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[Federal Register Volume 78, Number 125 (Friday, June 28, 2013)]
[Notices]
[Pages 38983-38985]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-15539]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-10105, CMS-10467, CMS-10469, CMS-10325 and 
CMS-10330]

Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

ACTION: Notice.

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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 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 on the collection(s) of information must be received by 
the OMB desk officer by July 29, 2013.

ADDRESSES: When commenting on the proposed information collections, 
please reference the document identifier or OMB control number. To be 
assured consideration, comments and recommendations must be received by 
the OMB desk officer via one of the following transmissions: OMB, 
Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-6974 OR Email: OIRA_submission@omb.eop.gov.
    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: 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: Reinstatement with 
change of a previously approved collection; Title of

[[Page 38984]]

Information Collection: National Implementation of In-Center 
Hemodialysis CAHPS Survey; Use: Data collected in the national 
implementation of the In-center Hemodialysis Consumer Assessment of 
Healthcare Providers and Systems (CAHPS) Survey will be used to: (1) 
Provide a source of information from which selected measures can be 
publicly reported to beneficiaries as a decision aid for dialysis 
facility selection; (2) aid facilities with their internal quality 
improvement efforts and external benchmarking with other facilities; 
(3) provide CMS with information for monitoring and public reporting 
purposes; and (4) support the end-stage renal disease value-based 
purchasing program. In the April 19, 2013 (78 FR 23566) Federal 
Register, this information collection request was inadvertently 
published as a new collection under CMS-10478 (OCN: 0938-New). We will 
not continue seeking approval for the information collection request 
under CMS-10478. The CMS-10105 was discontinued in 2007, but we are now 
seeking to have it reinstated.
    Form Number: CMS-10105 (OCN: 0938-0926).
    Frequency: Occasionally;
    Affected Public: Individuals or households;
    Number of Respondents: 165,000;
    Total Annual Responses: 165,000;
    Total Annual Hours: 87,750. (For policy questions regarding this 
collection contact Elizabeth Goldstein at 410-786-6665.)
    2. Type of Information Collection Request: New collection (Request 
for a new OMB control number);
    Title of Information Collection: Evaluation of the Graduate Nurse 
Education Demonstration Program;
    Use: The Graduate Nurse Education (GNE) Demonstration is mandated 
under Section 5509 of the Affordable Care Act (ACA) under title XVIII 
of the Social Security Act (42 U.S.C. 1395 et seq.). According to 
Section 5509 of the ACA, the five selected demonstration sites receive 
``payment for the hospital's reasonable costs for the provision of 
qualified clinical training to advance practice registered nurses''. 
Section 5509 of the ACA also states that an evaluation of the graduate 
nurse education demonstration must be completed no later than October 
17, 2017. This evaluation includes analysis of the following: (1) 
Growth in the number of advanced practice registered nurses (APRNs) 
with respect to a specific base year as a result of the demonstration; 
(2) growth for each of the following specialties: clinical nurse 
specialist, nurse practitioner, certified nurse anesthetist, certified 
nurse-midwife; and (3) costs to the Medicare program as result of the 
demonstration.
    Quantitative and qualitative data from primary and secondary 
sources will be gathered and analyzed for this evaluation. The primary 
data will be collected through site visits, key stakeholder interviews, 
small discussion groups and focus groups, telephone interviews, 
electronic templates for quantitative data submission, and quarterly 
demonstration-site reports. The secondary data will come from mandatory 
hospital cost reports provided to both us and several other existing 
secondary data sources, such as the American Association of Colleges of 
Nursing (AACN).
    Form Number: CMS-10467 (OCN: 0938-NEW);
    Frequency: Annually;
    Affected Public: State, Local, or Tribal Governments, Business and 
other for-profit and Not-for-profit institutions;
    Number of Respondents: 330;
    Total Annual Responses: 330;
    Total Annual Hours: 3,370. (For policy questions regarding this 
collection contact Pauline Karikari-Martin at 410-786-1040.)
    3. Type of Information Collection Request: New collection (Request 
for a new OMB control number);
    Title of Information Collection: Issuer Reporting Requirements for 
Selecting a Cost-Sharing 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 moderate-income 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.
    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 we 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 us with the amount of cost-sharing paid by each 
enrollee, as well as the level of cost-sharing that enrollee would have 
paid under a standard plan without cost-sharing 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 for 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

[[Page 38985]]

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 receive a notification by email with instructions on how 
to inform HHS of their selection. 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.
    A Federal Register notice was published on April 12, 2013 (78 FR 
21956), providing the public with a 60-day period to submit written 
comments on the information collection requirements, no comments were 
received.
    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.)
    4. Type of Information Collection Request: Reinstatement with 
change of a previously approved collection of information;
    Title of Information Collection: Disclosure and Recordkeeping 
Requirements for Grandfathered Health Plans under the Affordable Care 
Act;
    Use: Section 1251 of the Patient Protection and Affordable Care 
Act, Public Law 111-148, (the Affordable Care Act) provides that 
certain plans and health insurance coverage in existence as of March 
23, 2010, known as grandfathered health plans, are not required to 
comply with certain statutory provisions in the Act. To maintain its 
status as a grandfathered health plan, the interim final regulations 
titled ``Interim Final Rules for Group Health Plans and Health 
Insurance Coverage Relating to Status as a Grandfathered Health Plan 
Under the Patient Protection and Affordable Care Act'' (75 FR 34538, 
June 17, 2010) require the plan to maintain records documenting the 
terms of the plan in effect on March 23, 2010, and any other documents 
that are necessary to verify, explain or clarify status as a 
grandfathered health plan. The plan must make such records available 
for examination upon request by participants, beneficiaries, individual 
policy subscribers, or a State or Federal agency official. The 
recordkeeping requirement will allow a participant, beneficiary, or 
federal or state official to inspect plan documents to verify that a 
plan or health insurance coverage is a grandfathered health plan. A 
grandfathered health plan must include a statement in any plan 
materials provided to participants or beneficiaries (in the individual 
market, primary subscriber) describing the benefits provided under the 
plan or health insurance coverage, and that the plan or coverage is 
intended to be grandfathered health plan. The disclosure requirement 
will provide participants and beneficiaries with important information 
about their grandfathered health plans, such as that grandfathered 
plans are not required to comply with certain consumer protection 
provisions contained in the Act. It also will provide important contact 
information for participants to find out which protections apply and 
which protections do not apply to a grandfathered health plan and what 
might cause a plan to change from grandfathered to non-grandfathered 
health plan status. An amendment to the interim final regulations (75 
FR 70114, November 17, 2010) requires a grandfathered group health plan 
that is changing health insurance issuers to provide the succeeding 
health insurance issuer (and the succeeding health insurance issuer 
must require) documentation of plan terms (including benefits, cost 
sharing, employer contributions, and annual limits) under the prior 
health insurance coverage sufficient to make a determination whether 
the standards set forth in paragraph (g)(1) of the interim final 
regulations are exceeded.
    Form Number: CMS-10325 (OCN: 0938-1093);
    Frequency: Annually;
    Affected Public: State, Local, or Tribal governments and health 
insurance coverage issuers;
    Number of Respondents: 64,552;
    Number of Responses: 10,113,926;
    Total Annual Hours: 85. (For policy questions regarding this 
collection, contact Usree Bandyopadhyay at (410) 786-6650.)
    5. Type of Information Collection Request: Reinstatement with 
change of a previously approved information collection;
    Title of Information Collection: Enrollment Opportunity Notice 
Relating to Lifetime Limits; Required Notice of Rescission of Coverage; 
and Disclosure Requirements for Patient Protection under the Affordable 
Care Act;
    Use: Under section 2711 of the Public Health Services Act (PHS Act) 
amended by the Affordable Care Act, the enrollment opportunity notice 
was to be used by health plans to notify certain individuals of their 
right to re-enroll in their plan. The affected individuals were those 
whose coverage ended due to reaching a lifetime limit on the dollar 
value of all benefits for any individual. This notice was a one-time 
requirement and is being discontinued. Under section 2712 of the PHS 
Act as amended by the Affordable Care Act, the rescission notice will 
be used by health plans to provide advance notice to certain 
individuals that their coverage may be rescinded. The affected 
individuals are those who are at risk of rescission on their health 
insurance coverage. Under section 2719A of the PHS Act as amended by 
the Affordable Care Act, the patient protection notification will be 
used by health plans to inform certain individuals of their right to 
choose a primary care provider or pediatrician and to use obstetrical/
gynecological services without prior authorization.
    Form Number: CMS-10330 (OCN: 0938-1094);
    Frequency: Occasionally;
    Affected Public: State, Local, or Tribal Governments, Private 
Sector;
    Number of Respondents: 8,382;
    Number of Responses: 1,583,371;
    Total Annual Hours: 2,267. (For policy questions regarding this 
collection, contact Usree Bandyopadhyay at 410-786-6650.)

    Dated: June 25, 2013.
Martique Jones
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2013-15539 Filed 6-27-13; 8:45 am]
BILLING CODE 4120-01-P
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