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[Federal Register Volume 77, Number 174 (Friday, September 7, 2012)]
[Notices]
[Page 55216]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-22087]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10003]

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: Revision of a currently 
approved collection.
    Title of Information Collection: Notice of Denial of Medical 
Coverage (or Payment); Use: In the July 6, 2012, Federal Register (77 
FR 40064), the Centers for Medicare and Medicaid Services (CMS) 
published a 60-day notice regarding the information collection request 
approved under 0938-0829. However, due to technical difficulties, the 
documents associated with the information collection request were not 
made available to the public until August 14, 2012. Because of the 
technical difficulties, CMS is republishing the notice to allow the 
public to have a full 60-day comment period.
    Section 1852(g)(1)(B) of the Social Security Act (SSA) requires 
Medicare health plans to provide enrollees with a written notice in 
understandable language that explains the plan's reasons for denying a 
request for a service or payment for a service the enrollee has already 
received. The written notice must also include a description of the 
applicable appeals processes. Regulatory authority for this notice is 
set forth in Subpart M of Part 422 at 42 CFR 422.568, 422.572, 
417.600(b), and 417.840.
    Section 1932 of the Social Security Act (SSA) sets forth 
requirements for Medicaid managed care plans, including beneficiary 
protections related to appealing a denial of coverage or payment. The 
Medicaid managed care appeals regulations are set forth in Subpart F of 
Part 438 of Title 42 of the CFR. Rules on the content of the written 
denial notice can be found at 42 CFR 438.404.
    This notice combines the existing Notice of Denial of Medicare 
Coverage with the Notice of Denial of Payment and includes optional 
language to be used in cases where a Medicare health plan enrollee also 
receives full Medicaid benefits that are being managed by the Medicare 
health plan. Form Number: CMS-10003 (OCN: 0938-0829). Frequency: 
Occasionally. Affected Public: Private Sector (business or other for-
profits, not-for-profit institutions). Number of Respondents: 665. 
Total Annual Responses: 6,960,410. Total Annual Hours: 1,159,604. (For 
policy questions regarding this collection contact Gladys Wheeler at 
410-786-0273. 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 November 6, 2012:
    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: September 4, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-22087 Filed 9-6-12; 8:45 am]
BILLING CODE 4120-01-P
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