78438 Federal Register / Vol. 79, No. 249 / Tuesday, December 30, 2014 / Notices 

SUPPLEMENTARY INFORMATION: 

Change in Standard Procedure 

GSA posts the POV mileage 

reimbursement rates, formerly 

published in 41 CFR Chapter 301, solely 

on the internet at www.gsa.gov/mileage. 

Also, posted on this site is the standard 

mileage rate for moving purposes. This 

process, implemented in FTR 

Amendments 2010–07, 75 FR 72965, 

November 29, 2010, 2007–03, 72 FR 

35187, June 27, 2007, and 2007–06, 72 

FR 70234, December 11, 2007, in the 

Federal Register ensures more timely 

updates in mileage reimbursement rates 

by GSA for Federal employees who are 

on official travel or relocating. Notices 

published periodically in the Federal 

Register, such as this one, and the 

changes posted on the GSA Web site, 

now constitute the only notification to 

Federal agencies of revisions to the POV 

mileage reimbursement rates and the 

standard mileage reimbursement rate for 

moving purposes. 

Dated: December 16, 2014. 

Alexander J. Kurien, 

Deputy Associate Administrator, Office of 

Asset and Transportation Management, 

Office of Government-Wide Policy. 

[FR Doc. 2014–30317 Filed 12–29–14; 8:45 am] 

BILLING CODE 6820–14–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10421] 

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 January 29, 2015. 

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: Fee-for-Service 

Recovery Audit Prepayment Review 

Demonstration and Prior Authorization 

Demonstration; Use: On July 23, 2012, 

the Office of Management and Budget 

approved the collections required for 

two demonstrations of prepayment 

review and prior authorization. The first 

demonstration allows Medicare 

Recovery Auditors to review claims on 

a pre-payment basis in certain States. 

The second demonstration established a 

prior authorization program for Power 

Mobility Device claims in certain States. 

For the Recovery Audit Prepayment 

Review Demonstration, CMS and its 

agents request additional 

documentation, including medical 

records, to support submitted claims. As 

discussed in more detail in Chapter 3 of 

the Program Integrity Manual, 

additional documentation includes any 

medical documentation, beyond what is 

included on the face of the claim that 

supports the item or service that is 

billed. For Medicare to consider 

coverage and payment for any item or 

service, the information submitted by 

the provider or supplier (e.g., claims) 

must be supported by the 

documentation in the patient’s medical 

records. When conducting complex 

medical review, the contractor specifies 

documentation they require in 

accordance with Medicare’s rules and 

policies. In addition, providers and 

suppliers may supply additional 

documentation not explicitly listed by 

the contractor. This supporting 

information may be requested by CMS 

and its agents on a routine basis in 

instances where diagnoses on a claim do 

not clearly indicate medical necessity, 

or if there is a suspicion of fraud. 

For the Prior Authorization of Power 

Mobility Devices (PMDs) 

Demonstration, we are piloting prior 

authorization for PMDs. Prior 

authorization will allow the applicable 

documentation that supports a claim to 

be submitted before the item is 

delivered. For prior authorization, 

relevant documentation for review is 

submitted before the item is delivered or 

the service is rendered. CMS will 

conduct this demonstration in 

California, Florida, Illinois, Michigan, 

New York, North Carolina, Texas, 

Pennsylvania, Ohio, Louisiana, 

Missouri, Maryland, New Jersey, 

Indiana, Kentucky, Georgia, Tennessee, 

Washington, and Arizona based on 

beneficiary address as reported to the 

Social Security Administration and 

recorded in the Common Working File 

(CWF). For the demonstration, a prior 

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Federal Register / Vol. 79, No. 249 / Tuesday, December 30, 2014 / Notices 78439 

authorization request can be completed 

by the (ordering) physician or treating 

practitioner and submitted to the 

appropriate DME MAC for an initial 

decision. The supplier may also submit 

the request on behalf of the physician or 

treating practitioner. The physician, 

treating practitioner or supplier who 

submits the request on behalf of the 

physician or treating practitioner, is 

referred to as the ‘‘submitter.’’ Under 

this demonstration, the submitter will 

submit to the DME MAC a request for 

prior authorization and all relevant 

documentation to support Medicare 

coverage of the PMD item. Form 

Number: CMS–10421 (OMB control 

number: 0938–1169); Frequency: 

Occasionally; Affected Public: State, 

Local or Tribal Governments; Number of 

Respondents: 333,750; Total Annual 

Responses: 333,750; Total Annual 

Hours: 170,060. (For policy questions 

regarding this collection contact Daniel 

Schwartz at 410–786–4197.) 

Dated: December 23, 2014. 

Martique Jones, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2014–30468 Filed 12–29–14; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–3296–FN] 

RIN 0938–ZB14 

Medicare Program; Evaluation Criteria 

and Standards for Beneficiary and 

Family Centered Care Quality 

Improvement Organization Contract 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final notice. 

SUMMARY: This final notice announces 

the general criteria we will use to 

evaluate the effectiveness and efficiency 

of Beneficiary and Family Centered Care 

(BFCC) Quality Improvement 

Organizations (QIOs) that entered into 

contracts with CMS under the 11th 

Statement of Work (SOW) in May 2014. 

The activities for the BFCC–QIO SOW 

began August 1, 2014. (This contract 

allows for a transition period from the 

incumbent QIOs to the successor QIOs.) 

In addition, this notice addresses the 

public comments received on the July 

28, 2014 notice with comment period 

entitled, ‘‘Evaluation Criteria and 

Standards for Beneficiary and Family 

Centered Care Quality Improvement 

Organization Contracts.’’ 

DATES: Effective Dates: August 1, 2014 

to July 31, 2019. 

FOR FURTHER INFORMATION CONTACT: 

Alfreda Staton, (410) 786–4194. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Section 1153(h)(2) of the Social 

Security Act (the Act) requires the 

Secretary of the Department of Health 

and Human Services (the Secretary) to 

publish in the Federal Register the 

general criteria and standards that will 

be used to evaluate the effective and 

efficient performance of contract 

obligations by the Quality Improvement 

Organizations (QIOs) and to provide the 

opportunity for public comment with 

respect to these criteria and standards. 

II. Provisions of the Notice With 

Comment Period 

On July 28, 2014, we published a 

notice with comment period in the 

Federal Register (79 FR 43747 through 

43749) entitled, ‘‘Evaluation Criteria 

and Standards for Beneficiary and 

Family Centered Care Quality 

Improvement Organization Contracts,’’ 

announcing the general criteria we 

would use to evaluate the effectiveness 

and efficiency of Beneficiary and Family 

Centered Care (BFCC) Quality 

Improvement Organizations (QIOs) that 

entered into contracts with CMS under 

the 11th Statement of Work (SOW) in 

May 2014 (HHSM–500–2014–RFP– 

BFCC–QIO). That notice generally 

summarized the tasks of the BFCC–QIOs 

and the criteria to be used for annual 

performance evaluations during the 5- 

year term of the contract. BFCC–QIO 

performance under the 11th SOW 

contract began on August 1, 2014, after 

a transition period. 

The tasks of the BFCC–QIOs under 

the BFCC–QIO 11th SOW contract are as 

follows: 

• Quality of care reviews, including 

beneficiary complaint and general 

quality of care reviews. 

• Beneficiary appeals of denials of 

hospital admissions discharge and 

terminations of services decisions 

commonly referred to as Grijalva, BIPA, 

and Weichardt appeals. 

• Medical necessity reviews. 

• Appropriateness of setting reviews. 

• Diagnosis Related Group (DRG) 

reviews. 

• Readmission reviews. 

• Reviews under Emergency Medical 

Treatment and Active Labor Act 

(EMTALA). 

• Sanctions. 

• Monitoring of Physician 

Acknowledgement Statements under 

section 1156(a) of the Act and our 

regulations at 42 CFR 412.46. 

Evaluation of the Tasks Measures 

The measures of BFCC–QIO 

performance for the 11th SOW are as 

follows: 

• Quality of Review: Inter-Rater 

Reliability. 

• 4-day Data Entry Compliance. 

• Timeliness of Beneficiary 

Complaints and Other Quality of Care 

Reviews. 

• Timeliness of Discharge/Service 

Termination Reviews. 

• Timeliness of EMTALA and Higher 

Weighted Diagnosis-Related Group 

Reviews. 

• Complainant Agreement to 

Complete Survey. 

• Beneficiary Experience with 

Quality of Care Complaints. 

• Beneficiary Experience with Appeal 

Reviews. 

Evaluation Criteria 

The Annual and 54th Month 

Evaluation Criteria for each of these 

measures are specifically defined in 

Attachment J–10, ‘‘Annual and 54th 

Month Evaluation Criteria Measures 

Table,’’ of the BFCC–QIO SOW; the 

criteria for evaluating each deliverable 

are identified in Schedule F of the 11th 

SOW. Additional detail is provided in 

the notice posted at: http://

www.gpo.gov/fdsys/pkg/FR-2014-07-28/

pdf/2014-17625.pdf. 

III. Analysis of and Responses to Public 

Comments on the Notice With Comment 

Period 

Two commenters submitted several 

comments concerning the general 

criteria we would use to evaluate the 

effectiveness and efficiency of BFCC– 

QIOs that will enter into contracts with 

CMS under the 11th SOW. One 

commenter was affiliated with a private 

healthcare quality improvement entity 

and the other commenter was with a 

healthcare quality improvement 

association. A summary of the 

comments and our responses are as 

follows: 

Comment: Both commenters 

expressed concern with potential public 

perception of bias arising from the 

evaluation criterion that considers of 

beneficiary experience with the quality 

of care complaints and appeal reviews 

as part of the evaluation of the BFCC– 

QIO’s performance of quality-of-care 

and other statutory and regulatory 

reviews and appeals. The commenters 

indicated that consideration of 

beneficiary experience with the quality 

of care complaints and appeal reviews 

as part of the evaluation of the BFCC– 

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