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[Federal Register Volume 79, Number 105 (Monday, June 2, 2014)]
[Notices]
[Pages 31336-31338]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-12664]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-10340 and CMS-10380]

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 August 1, 2014:

[[Page 31337]]

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-10340 Collection of Encounter Data From Medicare Advantage 
Organizations, Section 1876 Cost HMOS/CMPS, Section 1833 Health Care 
Prepayment Plans (HCPPS), and Pace Organizations

CMS-10380 Reporting Requirements for Grants to States for Rate Review 
Cycle I, Cycle II, Cycle III, and Cycle IV and Effective Rate Review 
Program

    Under the Paperwork Reduction Act (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: Collection of 
Encounter Data from Medicare Advantage Organizations, Section 1876 Cost 
HMOS/CMPS, Section 1833 Health Care Prepayment Plans (HCPPS), and Pace 
Organizations; Use: CMS collects encounter data or data on each item or 
service delivered to enrollees of Medicare Advantage (MA) plans offered 
by MA organizations. MA organizations currently obtain this data from 
providers. CMS collects this information using standard transaction 
forms and code sets. CMS will use the data for determining risk 
adjustment factors for payment, updating the risk adjustment model, 
calculating Medicare DSH percentages, Medicare coverage purposes, and 
quality review and improvement activities. The data is also used to 
verify the accuracy and validity of the costs claimed on cost reports. 
For PACE organizations, encounter data would serve the same purpose it 
does related to the MA program and would be submitted in a similar 
manner. Form Number: CMS-10340 (OCN: 0938-1152); Frequency: Weekly; 
Affected Public: Private sector (business or other for-profits); Number 
of Respondents: 683; Total Annual Responses: 516,493,635; Total Annual 
Hours: 34,433 (For policy questions regarding this collection contact 
Michael Massimini at 410-786-1566).
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Reporting 
Requirements for Grants to States for Rate Review Cycle I, Cycle II, 
Cycle III, and Cycle IV and Effective Rate Review Program; Use: Under 
the section 1003 of the Affordable Care Act (ACA) (section 2794 of the 
Public Health Service Act), the Secretary, in conjunction with the 
states and territories, is required to establish a process for the 
annual review, beginning with the 2010 plan year, of unreasonable 
increases in premiums for health insurance coverage. Section 2794(c) 
requires the Secretary to establish the Rate Review Grant Program to 
assist states to implement this provision. In addition, section 2794(c) 
requires the Rate Review Grant Program to assist states in the 
establishment and enhancement of ``Data Centers'' that collect, 
analyze, and disseminate health care pricing data to the public.
    Concurrent with this information collection request, HHS released 
Cycle IV of the Rate Review Grants, ``Grants to States to Support 
Health Insurance Rate Review and Increase Transparency in the Pricing 
of Medical Services.'' The purpose of Cycle IV of the Rate Review Grant 
Program is to continue the rate review successes of Cycles I, II, and 
III, as well as to provide greater support to Data Centers, thereby 
enhancing medical pricing transparency. States and territories that 
apply for funds are required to complete the grant application. States 
and territories that are awarded funds under this funding opportunity 
are required to provide the Secretary with rate review data, four 
quarterly reports, and one annual report per year until the end of the 
grant period detailing the state's progression towards a more 
comprehensive and effective rate review process. A final report is due 
at the end of the grant period. This information collection is required 
for effective monitoring of grantees and to fulfill statutory 
requirements under section 2794(b)(1)(A) of the ACA that requires 
grantees, as a condition of receiving a grant authorized under section 
2794(c), to report to the Secretary information about premium 
increases.
    On May 23, 2011, CMS published a final rule with comment period (76 
FR 29964) to implement the annual review of unreasonable increases in 
premiums for health insurance coverage called for by section 2794. 
Under the regulation, if CMS determines that a state has an Effective 
Rate Review Program in a given market, using the criteria set forth in 
the rule, CMS will adopt that state's determinations regarding whether 
rate increases in that market are unreasonable, provided that the state 
reports its final determinations to CMS and explains the bases of its 
determinations. The final rule titled ``Patient Protection and 
Affordable Care Act; Health Insurance Market Rules; Rate Review'' (78 
FR 13406, February 27, 2013) amends the standards under

[[Page 31338]]

the Effective Rate Review Program. Currently, CMS relies on publicly 
available information and annual calls with individual states to obtain 
the information needed to evaluate whether a state has begun to or 
continues to satisfy the Effective Rate Review Program criteria. CMS is 
proposing to instead collect the information in writing from all states 
that would like to request effective status. Form Number: CMS-10380 
(OCN: 0938-1121); Frequency: Annually and On occasion; Affected Public: 
Public Sector and State and Territory Governments; Number of 
Respondents: 50; Total Annual Responses: 553; Total Annual Hours: 
20,951. (For policy questions regarding this collection contact Susie 
Lorden at 301-492-4162.)

    Dated: May 28, 2014.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2014-12664 Filed 5-30-14; 8:45 am]
BILLING CODE 4120-01-P
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