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[Federal Register Volume 76, Number 105 (Wednesday, June 1, 2011)]
[Notices]
[Pages 31613-31614]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-13458]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10379]

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: Rate Increase Disclosure and Review Reporting 
Requirements (45 CFR Part 154). Use: Under the Section 1003 of the 
Affordable Care Act (Section 2794 of the Public Health Service Act), 
The Secretary, in conjunction with the States, is required to establish 
a process for the annual review, beginning with the 2010 plan year, of 
unreasonable increases in premiums for health insurance coverage. 
Section 2794 directs the Secretary to ensure the public disclosure of 
information of unreasonable rate increases and justification for those 
increases.
    On December 23, 2010, CMS published a proposed rate review 
regulation in the Federal Register for public comment (Rate Increase 
Disclosure and Review Rule, 75 FR 81004). CMS revised the proposed rule 
based on the public comments and published the final rate review 
regulation in the Federal Register on May 19, 2011. The final rule 
defines the unreasonable rate review process and issuer reporting and 
disclosure requirements (Rate Increase Disclosure and Review Rule, 76 
FR 29964). The

[[Page 31614]]

regulation establishes the following reporting requirements:
     The Preliminary Justification: This data collection is 
required of all health insurance issuers for all rate increases that 
exceed the ``subject to review''' reporting threshold as defined in the 
rule. This information will be posted on an HHS Web site.
     Rate Review Final Determination: This data collection 
requires States with effective rate review programs and CMS to report 
their review findings and unreasonable rate increase determinations on 
all rate increases that are subject to review. This information will be 
posted on an HHS Web site.
     The Final Justification for An Unreasonable Rate Increase: 
This data collection is required of health insurance issuers that elect 
to implement a rate increase that is determined to be unreasonable 
based on State or CMS review. This information will be posted on the 
Health Insurance Issuer's Web site and on a CMS Web site.

2. Preliminary Justification

    The Preliminary Justification consists of three parts, Part I: Rate 
Increase Summary, Part II: Written Explanation of the Rate Increase, 
and Part III: Rate Filing Documentation. Issuers must complete Parts I 
and II for all rate increases that exceed the reporting threshold as 
defined in the rule. As described in the preamble of the rule, this 
information would be collected to provide consumers with basic 
information on all rate increases that are subject to review under the 
rate review program.
    Under the rule, ``subject to review'' rate increases would be 
reviewed by either States or CMS, depending on whether a State has an 
effective rate review program. Issuers would only be required to submit 
Part III of the Preliminary Justification when CMS is conducting the 
review of a rate increase that is ``subject to review.'' Accordingly, 
Part III requires health insurance issuers to provide detailed rate 
data that would be used for the purposes of conducting thorough 
actuarial reviews and for making determinations about whether rate 
increases are unreasonable. This Notice contains the following 
information about the Preliminary Justification:
     Preliminary Justification Issuer Instructions: Health 
insurance issuer instructions for completing all three parts of the 
Preliminary Justification.
     Part I Worksheet: A standardized Excel worksheet that must 
be used to complete Part I of the Preliminary Justification.
     Sample Internet display of the Rate Review Consumer 
Disclosure: Information provided in the Preliminary Justification would 
be posted on an HHS Web site. This sample display shows how the 
information contained in the Part I Worksheet would be displayed to 
consumers.

3. Rate Review Final Determination

    Under the rule, States and CMS would have to provide a Rate Review 
Final Determination at the close of their review of all ``subject to 
review'' rate increases. The Rate Review Final Determination must 
provide the State's or CMS' determination on whether a rate increase is 
`unreasonable'. Section 154.301(a)(3) of the rule provides a list of 
actuarial review elements that must be taken into account as part of 
the rate review process. The Final Determination must provide a brief 
statement explaining how the review of elements set forth in Sec.  
154.301(a)(3) caused the State or CMS to arrive at its determination 
that the rate is unreasonable.
    The Rate Review Final Determination will be entered into a data 
entry text box in the Rate Review Data Collection System. CMS is 
estimating that this statement would be approximately a paragraph in 
length. There is no specific form or set of instructions associated 
with this reporting requirement, apart from the reporting requirements 
provided in the rule. The information provided in the Rate Review Final 
Determination will be posted as part of the rate review consumer 
disclosure information on an HHS Web site.

4. Final Justification for An Unreasonable Rate Increase

    The rule states that if a health insurance issuer implements a rate 
increase determined by CMS or a State to be unreasonable, the health 
insurance issuer must provide a Final Justification for an Unreasonable 
Rate Increase. In the Final Justification, issuers would have to 
provide a short statement about why they are electing to implement an 
unreasonable rate increase. This statement would be entered into a data 
entry text box in the Rate Review Data Collection System and would not 
need to be more than a paragraph or two in length. There is no form or 
instructions associated with this statement apart from the requirements 
provided in the regulation.
    The Final Justification Statement will be posted on an HHS Web site 
in the same location as the Preliminary Justification and Rate Review 
Final Determination. Additionally, health insurance issuers 
implementing rate increases that were determined to be unreasonable, 
must post all of this information--the Preliminary Justification, the 
Rate Review Final Determination, and the Final Justification Statement 
on their Web sites for a period of 3 years. Form Number: CMS-10379; 
(OCN: 0938-NEW) Frequency: Annually; Affected Public: Private Sector 
and States; Number of Respondents: 452; Number of Responses: 3,571; 
Total Annual Hours: 11,902. (For policy questions regarding this 
collection, contact Sally McCarty at (301) 492-4489 or 
RateReview@hhs.gov. For all other issues call 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 June 27, 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: May 26, 2011.
Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2011-13458 Filed 5-27-11; 8:45 am]
BILLING CODE 4120-01-P
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