62414 Federal Register / Vol. 76, No. 195 / Friday, October 7, 2011 / Notices 

Hours: 66,370. (For policy questions 

regarding this collection contact 

Katherine Hosna at 410–786–4993. 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 must be received by 

December 6, 2011, and submitted in one 

of the following ways: 

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. 

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: October 4, 2011. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2011–26034 Filed 10–6–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10340, CMS– 

10237, CMS–10137, and CMS–265–11 and 

CMS–265–94] 

Agency Information Collection 

Activities: Submission for OMB 

Review; 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), Department of Health 

and Human Services, 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 function; 

(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: Collection of 

Encounter Data from Medicare 

Advantage Organizations; Use: The 

Centers for Medicare and Medicaid 

Services (CMS) intends to collect 

encounter data, or data on each item or 

service delivered to an enrollee, from 

Medicare Advantage Organizations. 

Medicare Advantage organizations will 

obtain this data from providers. CMS 

would collect the data electronically 

from Medicare Advantage Organizations 

via the Health Insurance Portability and 

Accountability Act (HIPAA) compliant 

standard Health Care Claims 

transactions for professional data and 

institutional data. The information is 

used to submit health care claims or 

equivalent health encounter 

information, carry out health plan 

enrollments and disenrollments, 

determine health plan eligibility, send 

and receive health care payment and 

remittance advices, transmit health plan 

premium payments, determine health 

care claim status, provide referral 

certifications and authorizations, and 

coordinate the benefits for individuals 

who have more than one health plan. 

Form Number: CMS–10340 (OMB#: 

0938–New); Frequency: Weekly; 

Affected Public: Private Sector; 

Businesses or other for-profits; Number 

of Respondents: 827; Total Annual 

Responses: 517,793,438; Total Annual 

Hours: 34,520. (For policy questions 

regarding this collection contact Sean 

Creighton at 410–786–9302 or Deondra 

Moseley at 410–786–4577. For all other 

issues call 410–786–1326.) 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; 

Title of Information Collection: Part C 

Medicare Advantage and 1876 Cost Plan 

Expansion Application; Use: Collection 

of this information is mandated in Part 

C of the Medicare Prescription Drug, 

Improvement and Modernization Act of 

2003 (MMA) in Subpart K of 42 CFR 

part 422 entitled Contracts with 

Medicare Advantage Organizations. In 

addition, the Medicare Improvements 

for Patients and Providers Act of 2008 

(MIPPA) amended titles XVII and XIX of 

the Social Security Act to improve the 

Medicare program. 

In general, coverage for the 

prescription drug benefit is provided 

through prescription drug plans (PDPs) 

that offer drug-only coverage or through 

Medicare Advantage (MA) organizations 

that offer integrated prescription drug 

and health care products (MA–PD 

plans). PDPs must offer a basic drug 

benefit. Medicare Advantage 

Coordinated Care Plans (MA–CCPs) 

either must offer a basic benefit or may 

offer broader coverage for no additional 

cost. Medicare Advantage Private Fee 

for Service Plans (MA–PFFS) may 

choose to offer enrollees a Part D 

benefit. Employer Group Plans may also 

provide Part D benefits. If any of the 

contracting organizations meet basic 

requirements, they may also offer 

supplemental benefits through 

enhanced alternative coverage for an 

additional premium. 

Organizations wishing to provide 

healthcare services under MA and/or 

MA–PD plans must complete an 

application, file a bid, and receive final 

approval from CMS. Existing MA plans 

may request to expand their contracted 

service area by completing the Service 

Area Expansion (SAE) application. 

Applicants may offer a local MA plan in 

a county, a portion of a county (i.e., a 

partial county) or multiple counties. 

Applicants may offer a MA regional 

plan in one or more of the 26 MA 

regions. 

This clearance request is for the 

information collected to ensure 

applicant compliance with CMS 

requirements and to gather data used to 

support determination of contract 

awards. The information will be 

collected under the solicitation of Part 

C application from MA, EGWP Plan, 

and Cost Plan applicants. The collection 

information will be used by CMS to: (1) 

Ensure that applicants meet CMS 

requirements, (2) support the 

determination of contract awards. 

Participation in all Programs is 

voluntary in nature. Only organizations 

that are interested in participating in the 

program will respond to the solicitation. 

MA–PDs that voluntarily participate in 

the Part C program must submit a Part 

D application and successful bid. Form 

Number: CMS–10237 (OMB # 0938– 

0935); Frequency: Yearly; Affected 

Public: Private Sector; Number of 

Respondents: 378; Total Annual 

Responses: 378; Total Annual Hours: 


jlentini on DSK4TPTVN1PROD with NOTICES
Federal Register / Vol. 76, No. 195 / Friday, October 7, 2011 / Notices 62415 

13,296. (For policy questions regarding 

this collection contact Letticia Ramsey 

at 410–786–5262. For all other issues 

call 410–786–1326.) 

3. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Application for 

Prescription Drug Plans (PDP); 

Application for Medicare Advantage 

Prescription Drug (MA–PD); 

Application for Cost Plans to Offer 

Qualified Prescription Drug Coverage; 

Application for Employer Group Waiver 

Plans to Offer Prescription Drug 

Coverage; Service Area Expansion 

Application for Prescription Drug 

Coverage; Use: The Medicare 

Prescription Drug Benefit program was 

established by section 101 of the 

Medicare Prescription Drug, 

Improvement, and Modernization Act of 

2003 (MMA) and is codified in section 

1860D of the Social Security Act (the 

Act). Section 101 of the MMA amended 

Title XVIII of the Social Security Act by 

redesignating Part D as Part E and 

inserting a new Part D, which 

establishes the voluntary Prescription 

Drug Benefit Program (‘‘Part D’’). The 

MMA was amended on July 15, 2008 by 

the enactment of the Medicare 

Improvements for Patients and 

Providers Act of 2008 (MIPPA), on 

March 23, 2010 by the enactment of the 

Patient Protection and Affordable Care 

Act and on March 30, 2010 by the 

enactment the Health Care and 

Education Reconciliation Act of 2010 

(collectively the Affordable Care Act). 

Coverage for the prescription drug 

benefit is provided through contracted 

prescription drug plans (PDPs) or 

through Medicare Advantage (MA) 

plans that offer integrated prescription 

drug and health care coverage (MA–PD 

plans). Cost Plans that are regulated 

under Section 1876 of the Social 

Security Act, and Employer Group 

Waiver Plans (EGWP) may also provide 

a Part D benefit. Organizations wishing 

to provide services under the 

Prescription Drug Benefit Program must 

complete an application, negotiate rates, 

and receive final approval from CMS. 

Existing Part D Sponsors may also 

expand their contracted service area by 

completing the Service Area Expansion 

(SAE) application. 

Effective January 1, 2006, the Part D 

program established an optional 

prescription drug benefit for individuals 

who are entitled to Medicare Part A or 

enrolled in Part B. In general, coverage 

for the prescription drug benefit is 

provided through PDPs that offer drugonly coverage, or through MA 

organizations that offer integrated 

prescription drug and health care 

coverage (MA–PD plans). PDPs must 

offer a basic drug benefit. Medicare 

Advantage Coordinated Care Plans 

(MA–CCPs) must offer either a basic 

benefit or may offer broader coverage for 

no additional cost. Medicare Advantage 

Private Fee for Service Plans (MA– 

PFFS) may choose to offer a Part D 

benefit. Cost Plans that are regulated 

under Section 1876 of the Social 

Security Act, and Employer Group Plans 

may also provide a Part D benefit. If any 

of the contracting organizations meet 

basic requirements, they may also offer 

supplemental benefits through 

enhanced alternative coverage for an 

additional premium. 

Applicants may offer either a PDP or 

MA–PD plan with a service area 

covering the nation (i.e., offering a plan 

in every region) or covering a limited 

number of regions. MA–PD and Cost 

Plan applicants may offer local plans. 

There are 34 PDP regions and 26 MA 

regions in which PDPs or regional MA– 

PDs may be offered respectively. The 

MMA requires that each region have at 

least two Medicare prescription drug 

plans from which to choose, and at least 

one of those must be a PDP. 

Requirements for contracting with Part 

D Sponsors are defined in part 423 of 42 

CFR. 

This clearance request is for the 

information collected to ensure 

applicant compliance with CMS 

requirements and to gather data used to 

support determination of contract 

awards.; Form Number: CMS–10137 

(OMB # 0938–0936); Frequency: 

Occasionally; Affected Public: State, 

Local, or Tribal Governments; Number 

of Respondents: 178; Total Annual 

Responses: 178; Total Annual Hours: 

2,322. (For policy questions regarding 

this collection contact Linda Anders at 

410–786–0459. For all other issues call 

410–786–1326.) 

4. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Independent 

Renal Dialysis Facility Cost Report; Use: 

Form CMS–265–94 has not been revised 

and will be used for cost reporting 

periods ending on or before December 

31, 2010. Form CMS–265–11 is a new 

form that incorporates portions of CMS– 

265–94 and CMS–339. It is effective for 

cost reporting that begins or overlaps 

January 1, 2011. Providers of services 

participating in the Medicare program 

are required under sections 1815(a), 

1833(e), 1861(v)(1)(A) and 1881(b)(2)(B) 

of the Social Security Act (42 U.S.C. 

1395g) to submit annual information to 

achieve settlement of costs for health 

care services rendered to Medicare 

beneficiaries. The Form CMS–265–11 

cost report is needed to determine the 

amount of reasonable cost due to the 

providers for furnishing medical 

services to Medicare beneficiaries; Form 

Numbers: CMS–265–11 and CMS–265– 

94 (OMB#: 0938–0236); Frequency: 

Yearly; Affected Public: Business or 

other for-profits and Not-for-profit 

institutions; Number of Respondents: 

5,654 Total Annual Responses: 5,654; 

Total Annual Hours: 367,510 (For 

policy questions regarding this 

collection contact Gail Duncan at 410– 

786–7278. 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 November 7, 2011. 

OMB, Office of Information and 

Regulatory Affairs, 

Attention: CMS Desk Officer. 

Fax Number: (202) 395–6974. 

E-mail: 

OIRA_submission@omb.eop.gov. 

Dated: October 4, 2011. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2011–26026 Filed 10–6–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–8049–N] 

Medicare Program; Establishment of 

the Medicare Economic Index 

Technical Advisory Panel and Request 

for Nominations for Members 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

establishment of the Medicare Economic 

Index Technical Advisory Panel and 

discusses the group’s purpose and 


jlentini on DSK4TPTVN1PROD with NOTICES