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[Federal Register Volume 90, Number 10 (Thursday, January 16, 2025)]
[Notices]
[Pages 4744-4745]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-01022]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-10398 #87, #90, and #91]

Medicaid and Children's Health Insurance Program (CHIP) Generic 
Information Collection Activities: Proposed Collection; Comment Request

AGENCY: Centers for Medicare & Medicaid Services, Health and Human 
Services (HHS).

ACTION: Notice.

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SUMMARY: On May 28, 2010, the Office of Management and Budget (OMB) 
issued Paperwork Reduction Act (PRA) guidance related to the 
``generic'' clearance process. Generally, this is an expedited process 
by which agencies may obtain OMB's approval of collection of 
information requests that are ``usually voluntary, low-burden, and 
uncontroversial collections,'' do not raise any substantive or policy 
issues, and do not require policy or methodological review. The process 
requires the submission of an overarching plan that defines the scope 
of the individual collections that would fall under its umbrella. This 
Federal Register notice seeks public comment on one or more of our 
collection of information requests that we believe are generic and fall 
within the scope of the umbrella. Interested persons are invited to 
submit 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 January 30, 2025.

[[Page 4745]]

ADDRESSES: When commenting, please reference the applicable form number 
(CMS-10398 #___) and the OMB control number (0938-1148). 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: CMS-10398 #___/OMB 
control number: 0938-1148, 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, please access 
the CMS PRA website by copying and pasting the following web address 
into your web browser: https://www.cms.gov/medicare/regulations-guidance/legislation/paperwork-reduction-act-1995/pra-listing.

FOR FURTHER INFORMATION CONTACT: William N. Parham at 410-786-4669.

SUPPLEMENTARY INFORMATION: Following is a summary of the use and burden 
associated with the subject information collection(s). More detailed 
information can be found in the collection's supporting statement and 
associated materials (see ADDRESSES).

Generic Information Collection

    1. Title of Information Collection: Managed Care Plan (MCP) Medical 
Loss Ratio (MLR) Reporting Template; Type of Information Collection 
Request: New collection of information request; Use: Medicaid managed 
care is the predominant delivery system for Medicaid beneficiaries to 
access health care services. State Medicaid agencies contract with 
managed care plans (MCPs) that accept a fixed, prospective monthly 
payment for each enrolled beneficiary (also referred to as risk-based 
managed care). Section 1903(m)(2) of the Social Security Act and 42 CFR 
438.4 require that capitation rates be actuarially sound, meaning that 
the capitation rates are projected to provide for all reasonable, 
appropriate, and attainable costs that are required under the terms of 
the contract and for the operation of the MCP for the time period and 
the population covered under the terms of the contract. The medical 
loss ratio (MLR) is a key measure of MCP financial performance and 
indicates the share of premium revenue (capitation payments) that a 
plan spends on covered health services and activities to improve health 
care quality compared to the share of revenue to cover administrative 
expenses and profit/surplus. MLRs are used as a retrospective tool to 
assess financial performance of MCPs. Section 438.8 provides detail on 
MLR calculations and MCP reporting requirements.
    Section 438.8(k) requires State contracts with MCPs to include a 
requirement to annually report to the state specific details of the 
plan's MLR. The attached Medicaid managed care plan MLR reporting 
template provides States with a standard format for collecting the 
required details from their contracted MCPs. States are not required to 
have their MCPs use this template; it is provided in response to 
States' requests for a streamlined, consistent way to collect the 
required information. CMS' review process for managed care MLR 
represents an essential Federal oversight function to ensure that 
States and MCPs are compliant with applicable Federal laws and 
regulations.
    Form Number: CMS-10398 #87 (OMB control number: 0938-1148); 
Frequency: Yearly; Affected Public: Private Sector and State, Local, or 
Tribal Governments; Number of Respondents: 47; Total Annual Responses: 
47; Total Annual Hours: 2,350. (For policy questions regarding this 
collection contact: Amy Gentile at 410-786-3499.)
    2. Title of Information Collection: CAA of 2024, Section 206 
Planning Grant Reporting; Type of Information Collection Request: New 
collection of information request; Use: This collection relates to 
section 206(a) of the Consolidated Appropriations Act, 2024 (CAA of 
2024), ``State Planning Grants to Promote Continuity of Care for 
Medicaid and CHIP Beneficiaries Following Incarceration''. This four-
year, discretionary grant program supports state Medicaid agencies and 
Children's Health Insurance Programs (CHIP) to develop the operational 
capabilities to promote continuity of care for Medicaid-eligible 
individuals who have been incarcerated. To ensure maximum state 
flexibility and to reduce the reporting burden on states as much as 
possible, states will submit semi-annual and final progress reports in 
their preferred format. CMS will not require states to use a 
standardized template or form, and CMS is not making an optional 
template or form available for states to use. Form Number: CMS-10398 
#90 (OMB control number: 0938-1148); Frequency: Semi-annually and once; 
Affected Public: State, Local, or Tribal Governments; Number of 
Respondents: 30; Total Annual Responses: 300; Total Annual Hours: 
1,200. (For policy questions regarding this collection contact: 
Jennifer Bowdoin at 410-786-8551.)
    3. Title of Information Collection: State Plan Amendment (SPA) 
Template for Medicaid Clinic Benefit; Type of Information Collection 
Request: New information collection request information request; Use: 
On November 27, 2024, CMS published the Prospective Payment System and 
Ambulatory Surgical Center Payment System final rule (CMS-1809-FC, RIN 
0938-AV35) which amended 42 CFR 440.90 to authorize Medicaid coverage 
for clinic services furnished outside the ``four walls'' of their 
clinic. The rule provided States with the authority to amend their 
state plans and add additional coverage outside of the clinic to the 
optional clinic benefit. We have developed and attached a new state 
plan template to simplify the SPA development, submission, and review/
approval processes for states and CMS.
    Completion of the template is mandatory for states that both cover 
the clinic services benefit and cover tribal clinics to allow clinic 
services to be provided outside of the clinic under the clinic services 
benefit but will be available as an option for all states who wish to 
use the template to amend their state plan clinic pages for general 
updates.
    Form Number: CMS-10398 #91 (OMB control number: 0938-1148); 
Frequency: One-time and on occasion; Affected Public: State, Local, or 
Tribal Governments; Number of Respondents: 56; Total Annual Responses: 
56; Total Annual Hours: 1,400. (For policy questions regarding this 
collection contact: Marlana Thieler at 410-786-6274.)

William N. Parham, III,
Director, Division of Information Collections and Regulatory Impacts, 
Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2025-01022 Filed 1-15-25; 8:45 am]
BILLING CODE 4120-01-P
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