Federal Register / Vol. 79, No. 21 / Friday, January 31, 2014 / Notices 5417 

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–10515 Payment Collections 

Operations Contingency Plan CMS–R–48 Hospital Conditions of 

Participation and Supporting 

Regulations 

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 Collections 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Payment 

Collection Operations Contingency 

Plan; Use: Under sections 1401, 1411, 

and 1412 of the Affordable Care Act and 

45 CFR part 155 subpart D, an Exchange 

makes an advance determination of tax 

credit eligibility for individuals who 

enroll in Qualified Health Plan (QHP) 

coverage through the Exchange and seek 

financial assistance. Using information 

available at the time of enrollment, the 

Exchange determines whether the 

individual meets the income and other 

requirements for advance payments and 

the amount of the advance payments 

that can be used to pay premiums. 

Advance payments are made 

periodically under section 1412 of the 

Affordable Care Act to the issuer of the 

QHP in which the individual enrolls. 

Section 1402 of the Affordable Care Act 

provides for the reduction of cost 

sharing for certain individuals enrolled 

in a QHP through an Exchange, and 

section 1412 of the Affordable Care Act 

provides for the advance payment of 

these reductions to issuers. The statute 

directs issuers to reduce cost sharing for 

essential health benefits for individuals 

with household incomes between 100 

and 400 percent of the Federal poverty 

level (FPL) who are enrolled in a silver 

level QHP through an individual market 

Exchange and are eligible for advance 

payments of the premium tax credit. 

Health insurance issuers will manually 

enter enrollment and payment data into 

a Microsoft Excel-based spreadsheet, 

and submit the information to HHS. The 

data collection will be used by HHS to 

make payments or collect charges from 

issuers under the following programs: 

advance payments of the premium tax 

credit, advanced cost-sharing 

reductions, and Marketplace user fees. 

HHS will use the information collected 

to make payments and collect charges in 

January 2014 and for a number of 

months thereafter, as may be required 

based on HHS’ operational progress. 

Form Number: CMS–10515 (OCN: 

0938–1217); Frequency: Monthly; 

Affected Public: Private sector (business 

or other for-profits and not-for-profit 

institutions); Number of Respondents: 

575; Total Annual Responses: 7,475; 

Total Annual Hours: 51,175. (For policy 

questions regarding this collection 

contact Jaya Ghildiyal at 301–492– 

5149.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Hospital 

Conditions of Participation and 

Supporting Regulations; Use: The 

information collection requirements 

described in this information collection 

request are needed to implement the 

Medicare and Medicaid conditions of 

participation (CoP) for 4,890 accredited 

and non-accredited hospitals and an 

additional 101 critical access hospitals 

(CAHs) that have distinct part 

psychiatric or rehabilitation units 

(DPUs). CAHs that have DPUs must 

comply with all of the hospital CoPs on 

these units. Thus, this package reflects 

the paperwork burden for a total of 

4,991 (that is, 4,890 hospitals and 101 

CAHs which include 81 CAHs that have 

psychiatric DPUs and 20 CAHs that 

have rehabilitation DPUs). The 

information collection requirements for 

the remaining 1,183 CAHs have been 

reported in a separate package under 

CMS–10239. 

The CoPs and accompanying 

requirements specified in the 

supporting regulations are used by our 

surveyors as a basis for determining 

whether a hospital qualifies for a 

provider agreement under Medicare and 

Medicaid. CMS and the health care 

industry believe that the availability to 

the facility of the type of records and 

general content of records, which this 

regulation specifies, is standard medical 

practice and is necessary in order to 

ensure the well-being and safety of 

patients and professional treatment 

accountability. Form Number: CMS–R– 

48 (OCN: 0938–0328); Frequency: 

Yearly; Affected Public: Private sector 

(business or other for-profits); Number 

of Respondents: 4,991; Total Annual 

Responses: 1,342,424; Total Annual 

Hours: 18,84,0617. (For policy questions 

regarding this collection contact Scott 

Cooper at 410–786–9465.) 

Dated: January 28, 2014. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2014–02065 Filed 1–30–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10418, CMS– 

10507, and CMS–10157] 

Agency Information Collection 

Activities: Submission for OMB 

Review; 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 

(PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 


tkelley on DSK3SPTVN1PROD with NOTICES
5418 Federal Register / Vol. 79, No. 21 / Friday, January 31, 2014 / Notices 

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 March 5, 2014: 

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) 395–5806 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: Revision of currently approved 

collection; Title of Information 

Collection: Annual MLR and Rebate 

Calculation Report and MLR Rebate 

Notices; Use: We will use the data 

collection of annual reports provided by 

an issuer for each state’s individual, 

small group, and large group markets to 

ensure that consumers are receiving 

value for their premium dollar by 

calculating each issuer’s medical loss 

ratio (MLR) and any rebate payments 

due for the respective MLR reporting 

year, as well as verifying the provision 

of any rebates and the provisions of the 

rebate notices. The notices will be used 

to ensure that consumers are receiving 

information about the rebate they will 

be receiving, how their issuer is using 

health care premium dollars and about 

the value they are receiving for their 

premium dollar. The notices will help 

provide greater transparency to 

consumers. We will use the 

recordkeeping requirements to 

determine issuers’ compliance with the 

MLR requirements, including 

compliance with how issuers’ 

experience is to be reported, their MLR 

and any rebates owing are to be 

calculated, distribution of rebates and 

provisions of rebate notices. 

Additionally, each issuer is required to 

maintain for a period of seven years all 

documents, records and other evidence 

that support the data included in each 

issuer’s annual report to the Secretary. 

The 60-day Federal Register notice that 

published on November 22, 2013 (78 FR 

70059) pertained to the 2013 MLR 

Annual Reporting Form and 

Instructions, and closed on January 21, 

2014. We received a total of 2 public 

comments on 12 specific issues 

regarding the notice of the revised MLR 

PRA package. Most of the comments 

addressed clarifying the instructions, 

updates for recent guidance issuance, 

treatment of Student Health Plans, 

treatment of Affordable Care Act fees, 

adjusted MLR standard experience 

aggregation, annual Mini-med 

multipliers for credibility 

determination, reporting for both QIA 

and non-claims costs and reporting 

requirements for businesses in run-off. 

We considered all of the proposed 

suggestions and have revised the 2013 

MLR Annual Reporting Form and 

Instructions. Form Number: CMS–10418 

(OCN: 0938–1164); Frequency: 

Annually; Affected Public: Private 

sector (business or other for-profits and 

not-for-profit institutions); Number of 

Respondents: 522; Total Annual 

Responses: 3,394; Total Annual Hours: 

294,911. (For policy questions regarding 

this collection contact Julie McCune at 

301–492–4196.) 

2. Type of Information Collection 

Request: New collection (Request for a 

new OMB control number); Title of 

Information Collection: State-based 

Marketplace Annual Reporting Tool 

(SMART); Use: The annual report is the 

primary vehicle to insure 

comprehensive compliance with all 

reporting requirements contained in the 

Affordable Care Act. It is specifically 

called for in section 1313(a)(1) of the 

Act which requires that an SBM keep an 

accurate accounting of all activities, 

receipts, and expenditures, and to 

submit a report annually to the 

Secretary concerning such accounting. 

We will use the information collected 

from states to assist in determining if a 

state is maintaining a compliant 

operational Exchange. It will also 

provide a mechanism to collect 

innovative approaches to meeting 

challenges encountered by the SBMs 

during the preceding year as well as 

providing information to us regarding 

potential changes in priorities and 

approaches for the upcoming year. Form 

Number: CMS–10507 (OCN: 0938– 

NEW); Frequency: Annually; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

19; Total Annual Responses: 19; Total 

Annual Hours: 1,482. (For policy 

questions regarding this collection 

contact Shelley Bain at 301–492–4453.) 

3. Type of Information Collection 

Request: Reinstatement of a previously 

approved collection; Title of 

Information Collection: HIPAA 

Eligibility Transaction System (HETS) 

Trading Partner Agreement (TPA); Use: 

The HETS is intended to allow the 

release of eligibility data to Medicare 

providers, suppliers or their authorized 

billing agents for the purposes of 

preparing accurate Medicare claims, 

determining beneficiary liability or 

determining eligibility for specific 

services. Such information may not be 

disclosed to anyone other than 

providers, suppliers or a beneficiary for 

whom a claim has been filed. Form 

Number: CMS–10157 (OCN: 0938– 

0960); Frequency: Yearly; Affected 

Public: Private sector (business or other 

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

Number of Respondents: 1,000; Total 


tkelley on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 79, No. 21 / Friday, January 31, 2014 / Notices 5419 

Annual Responses: 1,000; Total Annual 

Hours: 125. (For policy questions 

regarding this collection contact Ada 

Sanchez at 410–786–9466.) 

Dated: January 28, 2014. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2014–02061 Filed 1–30–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–9082–N] 

Medicare and Medicaid Programs; 

Quarterly Listing of Program 

Issuances— 

October through December 2013 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice 

SUMMARY: This quarterly notice lists 

CMS manual instructions, substantive 

and interpretive regulations, and other 

Federal Register notices that were 

published from October through 

December 2013, relating to the Medicare 

and Medicaid programs and other 

programs administered by CMS. 

FOR FURTHER INFORMATION CONTACT: It is 

possible that an interested party may 

need specific information and not be 

able to determine from the listed 

information whether the issuance or 

regulation would fulfill that need. 

Consequently, we are providing contact 

persons to answer general questions 

concerning each of the addenda 

published in this notice. 

Addenda Contact Phone number 

I CMS Manual Instructions ................................................................................................................. Ismael Torres ............... (410) 786–1864 

II Regulation Documents Published in the FEDERAL REGISTER .......................................................... Terri Plumb ................... (410) 786–4481 

III CMS Rulings .................................................................................................................................. Tiffany Lafferty .............. (410) 786–7548 

IV Medicare National Coverage Determinations ................................................................................ Wanda Belle ................. (410) 786–7491 

V FDA-Approved Category B IDEs .................................................................................................... John Manlove ............... (410) 786–6877 

VI Collections of Information .............................................................................................................. Mitch Bryman ............... (410) 786–5258 

VII Medicare –Approved Carotid Stent Facilities ............................................................................... Lori Ashby .................... (410) 786–6322 

VIII American College of Cardiology-National Cardiovascular Data Registry Sites .......................... Marie Casey, BSN, 

MPH.

(410) 786–7861 

IX Medicare’s Active Coverage-Related Guidance Documents ........................................................ Lori Ashby .................... (410) 786–6322 

X One-time Notices Regarding National Coverage Provisions ......................................................... Lori Ashby .................... (410) 786–6322 

XI National Oncologic Positron Emission Tomography Registry Sites .............................................. Stuart Caplan, RN, 

MAS.

(410) 786–8564 

XII Medicare-Approved Ventricular Assist Device (Destination Therapy) Facilities .......................... Marie Casey, BSN, 

MPH.

(410) 786–7861 

XIII Medicare-Approved Lung Volume Reduction Surgery Facilities ................................................. Marie Casey, BSN, 

MPH.

(410) 786–7861 

XIV Medicare-Approved Bariatric Surgery Facilities .......................................................................... Kate Tillman, RN, MAS (410) 786–9252 

XV Fluorodeoxyglucose Positron Emission Tomography for Dementia Trials .................................. Stuart Caplan, RN, 

MAS.

(410) 786–8564 

All Other Information .......................................................................................................................... Annette Brewer ............. (410) 786–6580 

I. Background 

The Centers for Medicare & Medicaid 

Services (CMS) is responsible for 

administering the Medicare and 

Medicaid programs and coordination 

and oversight of private health 

insurance. Administration and oversight 

of these programs involves the 

following: (1) Furnishing information to 

Medicare and Medicaid beneficiaries, 

health care providers, and the public; 

and (2) maintaining effective 

communications with CMS regional 

offices, state governments, state 

Medicaid agencies, state survey 

agencies, various providers of health 

care, all Medicare contractors that 

process claims and pay bills, National 

Association of Insurance Commissioners 

(NAIC), health insurers, and other 

stakeholders. To implement the various 

statutes on which the programs are 

based, we issue regulations under the 

authority granted to the Secretary of the 

Department of Health and Human 

Services under sections 1102, 1871, 

1902, and related provisions of the 

Social Security Act (the Act) and Public 

Health Service Act. We also issue 

various manuals, memoranda, and 

statements necessary to administer and 

oversee the programs efficiently. 

Section 1871(c) of the Act requires 

that we publish a list of all Medicare 

manual instructions, interpretive rules, 

statements of policy, and guidelines of 

general applicability not issued as 

regulations at least every 3 months in 

the Federal Register. 

II. Revised Format for the Quarterly 

Issuance Notices 

While we are publishing the quarterly 

notice required by section 1871(c) of the 

Act, we will no longer republish 

duplicative information that is available 

to the public elsewhere. We believe this 

approach is in alignment with CMS’ 

commitment to the general principles of 

the President’s Executive Order 13563 

released January 2011entitled 

‘‘Improving Regulation and Regulatory 

Review,’’ which promotes modifying 

and streamlining an agency’s regulatory 

program to be more effective in 

achieving regulatory objectives. Section 

6 of Executive Order 13563 requires 

agencies to identify regulations that may 

be ‘‘outmoded, ineffective, insufficient, 

or excessively burdensome, and to 

modify, streamline, expand or repeal 

them in accordance with what has been 

learned.’’ This approach is also in 

alignment with the President’s Open 

Government and Transparency Initiative 

that establishes a system of 

transparency, public participation, and 

collaboration. 

Therefore, this quarterly notice 

provides only the specific updates that 

have occurred in the 3-month period 

along with a hyperlink to the full listing 

that is available on the CMS Web site or 

the appropriate data registries that are 

used as our resources. This information 

is the most current up-to-date 

information and will be available earlier 

than we publish our quarterly notice. 

We believe the Web site list provides 

more timely access for beneficiaries, 


tkelley on DSK3SPTVN1PROD with NOTICES