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[Federal Register Volume 78, Number 212 (Friday, November 1, 2013)]
[Notices]
[Pages 65656-65657]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-26083]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-1561, CMS-417, CMS-10433, and CMS-R-262]

Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

ACTION: Notice.

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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 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 must be received by December 31, 2013.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number (OCN). 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 --; 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' 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:

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-1561 Provider Agreement--CMS Form 1561 and 1561A and Supporting 
Regulations
CMS-417 Hospice Request for Certification and Supporting Regulations
CMS-10433 Initial Plan Data Collection to Support Qualified

[[Page 65657]]

Health Plan (QHP) Certification and Other Financial Management and 
Exchange Operations
CMS-R-262 CY 2015 Plan Benefit Package (PBP), Formulary, and Supporting 
Regulations

    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 Collections

    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Health Insurance 
Benefit Agreement; Use: Applicants to the Medicare program are required 
to agree to provide services in accordance with Federal requirements. 
The CMS-1561 is essential in that is allows us to ensure that 
applicants are in compliance with the requirements. Applicants will be 
required to sign the completed form and provide operational information 
to us to assure that they continue to meet the requirements after 
approval. Form Number: CMS-1561 (OCN: 0938-0832); Frequency: Yearly; 
Affected Public: Private Sector--Business or other for-profits and Not-
for-profit institutions; Number of Respondents: 3,000; Total Annual 
Responses: 3,000; Total Annual Hours: 500. (For policy questions 
regarding this collection contact Shonte Carter at 410-786-3532).
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Hospice Request 
for Certification and Supporting Regulations; Use: The Hospice Request 
for Certification Form is the identification and screening form used to 
initiate the certification process and to determine if the provider has 
sufficient personnel to participate in the Medicare program. Form 
Number: CMS-417 (OCN: 0938-0313); Frequency: Annually; Affected Public: 
Private Sector--Business or other for-profits; Number of Respondents: 
3,807; Total Annual Responses: 3,807; Total Annual Hours: 952. (For 
policy questions regarding this collection contact Patricia Sevast at 
410-786-8135).
    3. Title of Information Collection: Initial Plan Data Collection to 
Support Qualified Health Plan (QHP) Certification and Other Financial 
Management and Exchange Operations; Type of Information Collection 
Request: Revision of a currently approved collection; Use: As required 
by the CMS-9989-F, Patient Protection and Affordable Care Act; 
Establishment of Exchanges and Qualified Health Plans; Exchange 
Standards for Employers (77 FR 18310) (Exchange Establishment Rule), 
published on March 27, 2012, each Exchange must assume responsibilities 
related to the certification and offering of Qualified Health Plans 
(QHPs). To offer insurance through an Exchange, a health insurance 
issuer must have its health plans certified as QHPs by the Exchange. A 
QHP must meet certain minimum certification standards, such as those 
pertaining to essential community providers, essential health benefits, 
and actuarial value. In order to meet those standards, the Exchange is 
responsible for collecting data and validating that QHPs meet these 
minimum requirements as described in the Exchange rule under 45 CFR 
parts 155 and 156, based on the Affordable Care Act, as well as other 
requirements determined by the Exchange. In addition to data collection 
for the certification of QHPs, the reinsurance and risk adjustment 
programs outlined by the Affordable Care Act, detailed in 45 CFR part 
153, as established by CMS-9975-F, Patient Protection and Affordable 
Care Act; Standards for Reinsurance, Risk Corridors, and Risk 
Adjustment (77 FR 17220), published in March 23, 2012, have general 
information reporting requirements that apply to issuers, group health 
plans, third party administrators, and plan offerings outside of the 
Exchanges. Subsequent regulations for these programs including the 
final HHS Notice of Benefit and Payment Parameters for 2014 and the 
Program Integrity: Exchange, Premium Stabilization Programs, and Market 
Standards; Amendments to the HHS Notice of Benefit and Payment 
Parameters for 2014 provide further reporting requirements. The Office 
of Management and Budget (OMB) issued OMB Control Number 0938-1187 for 
this Paperwork Reduction Act (PRA) package on March 13, 2013. Based on 
experience with the first year of data collection, we propose revisions 
to data elements being collected and the burden estimates for years two 
and three. Form Number: CMS-10433 (OCN: 0938-1187); Frequency: 
Annually; Affected Public: States and Private Sector--Business or other 
for-profits and Not-for-profit institutions; Number of Respondents: 
27,225; Number of Responses: 27,225; Total Annual Hours: 216,028. (For 
questions regarding the collection contact Danielle Chestang at (410) 
786-7815.)
    4. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: CY 2015 Plan 
Benefit Package (PBP), Formulary, and Supporting Regulations; Use: We 
require Medicare Advantage and Prescription Drug Plan organizations 
submit a completed plan benefit package (PBP) and formulary as part of 
the annual bidding process. During this process, organizations prepare 
their proposed plan benefit packages for the upcoming contract year and 
submit them to us for review and approval. We publish beneficiary 
education information using a variety of formats. Specific education 
initiatives that utilize PBP and formulary data include web application 
tools on medicare.gov and the plan benefit insert in the Medicare & You 
handbook. In addition, organizations utilize the PBP data to generate 
their Summary of Benefits marketing information. Form Number: CMS-R-262 
(OCN: 0938-0763); Frequency: Yearly; Affected Public: Private sector--
Business or other for-profits and Not-for-profit institutions; Number 
of Respondents: 652; Total Annual Responses: 6,265; Total Annual Hours: 
57,477. (For policy questions regarding this collection contact Kristy 
Holtje at 410-786-2209).

    Dated: October 29, 2013.
Martique Jones,
Deputy Director, Regulations Development Group Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2013-26083 Filed 10-31-13; 8:45 am]
BILLING CODE 4120-01-P
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