANA received two 

comments related to proposed language 

requiring community involvement in 

both the development of proposed 

projects and in their implementation. 

One commenter praised ANA for 

clarifying that community involvement 

in the development of the project is 

required, as well as in the 

implementation of the project, and 

expressed the recommendation that the 

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