89710 Federal Register / Vol. 88, No. 248 / Thursday, December 28, 2023 / Notices 

TOTAL ESTIMATED ANNUALIZED BURDEN HOURS—Continued 

Form name 

(includes the ANE program specific tables and attachments) 

Number of 

respondents 

Number of 

responses per 

respondent 

Total 

responses 

Average 

burden per 

response 

(in hours) 

Total burden 

hours 

Advanced Nursing Education Sexual Assault Nurse Examiners .................................................................................. 54 1 54 7 378 

ANE–NPRF .......................................................................... 64 1 64 7 448 

Maternity Care Nursing Workforce Expansion .................... 10 1 10 7 70 

Total .............................................................................. 348 ........................ 348 ........................ 2,436 

HRSA specifically requests comments 

on (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. 

Maria G. Button, 

Director, Executive Secretariat. 

[FR Doc. 2023–28664 Filed 12–27–23; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

[OMHA–2302–N] 

Medicare Program; Administrative Law 

Judge Hearing Program for Medicare 

Claim and Entitlement Appeals; 

Quarterly Listing of Program 

Issuances—July Through September 

2023 

AGENCY: Office of Medicare Hearings 

and Appeals (OMHA), HHS. 

ACTION: Notice. 

SUMMARY: This quarterly notice lists the 

OMHA Case Processing Manual (OCPM) 

instructions that were published from 

July through September 2023. This 

manual standardizes the day-to-day 

procedures for carrying out adjudicative 

functions, in accordance with 

applicable statutes, regulations, and 

OMHA directives, and gives OMHA 

staff direction for processing appeals at 

the OMHA level of adjudication. 

FOR FURTHER INFORMATION CONTACT: Jon 

Dorman, by telephone at (571) 457– 

7220, or by email at jon.dorman@

hhs.gov. 

SUPPLEMENTARY INFORMATION: 

I. Background 

The Office of Medicare Hearings and 

Appeals (OMHA), a staff division within 

the Office of the Secretary within the 

U.S. Department of Health and Human 

Services (HHS), administers the 

nationwide Administrative Law Judge 

hearing program for Medicare claim; 

organization, coverage, and at-risk 

determination; and entitlement appeals 

under sections 1869, 1155, 

1876(c)(5)(B), 1852(g)(5), and 1860D– 

4(h) of the Social Security Act (the Act). 

OMHA ensures that Medicare 

beneficiaries and the providers and 

suppliers that furnish items or services 

to Medicare beneficiaries, as well as 

Medicare Advantage organizations 

(MAOs), Medicaid State agencies, and 

applicable plans, have a fair and 

impartial forum to address 

disagreements with Medicare coverage 

and payment determinations made by 

Medicare contractors, MAOs, or Part D 

plan sponsors (PDPSs), and 

determinations related to Medicare 

eligibility and entitlement, Part B late 

enrollment penalty, and income-related 

monthly adjustment amounts (IRMAA) 

made by the Social Security 

Administration (SSA). 

The Medicare claim, organization 

determination, coverage determination, 

and at-risk determination appeals 

processes consist of four levels of 

administrative review, and a fifth level 

of review with the Federal district 

courts after administrative remedies 

under HHS regulations have been 

exhausted. The first two levels of review 

are administered by the Centers for 

Medicare & Medicaid Services (CMS) 

and conducted by Medicare contractors 

for claim appeals, by MAOs and an 

Independent Review Entity (IRE) for 

Part C organization determination 

appeals, or by PDPSs and an IRE for Part 

D coverage determination and at-risk 

determination appeals. The third level 

of review is administered by OMHA and 

conducted by Administrative Law 

Judges and attorney adjudicators. The 

fourth level of review is administered by 

the HHS Departmental Appeals Board 

(DAB) and conducted by the Medicare 

Appeals Council (Council). In addition, 

OMHA and the DAB administer the 

second and third levels of appeal, 

respectively, for Medicare eligibility, 

entitlement, Part B late enrollment 

penalty, and IRMAA reconsiderations 

made by SSA; a fourth level of review 

with the Federal district courts is 

available after administrative remedies 

within SSA and HHS have been 

exhausted. 

Sections 1869, 1155, 1876(c)(5)(B), 

1852(g)(5), and 1860D–4(h) of the Act 

are implemented through the 

regulations at 42 CFR part 405 subparts 

I and J; part 417, subpart Q; part 422, 

subpart M; part 423, subparts M and U; 

and part 478, subpart B. As noted above, 

OMHA administers the nationwide 

Administrative Law Judge hearing 

program in accordance with these 

statutes and applicable regulations. To 

help ensure nationwide consistency in 

that effort, OMHA established a manual, 

the OCPM. Through the OCPM, the 

OMHA Chief Administrative Law Judge 

establishes the day-to-day procedures 

for carrying out adjudicative functions, 

in accordance with applicable statutes, 

regulations, and OMHA directives. The 

OCPM provides direction for processing 

appeals at the OMHA level of 

adjudication for Medicare Part A and B 

claims; Part C organization 

determinations; Part D coverage 

determinations and at-risk 

determinations; and SSA eligibility and 

entitlement, Part B late enrollment 

penalty, and IRMAA determinations. 

Section 1871(c) of the Act requires 

that the Secretary publish a list of all 

Medicare manual instructions, 

interpretive rules, statements of policy, 

and guidelines of general applicability 

not issued as regulations at least every 

three months in the Federal Register. 

II. Format for the Quarterly Issuance 

Notices 

This quarterly notice provides the 

specific updates to the OCPM that have 

occurred in the three-month period of 

July through September 2023. A 

hyperlink to the available chapters on 

the OMHA website is provided below. 

The OMHA website contains the most 

current, up-to-date chapters and 

revisions to chapters, and will be 


khammond on DSKJM1Z7X2PROD with NOTICES
Federal Register / Vol. 88, No. 248 / Thursday, December 28, 2023 / Notices 89711 

available earlier than we publish our 

quarterly notice. We believe the OMHA 

website provides more timely access to 

the current OCPM chapters for those 

involved in the Medicare claim; 

organization, coverage, and at-risk 

determination; and entitlement appeals 

processes. We also believe the website 

offers the public a more convenient tool 

for real time access to current OCPM 

provisions. In addition, OMHA has a 

listserv to which the public can 

subscribe to receive notification of 

certain updates to the OMHA website, 

including when new or revised OCPM 

chapters are posted. If accessing the 

OMHA website proves to be difficult, 

the contact person listed above can 

provide the information. 

III. How To Use the Notice

This notice lists the OCPM chapters

and subjects published during the 

quarter covered by the notice so the 

reader may determine whether any are 

of particular interest. The OCPM can be 

accessed at https://www.hhs.gov/about/ 

agencies/omha/the-appeals-process/ 

case-processing-manual/index.html. 

IV. OCPM Releases for July Through

September 2023

The OCPM is used by OMHA 

adjudicators and staff to administer the 

OMHA program. It offers day-to-day 

operating instructions, policies, and 

procedures based on statutes and 

regulations, and OMHA directives. 

The following is a list and description 

of OCPM provisions that were issued or 

revised in the three-month period of 

July through September 2023. This 

information is available on our website 

at https://www.hhs.gov/about/agencies/ 

omha/the-appeals-process/caseprocessing-manual/index.html. 

OCPM Chapter 20 (Post-Adjudication 

Actions) Updates 

OMHA issued the initial version of 

this chapter on May 25, 2018, and 

included it in a quarterly notice 

published in the August 7, 2018 Federal 

Register (83 FR 38700). The revised 

chapter addresses changes to postadjudication appeals processing 

resulting from increased electronic case 

processing through OMHA’s Electronic 

Case Adjudication and Processing 

Environment (ECAPE), advances in 

appeal filing procedures through the eAppeal Portal, and other improvements 

in appeals operations and processing. 

This revision removes outdated data 

entry processes that were updated with 

electronic case processing. This revision 

also clarifies how post-adjudication 

actions are processed if the original 

adjudicator is not available for more 

than 20 calendar days; clarifies how 

various post-adjudication requests are 

filed; updates the operational process to 

re-establish an appeal. Finally, the 

revision adds a new section, 20.13, 

Requests to Obtain Approval of a Fee, 

which incorporates information 

previously included in OCPM Chapter 

5. OMHA made revisions in the

following sections: 20.2.1, 20.2.2, 20.3.2,

20.3.4, 20.4.1, 20.4.3, 20.4.4, 20.4.5,

20.4.6, 20.5.2, 20.5.3, 20.5.4, 20.5.5

(multiple), 20.5.7 (multiple), 20.5.8

(multiple), 20.6.1 (multiple), 20.6.2,

20.6.4, 20.6.5 (multiple), 20.6.6.1, 20.6.7

(multiple), 20.7.1.4, 20.7.2, 20.7.4,

20.7.5 (multiple), 20.7.7 (multiple),

20.8.1.3, 20.8.2, 20.8.4, 20.8.5

(multiple), 20.8.6.1, 20.8.7 (multiple),

20.9.1, 20.9.2, 20.9.4, 20.9.5, 20.10.2,

20.10.3, 20.11.2, 20.11.4, 20.11.5,

20.11.6, 20.12.1, 20.12 (multiple), 20.13.

Karen W. Ames, 

Executive Director of Operations, Office of 

Medicare Hearings and Appeals. 

[FR Doc. 2023–28625 Filed 12–27–23; 8:45 am] 

BILLING CODE 4150–46–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Indian Health Service 

Funding Opportunity for the Tribal 

Management Grant Program 

Announcement Type: New. 

Funding Announcement Number: 

HHS–2024–IHS–TMD–0001. 

Assistance Listing (Catalog of Federal 

Domestic Assistance or CFDA) Number: 

93.228. 

Key Dates 

Application Deadline Date: March 14, 

2024. 

Earliest Anticipated Start Date: June 

1, 2024. 

I. Funding Opportunity Description

Statutory Authority

The Indian Health Service (IHS) is 

accepting applications for grants for the 

Tribal Management Grant (TMG) 

Program. This program is authorized 

under the Snyder Act, 25 U.S.C. 13; the 

Transfer Act, 42 U.S.C. 2001(a); and the 

Indian Self-Determination and 

Education Assistance Act (ISDEAA), 

Public Law 93–638, as amended, 25 

U.S.C. 5322(b)(2) and 25 U.S.C. 5322(e). 

The Assistance Listings section of 

SAM.gov (https://sam.gov/content/ 

home) describes this program under 

93.228. 

Background 

The TMG Program is a competitive 

grant program that is capacity building 

and developmental in nature and has 

been available for federally recognized 

Indian Tribes and Tribal Organizations 

(T/TO) since shortly after enactment of 

the ISDEAA in 1975. The TMG Program 

was established to assist T/TOs to 

prepare for assuming all or part of 

existing IHS programs, functions, 

services, and activities (PFSAs) and 

further develop and improve Tribal 

health management capabilities. The 

TMG Program provides competitive 

grants to T/TOs to establish goals and 

performance measures for current health 

programs, assess current management 

capacity to determine if new 

components are appropriate, analyze 

programs to determine if a T/TO’s 

management is practicable, and develop 

infrastructure systems to manage or 

organize PFSAs. 

Purpose 

The purpose of this program is to 

enhance and develop health 

management infrastructure and assist T/ 

TOs in assuming all or part of existing 

IHS PFSAs through a title I ISDEAA 

contract and assist established title I 

ISDEAA contractors and title V ISDEAA 

compactors to further develop and 

improve management capability. In 

addition, Tribal Management Grants are 

available to T/TOs under the authority 

of 25 U.S.C. 5322(e) for the following: 

1. Obtaining technical assistance from

providers designated by the T/TO 

(including T/TOs that operate mature 

contracts) for the purposes of program 

planning and evaluation, including the 

development of any management 

systems necessary for contract 

management, and the development of 

cost allocation plans for indirect cost 

rates. 

2. Planning, designing, monitoring,

and evaluating Federal programs serving 

T/TOs, including Federal administrative 

functions. 

II. Award Information

Funding Instrument—Grant

Estimated Funds Available

The total funding identified for fiscal 

year (FY) 2024 is approximately 

$2,464,000. Individual award amounts 

for the first budget year are anticipated 

to be between $50,000 and $150,000. 

The funding available for competing 

and subsequent continuation awards 

issued under this announcement is 

subject to the availability of 

appropriations and budgetary priorities 

of the Agency. The IHS is under no 


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