32028 Federal Register / Vol. 87, No. 102 / Thursday, May 26, 2022 / Notices 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Reinstatement with change of a 

previously approved collection; Title of 

Information Collection: Standards 

Related to Reinsurance, Risk Corridors, 

and Risk Adjustment; Use: The data 

collection and reporting requirements 

will be used by HHS to run the 

permanent risk adjustment program, 

including validation of data submitted 

by issuers, on behalf of States that 

requested HHS to run it for them. Risk 

adjustment is one of three market 

stability programs established by the 

Patient Protection and Affordable Care 

Act and is intended to mitigate the 

impact of adverse selection in the 

individual and small group health 

insurance markets inside and outside of 

the Health Insurance Exchanges. 

HHS will also use this data to adjust 

the payment transfer formula for risk 

associated with high-cost enrollees. 

State regulators can use the reporting 

requirements outlined in this collection 

to request a reduction to the statewide 

average premium factor of the risk 

adjustment transfer formula, beginning 

for the 2019 benefit year, and thereby 

avoid having to establish their own 

programs. Issuers and providers can use 

the alternative reporting requirements 

for mental and behavioral health records 

described herein to comply with State 

privacy laws. Form Number: CMS– 

10401 (OMB control number: 0938– 

1155); Frequency: Annually; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

650; Total Annual Responses: 173,918; 

Total Annual Hours: 4,126,850. (For 

policy questions regarding this 

collection contact Jacqueline Wilson at 

jacqueline.wilson1@cms.hhs.gov.) 

Dated: May 23, 2022. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2022–11302 Filed 5–25–22; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers CMS–10065/10066, 

CMS–10611, CMS–10464, CMS–10430 and 

CMS–10492] 

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 

July 25, 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. 

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–10065/10066 Hospital Notices: 

IM/DND 

CMS–10611 Medicare Outpatient 

Observation Notice (MOON) 

CMS–10464 Agent/Broker Data 

Collection in Federally-Facilitated 

Health Insurance Exchanges 

CMS–10430 Compliance with 

Individual and Group Market 

Reforms under Title XXVII of the 

Public Health Service Act 

CMS–10492 Data Submission 

Requirements to Receive the 

Federally-facilitated Exchange User 

Fee Adjustment 

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: Hospital 

Notices: IM/DND; Use: The purpose of 


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Federal Register / Vol. 87, No. 102 / Thursday, May 26, 2022 / Notices 32029 

the IM is to inform beneficiaries and 

enrollees of their rights as hospital 

inpatients and how to request a 

discharge appeal by a Quality 

Improvement Organization (QIO) and 

how to file a request. For all Medicare 

beneficiaries, hospitals must deliver 

valid, written notice of a beneficiary’s 

rights as a hospital inpatient, including 

discharge appeal rights. The hospital 

must use a standardized notice, as 

specified by CMS. This is satisfied by 

IM delivery. 

Consistent with 42 CFR 405.1205 for 

Original Medicare and 422.620 for 

Medicare health plans, hospitals must 

provide the initial IM within 2 calendar 

days of admission. A follow-up copy of 

the signed IM is given no more than 2 

calendar days before discharge. The 

follow-up copy is not required if the 

first IM is provided within 2 calendar 

days of discharge. In accordance with 42 

CFR 405.1206 for Original Medicare and 

422.622 for Medicare health plans, if a 

beneficiary/enrollee appeals the 

discharge decision, the beneficiary/ 

enrollee and the QIO must receive a 

detailed explanation of the reason’s 

services should end. This detailed 

explanation is provided to the 

beneficiary/enrollee using the DND, the 

second notice included in this renewal 

package. Form Number: CMS–10065/ 

10066 (OMB control number: 0938– 

1019); Frequency: Yearly; Affected 

Public: Private Sector (Business or other 

for-profits, Not-for-Profit Institutions); 

Number of Respondents: 14,087,086; 

Total Annual Responses: 14,087,086; 

Total Annual Hours: 2,385,107. (For 

policy questions regarding this 

collection contact Janet Miller at 

Janet.Miller@cms.hhs.gov.) 

2. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Medicare 

Outpatient Observation Notice (MOON); 

Use: The Medicare Outpatient 

Observation Notice (MOON) serves as 

the written notice component of this 

mandatory notification process. The 

standardized content of the MOON 

includes all informational elements 

required by statute, in language 

understandable to beneficiaries, and 

fulfils the regulatory requirements at 42 

CFR part 489.20(y). 

The MOON is a standardized notice 

delivered to persons entitled to 

Medicare benefits under Title XVIII of 

the Act who receive more than 24 hours 

of observation services, informing them 

that their hospital stay is outpatient and 

not inpatient, and the implications of 

being an outpatient. This information 

collection applies to beneficiaries in 

Original Medicare and enrollees in 

Medicare health plans. Form Number: 

CMS–10611 (OMB control number: 

0938–1308); Frequency: Yearly; Affected 

Public: State, Local, or Tribal 

Governments; Number of Respondents: 

4,312; Total Annual Responses: 

683,222; Total Annual Hours: 170,806. 

(For policy questions regarding this 

collection contact Janet Miller at 

Janet.Miller@cms.hhs.gov.) 

3. Type of Information Collection 

Request: Extension of a currently 

approved information collection; Title 

of Information Collection: Agent/Broker 

Data Collection in Federally-Facilitated 

Health Insurance Exchanges; Use: The 

Patient Protection and Affordable Care 

Act, Public Law 111–148, enacted on 

March 23, 2010, and the Health Care 

and Education Reconciliation Act, 

Public Law 111–152, enacted on March 

30, 2010 (collectively, ‘‘Affordable Care 

Act’’), expands access to health 

insurance for individuals and 

employees of small businesses through 

the establishment of new Affordable 

Insurance Exchanges (Exchanges), also 

called Marketplaces, including the 

Small Business Health Options Program 

(SHOP). 

The Centers for Medicare & Medicaid 

Services (CMS) recognizes the 

longstanding role that agents/brokers 

have played in connecting individuals 

and small businesses with health 

insurance products. Section 1312(e) of 

the Affordable Care Act and 45 CFR 

155.220(a)(1) expands the role of agents/ 

brokers by permitting them to enroll 

qualified individuals or small 

employers/employees in qualified 

health plans (QHPs) through the 

Exchanges, and assist individuals in 

applying for Advance Premium Tax 

Credits (APTCs) and Cost Sharing 

Reductions (CSRs). To participate as 

facilitators to enrollment, agents/brokers 

must register with the FFE, complete a 

training course covering eligibility and 

enrollment criteria for assisting in QHP 

enrollment, and sign agreements that 

formalize their understanding and 

commitment to adhere to the rules of 

the program. This requirement is 

specific to the FFE and does not 

automatically apply to State-based 

Exchanges (SBEs). This ICR serves as 

the formal request for renewal of the 

existing data collection. Form Number: 

CMS–10464 (OMB control number: 

0938–1204); Frequency: Annually; 

Affected Public: Private Sector (Business 

or other for-profits) Number of 

Respondents: 64,000; Number of 

Responses: 64,000; Total Annual Hours: 

15,360. (For questions regarding this 

collection contact Madeline Pellish at 

301–492–4390). 

4. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Information 

Collection Requirements for Compliance 

with Individual and Group Market 

Reforms under Title XXVII of the Public 

Health Service Act; Use: Sections 2723 

and 2761 of the Public Health Service 

Act (PHS Act) direct the Centers for 

Medicare and Medicaid Services (CMS) 

to enforce a provision (or provisions) of 

title XXVII of the PHS Act (including 

the implementing regulations in parts 

144, 146, 147, and 148 of title 45 of the 

Code of Federal Regulations) with 

respect to health insurance issuers when 

a state has notified CMS that it has not 

enacted legislation to enforce or that it 

is not otherwise enforcing a provision 

(or provisions) of the group and 

individual market reforms with respect 

to health insurance issuers, or when 

CMS has determined that a state is not 

substantially enforcing one or more of 

those provisions. Section 2723 of the 

PHS Act directs CMS to enforce an 

applicable provision (or applicable 

provisions) of title XXVII of the PHS Act 

(including the implementing regulations 

in parts 146 and 147 of title 45 of the 

Code of Federal Regulations) with 

respect to group health plans that are 

non-Federal governmental plans. This 

collection of information includes 

requirements that are necessary for CMS 

to conduct compliance review activities. 

Form Number: CMS–10430 (OMB 

control number: 0938–0702); Frequency: 

Annually; Affected Public: Private 

Sector, State, Local, or Tribal 

Governments; Number of Respondents: 

794; Total Annual Responses: 51,385; 

Total Annual Hours: 1,786. (For policy 

questions regarding this collection 

contact Usree Bandyopadhyay at 410– 

786–6650.) 

5. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Data 

Submission for the Federally-facilitated 

Exchange User Fee Adjustment; Use: 

Section 2713 of the Public Health 

Service Act requires coverage without 

cost sharing of certain preventive health 

services, including certain contraceptive 

services, in non-exempt, nongrandfathered group health plans and 

health insurance coverage. The final 

regulations establish rules under which 

the third party administrator of the plan 

would provide or arrange for a third 

party to provide separate contraceptive 

coverage to plan participants and 

beneficiaries without cost sharing, 

premium, fee, or other charge to plan 

participants or beneficiaries or to the 


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32030 Federal Register / Vol. 87, No. 102 / Thursday, May 26, 2022 / Notices 

eligible organization or its plan. Eligible 

organizations are required to self-certify 

that they are eligible for this 

accommodation and provide a copy of 

such self-certification to their third 

party administrators. The final rules 

also set forth processes and standards to 

fund the payments for the contraceptive 

services that are provided for 

participants and beneficiaries in selfinsured plans of eligible organizations 

under the accommodation described 

previously, through an adjustment in 

the FFE user fee payable by an issuer 

participating in an FFE. 

CMS will use the data collections 

from participating issuers and third 

party administrators to verify the total 

dollar amount for such payments for 

contraceptive services provided under 

this accommodation for the purpose of 

determining a participating issuer’s user 

fee adjustment. The attestation that the 

payments for contraceptive services 

were made in compliance with 26 CFR 

54.9815–2713A(b)(2) or 29 CFR 

2590.715–2713A(b)(2) will help ensure 

that the user fee adjustment is being 

utilized to provide contraceptive 

services for the self-insured plans in 

accordance with the previously noted 

accommodation. Form Number: CMS– 

10492 (OMB control number: 0938– 

1285); Frequency: Annually; Affected 

Public: Private sector (Business or other 

for-profits and Not-for-profit 

institutions); Number of Respondents: 

861; Total Annual Responses: 861; Total 

Annual Hours: 12,930. (For policy 

questions regarding this collection 

contact Jacqueline Wilson at 

jacqueline.wilson1@cms.hhs.gov.) 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2022–11301 Filed 5–25–22; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Sexual Risk Avoidance 

Education National Evaluation: 

Nationwide Study of the National 

Descriptive Study (New Collection) 

AGENCY: Office of Planning, Research 

and Evaluation; Administration for 

Children and Families; HHS. 

ACTION: Request for public comment. 

SUMMARY: The Office of Planning, 

Research and Evaluation (OPRE), 

Administration for Children and 

Families (ACF), U.S. Department of 

Health and Human Services (HHS), 

proposes survey and focus group data 

collection activities for the Sexual Risk 

Avoidance Education National 

Evaluation (SRAENE) Nationwide Study 

(NWS) of the National Descriptive 

Study. 

DATES: Comments due within 60 days of 

publication. In compliance with the 

Paperwork Reduction Act of 1995, ACF 

is soliciting public comment on the 

specific aspects of the information 

collection described above. 

ADDRESSES: You can obtain copies of the 

proposed collection of information and 

submit comments by emailing 

OPREinfocollection@acf.hhs.gov. 

Identify all requests by the title of the 

information collection. 

SUPPLEMENTARY INFORMATION: 

Description: OPRE/ACF/HHS 

proposes to conduct the NWS, a substudy under the National Descriptive 

Study (NDS) of the SRAENE, to learn 

about Sexual Risk Avoidance Education 

(SRAE) program implementation 

experiences and outcomes of the SRAE 

grant program. The NWS builds on the 

Early Implementation Study, the first 

sub-study of the NDS, which was 

designed to tell the story about SRAE 

grant program plans (OMB Control 

#0970–0530). The NWS, which supports 

Congress’s reauthorization in February 

2018 of title V, section 510 of the Social 

Security Act (Pub. L. 115–123) and 

extended by the Coronavirus Aid, 

Relief, and Economic Security (CARES) 

ACT of 2020 (Pub. L. 116–136), will use 

a mixed-methods approach of surveys 

and focus groups to tell the story of the 

SRAE grant program, collecting detailed 

information on grantee program 

implementation experiences from grant 

recipients, SRAE program providers and 

facilitators, and youth program 

recipients. The NWS will also make use 

of extant data from grant-recipient 

performance measures on program 

outputs and outcomes. Combined with 

data on program implementation, the 

NWS will examine associations between 

implementation, outputs, and outcomes. 

The survey and focus group data are key 

to fully understanding program 

implementation experiences from all 

levels that bring the SRAE programs to 

youth-from grant administrators to 

program supervisors to the facilitators 

who interact directly with the youth 

themselves. 

The study is being undertaken by ACF 

and its contractor Mathematica. The 

study research questions driving the 

need for data collection are as follows: 

1. What are grant recipients’ and 

providers’ experiences with delivering 

SRAE curricular content? What are 

youth’s experiences with receiving the 

SRAE curricular content? 

2. How did grant recipients and 

providers interpret, understand, and 

address the A to F topics in the SRAE 

legislation? 

3. Are some features of 

implementation more strongly 

associated with youth outcomes than 

others? 

4. What provider characteristics are 

associated with a greater number of 

youth served and with youth outcomes? 

To support these efforts, ACF 

proposes the following data collection 

activities: (1) A web-based survey of all 

grant recipient Directors who are not 

also providers, (2) a web-based survey of 

all SRAE program providers, (3) a webbased survey of all SRAE program 

facilitators, and (4) in-person (or virtual 

if necessary) focus groups with youth 

recipients of SRAE programming across 

five geographic regions of the United 

States. 

Respondents: Respondents to the 

surveys will be SRAE program grant 

Directors, SRAE program providers, and 

SRAE program facilitators. Focus group 

participants will be youth recipients of 

SRAE programming. The focus group 

participants will be recruited from 

middle and high school across five U.S. 

Geographic regions: West, Midwest, 

Southwest, Southeast, and Northeast. 


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