Federal Register / Vol. 88, No. 199 / Tuesday, October 17, 2023 / Notices 71573 

1 year (adjusted every 3 years by the 

Administrator of the Office of 

Information and Regulatory Affairs 

(OIRA) for changes in gross domestic 

product) or adversely affecting in a 

material way the economy, a sector of 

the economy, productivity, competition, 

jobs, the environment, public health or 

safety, or State, local, territorial, or tribal 

governments or communities; (2) 

creating a serious inconsistency or 

otherwise interfering with an action 

taken or planned by another agency; (3) 

materially altering the budgetary 

impacts of entitlement grants, user fees, 

or loan programs or the rights and 

obligations of recipients thereof; or (4) 

raising legal or policy issues, for which 

centralized review would meaningfully 

further the President’s priorities or the 

principles set forth in this Executive 

order, as specifically authorized in a 

timely manner by the Administrator of 

OIRA in each case. 

A regulatory impact analysis (RIA) 

must be prepared for major rules with 

significant regulatory action/s and/or 

with significant effects as per section 

3(f)(1) of Executive Order 12866 ($200 

million or more in any 1 year). Based on 

our estimates, OMB’s Office of 

Information and Regulatory Affairs has 

determined that this rulemaking is not 

significant and not major under Subtitle 

E of the Small Business Regulatory 

Enforcement Fairness Act of 1996 (also 

known as the Congressional Review 

Act). 

As stated in section IV of this notice, 

we estimate that the overall effect of the 

changes in the Medicare Part A 

premium will be a savings to voluntary 

enrollees (sections 1818 and 1818A of 

the Act) of about $9 million. 

C. Accounting Statement and Table 

As required by OMB Circular A–4 

(available at https://

www.whitehouse.gov/wp-content/ 

uploads/legacy_drupal_files/omb/ 

circulars/A4/a-4.pdf), in the Table 

below we have prepared an accounting 

statement showing the total aggregate 

savings to enrollees paying premiums in 

CY 2024, compared with the amount 

that they paid in CY 2023. The amount 

of savings will be about $9 million. As 

stated in section IV of this notice, the 

CY 2024 premium of $505 is 

approximately 0.2 percent lower than 

the CY 2023 premium of $506. We 

estimate that approximately 729,000 

enrollees will voluntarily enroll in 

Medicare Part A by paying the full 

premium and that over 90 percent of 

these individuals will have their Part A 

premium paid for by states, since they 

are enrolled in the QMB eligibility 

group. Furthermore, the CY 2024 

reduced premium of $278 is the same as 

for CY 2023. 

TABLE—ESTIMATED TRANSFERS FOR

CY 2024 MEDICARE PART A PREMIUMS

Category Transfers 

Annualized Monetized 

Transfers.

¥$9 million. 

From Whom to Whom Beneficiaries to Federal Government. 

D. Regulatory Flexibility Act 

The Regulatory Flexibility Act (RFA) 

requires agencies to analyze options for 

regulatory relief of small entities if a 

rule has a significant impact on a 

substantial number of small entities. For 

purposes of the RFA, small entities 

include small businesses, nonprofit 

organizations, and small governmental 

jurisdictions. Most hospitals and most 

other providers and suppliers are small 

entities, either by being nonprofit 

organizations or by meeting the Small 

Business Administration’s definition of 

a small business (having revenues of 

less than $9.0 million to $47 million in 

any 1 year). Individuals and states are 

not included in the definition of a small 

entity. This annual notice announces 

the Medicare Part A premiums for CY 

2024 and will have an impact on certain 

Medicare beneficiaries. As a result, we 

are not preparing an analysis for the 

RFA because the Secretary has certified 

that this notice will not have a 

significant economic impact on a 

substantial number of small entities. 

In addition, section 1102(b) of the Act 

requires us to prepare a RIA if a rule 

may have a significant impact on the 

operations of a substantial number of 

small rural hospitals. This analysis must 

conform to the provisions of section 604 

of the RFA. For purposes of section 

1102(b) of the Act, we define a small 

rural hospital as a hospital that is 

located outside of a metropolitan 

statistical area and has fewer than 100 

beds. This annual notice announces the 

Medicare Part A premiums for CY 2024 

and will have an impact on certain 

Medicare beneficiaries. As a result, we 

are not preparing an analysis for section 

1102(b) of the Act because the Secretary 

has certified that this notice will not 

have a significant impact on the 

operations of a substantial number of 

small rural hospitals. 

E. Unfunded Mandates Reform Act 

Section 202 of the Unfunded 

Mandates Reform Act of 1995 also 

requires that agencies assess anticipated 

costs and benefits before issuing any 

rule whose mandates require spending 

in any 1 year of $100 million in 1995 

dollars, updated annually for inflation. 

In 2023, that threshold is approximately 

$177 million. This notice would not 

impose a mandate that will result in 

expenditures by state, local, and Tribal 

Governments, in the aggregate, or by the 

private sector, of more than $177 

million in any 1 year. 

F. Federalism 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it promulgates a 

proposed rule (and subsequent final 

rule) that imposes substantial direct 

requirement costs on state and local 

governments, preempts state law, or 

otherwise has Federalism implications. 

This notice will not have a substantial 

direct effect on state or local 

governments, preempt state law, or 

otherwise have Federalism implications. 

G. Congressional Review 

This final regulation is subject to the 

Congressional Review Act provisions of 

the Small Business Regulatory 

Enforcement Fairness Act of 1996 (5 

U.S.C. 801 et seq.) and has been 

transmitted to the Congress and the 

Comptroller General for review. 

Chiquita Brooks-LaSure, 

Administrator of the Centers for 

Medicare & Medicaid Services, 

approved this document on October 11, 

2023. 

Xavier Becerra, 

Secretary, Department of Health and Human 

Services. 

[FR Doc. 2023–22848 Filed 10–12–23; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10450, CMS– 

10383, and CMS–10466] 

Agency Information Collection 

Activities: Proposed Collection; 

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 (the 

PRA), federal agencies are required to 

publish notice in the Federal Register 


lotter on DSK11XQN23PROD with NOTICES1
71574 Federal Register / Vol. 88, No. 199 / Tuesday, October 17, 2023 / Notices 

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 

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 must be received by 

December 18, 2023. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number. 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: lll, 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, please access the CMS PRA 

website by copying and pasting the 

following web address into your web 

browser: https://www.cms.gov/ 

Regulations-and-Guidance/Legislation/

PaperworkReductionActof1995/PRAListing. 

FOR FURTHER INFORMATION CONTACT: 

William N. Parham at (410) 786–4669. 

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–10450 Consumer Assessment of 

Healthcare Providers and Systems 

(CAHPS) Survey for Merit-based 

Incentive Payment Systems (MIPS) 

CMS–10383 Review and Approval 

Process for Waivers for State 

Innovation 

CMS–10466 Patient Protection and 

Affordable Care Act; Exchange 

Functions: Eligibility for Exemptions 

Under the 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 Information Collection; Title 

of Information Collection: Consumer 

Assessment of Healthcare Providers and 

Systems (CAHPS) Survey for Meritbased Incentive Payment Systems 

(MIPS); Use: The CAHPS for MIPS 

survey is used in the Quality Payment 

Program (QPP) to collect data on fee-forservice Medicare beneficiaries’ 

experiences of care with eligible 

clinicians participating in MIPS and is 

designed to gather only the necessary 

data that CMS needs for assessing 

physician quality performance, and 

related public reporting on physician 

performance, and should complement 

other data collection efforts. The survey 

consists of the core Agency for 

Healthcare Research and Quality 

(AHRQ) CAHPS Clinician & Group 

Survey, version 3.0, plus additional 

survey questions to meet CMS’s 

information and program needs. The 

survey information is used for quality 

reporting, the compare tool on the 

Medicare.gov website, and annual 

statistical experience reports describing 

MIPS data for all MIPS eligible 

clinicians. 

This 2024 information collection 

request addresses the requirements 

related to the statutorily required 

quality measurement. The CAHPS for 

MIPS survey results in burden to three 

different types of entities: groups, 

virtual groups, and subgroups; vendors; 

and beneficiaries associated with 

administering the survey. Virtual groups 

are subject to the same requirements as 

groups and subgroups; therefore, we 

will refer only to ‘‘groups’’ as an 

inclusive term for all entities unless 

otherwise noted. Form Number: CMS– 

10450 (OMB control number: 0938– 

1222); Frequency: Yearly; Affected 

Public: Business or other for-profits and 

Not-for-profit institutions and 

Individuals and Households; Number of 

Respondents: 25,536; Total Annual 

Responses: 25,536; Total Annual Hours: 

5,867 (For policy questions regarding 

this collection contact Renee Oneill at 

410–786–8821.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Review and 

Approval Process for Waivers for State 

Innovation; Use: The information 

required under this collection is 

necessary to ensure that states comply 

with statutory and regulatory 

requirements related to the development 

and implementation of section 1332 

waivers. States seeking waiver authority 

under section 1332 of the ACA are 

required to meet certain requirements 

for applications, public notice, and 

reporting. The authority for these 

requirements is found in section 1332 of 

the ACA. This information collection 

reflects the requirements provided in 

the final rules published in February 

2012 (77 FR 11700) and September 2021 

(86 FR 3412). 

On October 24, 2018, the Departments 

published guidance (86 FR 53575) that 

provided supplementary information 

about the requirements that must be met 

for the approval of a section 1332 

waiver, the Secretaries’ application 

review procedures, the calculation of 

pass-through funding, certain analytical 

requirements, and operational 

considerations. However, the September 

2021 final rule superseded and 

rescinded policies and interpretations 

outlined in the 2018 guidance and 

repealed the previous codification of the 

interpretations of the statutory 

guardrails in part 1 of the 2022 Payment 

Notice final rule (86 FR 6138). The 

September 2021 final rule (86 FR 53412) 

finalized modifications to section 1332 

waiver implementing regulations, 

including changes to many of the 

policies and interpretations of the 

statutory guardrails codified in 

regulation. In addition, the September 

2021 final rule modified regulations to 

provide flexibilities in the public notice 

requirements and post-award public 

participation requirements for section 

1332 waivers under certain future 


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Federal Register / Vol. 88, No. 199 / Tuesday, October 17, 2023 / Notices 71575 

emergent situations. The final rule also 

provided new information regarding the 

processes and procedures for 

amendments and extensions for 

approved waiver plans. Form Number: 

CMS–10383 (OMB Control Number 

0938–1389; Frequency: Occasionally; 

Affected Public: State Governments; 

Number of Respondents: 19; Total 

Annual Responses: 399; Total Annual 

Hours: 5,549. (For policy questions 

regarding this collection contact Lina 

Rashid at 301–492–4193.) 

3. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Patient 

Protection and Affordable Care Act; 

Exchange Functions: Eligibility for 

Exemptions; Use: The data collection 

and reporting requirements in ‘‘Patient 

Protection and Affordable Care Act; 

Exchange Functions: Eligibility for 

Exemptions; Miscellaneous Minimum 

Essential Coverage Provisions’’ (78 FR 

39494 (July 1, 2013)), address federal 

requirements that states must meet with 

regard to the Exchange minimum 

function of performing eligibility 

determinations and issuing certificates 

of exemption from the shared 

responsibility payment. In the final 

regulation, CMS addresses standards 

related to eligibility, including the 

verification and eligibility 

determination process, eligibility 

redeterminations, options for states to 

rely on HHS to make eligibility 

determinations for certificates of 

exemption, and reporting. CMS 

developed four appendices of 

application materials to illustrate the 

process applicants use to apply for 

exemptions from the shared 

responsibility payment. This 

information collection requests seeks 

approval for the requirements associated 

with the collection of information 

associated with these four appendices. 

Form Number: CMS–10466 (OMB 

Control Number 0938–1190; Frequency: 

Annually; Affected Public: Individuals 

and Households—State, Local, or Tribal 

Governments; Number of Respondents: 

849; Total Annual Responses: 849; Total 

Annual Hours: 1,962. (For policy 

questions regarding this collection 

contact John Kenna at 301–492–4452.) 

Dated: October 12, 2023. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2023–22897 Filed 10–16–23; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Submission for Office of Management 

and Budget Review; Federal Case 

Registry (Office of Management and 

Budget #0970–0421) 

AGENCY: Office of Child Support 

Enforcement, Administration for 

Children and Families, United States 

Department of Health and Human 

Services. 

ACTION: Request for public comments. 

SUMMARY: The Office of Child Support 

Enforcement (OCSE), Administration for 

Children and Families (ACF), is 

requesting from the Office of 

Management and Budget (OMB) to 

extend approval of the Federal Case 

Registry (FCR) for an additional three 

years. The current approval expires 

November 30, 2023. OCSE is proposing 

minor changes to punctuation, 

formatting, grammar, clarity, and 

spacing to enable easier completion of 

the form. 

DATES: Comments due within 30 days of 

publication. OMB must make a decision 

about the collection of information 

between 30 and 60 days after 

publication of this document in the 

Federal Register. Therefore, a comment 

is best assured of having its full effect 

if OMB receives it within 30 days of 

publication. 

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. You can also obtain 

copies of the proposed collection of 

information by emailing infocollection@

acf.hhs.gov. Identify all emailed 

requests by the title of the information 

collection. 

SUPPLEMENTARY INFORMATION: 

Description: The FCR is a national 

database of information pertaining to 

child support cases processed by state 

child support agencies, referred to as 

‘‘IV–D’’ cases, and non-IV–D support 

orders privately established or modified 

by courts or tribunals on or after 

October 1, 1998. FCR information is 

comprised of child support orders and 

case information from each State Case 

Registry (SCR). The FCR automatically 

compares new SCR submissions to 

existing FCR information and to wage 

and employment information in the 

National Directory of New Hires. The 

Federal Parent Locator Service notifies 

state agencies if a IV–D case participant 

in the state matches a participant in a 

IV–D or non-IV–D case in another state 

and supplies any matched wage and 

employment information. Matches 

enable state agencies to locate parties 

that live in different states to establish, 

modify, or enforce child support 

obligations; to establish paternity; to 

enforce state law regarding parental 

kidnapping; and to establish or enforce 

child custody or visitation 

determinations. 

The FCR instrument, Appendix G: 

Input Record Layout, contains minor 

changes in punctuation, formatting, 

grammar, clarity, and spacing to enable 

easier completion of the form. 

Respondents: State child support 

enforcement agencies. 

ANNUAL BURDEN ESTIMATES

Instrument 

Total 

number of 

respondents 

Annual 

number of 

responses per 

respondent 

Average 

burden hours 

per response 

Annual 

burden hours 

Appendix G: Input Transactions Layout .......................................................... 54 406 0.033 730 

Estimated Total Annual Burden 

Hours: 730. 

Authority: 42 U.S.C. 653(h); 42 U.S.C. 

654a(e); 42 U.S.C. 654a(f)(1). 


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