[Federal Register Volume 88, Number 207 (Friday, October 27, 2023)]
[Notices]
[Pages 73856-73857]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-23790]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-262 and CMS-10346]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, Health and Human 
Services (HHS).

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 (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 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 26, 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 
https://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, 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/PRA-Listing.

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-R-262 CMS Plan Benefit Package (PBP) and Formulary CY 2025
CMS-10346 Quality Bonus Payment Appeals

    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.

[[Page 73857]]

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: Revision of a currently 
approved Information Collection; Title of Information Collection: CMS 
Plan Benefit Package (PBP) and Formulary CY 2025; Use: Under the 
Medicare Modernization Act (MMA), Medicare Advantage (MA) and 
Prescription Drug Plan (PDP) organizations are required to submit plan 
benefit packages for all Medicare beneficiaries residing in their 
service area. The plan benefit package submission consists of the Plan 
Benefit Package (PBP) software, formulary file, and supporting 
documentation, as necessary. MA and PDP organizations use the PBP 
software to describe their organization's plan benefit packages, 
including information on premiums, cost sharing, authorization rules, 
and supplemental benefits. They also generate a formulary to describe 
their list of drugs, including information on prior authorization, step 
therapy, tiering, and quantity limits.
    CMS requires that MA and PDP organizations submit a completed PBP 
and formulary as part of the annual bidding process. During this 
process, organizations prepare their proposed plan benefit packages for 
the upcoming contract year and submit them to CMS for review and 
approval. CMS uses this data to review and approve the benefit packages 
that the plans will offer to Medicare beneficiaries. This allows CMS to 
review the benefit packages in a consistent way across all submitted 
bids during with incredibly tight timeframes. This data is also used to 
populate data on Medicare Plan Finder, which allows beneficiaries to 
access and compare Medicare Advantage and Prescription Drug plans. Form 
Number: CMS-R-262 (OMB control number: 0938-0763); Frequency: Yearly; 
Affected Public: Private Sector, Business or other for-profits and Not-
for-profit institutions; Number of Respondents: 825; Total Annual 
Responses: 8,770; Total Annual Hours: 55,782 (For policy questions 
regarding this collection contact Kristy Holtje at 410-786-2209.)
    2. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Quality Bonus Payment Appeals; Use: Section 1853(o) of the Act requires 
CMS to make QBPs to MA organizations that achieve performance rating 
scores of at least 4 stars under a five-star rating system. While CMS 
has applied a Star Rating system to MA organizations for a number of 
years, prior to the QBP program these Star Ratings were used only to 
provide additional information for beneficiaries to consider in making 
their Part C and D plan elections. Beginning in 2012, the Star Ratings 
CMS assigns for purposes of QBPs directly affected the monthly payment 
amount MA organizations receive from CMS under their contracts. 
Additionally, section 1854(b)(1)(C)(v) of the Act, as added by the 
Affordable Care Act, also requires CMS to change the share of savings 
that MA organizations must provide to enrollees as the beneficiary 
rebate specified at Sec.  422.266(a) based on the level of a sponsor's 
Star Rating for quality performance.
    The information collected on the Request for Reconsideration form 
from MA organizations is considered by the reconsideration official and 
potentially the hearing officer to review CMS's determination of the 
organization's eligibility for a QBP. The form asks MA organizations to 
select the Star Ratings measure(s) they believe was miscalculated or 
used incorrect data and describe what they believe is the issue. Under 
Sec.  422.260(c)(3)(ii) these are the only bases for appeals. In 
conducting the reconsideration, the reconsideration official will 
review the QBP determination, the evidence and findings upon which it 
was based, and any other written evidence submitted by the organization 
with their Request for Reconsideration or by CMS before the 
reconsideration determination is made. Form Number: CMS-10346 (OMB 
Control Number 0938-1129; Frequency: Yearly; Affected Public: Private 
Sector; Number of Respondents: 20; Total Annual Responses: 20; Total 
Annual Hours: 160. (For policy questions regarding this collection 
contact Joy Binion at 410-786-6567.)

    Dated: October 24, 2023.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2023-23790 Filed 10-26-23; 8:45 am]
BILLING CODE 4120-01-P