17092 Federal Register / Vol. 87, No. 58 / Friday, March 25, 2022 / Notices 

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 Suzette 

Seng at 410–786–4703. 

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: 2,735,964; Total Annual 

Hours: 371,710. For policy questions 

regarding this collection contact Amy 

Lutzky at 410–786–0721. 

3. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Disclosure and 

Recordkeeping Requirements for 

Grandfathered Health Plans under the 

Affordable Care Act; Use: Section 1251 

of the Affordable Care Act provides that 

certain plans and health insurance 

coverage in existence as of March 23, 

2010, known as grandfathered health 

plans, are not required to comply with 

certain statutory provisions in the Act. 

The final regulations titled ‘‘Final Rules 

under the Affordable Care Act for 

Grandfathered Plans, Preexisting 

Condition Exclusions, Lifetime and 

Annual Limits, Rescissions, Dependent 

Coverage, Appeals, and Patient 

Protections’’ (80 FR 72192, November 

18, 2015) require that, to maintain its 

status as a grandfathered health plan, a 

plan must maintain records 

documenting the terms of the plan in 

effect on March 23, 2010, and any other 

documents that are necessary to verify, 

explain or clarify status as a 

grandfathered health plan. The plan 

must make such records available for 

examination upon request by 

participants, beneficiaries, individual 

policy subscribers, or a state or federal 

agency official. A grandfathered health 

plan is also required to include a 

statement in any summary of benefits 

under the plan or health insurance 

coverage, that the plan or coverage 

believes it is a grandfathered health plan 

within the meaning of section 1251 of 

the Affordable Care Act, and providing 

contact information for participants to 

direct questions and complaints. In 

addition, a grandfathered group health 

plan that is changing health insurance 

issuers is required to provide the 

succeeding health insurance issuer (and 

the succeeding health insurance issuer 

must require) documentation of plan 

terms (including benefits, cost sharing, 

employer contributions, and annual 

limits) under the prior health insurance 

coverage sufficient to make a 

determination whether the standards of 

paragraph § 147.140(g)(1) of the final 

regulations are exceeded. It is also 

required that, for an insured group 

health plan (or a multiemployer plan) 

that is a grandfathered plan, the relevant 

policies, certificates, or contracts of 

insurance, or plan documents must 

disclose in a prominent and effective 

manner that employers, employee 

organizations, or plan sponsors, as 

applicable, are required to notify the 

issuer (or multiemployer plan) if the 

contribution rate changes at any point 

during the plan year. Form Number: 

CMS–10325 (OMB control number: 

0938–1093); Frequency: On Occasion; 

Affected Public: Private Sector, State, 

Local or Tribal governments; Number of 

Respondents: 14,669; Total Annual 

Responses: 2,651,523; Total Annual 

Hours: 40. For policy questions 

regarding this collection contact Usree 

Bandyopadhyay at 410–786–6650. 

Dated: March 22, 2022. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2022–06340 Filed 3–24–22; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10507 and CMS– 

10105] 

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 

May 24, 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: ll, Room C4–26–05, 

7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 


lotter on DSK11XQN23PROD with NOTICES1
Federal Register / Vol. 87, No. 58 / Friday, March 25, 2022 / Notices 17093 

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–10507 State-based Exchange 

Annual Report Tool (SMART) 

CMS–10105 National Implementation 

of the In-Center Hemodialysis CAHPS 

Survey 

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: Revision of a currently 

approved collection; Title of 

Information Collection: State-based 

Exchange Annual Report Tool 

(SMART); Use: The annual report is the 

primary vehicle to insure 

comprehensive compliance with all 

reporting requirements contained in the 

Affordable Care Act (ACA). It is 

specifically called for in Section 

1313(a)(1) of the Act which requires a 

State Based Exchange (including an 

Exchange using the Federal Platform) to 

keep an accurate accounting of all 

activities, receipts, and expenditures, 

and to submit a report annually to the 

Secretary concerning such accounting. 

CMS will use the information collected 

from States to assist in determining if a 

State is maintaining a compliant 

operational Exchange. Form Number: 

CMS–10507 (OMB control number: 

0938–1244); Frequency: Annually; 

Affected Public: State, Local, or Tribal 

governments; Number of Respondents: 

21; Total Annual Responses: 21; Total 

Annual Hours: 4,281. (For policy 

questions regarding this collection 

contact Shilpa Gogna at 301–492–4257.) 

2. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: National 

Implementation of the In-Center 

Hemodialysis CAHPS Survey; Use: The 

national implementation of the ICH 

CAHPS Survey is designed to allow 

third-party, CMS-approved survey 

vendors to administer the ICH CAHPS 

Survey using mail-only, telephone-only, 

or mixed (mail with telephone followup) modes of survey administration. 

Experience from previous CAHPS 

surveys shows that mail, telephone, and 

mail with telephone follow-up data 

collection modes work well for 

respondents, vendors, and health care 

providers. Any additional forms of 

information technology, such as web 

surveys, is under investigation as a 

potential survey option in this 

population. 

Data collected in the national 

implementation of the ICH CAHPS 

Survey are used for the following 

purposes: 

• To provide a source of information 

from which selected measures can be 

publicly reported to beneficiaries as a 

decision aid for dialysis facility 

selection. 

• To aid facilities with their internal 

quality improvement efforts and 

external benchmarking with other 

facilities. 

• To provide CMS with information 

for monitoring and public reporting 

purposes. 

• To support the ESRD Quality 

Improvement Program. 

Form Number: CMS–10105 (OMB 

control number: 0938–0926); Frequency: 

Semi Annually; Affected Public: 

Individuals and Households; Number of 

Respondents: 103,500; Total Annual 

Responses: 621,000; Total Annual 

Hours: 55,890. (For policy questions 

regarding this collection contact Israel 

H. Cross at 410–786–0619.) 

Dated: March 22, 2022. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2022–06341 Filed 3–24–22; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

[OMHA–2201–N] 

Medicare Program; Administrative Law 

Judge Hearing Program for Medicare 

Claim and Entitlement Appeals; 

Quarterly Listing of Program 

Issuances—October Through 

December 2021 

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 

October through December 2021. 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 


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