Federal Register / Vol. 89, No. 20 / Tuesday, January 30, 2024 / Notices 5907 

procedures. On February 21, 2006, we 

issued our decision memorandum on 

bariatric surgery procedures. We 

determined that bariatric surgical 

procedures are reasonable and necessary 

for Medicare beneficiaries who have a 

body-mass index (BMI) greater than or 

equal to 35, have at least one comorbidity related to obesity and have 

been previously unsuccessful with 

medical treatment for obesity. This 

decision also stipulated that covered 

bariatric surgery procedures are 

reasonable and necessary only when 

performed at facilities that are: (1) 

certified by the American College of 

Surgeons (ACS) as a Level 1 Bariatric 

Surgery Center (program standards and 

requirements in effect on February 15, 

2006); or (2) certified by the American 

Society for Bariatric Surgery (ASBS) as 

a Bariatric Surgery Center of Excellence 

(BSCOE) (program standards and 

requirements in effect on February 15, 

2006). 

There were no additions, deletions, or 

editorial changes to Medicare-approved 

facilities that meet CMS’ minimum 

facility standards for bariatric surgery 

that have been certified by ACS and/or 

ASMBS in the 3-month period. This 

information is available at 

www.cms.gov/MedicareApproved

Facilitie/BSF/list.asp#TopOfPage. 

For questions or additional 

information, contact Sarah Fulton, MHS 

(410–786–2749). 

Addendum XV: FDG–PET for Dementia 

and Neurodegenerative Diseases 

Clinical Trials (October Through 

December 2023) 

There were no FDG–PET for Dementia 

and Neurodegenerative Diseases 

Clinical Trials published in the 3-month 

period. 

This information is available on our 

website at www.cms.gov/Medicare

ApprovedFacilitie/PETDT/list.asp#

TopOfPage. 

For questions or additional 

information, contact David Dolan, MBA 

(410–786–3365). 

[FR Doc. 2024–01785 Filed 1–29–24; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–4207–NC] 

RIN 0938–ZB84 

Medicare Program; Request for 

Information on Medicare Advantage 

Data 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human Services (HHS). 

ACTION: Request for information. 

SUMMARY: This request for information 

(RFI) seeks input from the public 

regarding various aspects of Medicare 

Advantage (MA) data. Responses to this 

RFI may be used to inform general 

efforts to strengthen Centers for 

Medicare & Medicaid Services’ (CMS’) 

MA data capabilities and guide 

policymaking. 

DATES: To be assured consideration, 

comments must be received at one of 

the addresses provided below, by May 

29, 2024. 

ADDRESSES: In commenting, refer to file 

code CMS–4207–NC. 

Comments, including mass comment 

submissions, must be submitted in one 

of the following three ways (please 

choose only one of the ways listed): 

1. Electronically. You may submit 

electronic comments on this document 

to http://www.regulations.gov. Follow 

the ‘‘Submit a comment’’ instructions. 

2. By regular mail. You may mail 

written comments to the following 

address ONLY: Centers for Medicare & 

Medicaid Services, Department of 

Health and Human Services, Attention: 

CMS–4207–NC, P.O. Box 8013, 

Baltimore, MD 21244–8013. 

Please allow sufficient time for mailed 

comments to be received before the 

close of the comment period. 

3. By express or overnight mail. You 

may send written comments to the 

following address ONLY: Centers for 

Medicare & Medicaid Services, 

Department of Health and Human 

Services, Attention: CMS–4207–NC, 

Mail Stop C4–26–05, 7500 Security 

Boulevard, Baltimore, MD 21244–1850. 

For information on viewing public 

comments, see the beginning of the 

SUPPLEMENTARY INFORMATION section. 

FOR FURTHER INFORMATION CONTACT: Ilina 

Chaudhuri, (410) 786–8628. 

SUPPLEMENTARY INFORMATION: 

Inspection of Public Comments: All 

comments received before the close of 

the comment period are available for 

viewing by the public, including any 

personally identifiable or confidential 

business information that is included in 

a comment. We post all comments 

received before the close of the 

comment period on the following 

website as soon as possible after they 

have been received: http://

www.regulations.gov. Follow the search 

instructions on that website to view 

public comments. CMS will not post on 

Regulations.gov public comments that 

make threats to individuals or 

institutions or suggest that the 

individual will take actions to harm the 

individual. CMS continues to encourage 

individuals not to submit duplicative 

comments. We will post acceptable 

comments from multiple unique 

commenters even if the content is 

identical or nearly identical to other 

comments. 

I. Background 

In a request for information that 

appeared in the Federal Register on 

August 1, 2022 (87 FR 46918) 

(hereinafter referred to as 2022 General 

MA RFI), CMS sought feedback on ways 

to strengthen Medicare Advantage (MA) 

to align with the Vision for Medicare 

(https://www.cms.gov/blog/buildingcms-strategic-vision-working-togetherstronger-medicare) and the CMS 

Strategic Pillars (https://www.cms.gov/ 

about-cms/what-we-do/cms-strategicplan). The 2022 General MA RFI set out 

to create more opportunities for 

stakeholders to engage with CMS, and 

in alignment with the agency’s Strategic 

Pillars, prioritize increased engagement 

throughout the policy process with our 

partners and the communities we serve. 

As a result of this commitment, we 

received more than 4,000 responses 

from a wide variety of voices. One key 

theme that emerged was an interest in 

greater beneficiary protections, such as 

strengthened MA marketing regulations 

and prior authorization protections. 

Respondents also focused on issues 

related to payment, including accurate 

risk adjustment and value-based 

payment arrangements between 

providers and insurers, as well as 

competition in the market, such as 

topics related to insurer consolidation 

and vertical integration. Additionally, 

we received strong feedback from 

respondents who stated that CMS 

should have comprehensive highquality MA programmatic data and 

promote more program transparency 

through increased public releases of MA 

data. Respondents underscored the 

urgency for more complete MA data and 

data transparency as enrollment in MA 


khammond on DSKJM1Z7X2PROD with NOTICES
5908 Federal Register / Vol. 89, No. 20 / Tuesday, January 30, 2024 / Notices 

1From ‘‘Medicare Advantage and Medicare 

Prescription Drug Programs to Remain Stable in 

2024’’, available at https://www.cms.gov/newsroom/ 

press-releases/medicare-advantage-and-medicareprescription-drug-programs-remain-stable-2024. 

2Examples of such studies and reports include: 

‘‘Priority Open Recommendations: Department of 

Health and Human Services.’’ May 2023. https://

www.gao.gov/assets/gao-23-106467.pdf; ‘‘The 

Inability To Identify Denied Claims in Medicare 

Advantage Hinders Fraud Oversight.’’ OEI–03–21– 

00380. March 2023. https://oig.hhs.gov/oei/reports/ 

OEI-03-21-00380.asp; ‘‘Medicare Advantage: Plans 

Generally Offered Some Supplemental Benefits, but 

CMS Has Limited Data on Utilization.’’ Jan 2023. 

https://www.gao.gov/products/gao-23-105527; 

‘‘OIG’s Top Unimplemented Recommendations: 

Solutions to Reduce Fraud, Waste, and Abuse in 

HHS Programs.’’ 2022. https://oig.hhs.gov/reportsand-publications/compendium/files/

compendium2022.pdf; ‘‘CMS Generally Ensured 

That Medicare Part C and Part D Sponsors Did Not 

Pay Ineligible Providers for Services to Medicare 

Beneficiaries.’’ A–02–20–01027. Oct 2022. https://

oig.hhs.gov/oas/reports/region2/22001027.pdf; 

‘‘Some Medicare Advantage Organization Denials of 

Prior Authorization Requests Raise Concerns About 

Beneficiary Access to Medically Necessary Care.’’ 

OEI–09–18–00260. Apr 2022. https://oig.hhs.gov/ 

oei/reports/oei-09-18-00260.asp; ‘‘Medicare 

Advantage Organizations Are Missing 

Opportunities To Use Ordering Provider Identifiers 

to Protect Integrity.’’ OEI Report OEI–03–19–00432. 

Apr 2021. https://oig.hhs.gov/oei/reports/OEI-03- 

19-00432.asp; https://www.medpac.gov/wpcontent/uploads/import_data/scrape_files/docs/ 

default-source/reports/jun19_ch7_medpac_reportto

congress_sec.pdf; ‘‘The Inability To Identify Denied 

Claims in Medicare Advantage Hinders Fraud 

Oversight.’’ (OEI–03–21–00380) March 2023. 

https://oig.hhs.gov/oei/reports/OEI-03-21- 

00380.asp. 

3https://www.cms.gov/newsroom/fact-sheets/ 

2024-medicare-advantage-and-part-d-final-rulecms-4201-f. 

4https://www.cms.gov/newsroom/fact-sheets/ 

contract-year-2025-policy-and-technical-changesmedicare-advantage-plan-program-medicare; 

https://www.cms.gov/newsroom/fact-sheets/ 

contract-year-2024-policy-and-technical-changesmedicare-advantage-and-medicare-prescriptiondrug. 

5https://www.cms.gov/medicare/enrollmentrenewal/health-plans/part-c. 

6https://www.cms.gov/newsroom/fact-sheets/ 

contract-year-2024-policy-and-technical-changesmedicare-advantage-and-medicare-prescriptiondrug; https://www.cms.gov/newsroom/fact-sheets/ 

contract-year-2025-policy-and-technical-changesmedicare-advantage-plan-program-medicare. 

7https://www.cms.gov/newsroom/fact-sheets/ 

cms-interoperability-and-prior-authorization-finalrule-cms-0057-f. 

8https://www.cms.gov/regulations-and-guidance

legislationpaperworkreductionactof1995pra-listing/ 

cms-10718. 

has for the first time reached half of all 

people enrolled in Medicare.1

Recommendations regarding MA data 

included calls for CMS to collect and 

release more MA data on key areas of 

concern, such as supplemental benefit 

costs and utilization, value-based 

payment arrangements between 

providers and plans, utilization 

management and prior authorization 

including denials and appeals and 

access to inpatient services and postacute care, network adequacy and 

provider directory accuracy, 

competitive forces in the market such as 

the effects of market shifts and vertical 

integration and consolidation on 

consumers, care outcomes, and 

Medicare Loss Ratios (MLRs). 

Commenters also raised data 

considerations on topics such as MA 

marketing activity, especially predatory 

behavior, care outcomes and data 

available in MA compared to 

Traditional Medicare (Medicare Parts A 

and B), and geographic impacts 

including on rural areas, among other 

important topic areas. Respondents 

emphasized that CMS should improve 

its data capabilities to measure impacts 

of MA on underserved communities. 

HHS’ Office of Inspector General (OIG), 

the Government Accountability Office 

(GAO), and the Medicare Payment 

Advisory Commission (MedPAC) have 

pointed out program areas that would 

benefit from better or more MA data as 

well.2

During the Biden-Harris 

Administration, we have finalized 

policies for 2024 3 and proposed 

policies 4 that will improve MA data 

capabilities, among other important MA 

policy changes. We have also issued 

requirements for collecting more data 

related to supplemental benefits in the 

updated Part C reporting requirements,5

required MA organizations to improve 

prior authorization processes 6 and final 

interoperability requirements,7 and 

begun collecting race and ethnicity data 

on a voluntary basis on MA and Part D 

enrollment forms.8

This RFI is an extension of our 

ongoing work on MA data as we solicit 

feedback from the public on how best to 

meet the shared goals of enhancing data 

capabilities to have better insight into 

our programs, consider areas to increase 

MA data transparency, and propose 

future rulemaking. Our eventual goal is 

to have, and make publicly available, 

MA data commensurate with data 

available for Traditional Medicare to 

advance transparency across the 

Medicare program, and to allow for 

analysis in the context of other health 

programs like accountable care 

organizations, the Marketplace, 

Medicaid managed care, integrated 

delivery systems, among others. 

II. Solicitation of Public Comments 

We encourage feedback from a wide 

array of interested parties, including 

beneficiaries and beneficiary advocates, 

plans, providers, community-based 

organizations, researchers, employers 

and unions, and all other interested 

parties, including the public at large. 

Our interest in this RFI is to solicit 

comments on all aspects of data related 

to the MA program. Intimate knowledge 

of CMS’ current data availability or 

capability is not needed to provide 

input on the aspects of MA for which 

commenters think policymakers and the 

public should have more data. 

In this RFI, CMS requests comments 

on all aspects of data related to the MA 

program—both data not currently 

collected as well as data currently 

collected. We are especially interested 

in: data-related recommendations 

related to beneficiary access to care 

including provider directories and 

networks; prior authorization and 

utilization management, including 

denials of care and beneficiary 

experience with appeals processes as 

well as use and reliance on algorithms; 

cost and utilization of different 

supplemental benefits; all aspects of MA 

marketing and consumer decisionmaking; care quality and outcomes, 

including value-based care 

arrangements and health equity; healthy 

competition in the market, including the 

impact of mergers and acquisitions, high 

levels of enrollment concentration, and 

the effects of vertical integration, data 

topics related to Medicare Advantage 

prescription drug plans (MAPDs); and 

special populations such as individuals 

dually eligible for Medicare and 

Medicaid, individuals with end stage 

renal disease (ESRD), and other 

enrollees with complex conditions. We 

ask that academic researchers and other 

data analysts provide precise detail and 

definitions on the data format, fields, 

and content that would facilitate 

comprehensive analyses of any publicly 

released MA data, including 

comparisons with existing data sets, for 

example, between Traditional Medicare 

and MA. Additionally, we seek detail 

regarding the rationale, goals, and 

questions that you could address with 

newly released data and suggestions for 

how such data could support new 

action or regulation by CMS. We are 

also interested to hear if you have 

insight in ways in which CMS could 

leverage existing private sector data. 

It would also be helpful for plans, 

providers, data vendors, and other 

stakeholders with a deep understanding 

of MA data to provide recommendations 

related to operational considerations as 

part of this effort. Comments are 

welcome on ways that we could 

improve our current MA data collection 

and release methods, including 

recommendations on the preferred 

cadence of data releases. Finally, we 

seek detailed information from 

beneficiary advocates, health care 

providers, and other stakeholders on 

common challenges and experiences in 


khammond on DSKJM1Z7X2PROD with NOTICES
Federal Register / Vol. 89, No. 20 / Tuesday, January 30, 2024 / Notices 5909 

the MA program for which limited data 

are currently available. 

III. Collection of Information 

Requirements 

This is a request for information (RFI) 

only. In accordance with the 

implementing regulations of the 

Paperwork Reduction Act of 1995 (PRA) 

(44 U.S.C. 3501 et seq.), specifically 5 

CFR 1320.3(h)(4), this general 

solicitation is exempt from the PRA. 

Facts or opinions submitted in response 

to general solicitations of comments 

from the public, published in the 

Federal Register or other publications, 

regardless of the form or format thereof, 

provided that no person is required to 

supply specific information pertaining 

to the commenter, other than that 

necessary for self-identification, as a 

condition of the agency’s full 

consideration, are not generally 

considered information collections and 

therefore not subject to the PRA. 

This RFI is issued solely for 

information and planning purposes; it 

does not constitute a Request for 

Proposal (RFP), applications, proposal 

abstracts, or quotations. This RFI does 

not commit the U.S. Government to 

contract for any supplies or services or 

make a grant award. Further, we are not 

seeking proposals through this RFI and 

will not accept unsolicited proposals. 

Responders are advised that the U.S. 

Government will not pay for any 

information or administrative costs 

incurred in response to this RFI; all 

costs associated with responding to this 

RFI will be solely at the interested 

party’s expense. In addition, this RFI 

does not commit the Government to any 

policy decision and CMS will follow 

established methods for proposing 

future policy changes, including the MA 

Advance Notice and Rate 

Announcement process. We note that 

not responding to this RFI does not 

preclude participation in any future 

procurement or rulemaking, if 

conducted. It is the responsibility of the 

potential responders to monitor this RFI 

announcement for additional 

information pertaining to this request. 

In addition, we note that CMS will not 

respond to questions about the policy 

issues raised in this RFI. 

Chiquita Brooks-LaSure, 

Administrator of the Centers for 

Medicare & Medicaid Services, 

approved this document on January 22, 

2024. 

Dated: January 25, 2024. 

Xavier Becerra, 

Secretary, Department of Health and Human 

Services. 

[FR Doc. 2024–01832 Filed 1–25–24; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Submission for Office of Management 

and Budget Review; Office of Human 

Services Emergency Preparedness 

and Response Disaster Human 

Services Case Management Intake 

Assessment, Resource Referral, and 

Case Management Plan 

AGENCY: Office of Human Services 

Emergency Preparedness and Response, 

Administration for Children and 

Families, U.S. Department of Health and 

Human Services. 

ACTION: Request for public comments. 

SUMMARY: The Office of Human Services 

Emergency Preparedness and Response 

(OHSEPR), Administration for Children 

and Families (ACF), U.S. Department of 

Health and Human Services (HHS), is 

requesting an extension for approval of 

the following information collection: 

OHSEPR Disaster Human Services Case 

Management Intake Assessment, 

Resource Referral, and Case 

Management Plan; OMB No.: 0970– 

0619. This information collection was 

originally approved for 6 months 

through an emergency approval. 

DATES: Comments due within 30 days of 

publication. OMB is required to make a 

decision concerning the collection of 

information between 30 and 60 days 

after publication of this document in the 

Federal Register. Therefore, a comment 

is best assured of having its full effect 

if OMB receives it within 30 days of 

publication. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. You can also obtain 

copies of the proposed collection of 

information by emailing infocollection@

acf.hhs.gov. All emailed requests should 

be identified by the title of the 

information collection. 

SUPPLEMENTARY INFORMATION: 

Description: OHSEPR is seeking to 

continue data collection with all forms 

approved under OMB No. 0970–0619, 

which OMB recently approved through 

an emergency approval for 6 months. 

OHSEPR’s Disaster Human Services 

Intake Assessment, Resource Referral, 

and Case Management Plan collection is 

part of a system of tools that OHSEPR 

utilizes to support disaster survivors 

during response missions. OHSEPR’s 

case managers would use this collection 

during an intake assessment to identify 

a disaster survivor’s unmet needs and to 

work with the survivor to develop a case 

management plan based on the 

survivor’s responses. 

Respondents: Disaster survivors. 

ANNUAL BURDEN ESTIMATES

Data collection 

Annual 

number of 

respondents 

Total number 

of responses 

per respondent 

Average 

burden hours 

per response 

Annual 

burden hours 

Disaster Human Services Case Management Intake Assessment—Survivor ........................................................................................................ 9,000 1 1.5 13,500

Case Management Plan—Case Manager ................................................. 180 50 1 9,000 

Resource Referral Form—Case Manager ................................................. 180 50 1 9,000 

Case Record Notes—Case Manager ........................................................ 180 50 1 9,000 

Survivor Satisfaction Survey—Survivor ..................................................... 9,000 1 .25 2,250 

Estimated Total Annual Burden Hours: .............................................. ........................ .............................. ........................ 42,750 

Authority: The Disaster Human 

Services Case Management Program is 

authorized through appropriations 

language under the Children and 

Families Services account. It is operated 

by the ACF Office of Human Services 


khammond on DSKJM1Z7X2PROD with NOTICES