31336 Federal Register / Vol. 79, No. 105 / Monday, June 2, 2014 / Notices 

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: 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: Hospice 

Conditions of Participation and 

Supporting Regulations; Use: The 

Conditions of Participation and 

accompanying requirements are used by 

federal or state surveyors as a basis for 

determining whether a hospice qualifies 

for approval or re-approval under 

Medicare. The healthcare industry and 

CMS believe that the availability to the 

hospice of the type of records and 

general content of records, which the 

final rule (72 FR 32088) specifies, is 

standard medical practice, and is 

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

professional treatment accountability. 

Subsequent to the publication of the 60- 

day Federal Register notice (November 

29, 2013; 78 FR 71617), the burden 

hours previously accounted for in OMB 

control number 0938–0302 have been 

updated and moved under this package 

to consolidate all hospice-related 

burden into a single package. Form 

Number: CMS–10277 (OCN: 0938– 

1067); Frequency: Yearly; Affected 

Public: Private sector (business or other 

for-profit and not-for-profit institutions); 

Number of Respondents: 3,897; Total 

Annual Responses: 19,654,387; Total 

Annual Hours: 3,300,735. (For policy 

questions regarding this collection 

contact Danielle Shearer at 410–786– 

6617.) 

2. Type of Information Collection 

Request: New collection (Request for a 

new OMB control number); Title of 

Information Collection: Application for 

Participation in the Intravenous 

Immune Globulin (IVIG) Demonstration; 

Use: Traditional fee-for-service (FFS) 

Medicare covers some or all 

components of home infusion services 

depending on the circumstances. By 

special statutory provision, Medicare 

Part B covers intravenous immune 

globulin (IVIG) for persons with primary 

immune deficiency disease (PIDD) who 

wish to receive the drug at home. 

However, Medicare does not separately 

pay for any services or supplies to 

administer it if the person is not 

homebound and otherwise receiving 

services under a Medicare Home Health 

episode of care. As a result, many 

beneficiaries have chosen to receive the 

drug at their doctor’s office or in an 

outpatient hospital setting. On Tuesday, 

January 3, 2012, the President signed 

into law the ‘‘Medicare IVIG Access and 

Strengthening Medicare and Repaying 

Taxpayers Act of 2012.’’ The act 

authorizes a 3-year demonstration under 

Part B of Title XVIII of the Social 

Security Act to evaluate the benefits of 

providing payment for items and 

services needed for the in-home 

administration of IVIG for the treatment 

of PIDD. 

The statute limited the demonstration 

to 4,000 beneficiaries and $45 million, 

including administrative expenses for 

implementation and evaluation as well 

as benefit costs. The statute also 

required that an evaluation of the 

demonstration be conducted. Under this 

demonstration, Medicare will issue, 

under Part B, a bundled payment for all 

medically necessary supplies and 

services to administer IVIG in the home 

to enrolled beneficiaries who are not 

otherwise homebound and receiving 

home health care benefits. To 

implement the demonstration and 

ensure that statutory limits are not 

exceeded, it is necessary to positively 

enroll beneficiaries in the 

demonstration. 

This collection of information is for 

the application to participate in the 

demonstration. Participation is 

voluntary and may be terminated by the 

beneficiary at any time. Beneficiaries 

who do not participate will continue to 

be eligible to receive all of the regular 

Medicare Part B benefits that they are 

would be eligible for in the absence of 

the demonstration. Subsequent to the 

publication of the 60-day Federal 

Register notice (March 7, 2014; 79 FR 

13058), the application has been revised 

by changing the order of the questions, 

rewording questions, and allowing more 

response options. Form Number: CMS– 

10518 (OCN: 0938—New); Frequency: 

Annually; Affected Public: Individuals 

and households; Number of 

Respondents: 4,000; Total Annual 

Responses: 4,000; Total Annual Hours: 

1,000. (For policy questions regarding 

this collection contact Jody Blatt at 410– 

786–6921.) 

Dated: May 28, 2014. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2014–12665 Filed 5–30–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10340 and 

CMS–10380] 

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 

August 1, 2014: 


sroberts on DSK5SPTVN1PROD with NOTICES
Federal Register / Vol. 79, No. 105 / Monday, June 2, 2014 / Notices 31337 

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 _________, 

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–10340 Collection of Encounter 

Data From Medicare Advantage 

Organizations, Section 1876 Cost 

HMOS/CMPS, Section 1833 Health Care 

Prepayment Plans (HCPPS), and Pace 

Organizations 

CMS–10380 Reporting Requirements 

for Grants to States for Rate Review 

Cycle I, Cycle II, Cycle III, and Cycle IV 

and Effective Rate Review Program 

Under the Paperwork Reduction Act 

(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: Collection of 

Encounter Data from Medicare 

Advantage Organizations, Section 1876 

Cost HMOS/CMPS, Section 1833 Health 

Care Prepayment Plans (HCPPS), and 

Pace Organizations; Use: CMS collects 

encounter data or data on each item or 

service delivered to enrollees of 

Medicare Advantage (MA) plans offered 

by MA organizations. MA organizations 

currently obtain this data from 

providers. CMS collects this information 

using standard transaction forms and 

code sets. CMS will use the data for 

determining risk adjustment factors for 

payment, updating the risk adjustment 

model, calculating Medicare DSH 

percentages, Medicare coverage 

purposes, and quality review and 

improvement activities. The data is also 

used to verify the accuracy and validity 

of the costs claimed on cost reports. For 

PACE organizations, encounter data 

would serve the same purpose it does 

related to the MA program and would 

be submitted in a similar manner. Form 

Number: CMS–10340 (OCN: 0938– 

1152); Frequency: Weekly; Affected 

Public: Private sector (business or other 

for-profits); Number of Respondents: 

683; Total Annual Responses: 

516,493,635; Total Annual Hours: 

34,433 (For policy questions regarding 

this collection contact Michael 

Massimini at 410–786–1566). 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Reporting 

Requirements for Grants to States for 

Rate Review Cycle I, Cycle II, Cycle III, 

and Cycle IV and Effective Rate Review 

Program; Use: Under the section 1003 of 

the Affordable Care Act (ACA) (section 

2794 of the Public Health Service Act), 

the Secretary, in conjunction with the 

states and territories, is required to 

establish a process for the annual 

review, beginning with the 2010 plan 

year, of unreasonable increases in 

premiums for health insurance 

coverage. Section 2794(c) requires the 

Secretary to establish the Rate Review 

Grant Program to assist states to 

implement this provision. In addition, 

section 2794(c) requires the Rate Review 

Grant Program to assist states in the 

establishment and enhancement of 

‘‘Data Centers’’ that collect, analyze, and 

disseminate health care pricing data to 

the public. 

Concurrent with this information 

collection request, HHS released Cycle 

IV of the Rate Review Grants, ‘‘Grants to 

States to Support Health Insurance Rate 

Review and Increase Transparency in 

the Pricing of Medical Services.’’ The 

purpose of Cycle IV of the Rate Review 

Grant Program is to continue the rate 

review successes of Cycles I, II, and III, 

as well as to provide greater support to 

Data Centers, thereby enhancing 

medical pricing transparency. States 

and territories that apply for funds are 

required to complete the grant 

application. States and territories that 

are awarded funds under this funding 

opportunity are required to provide the 

Secretary with rate review data, four 

quarterly reports, and one annual report 

per year until the end of the grant 

period detailing the state’s progression 

towards a more comprehensive and 

effective rate review process. A final 

report is due at the end of the grant 

period. This information collection is 

required for effective monitoring of 

grantees and to fulfill statutory 

requirements under section 

2794(b)(1)(A) of the ACA that requires 

grantees, as a condition of receiving a 

grant authorized under section 2794(c), 

to report to the Secretary information 

about premium increases. 

On May 23, 2011, CMS published a 

final rule with comment period (76 FR 

29964) to implement the annual review 

of unreasonable increases in premiums 

for health insurance coverage called for 

by section 2794. Under the regulation, if 

CMS determines that a state has an 

Effective Rate Review Program in a 

given market, using the criteria set forth 

in the rule, CMS will adopt that state’s 

determinations regarding whether rate 

increases in that market are 

unreasonable, provided that the state 

reports its final determinations to CMS 

and explains the bases of its 

determinations. The final rule titled 

‘‘Patient Protection and Affordable Care 

Act; Health Insurance Market Rules; 

Rate Review’’ (78 FR 13406, February 

27, 2013) amends the standards under 


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31338 Federal Register / Vol. 79, No. 105 / Monday, June 2, 2014 / Notices 

1Public Law 11–352; 31 U.S.C. 1115(b)(10). 

2U.S. Department of Health and Human Services, 

Administration for Children and Families, Office of 

Community Services. (2007, June). Implementing a 

new performance measure to enhance efficiency 

(Information Memorandum Transmittal No. 04– 

2007). Available from http://archive.acf.hhs.gov/

programs/ocs/ssbg/procedures/ssbg_im_04_

2007.html. 

the Effective Rate Review Program. 

Currently, CMS relies on publicly 

available information and annual calls 

with individual states to obtain the 

information needed to evaluate whether 

a state has begun to or continues to 

satisfy the Effective Rate Review 

Program criteria. CMS is proposing to 

instead collect the information in 

writing from all states that would like to 

request effective status. Form Number: 

CMS–10380 (OCN: 0938–1121); 

Frequency: Annually and On occasion; 

Affected Public: Public Sector and State 

and Territory Governments; Number of 

Respondents: 50; Total Annual 

Responses: 553; Total Annual Hours: 

20,951. (For policy questions regarding 

this collection contact Susie Lorden at 

301–492–4162.) 

Dated: May 28, 2014. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2014–12664 Filed 5–30–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Submission for OMB Review; 

Comment Request 

Title: Social Services Block Grant 

(SSBG) Post-expenditure Report. 

OMB No.: 0970–0234. 

Description: 

Purpose: To request approval to: (1) 

Extend the collection of postexpenditure data using the current OMB 

approved post-expenditure reporting 

form (OMB No. 0970–0234) past the 

current expiration date of July 31, 2014; 

and (2) to request that States continue 

to voluntarily submit estimated preexpenditure and recipient data using the 

post-expenditure reporting form, as part 

of the required annual intended use 

plan. 

The Social Services Block Grant 

program (SSBG) is authorized under 

Title XX of the Social Security Act, as 

amended, and is codified at 42 U.S.C. 

1397 through § 13097e. SSBG provides 

funds to assist States in delivering 

critical services to vulnerable older 

adults, persons with disabilities, at-risk 

adolescents and young adults, and 

children and families. SSBG funds are 

allocated to each State in proportion to 

their relative population. 

Each State is responsible for designing 

and implementing its own SSBG 

program to meet the specialized needs 

of their most vulnerable populations. 

States may determine what services will 

be provided, who will be eligible, and 

how funds will be distributed among 

the various services. State or local SSBG 

agencies (i.e., county, city, regional 

offices) may provide the services or 

States may purchase services from 

qualified agencies, organizations, or 

individuals. States must administer 

their SSBG program according to their 

approved intended use plan, along with 

amendments, and in conformance with 

their own implementing rules and 

policies. The Office of Community 

Services (OCS), Administration for 

Children and Families administers the 

SSBG program. 

Annually, States are required to 

submit a pre-expenditure report or 

intended use plan as a prerequisite to 

receiving SSBG funds. The preexpenditure report must include 

information on the types of services to 

be supported and the characteristics of 

individuals to be served. This report is 

to be submitted 30 days prior to the start 

of the fiscal year (June 1 if the State 

operates on a July–June fiscal year, or 

September 1 if the State operates on a 

Federal fiscal year). No specific format 

is required for the intended use plan. 

States are required to submit a revised 

intended use plan if the planned use of 

SSBG funds changes during the year (42 

U.S.C. 1397c). 

In order to provide a more accurate 

analysis of the extent to which funds are 

spent ‘‘in a manner consistent’’ with 

each of the States plan for their use, as 

required by 42 U.S.C. 1397e(a), ACF 

continues to request that States 

voluntarily use the format of the postexpenditure reporting form to provide 

estimates of the amount of expenditures 

and the number of recipients, by service 

category, as part of the State’s intended 

use plan. Most of the States are 

currently using the format of the postexpenditure reporting form to report 

estimated expenditures and recipients, 

by service category, as part of their 

intended use plan. 

On annual basis, States also are 

required to submit a post-expenditure 

report that details their use of SSBG 

funds in each of 29 service categories. 

States are required to submit their postexpenditure report within six months of 

the end of the period covered by the 

report. The post-expenditure report 

must address: (1) The number of 

individuals (including number of 

children and number of adults) who 

receive services paid for, in whole or in 

part, with Federal funds under the 

SSBG; (2) The amount of SSBG funds 

spent in providing each service; (3) The 

total amount of Federal, State, and local 

funds spent in providing each service, 

including SSBG funds; and (4) The 

method(s) by which each service is 

provided, showing separately the 

services provided by public and private 

agencies (42 U.S.C. 1397e; 42 CFR 

96.74). 

This request seeks approval to 

continue the use of the current OMB 

approved post-expenditure reporting 

form (OMB No. 0970–0234) for 

estimating expenditures and recipients 

as part of States’ intended use plans and 

for annual post-expenditure reporting. 

Until recently, States reported the data 

on the post-expenditure reporting form 

in Microsoft ExcelTM and submitted it to 

ACF, via email. Beginning in 2013, 

States can complete the current 

reporting form on the SSBG Portal. The 

SSBG Portal is a secure web-based data 

portal. The SSBG Portal allows for more 

efficient data submission without 

increasing the overall burden on States. 

It provides a user-friendly means for 

States to submit and access their preexpenditure and post-expenditure and 

recipient data. 

Information collected in the postexpenditure reports submitted by States 

is analyzed and described in an annual 

report on SSBG expenditures and 

recipients produced by the Office of 

Community Services (OCS), 

Administration for Children and 

Families (ACF). The information 

contained in this report is used for 

program planning and management. The 

data establish how SSBG funding is 

used for the provision of services in 

each State to each of the many specific 

populations of vulnerable children and 

adults. 

The data is also analyzed to determine 

the performance of States’ in meeting 

the SSBG program performance 

measures developed to meet the 

requirements of the Government 

Performance and Results Act of 1993 

(GPRA), as amended by the GPRA 

Modernization Act of 2010.1 GPRA 

requires all Federal agencies to develop 

measurable performance goals. 

The SSBG program currently has an 

administrative costs efficiency measure 

which is intended to decrease the 

percentage of SSBG funds identified as 

administrative costs in the postexpenditure reports.2 The SSBG 

program is also implementing a new 


sroberts on DSK5SPTVN1PROD with NOTICES