44290 Federal Register / Vol. 88, No. 132 / Wednesday, July 12, 2023 / Notices 

their financial obligations and payment 

options? 

Anti-Kickback Statute 

HHS is interested in whether 

incentives offered to health care 

providers by financial companies may 

implicate the Federal anti-kickback 

statute. Specifically, HHS is interested 

in the following questions: 

8. What financial relationships exist 

between medical payment product 

companies and health care providers? 

For example, do companies provide 

financial incentives to providers who 

enroll patients in medical payment 

products? Do providers pay financial 

companies to collect patients’ overdue 

balances? Or, do providers have 

arrangements with financial companies 

to indemnify the company in whole or 

in part if the patient defaults, such as an 

arrangement that when patients default 

on their debt to the financial company, 

the debt reverts to the provider? 

9. Do health care providers or 

financial institutions market or 

recommend medical credit cards or 

loans to Federal health care program 

beneficiaries (e.g., Medicare, Medicaid, 

Affordable Care Act Marketplace, or 

Children’s Health Insurance Program 

enrollees)? Is the use of these products 

limited to certain types of health care 

items or services, such as items and 

services that are not reimbursable by 

Medicare or another third-party payor? 

10. Do medical payment product 

companies recommend certain health 

care providers to their users? Do 

companies limit where or how patients 

use medical credit cards? 

11. Is the health care provider (or the 

medical payment product company) 

offsetting some of the patient’s medical 

debt or providing any other incentives 

to the patient (e.g., travel rewards for 

charges to the card)? 

d. Treasury-Specific Questions 

The Treasury Department oversees 

policy decisions relating to the Internal 

Revenue Code, including those 

provisions relating to tax-exempt 

hospitals found in section 501(r). 

Section 501(r)(4) and 26 CFR 1.501(r)– 

4 require tax-exempt hospital 

organizations to establish and widely 

publicize a written financial assistance 

policy that applies to all medically 

necessary care provided by the hospital 

organization. Section 501(r)(6) and 26 

CFR 1.501(r)–6 require hospital 

organizations to make reasonable efforts 

to determine whether an individual is 

eligible for assistance under the hospital 

organization’s financial assistance 

policy (FAP) before engaging in 

extraordinary collection actions against 

that individual. Extraordinary collection 

actions include credit reporting an 

unpaid medical bill, deferring or 

denying care to a patient due to their 

unpaid medical bills, taking legal or 

judicial action to recoup an alleged 

medical debt, or selling an alleged 

medical debt. 

However, selling an alleged medical 

debt is not considered an extraordinary 

collection action if, prior to the sale, the 

hospital facility enters into a legally 

binding written agreement with the debt 

buyer that meets four conditions: (1) the 

buyer agrees not to engage in any 

extraordinary collection actions to 

obtain payment; (2) the buyer agrees not 

to charge interest in excess of the rate 

in effect under section 6621(a)(2) at the 

time the debt is sold (currently set at 7 

percent through June 2023); (3) the debt 

is returnable to or recallable by the 

hospital facility upon a determination 

that the individual is financial 

assistance-eligible; and (4) if the 

individual is determined to be financial 

assistance-eligible and the debt is not 

returned or recalled, the buyer must 

adhere to specified procedures which 

ensure that the individual does not pay, 

and has no obligation to pay, the buyer 

and the hospital facility together more 

than that individual is personally 

responsible for paying under the 

financial assistance policy. 

Treasury welcomes comment on the 

interplay between the requirements that 

apply to tax-exempt hospitals and 

medical payment products, including 

comments in response to any of the 

following specific questions: 

1. What policy actions should 

Treasury consider taking to address 

problematic practices related to medical 

credit cards or loans, including debt 

collection and credit reporting practices, 

to conform with the existing tax laws 

and regulations pertaining to tax-exempt 

hospitals? 

2. Should a tax-exempt hospital’s 

signing patients up for medical payment 

products be considered similar to a taxexempt hospital’s selling medical debt, 

such that the special rules that only 

exclude debt sales from being 

extraordinary collection actions if 

certain requirements are met would be 

applied to these payment products? 

3. How would applying the debt sale 

special rules to payment products 

change hospitals’ and payment product 

providers’ current practices, especially 

those related to financial assistance 

eligibility screening, extraordinary 

collection actions, interest rates, and 

recall or return of balances owed by 

FAP-eligible individuals? 

4. How do tax-exempt hospitals’ 

promotion of medical payment products 

compare to their operationalization of 

the requirement that their financial 

assistance policies be widely 

publicized? 

5. What are best practices for 

hospitals publishing and making 

patients aware of financial assistance 

programs (beyond compliance with the 

widely publicized requirements found 

in the section 501(r) regulations)? 

6. Are medical payment product 

companies advertising their products as 

delivering community benefits or as a 

form of financial assistance? 

7. Are tax-exempt hospitals claiming 

that their promotion of medical 

payment products delivers community 

benefits or provides financial assistance, 

including in their filings of Form 990, 

Schedule H? 

8. Does the availability of medical 

payment products generally benefit the 

community or assist patients 

financially? 

Signing Authority for HHS 

The Administrator of the Centers for 

Medicare & Medicaid Services (CMS), 

Chiquita Brooks-LaSure, having 

reviewed and approved this document, 

authorizes Vanessa Garcia, who is the 

Federal Register Liaison, to 

electronically sign this document for 

purposes of publication in the Federal 

Register. 

Rohit Chopra, 

Director, Consumer Financial Protection 

Bureau. 

Thomas C. West Jr., 

Deputy Assistant Secretary for Tax Policy, 

Department of the Treasury. 

Vanessa Garcia, 

Federal Register Liaison, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2023–14726 Filed 7–11–23; 8:45 am] 

BILLING CODE 4810–AM–P; 4120–01–P; 4810–AK–P 

CORPORATION FOR NATIONAL AND 

COMMUNITY SERVICE 

Agency Information Collection 

Activities; Submission to the Office of 

Management and Budget for Review 

and Approval; Comment Request; 

Application Package for AmeriCorps 

Seniors Application Instructions, 

Progress Reporting, Independent 

Living and Respite Surveys 

AGENCY: Corporation for National and 

Community Service. 

ACTION: Notice of information collection; 

request for comment. 

SUMMARY: The Corporation for National 

and Community Service, operating as 

AmeriCorps, has submitted a public 


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Federal Register / Vol. 88, No. 132 / Wednesday, July 12, 2023 / Notices 44291 

information collection request (ICR) for 

review and approval in accordance with 

the Paperwork Reduction Act. 

DATES: Written comments must be 

submitted to the individual and office 

listed in the ADDRESSES section by 

August 11, 2023. 

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. 

FOR FURTHER INFORMATION CONTACT: 

Copies of this ICR, with applicable 

supporting documentation, may be 

obtained by calling AmeriCorps, Robin 

Corindo, at (202) 489–5578 or by email 

to rcorindo@cns.gov. 

SUPPLEMENTARY INFORMATION: The OMB 

is particularly interested in comments 

which: 

• Evaluate whether the proposed 

collection of information is necessary 

for the proper performance of the 

functions of CNCS, including whether 

the information will have practical 

utility; 

• Evaluate the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information, 

including the validity of the 

methodology and assumptions; 

• Propose ways to enhance the 

quality, utility, and clarity of the 

information to be collected; and 

• Propose ways to minimize the 

burden of the collection of information 

on those who are to respond, including 

through the use of appropriate 

automated, electronic, mechanical, or 

other technological collection 

techniques or other forms of information 

technology. 

Comments 

A 60-day Notice requesting public 

comment was published in the Federal 

Register on April 27, 2023 at 88 FR 

25625. This comment period ended June 

27, 2023. The Notice received 32 public 

comments, of which 26 were identical. 

Of the other comments, one was in 

support and one was without specific 

comment. The others detailed how 

completing the Progress Report 

Supplement (PRS) is a burden. 

AmeriCorps Seniors agrees that the 

reporting reporting requirements of the 

PRS may be burdensome and is 

therefore reducing the number of 

questions it requires within it. The PRS 

is the only document with proposed 

revisions. 

Comment: AmeriCorps Seniors grants 

are awarded for a three-year period with 

required annual budget submissions. 

ASPN questions the value and 

additional time needed to update the 

grant application and workplan 

submission annually. With a three-year 

performance period, ASPN proposes for 

a grantee to submit an annual budget 

application and an executive summary 

to update amended community needs 

and changes instead of the entire grant 

application. This change would not only 

reduce the time needed of grantee staff, 

but also regional staff grant reviewers. 

AmeriCorps Response: AmeriCorps is 

in the process of modernizing our grant 

management systems. As part of the 

modernization effort, AmeriCorps will 

propose that grantees submit a 

simplified budget application and an 

update through a simplified amendment 

process, rather than an entire grant 

continuation application. 

Comment: While the Progress Report 

at the end of a grant year is 

straightforward, there is confusion as to 

how much information is needed in the 

narrative section. Instructions about the 

examples of info that is most helpful in 

the narrative sections would be 

welcome. 

AmeriCorps Response: In addition to 

Progress Report Instructions and 

training, AmeriCorps provides 

Appendix A.4—AmeriCorps Seniors 

Progress Report Tips in each Program 

Handbook. This document shares 

examples about what information is 

worth considering for the narrative 

sections of the Progress Report. In 

addition, grantees can also speak with 

their Portfolio Manager about the type 

and extent of information they should 

include. 

Comment: The Progress Report 

Supplement has been referred to as 

many different things over the years. 

With current Performance Measure 

workplans being very specific as to the 

special needs served by volunteers, this 

complete demographic report is 

burdensome for both program and 

station staff. ASPN has been told that 

there is no way for [AmeriCorps] to 

aggregate the data reported into a 

national needs snapshot. As such, ASPN 

strongly believes that if [AmeriCorps is] 

unable to aggregate this data, programs 

should not be asked to collect it. The 

current reporting dates do not take into 

account grant years; therefore, programs 

are reporting on portions of two 

different grant years, causing the 

information to often be incorrect. 

Demographics of the volunteers should 

be rolled into the annual Progress 

Report. The PPR–S should be 

eliminated and would reduce the 

administrative burden for both grantees 

and agency staff. 

AmeriCorps Response: AmeriCorps 

can and does aggregate the demographic 

section of the Progress Report 

Supplement (PRS). We are in the 

process of updating our grant 

management systems so that volunteer 

information can be entered directly into 

the system. AmeriCorps Seniors 

anticipates that this will eliminate the 

need for the PRS and reduce the 

administrative burden for grantees and 

agency staff. 

Comment: Independent Living and 

Respite Surveys: [Senior Companion 

Program] (SCP) directors report that 

national workplans do not require all 

the information requested on these 

surveys. If the workplan does not 

request the information, it would be best 

if those questions were eliminated from 

the survey and would possibly result in 

a better return on the number of clients 

completing the surveys. As Senior 

Companions serve those with dementia, 

it is often the caregiver of the client that 

completes this survey. In an effort to 

[lessen] caregiver burden, a shortened 

survey could be more easily completed 

which would then, in turn, produce a 

better response rate. 

AmeriCorps Response: AmeriCorps 

Seniors disagrees that, at only 13 

questions, this survey is too 

burdensome. Nevertheless, AmeriCorps 

Seniors will review the Independent 

Living and Respite Survey, and is 

interested in the specific questions 

which SCP Directors propose to be 

eliminated. 

Title of Collection: Application 

Package for AmeriCorps Seniors 

Applications Instructions, Progress 

Reporting, Independent Living and 

Respite Surveys. 

OMB Control Number: 3045–0143. 

Type of Review: Renewal with change. 

Respondents/Affected Public: 

Organizations and State, Local or Tribal 

Governments. 

Total Estimated Number of Annual 

Responses: 1,250. 

Total Estimated Number of Annual 

Burden Hours: 6,250. 

Abstract: The AmeriCorps Seniors 

Grant Application is used by 

prospective and existing sponsors of 

AmeriCorps Seniors projects under the 

AmeriCorps Seniors RSVP (RSVP), 

AmeriCorps Seniors FGP (FGP), 

AmeriCorps Seniors (SCP), and 

AmeriCorps Seniors Senior 

Demonstration Program (SDP). The 

Project Progress Report and Project 

Report Supplement will be used to 

report progress toward accomplishing 

work plan goals and objectives, 

reporting volunteer and service outputs, 


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44292 Federal Register / Vol. 88, No. 132 / Wednesday, July 12, 2023 / Notices 

reporting actual outcomes of selfnominated performance measures, 

meeting challenges encountered, 

describing significant activities, and 

requesting technical assistance. The 

Application Instructions and PPR and 

PRS forms in this package conform to 

AmeriCorps’ web-based electronic 

grants management system. The SCP 

Independent Living Survey and SCP 

Respite Survey are instruments that 

collect information from a sample of 

Senior Companion clients and 

caregivers. The purpose of the surveys 

is to assess the feasibility of conducting 

a longitudinal, quasi-experimental 

evaluation of the impact of independent 

living and respite services on clients’ 

social ties and perceived social support. 

The results of the surveys may also be 

used to inform the feasibility of using a 

similar instrument to measure client 

and caregiver outcomes for an 

evaluation of RSVP. AmeriCorps seeks 

to renew the current information 

collection with revisions. The revisions 

are intended to capture the 

socioeconomic status of AmeriCorps 

Seniors volunteers. The information 

collection will otherwise be used in the 

same manner as the existing 

application. AmeriCorps also seeks to 

continue using the current application 

until the revised application is 

approved by OMB. The current 

application is due to expire on March 

31, 2025. 

Danielle Melfi, 

Chief Program Officer. 

[FR Doc. 2023–14776 Filed 7–11–23; 8:45 am] 

BILLING CODE 6050–28–P 

DEPARTMENT OF DEFENSE 

Department of the Army 

U.S. Army Science Board Open 

Meeting; Notice 

AGENCY: Department of the Army, DoD. 

ACTION: Notice of Federal Advisory 

Committee meeting. 

SUMMARY: Pursuant to the Federal 

Advisory Committee Act, the 

Government in the Sunshine Act of 

1976, the Department of the Army 

announces the following committee 

meeting of the U.S. Army Science Board 

(ASB) Summer Voting Session. 

DATES: The U.S. Army Science Board 

Summer Voting Session will meet from 

8:15 a.m.–1:45 p.m. on Thursday, July 

20, 2023. 

ADDRESSES: The Arnold and Mabel 

Beckman Center of the National 

Academies of Sciences and Engineering, 

100 Academy Way, Irvine, CA 92617. 

FOR FURTHER INFORMATION CONTACT: 

Army Science Board, Designated 

Federal Officer, 2530 Crystal Drive, 

Suite 7098, Arlington, VA 22202; Ms. 

Heather J. Gerard (Ierardi), the ASB’s 

Designated Federal Officer (DFO), at 

(406) 926–9090 or email: 

heather.j.gerard.civ@army.mil, and Mr. 

Vince L. Bullard, the ASB’s Alternate 

Designated Federal Official at (571) 

215–1408 or email: 

vinson.l.bullard.civ@army.mil. 

SUPPLEMENTARY INFORMATION: Due to 

circumstances beyond the control of the 

Designated Federal Officer, the U.S. 

Army Science Board was unable to 

provide public notification required by 

41 CFR 102–3.150(a) concerning its July 

20, 2023 meeting. Accordingly, the 

Advisory Committee Management 

Officer for the Department of Defense, 

pursuant to 41 CFR 102–3.150(b), 

waives the 15-calendar day notification 

requirement. 

Purpose of Meeting: The purpose of 

the meeting is for ASB members to 

review, deliberate, and vote on the 

findings and recommendations 

presented for one Fiscal Year (FY) 2020 

study, one FY2021 study, and two 

(FY23) ASB studies. 

Agenda: The board will present 

findings and recommendations for 

deliberation and vote on the following 

studies: 

‘‘An lndependent Assessment of the 

Army’s Ability to Fight and Win on a 

Nuclear Battlefield.’’ This FY21 study is 

classified and will be presented in a 

closed session at 8:15 a.m.–9:15 a.m. 

‘‘Surge Capacity in the Industrial 

Base.’’ The study team collected data 

marked CUI from its source and cannot 

disseminate the information to the 

public. Reasons include (but are not 

limited to) the passing of proprietary 

business information and controlled 

technical information. This FY23 study 

is controlled unclassified and will be 

presented in a closed session at 9:30 

a.m.–10:30 a.m. 

‘‘An Independent Assessment of the 

Army Implementation of Digital 

Engineering.’’ This FY23 study is not 

classified and will be presented in an 

open session at 10:45 a.m.–11:45 a.m. 

‘‘An Independent Assessment of the 

2040 Battlefield and its Implications for 

5th Generation Combat Vehicle 

Technologies’’. This FY20 study is not 

classified and will be presented in an 

open session at 12:45 a.m.–1:45 p.m. 

Public Accessibility to the Meeting: 

Pursuant to 5 U.S.C. 552b, as amended, 

and 41 CFR 102–3.140 through 102– 

3.165, and subject to the availability of 

space, this meeting is open to the 

public. Registration of members of the 

public who wish to attend the meeting 

will begin at 8:30 a.m. on the day of the 

meeting. Seating is limited and is on a 

first-to-arrive basis. Attendees will be 

asked to provide their name, title, 

affiliation, and contact information to 

include email address and daytime 

telephone number at registration. Any 

interested person may attend the 

meeting, file written comments or 

statements with the committee, or make 

verbal comments from the floor during 

the public meeting, at the times, and in 

the manner, permitted by the 

committee, as set forth below. 

Special Accommodations: The 

meeting venue is fully handicap 

accessible, with wheelchair access. 

Individuals requiring special 

accommodations to access the public 

meeting or seeking additional 

information about public access 

procedures, should contact Mr. Vince 

Bullard, the Alternate Designated 

Federal Official (ADFO) for the ASB, at 

the email addresses or telephone 

numbers listed in the FOR FURTHER

INFORMATION CONTACT section, at least 

five (5) business days prior to the 

meeting so that appropriate 

arrangements can be made. 

Written Comments or Statements: 

Pursuant to 41 CFR 102–3.105(j) and 

§ 102–3.140(c) and 5 U.S.C. 1009(a)(3), 

the public or interested organizations 

may submit written comments or 

statements to the ASB about its mission 

and/or the topics to be addressed in this 

public meeting. Written comments or 

statements should be submitted to Mr. 

Vince Bullard, the ADFO of the ASB, 

via electronic mail, the preferred mode 

of submission, at the addresses listed in 

the FOR FURTHER INFORMATION CONTACT

section in the following formats: Adobe 

Acrobat or Microsoft Word. The 

comment or statement must include the 

author’s name, title, affiliation, address, 

and daytime telephone number. Written 

comments or statements being 

submitted in response to the agenda set 

forth in this notice must be received by 

the ADFO at least five (5) business days 

prior to the meeting so that they may be 

made available to the ASB for its 

consideration prior to the meeting. 

Written comments or statements 

received after this date may not be 

provided to the ASB until its next 

meeting. Please note that because the 

ASB operates under the provisions of 

the Federal Advisory Committee Act, as 

amended, all written comments will be 


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