Federal Register / Vol. 78, No. 65 / Thursday, April 4, 2013 / Notices 20321 

Each individual will be asked to 

complete the form which will include 

providing the individual’s name, PCIP 

account number (if known), date of 

birth, what personal health information 

they agree to share, the length of time 

the individual agrees their personal 

health information can be shared, the 

names and addresses of the third party 

the individual wants PCIP to share their 

personal health information with, and 

an attestation that the individual is 

giving PCIP permission to share their 

personal health information with the 

third party listed in the form. This 

completed form will be submitted to the 

PCIP benefits administrator, GEHA, 

which contracts with CMS. 

We estimate that it will take 

approximately 15 minutes per applicant 

to complete and submit a HIPAA 

Authorization Form to the PCIP 

program. 

The federally-run PCIP program 

operates in 23 states plus the District of 

Columbia and receives an average of 

35,000 enrollment applications per year. 

To estimate the number of PCIP 

applicants and enrollees who may 

complete an authorization, we looked at 

the percentage of individuals who 

request an authorization in Medicare as 

a baseline. Medicare estimates 3% of its 

population will submit an authorization 

per year. However, since the PCIP 

program caters to an exclusive 

population comprised of individuals 

who have one or more pre-existing 

conditions, we believe it is likely we 

could receive double the percentage 

estimated by Medicare. Accordingly, 

PCIP estimates 6% (or 2,100) of its 

applicants and enrollees may submit an 

authorization per year. 

Based on the above, it is estimated 

that up to 2,100 applicants and 

enrollees may submit an authorization 

annually. There is no cost to PCIP 

beneficiaries to request, complete, 

submit, or have the authorization form 

processed by PCIP. It should take 

approximately 15 minutes for a 

beneficiary to complete the 

authorization form. 15 minutes 

multiplied by 2,100 beneficiaries equals 

525 hours. Form Number: CMS–10428 

(OCN#: 0938–1161); Frequency: Once; 

Affected Public: Individuals or 

households; Number of Respondents: 

2,100; Total Annual Responses: 2,100; 

Total Annual Hours: 525. (For policy 

questions regarding this collection 

contact Geoffrey Cabin at 410–786– 

1744. For all other issues call 410–786– 

1326.) 

1. Type of Information Collection 

Request: New collection (request for a 

new OMB control number). Title of 

Information Collection: Consumer 

Research Supporting Outreach for 

Health Insurance Marketplace. Use: The 

Centers for Medicare and Medicaid 

Services is requesting clearance for two 

surveys to aid in understanding levels of 

awareness and customer service needs 

associated with the Health Insurance 

Marketplace established by the 

Affordable Care Act. Because the 

Marketplace will provide coverage to 

the almost 50 million uninsured in the 

United States through individual and 

small employer programs, we have 

developed one survey to be 

administered to individual consumers 

most likely to use the Marketplace and 

another to be administered to small 

employers most likely to use the Small 

Business Health Options portion of the 

Marketplace. These brief surveys, 

designed to be conducted quarterly, will 

give CMS the ability to obtain a rough 

indication of the types of outreach and 

marketing that will be needed to 

enhance awareness of and knowledge 

about the Marketplace for individual 

and business customers. CMS’ biggest 

customer service need is likely to be 

providing sufficient education so 

consumers: (a) Can take advantage of the 

Marketplace and (b) know how to access 

CMS’ customer service channels. The 

surveys will provide information on 

media use, concept awareness, and 

conceptual or content areas where 

education for customer service delivery 

can be improved. Awareness and 

knowledge gaps are likely to change 

over time based not only on 

effectiveness of CMS’ marketing efforts, 

but also of those of state, local, private 

sector, and nongovernmental 

organizations. Form Number: CMS– 

10458 (OCN: 0938–New). Frequency: 

Quarterly. Affected Public: Individuals 

or households, private sector (business 

or other for-profits). Number of 

Respondents: 40,200. Total Annual 

Responses: 40,200. Total Annual Hours: 

2,480. (For policy questions regarding 

this collection contact Julie Franklin at 

410–786–8126. For all other issues call 

410–786–1326.) 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS Web site 

address at http://www.cms.hhs.gov/ 

PaperworkReductionActof1995, or 

Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office on (410) 786– 

1326. 

To be assured consideration, 

comments and recommendations for the 

proposed information collections must 

be received by the OMB desk officer at 

the address below, no later than 5 p.m. 

on May 6, 2013. 

OMB, Office of Information and 

Regulatory Affairs, Attention: CMS Desk 

Officer, Fax Number: (202) 395–6974, 

Email: OIRA_submission@omb.eop.gov. 

Dated: March 29, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–07799 Filed 4–3–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10467, CMS– 

10330, and CMS–10325] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Centers for Medicare & Medicaid 

Services (CMS) is publishing the 

following summary of proposed 

collections for public comment. 

Interested persons are invited to send 

comments regarding this 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. 

1. Type of Information Collection 

Request: New Collection; 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 


wreier-aviles on DSK5TPTVN1PROD with NOTICES
20322 Federal Register / Vol. 78, No. 65 / Thursday, April 4, 2013 / Notices 

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 nursemidwife; 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 the Centers for Medicare 

and Medicaid Services, 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 forprofit 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. For all other issues call 410–786– 

1326.) 

2. 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 Service 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: 

On Occasion; Affected Public: Private 

Sector; State, Local, or Tribal 

Governments; 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. For all other issues call (410) 

786–1326.) 

3. 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 nongrandfathered 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. For 

all other issues call (410) 786–1326.) 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS’ Web site 

address at http://www.cms.hhs.gov/ 

PaperworkReductionActof1995, or email 

your request, including your address, 

phone number, OMB number, and CMS 

document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office on (410) 786– 

1326. 

In commenting on the proposed 

information collections please reference 

the document identifier or OMB control 

number. To be assured consideration, 

comments and recommendations must 

be submitted in one of the following 

ways by June 3, 2013: 

1. Electronically. You may submit 

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) accepting comments. 


wreier-aviles on DSK5TPTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 65 / Thursday, April 4, 2013 / Notices 20323 

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. 

Dated: March 29, 2013. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2013–07798 Filed 4–3–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10309, CMS– 

10475, CMS–R–5, CMS–R–234, and CMS– 

R–297] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Centers for Medicare & Medicaid 

Services (CMS) is publishing the 

following summary of proposed 

collections for public comment. 

Interested persons are invited to send 

comments regarding this 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. 

1. Type of Information Collection 

Request: Reinstatement with change of a 

previously approved collection. Title of 

Information Collection: Grandfathering 

Provisions of the Medicare DMEPOS 

Competitive Bidding Program. Use: 

Section 1847(a)(4) of the Social Security 

Act (the Act) requires that (in the case 

of covered durable medical equipment 

(DME) items for which payment is made 

on a rental basis under section 1834(a) 

of the Act and in the case of oxygen for 

which payment is made under section 

1834(a)(5) of the Act) the Secretary shall 

establish a grandfathering process by 

which covered items and supplies that 

were rented by suppliers before the 

implementation of a competitive 

bidding program may be continued. 

We established the grandfathering 

process in the April 10, 2007 final rule 

for competitive bidding (72 FR 17992) 

for rented DME and oxygen and oxygen 

equipment when these items are 

included under the Medicare DMEPOS 

Competitive Bidding Program. This 

process only applies to suppliers that 

rented DME and oxygen and oxygen 

equipment to beneficiaries who 

maintain a permanent residence in a 

competitive bidding area (CBA) before 

the implementation of the competitive 

bidding program. 

The competitive bidding program will 

require some beneficiaries to change 

their suppliers. In order to avoid a 

beneficiary being without medically 

necessary equipment we felt it 

necessary to establish this notification 

process. 

The notification to the beneficiaries is 

a beneficiary protection that will keep 

them informed of whether or not they 

can continue to rent an item from their 

current supplier or go to a contract 

supplier. The notification will also 

provide information to the beneficiary 

as to how to find a contract supplier in 

their CBA. In the event that the 

beneficiary must go to a contract 

supplier, the notification will identify 

the procedure for the pick-up of their 

current equipment and delivery of new 

equipment. 

Form Number: CMS–10309 (OCN 

0938–1079). Frequency: Once. Affected 

Public: Private sector (business or other 

for-profits). Number of Respondents: 

2,697 (or 8,091/3). Total Annual 

Responses: 536,667 (or 1,610,000/3). 

Total Annual Hours: 65 (or 196/3). (For 

policy questions regarding this 

collection contact Michael Keane at 

410–786–4495. For all other issues call 

410–786–1326.) 

2. Type of Information Collection 

Request: New collection (request for a 

new OMB control number). Title of 

Information Collection: Hospice 

Experience of Care Survey. Use: This 

survey supports the National Quality 

Strategy that was called for under the 

Affordable Care Act to create national 

aims and priorities to guide local, state, 

and national efforts to improve the 

quality of health care. This strategy has 

established six priorities that support a 

three-part aim focusing on better care, 

better health, and lower costs through 

improvement. Because the hospice 

survey focuses on experiences of care, 

implementation of the survey supports 

the following national priorities for 

improving care: engaging patients and 

families in care and promoting effective 

communication and coordination. In 

addition, upon national implementation 

and public reporting of hospice survey 

results, the survey will provide data on 

experiences with hospice care that 

enable consumers to make meaningful 

comparisons between hospices across 

the nation. Form Number: CMS–10475 

(OCN 0938–New). Frequency: Once. 

Affected Public: Individuals and 

households. Number of Respondents: 

730. Total Annual Responses: 730. Total 

Annual Hours: 185. (For policy 

questions regarding this collection 

contact Lori Teichman at 410–786– 

6684. For all other issues call 410–786– 

1326.) 

3. Type of Information Collection 

Request: Reinstatement without change 

of a previously approved collection. 

Title of Information Collection: 

Physician Certification/Recertification 

in Skilled Nursing Facilities (SNFs) 

Manual Instructions and Supporting 

Regulation in 42 CFR 424.20. Use: The 

Medicare program requires, as a 

condition for Medicare Part A payment 

for posthospital SNF services that a 

physician must certify and periodically 

recertify that a beneficiary requires an 

SNF level of care. The physician 

certification and recertification is 

intended to ensure that the beneficiary’s 

need for services has been established 

and then reviewed and updated at 

appropriate intervals. The 

documentation is a condition for 

Medicare Part A payment for posthospital SNF care. Form Number: CMS– 

R–5 (OCN 0938–0454). Frequency: 

Occasionally. Affected Public: Private 

sector (business or other for-profit and 

not-for-profit institutions). Number of 

Respondents: 1,796,502. Total Annual 

Responses: 1,796,502. Total Annual 

Hours: 559,713. (For policy questions 

regarding this collection contact Kia 

Sidbury at 410–786–7816. For all other 

issues call 410–786–1326.) 

4. Type of Information Collection 

Request: Extension without change of a 

currently approved collection. Title of 

Information Collection: Subpart D— 

Private Contracts and Supporting 

Regulations contained in 42 CFR 

405.410, 405.430, 405.435, 405.440, 

405.445, and 405.455. Use: Section 4507 

of Balancing Budget Act (BBA) 1997 

amended section 1802 of the Social 

Security Act to permit certain 

physicians and practitioners to opt-out 

of Medicare and to provide (through 

private contracts) services that would 

otherwise be covered by Medicare. 

Under such contracts the mandatory 

claims submission and limiting charge 


wreier-aviles on DSK5TPTVN1PROD with NOTICES