Federal Register / Vol. 79, No. 40 / Friday, February 28, 2014 / Notices 11435 

the we collect and disseminate valid 

and reliable information that can be 

used to improve quality of care through 

identification of quality improvement 

opportunities, assist us in carrying out 

our oversight responsibilities, and help 

beneficiaries make an informed choice 

among health plans. Form Number: 

CMS–10203 (OCN: 0938–0701); 

Frequency: Yearly; Affected Public: 

Individuals and households; Number of 

Respondents: 739,959; Total Annual 

Responses: 244,187; Total Annual 

Hours: 244,187. (For policy questions 

regarding this collection contact 

Kimberly DeMichele at 410–786–4286.) 

Dated: February 24, 2014. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2014–04328 Filed 2–27–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10346 and CMS– 

10496] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 

(PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, and to allow 

a second opportunity for public 

comment on the notice. Interested 

persons are invited to send comments 

regarding the 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. 

DATES: Comments on the collection(s) of 

information must be received by the 

OMB desk officer by March 31, 2014. 

ADDRESSES: When commenting on the 

proposed information collections, 

please reference the document identifier 

or OMB control number. To be assured 

consideration, comments and 

recommendations must be received by 

the OMB desk officer via one of the 

following transmissions: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–5806 or Email: 

OIRA_submission@omb.eop.gov. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

http://www.cms.hhs.gov/

PaperworkReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326 

SUPPLEMENTARY INFORMATION: Under the 

Paperwork Reduction Act of 1995 (PRA) 

(44 U.S.C. 3501–3520), federal agencies 

must obtain approval from the Office of 

Management and Budget (OMB) for each 

collection of information they conduct 

or sponsor. The term ‘‘collection of 

information’’ is defined in 44 U.S.C. 

3502(3) and 5 CFR 1320.3(c) and 

includes agency requests or 

requirements that members of the public 

submit reports, keep records, or provide 

information to a third party. Section 

3506(c)(2)(A) of the PRA (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-day notice in the 

Federal Register concerning each 

proposed collection of information, 

including each proposed extension or 

reinstatement of an existing collection 

of information, before submitting the 

collection to OMB for approval. To 

comply with this requirement, CMS is 

publishing this notice that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Appeals of 

Quality Bonus Payment Determinations; 

Use: Section 1853(o) of the Social 

Security Act (the Act) requires us to 

make quality bonus payments (QBPs) 

QBPs to Medicare Advantage (MA) 

organizations that achieve performance 

rating scores of at least 4 stars under a 

five-star rating system. While we have 

applied a Star Rating system to MA 

organizations for a number of years, 

prior to the QBP program these Star 

Ratings were used only to provide 

additional information for beneficiaries 

to consider in making their Part C and 

D plan elections. Beginning in 2012, the 

Star Ratings we assign for purposes of 

QBPs directly affected the monthly 

payment amount MA organizations 

receive from us under their contracts. 

Additionally, section 1854(b)(1)(C)(v) of 

the Act, as added by the Affordable Care 

Act, also requires us to change the share 

of savings that MA organizations must 

provide to enrollees as the beneficiary 

rebate specified at § 422.266(a) based on 

the level of a sponsor’s Star Rating for 

quality performance. 

While the statute does not specify an 

administrative review process for 

appealing low QBP Star Ratings, we 

have implemented an appeals process in 

accordance with its authority to 

establish MA program standards by 

regulation at section 1856(b)(1) of the 

Act. Under this process, MA 

organizations may seek review of their 

QBP Star Rating determinations. This 

review process also applies to the 

determinations we made where the 

organization’s Star Rating sets its QBP 

status at ineligible for rebate retention. 

The information collected from 

Medicare Advantage organizations is 

considered by the reconsideration 

official and potentially the hearing 

officer to review our determination of 

the organization’s eligibility for a 

quality bonus payment. Form Number: 

CMS–10346 (OCN: 0938–1129; 

Frequency: Yearly; Affected Public: 

Private sector—Business or other forprofits; Number of Respondents: 350; 

Total Annual Responses: 25; Total 

Annual Hours: 200. (For policy 

questions regarding this collection 

contact Sarah Gaillot at 410–786–4637). 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: State Health 

Insurance Exchange Incident Report; 

Use: We have implemented a Computer 

Matching Agreement (CMA) with the 

State-Based Administering Entities 

(AEs). This agreement establishes the 

terms, conditions, safeguards, and 

procedures under which we will 

disclose certain information to the AEs 

in accordance with the Patient 

Protection and Affordable Care Act of 

2010 (Pub. L. 111–148), as amended by 

the Health Care and Education 

Reconciliation Act (Pub. L. 111–152), 

which are referred to collectively as the 

Affordable Care Act (ACA), 


tkelley on DSK3SPTVN1PROD with NOTICES
11436 Federal Register / Vol. 79, No. 40 / Friday, February 28, 2014 / Notices 

amendments to the Social Security Act 

made by the ACA, and the 

implementing regulations. The AEs, 

which are state entities administering 

Insurance Affordability Programs, will 

use the data, accessed through the CMS 

Data Services Hub (Hub), to make 

Eligibility Determinations for Insurance 

Affordability Programs and certificates 

of exemption. 

The AEs shall report suspected or 

confirmed incidents affecting loss or 

suspected loss of PII within one hour of 

discovery to their designated Center for 

Consumer Information and Insurance 

Oversight State Officer who will then 

notify the affected Federal agency data 

sources, i.e., Internal Revenue Service, 

Department of Defense, Department of 

Homeland Security, Social Security 

Administration, Peace Corps, Office of 

Personnel Management and Veterans 

Health Administration. Additionally, 

AEs shall contact the office of the 

appropriate Special Agent-in-Charge, 

Treasury Inspector General for Tax 

Administration (TIGTA), and the IRS 

Office of Safeguards within 24 hours of 

discovery of any potential breach, loss, 

or misuse of Return Information. Form 

Number: CMS–10496 (OCN: 0938– 

1216); Frequency: Occasionally; 

Affected Public: State, Local or Tribal 

governments; Number of Respondents: 

18; Total Annual Responses: 936; Total 

Annual Hours: 234. (For policy 

questions regarding this collection 

contact Theodora Wills at 410–786– 

1504.) 

Dated: February 24, 2014. 

Martique Jones, 

Deputy Director, Regulations Development 

Group, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2014–04327 Filed 2–27–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–2389–N] 

Medicaid Program; Preliminary 

Disproportionate Share Hospital 

Allotments (DSH) for Fiscal Year (FY) 

2014 and the Preliminary Institutions 

for Mental Diseases Disproportionate 

Share Hospital Limits for FY 2014 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

preliminary federal share DSH 

allotments for FY 2014 and the 

preliminary federal share FY 2014 limits 

on aggregate DSH payments that states 

may make to institutions for mental 

diseases (IMDs) and other mental health 

facilities. This notice also includes 

additional information regarding the 

calculation of the FY 2014 DSH 

allotments and FY 2014 IMD DSH 

limits. 

DATES: Effective Date: This notice is 

effective on March 31, 2014. The final 

allotments and limitations set forth in 

this notice are effective for the fiscal 

years specified. 

FOR FURTHER INFORMATION CONTACT: Rory 

Howe, (410) 786–4878; or Richard 

Strauss, (410) 786–2019. 

SUPPLEMENTARY INFORMATION: 

I. Background 

A. Fiscal Year DSH Allotments 

A state’s federal fiscal year (FY) 

disproportionate share hospital (DSH) 

allotment represents the aggregate limit 

on the federal share amount of the 

state’s payments to DSH hospitals in the 

state for the FY. The amount of such 

allotment is determined in accordance 

with the provisions of section 1923(f)(3) 

of the Social Security Act (the Act). 

Under such provisions, in general a 

state’s FY DSH allotment is calculated 

by increasing the amount of its DSH 

allotment for the preceding FY by the 

percentage change in the Consumer 

Price Index for all Urban Consumers 

(CPI–U) for the previous FY. 

The Affordable Care Act amended 

Medicaid DSH provisions, adding 

section 1923(f)(7) of the Act which 

would have required reductions to 

states’ FY DSH allotments beginning 

with FY 2014, the calculation of which 

was described in the Disproportionate 

Share Hospital Payment Reduction final 

rule published in the September 18, 

2013 Federal Register (78 FR 57293). 

Under the DSH reduction methodology, 

first, each state’s unreduced FY DSH 

allotment would have been calculated 

in accordance with the provisions of 

section 1923(f) of the Act, excluding 

section 1923(f)(7) of the Act; then, the 

reduction amount for each state would 

have been determined under the 

provisions of section 1923(f)(7) of the 

Act and implementing regulations at 42 

CFR 447.294; and, finally, the net FY 

DSH allotment for each state would 

have been determined by subtracting the 

DSH reduction amount for the state 

from its unreduced FY 2014 DSH 

allotment. 

The reductions under section 

1923(f)(7) of the Act were delayed and 

modified by section 1204 of Division B 

(Medicare and Other Health Provisions) 

of the ‘‘Pathway for SGR Reform Act of 

2013’’ (Pub. L. 113–67), which was 

enacted on December 26, 2013. The 

reductions of states’ fiscal year DSH 

allotments under section 1923(f)(7) of 

the Act that were applicable to FY 2014 

and 2015 were repealed, and the FY 

2016 was increased substantially. 

Because there is no reduction to DSH 

allotments for FY 2014 under section 

1923(f)(7) of the Act, this notice 

contains only the state-specific FY 2014 

DSH allotments, as calculated under the 

statute without application of the 

reductions that would have been 

imposed under the Affordable Care Act 

provisions beginning with FY 2014. 

This notice also provides information 

on the calculation of such FY DSH 

allotments, the calculation of the states’ 

IMD DSH limits, and the amounts of 

states’ preliminary FY 2014 IMD DSH 

limits. 

B. Determination of Fiscal Year DSH 

Allotments 

Generally, in accordance with the 

methodology specified under section 

1923(f)(3) of the Act, a state’s FY DSH 

allotment is calculated by increasing the 

amount of its DSH allotment for the 

preceding FY by the percentage change 

in the CPI–U for the previous FY. Also 

in accordance with section 1923(f)(3) of 

the Act, a state’s DSH allotment for a FY 

is subject to the limitation that an 

increase to a state’s DSH allotment for 

a FY cannot result in the DSH allotment 

exceeding the greater of the state’s DSH 

allotment for the previous FY or 12 

percent of the state’s total medical 

assistance expenditures for the 

allotment year (this is referred to as the 

12 percent limit). 

Furthermore, under section 1923(h) of 

the Act, federal financial participation 

(FFP) for DSH payments to institutions 

for mental diseases (IMDs) and other 

mental health facilities is limited to 

state-specific aggregate amounts. Under 

this provision, the aggregate limit for 

DSH payments to IMDs and other 

mental health facilities is the lesser of 

a state’s FY 1995 total computable (state 

and federal share) IMD and other mental 

health facility DSH expenditures 

applicable to the state’s FY 1995 DSH 

allotment (as reported on the Form 

CMS–64 as of January 1, 1997), or the 

amount equal to the product of the 

state’s current year total computable 

DSH allotment and the applicable 

percentage specified in section 1902(h) 

of the Act (the applicable percentage is 

the IMD share of DSH total computable 

expenditures as of FY 1995). 

In general, we determine states’ DSH 

allotments for a FY and the IMD DSH 

limits for the same FY using the most 


tkelley on DSK3SPTVN1PROD with NOTICES