Federal Register / Vol. 87, No. 3 / Wednesday, January 5, 2022 / Notices 461 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10410, CMS– 

10554, CMS–10791 and CMS–10377] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, Health and Human 

Services (HHS). 

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 (the 

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 

60 days for public comment on the 

proposed action. Interested persons are 

invited to send comments regarding our 

burden estimates or any other aspect of 

this collection of information, including 

the necessity and utility of the proposed 

information collection for the proper 

performance of the agency’s functions, 

the accuracy of the estimated burden, 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected, and the use of automated 

collection techniques or other forms of 

information technology to minimize the 

information collection burden. 

DATES: Comments must be received by 

March 7, 2022. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number. To be assured 

consideration, comments and 

recommendations must be submitted in 

any one of the following ways: 

1. Electronically. You may send 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) that are 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: lll, Room C4–26– 

05, 7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

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’ website address at 

website address at https://www.cms.gov/ 

Regulations-and-Guidance/Legislation/ 

PaperworkReductionActof1995/PRAListing. 

FOR FURTHER INFORMATION CONTACT: 

William N. Parham at (410) 786–4669. 

SUPPLEMENTARY INFORMATION: 

Contents 

This notice sets out a summary of the 

use and burden associated with the 

following information collections. More 

detailed information can be found in 

each collection’s supporting statement 

and associated materials (see 

ADDRESSES). 

CMS–10410 Medicaid Program; 

Eligibility Changes under the 

Affordable Care Act of 2010 

CMS–10554 Children’s Health 

Insurance Program Managed Care and 

Supporting Regulations 

CMS–10791 Requirements Related to 

Surprise Billing; Part II 

CMS–10377 Student Health Insurance 

Coverage 

Under the 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 

requires federal agencies to publish a 

60-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. 

Information Collection 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicaid 

Program; Eligibility Changes under the 

Affordable Care Act of 2010; Use: The 

State Medicaid and CHIP agencies will 

collect all information needed to 

determine and redetermine eligibility 

for Medicaid and will transmit 

information, as appropriate, to other 

insurance affordability programs. The 

information collection requirements 

will assist the public to understand 

information about health insurance 

affordability programs and will assist 

CMS in ensuring the seamless, 

coordinated, and simplified system of 

Medicaid and CHIP application, 

eligibility determination, verification, 

enrollment, and renewal. Form Number: 

CMS–10410 (OMB control number: 

0938–1147); Frequency: Occasionally; 

Affected Public: Individuals or 

Households, and State, Local, and Tribal 

Governments; Number of Respondents: 

25,500,096; Total Annual Responses: 

76,500,218; Total Annual Hours: 

21,276,302. (For policy questions 

regarding this collection contact 

Stephanie Bell at 410–786–0617.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Children’s 

Health Insurance Program Managed 

Care and Supporting Regulations; Use: 

CHIP enrollees use the information 

collected and reported as a result of this 

regulation to make informed choices 

regarding health care, including how to 

access health care services and the 

grievance and appeal system. States use 

the information collected and reported 

as part of contracting processes with 

managed care entities, as well as its 

compliance oversight role. CMS uses the 

information collected and reported in an 

oversight role of State CHIP managed 

care programs and CHIP state agencies. 

Form Number: CMS–10554 (OMB 

control number: 0938–1282); Frequency: 

Yearly; Affected Public: State, Local, 

and Tribal Governments, and the Private 

Sector (Business or other for-profits and 

Not-for-profit institutions); Number of 

Respondents: 62; Total Annual 

Responses: 2,735,906; Total Annual 

Hours: 410,989. (For policy questions 

regarding this collection contact Meg 

Barry at 410–786–1536.) 

3. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Requirements 

Related to Surprise Billing; Part II; Use: 

The information requirements have two 

components: Good faith estimates and 

patient-provider dispute resolution for 

uninsured (or self-pay) individuals. 

Good Faith Estimates. Providers and 

facilities must furnish a good faith 

estimate of expected items and services 

beginning on or after January 1, 2022, 

which will allow uninsured (or self-pay) 

individuals to have access to 

information about health care pricing 

before receiving care. This information 

will allow uninsured (or self-pay) 

individuals to evaluate options for 

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462 Federal Register / Vol. 87, No. 3 / Wednesday, January 5, 2022 / Notices 

conscious health care purchasing 

decisions, and reduce surprises in 

relation to their health care costs for 

items and services. Additionally, 

uninsured (or self-pay) individuals will 

need a good faith estimate to initiate the 

patient-provider dispute resolution 

process. Patient-Provider Dispute 

Resolution Process. HHS will request 

information from uninsured (or self-pay) 

individuals in order to initiate patientprovider dispute resolution process. 

This information will be used to help 

determine eligibility for the patientprovider dispute resolution process and 

is necessary for determining which 

provider or facility should be contacted 

for dispute resolution. Providers and 

facilities are required to submit 

information to SDR entities to inform 

the SDR entity’s payment 

determinations. Form Number: CMS– 

10791 (OMB control number: 0938– 

NEW); Frequency: Annually; Affected 

Public: Private sector (Business or other 

for-profits and Not-for-profit 

institutions); Number of Respondents: 

238,942; Total Annual Responses: 

398,680; Total Annual Hours: 6,564,413. 

For policy questions regarding this 

collection contact Janny Frimpong at 

301–492–4174. 

4. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Student Health 

Insurance Coverage; Use: Under the 

Student Health Insurance Coverage 

Final Rule published March 21, 2012 

(77 FR 16453), student health insurance 

coverage is a type of individual health 

insurance coverage provided pursuant 

to a written agreement between an 

institution of higher education (as 

defined in the Higher Education Act of 

1965) and a health insurance issuer, and 

provided to students who are enrolled 

in that institution and their dependents. 

The Patient Protection and Affordable 

Care Act; HHS Notice of Benefit and 

Payment Parameters for 2017 Final Rule 

provided that, for policy years 

beginning on or after July 1, 2016, 

student health insurance coverage is 

exempt from the actuarial value (AV) 

requirements under section 1302(d) of 

the Affordable Care Act, but must 

provide coverage with an AV of at least 

60 percent. This provision also requires 

issuers of student health insurance 

coverage to specify in any plan 

materials summarizing the terms of the 

coverage the AV of the coverage and the 

metal level (or the next lowest metal 

level) the coverage would otherwise 

satisfy under § 156.140. This disclosure 

will provide students with information 

that allows them to compare the student 

health coverage with other available 

coverage options. Form Number: CMS– 

10377 (OMB control number 0938– 

1157); Frequency: Annually; Affected 

Public: Private Sector; Number of 

Respondents: 48; Total Annual 

Responses: 953,541; Total Annual 

Hours: 48. For policy questions 

regarding this collection contact Russell 

Tipps at 301–492–4371. 

Dated: December 29, 2021. 

William N. Parham, III 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2021–28527 Filed 1–4–22; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

[Document Identifier: OS–0990–new] 

Agency Information Collection 

Request. 30-Day Public Comment 

Request 

AGENCY: Office of the Secretary, HHS. 

ACTION: Notice. 

SUMMARY: In compliance with the 

requirement of the Paperwork 

Reduction Act of 1995, the Office of the 

Secretary (OS), Department of Health 

and Human Services, is publishing the 

following summary of a proposed 

collection for public comment. 

DATES: Comments on the ICR must be 

received on or before February 4, 2022. 

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. 

FOR FURTHER INFORMATION CONTACT: 

Sherrette Funn, Sherrette.Funn@hhs.gov 

or (202) 795–7714. When submitting 

comments or requesting information, 

please include the document identifier 

0990–New–30D and project title for 

reference. 

SUPPLEMENTARY INFORMATION: 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. 

Title of the Collection: For HHS/ 

OHRP Consultation Process, 

Institutional Review Board Records. 

Type of Collection: New OMB No. 

0990–XXXX. 

Abstract: The Assistant Secretary for 

Health, Office for Human Research 

Protections is requesting a new approval 

from the Office of Management and 

Budget of the Office for Human 

Research Protections (OHRP) 

requirement that Institutional Review 

Board records be submitted when an 

IRB or its institution request an HHS 

consultation process, for proposed 

research involving, respectively: (1) 

Pregnant women, human fetuses and 

neonates; (2) prisoners; or, (3) children, 

as subjects that are not otherwise 

approval by an IRB. The Office of the 

Assistant Secretary for Health, on behalf 

of the Secretary of HHS, may determine 

that such research can be conducted or 

supported by HHS after consulting with 

experts and allowing for public review 

of, and comment on, the proposed 

research. 

Likely Respondents: IRBs. 

TABLE—ANNUALIZED BURDEN HOUR

45 CFR part 46—HHS consultation process provision Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Total burden 

hours 

Subpart B, § 46. 207 ........................................................................................ 3 1 1 3 

Subpart C, § 46.306 (iii) and (iv) ...................................................................... 3 1 1 3 

Subpart D, § 46.407 ......................................................................................... 4 1 1 4 


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