[Federal Register Volume 72, Number 56 (Friday, March 23, 2007)]
[Notices]
[Pages 13793-13794]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-5297]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10216, CMS-R-0053, CMS-179, CMS-10137, CMS-
10069 and CMS-R-246]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.

    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid 
Services (CMS) is publishing the following summary of proposed 
collections for public comment. Interested persons are invited to send 
comments regarding this burden estimate 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.
    1. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Alternative Benefits State Plan Amendment Health Opportunity Accounts 
(HOA) Demonstration Program; Use: The DRA provides States with numerous 
flexibilities in operating their State Medicaid programs. For example, 
Section 6082 of the DRA allows up to 10 States to operate Medicaid 
demonstrations to test alternative systems for delivering their 
Medicaid benefits. Under these demonstrations, States would have the 
flexibility to deliver their Medicaid benefits to volunteer 
beneficiaries through a program that is comprised of an HOA and a High 
Deductible Health Plan (HDHP). Under the DRA, States can submit a State 
Plan Pre-print to CMS to effectuate this change to their Medicaid 
programs. CMS will provide a State Medicaid Director letter providing 
guidance on this provision and the implementation of the DRA and the 
associated State Plan Amendment template for use by States to modify 
their Medicaid State Plans if they choose to implement this 
flexibility; Form Number: CMS-10216 (OMB: 0938-1007); 
Frequency: Reporting: One-time; Affected Public: State, Local or tribal 
Government; Number of Respondents: 56; Total Annual Responses: 10; 
Total Annual Hours: 10.
    2. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Imposition of Cost Sharing Charges Under Medicare and Supporting 
Regulations Contained in 42 CFR 447.53; Use: The purpose of this 
collection is to ensure that States impose nominal cost sharing charges 
upon categorically and medically needy individuals as allowed by law 
and implementing regulations. States must identify in their State plan 
the following: (1) The service for which the charge is made; (2) The 
amount of the charge; (3) The basis for determining the charge; (4) The 
method used to collect the charge; (5) The basis for determining 
whether an individual is unable to pay the charge and the way in which 
the individual will be identified to providers; and, (6) The procedures 
for implementing and enforcing the exclusions from cost sharing; Form

[[Page 13794]]

Number: CMS-R-0053 (OMB: 0938-0429); Frequency: Reporting: 
Occasionally; Affected Public: State, Local or tribal Government; 
Number of Respondents: 56; Total Annual Responses: 2; Total Annual 
Hours: 20.
    3. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Transmittal and Notice of Approval of State Plan Material and 
Supporting Regulations in 42 CFR 430.10-430.20 and 440.167; Use: The 
CMS-179 is used by State agencies to transmit State plan material to 
the Centers for Medicare & Medicaid Services (CMS) for approval prior 
to amending their State plan. The State plan is the method in which 
States inform staff of State policies, standards, procedures and 
instructions. The CMS-179 is currently used by State agencies 
administering the Medicaid program and CMS regional offices (RO). State 
agencies use the form to submit State plan amendments (SPAs) (including 
supporting documentation) to the CMS RO for review and approval prior 
to amending their plan in accordance with 42 CFR 430.10-430.20. The 
CMS-179 includes instructions for completing the form. The inclusion of 
instructions is to assist State agencies in completing the form, 
thereby ensuring a more uniform and timely plan amendment approval 
process. The CMS-179 is the only source available to State agencies for 
submittal/approval of SPAs. This plan amendment approval process is 
necessary to ensure the State plan continues to meet statutory and 
regulatory requirements and thereby ensure the State's eligibility for 
Federal financial participation. CMS will use this information to track 
the estimated Federal budget impact associated with the SPAs. This 
information may result in more accurate Federal Medicaid expenditure 
estimates; Form Number: CMS-179 (OMB: 0938-0193); Frequency: 
Reporting: Occasionally; Affected Public: State, Local or tribal 
Government; Number of Respondents: 56; Total Annual Responses: 10; 
Total Annual Hours: 560.
    4. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Application for 
Prescription Drug Plans (PDP); Application for Medicare Advantage 
Prescription Drug (MA-PD); Application for Cost Plans To Offer 
Qualified Prescription Drug Coverage; Application for Employer Group 
Waiver Plans To Offer Prescription Drug Coverage; Service Area 
Expansion Application for Prescription Drug Coverage; Use: Collection 
of this information is mandated in Part D of the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003. The application 
requirements are codified in Subpart K of 42 CFR part 423. Coverage for 
the prescription drug benefit is provided through prescription drug 
plans (PDPs) that offer drug-only coverage, or through Medicare 
Advantage (MA) organizations that offer integrated prescription drug 
and health care coverage (MA-PD plans). PDPs must offer a basic drug 
benefit. Medicare Advantage Coordinated Care Plans (MA-CCPs) must offer 
either a basic benefit or may offer broader coverage for no additional 
cost. Medicare Advantage Private Fee for Service Plans (MA-PFFS) may 
choose to offer a Part D benefit. Cost Plans that are regulated under 
Section 1876 of the Social Security Act, and Employer Group Plans may 
also provide a Part D benefit. If any of the contracting organizations 
meet basic requirements, they may also offer supplemental benefits 
through enhanced alternative coverage for an additional premium.
    The information will be collected under the solicitation of 
proposals from PDP, MA-PD, Cost Plan, and Employer Group Waiver Plans 
applicants. The collected information will be used by CMS to: (1) 
Insure that applicants meet CMS requirements, and (2) support the 
determination of contract awards.
    The major program change that has occurred in Part D applications 
was that CMS removed several attestations related to Health Insurance 
Portability and Accountability Act (HIPAA), bids and privacy; Form 
Number: CMS-10137 (OMB: 0938-0936); Frequency: Reporting: 
Once; Affected Public: Business or other for-profit and Not-for-profit 
institutions; Number of Respondents: 857; Total Annual Responses: 857; 
Total Annual Hours: 28,122.
    5. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Medicare Waiver Demonstration Application; Use: The Medicare Waiver 
Demonstration Application will be used to collect standard information 
needed to implement congressionally mandated and administration high 
priority demonstrations. The application will be used to gather 
information about the characteristics of the applicant's organization, 
benefits, and services they propose to offer, success in operating the 
model, and evidence that the model is likely to be successful in the 
Medicare program. The standard application will be used for all waiver 
demonstrations and will reduce the burden on applicants, provide for 
consistent and timely information collections across demonstrations, 
and provide a user-friendly format for respondents; Form Number: CMS-
10069 (OMB: 0938-0880); Frequency: Reporting: Once; Affected 
Public: Business or other for-profit and Not-for-profit institutions; 
Number of Respondents: 75; Total Annual Responses: 75; Total Annual 
Hours: 6000.
    6. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Medicare CAHPS Survey; Use: The collection of Consumer Assessment of 
Healthcare Providers and Systems (CAHPS) Survey measures is necessary 
to hold health and prescription drug plans accountable for the quality 
of care and services they deliver. This requirement will allow CMS to 
obtain information for the proper oversight of the program. This 
information is used to help beneficiaries choose among plans, 
contribute to improved quality of care through identification of 
quality improvement opportunities, and assist CMS in carrying out its 
responsibilities; Form Number: CMS-R-246 (OMB: 0938-0732); 
Frequency: Reporting: Yearly; Affected Public: Individuals or 
households; Number of Respondents: 660,000; Total Annual Responses: 
660,000; Total Annual Hours: 217,800.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS' 
Web Site address at http://www.cms.hhs.gov/PaperworkReductionActof1995, 
or e-mail your request, including your address, phone number, OMB 
number, and CMS document identifier, to [email protected], or call 
the Reports Clearance Office on (410) 786-1326.
    To be assured consideration, comments and recommendations for the 
proposed information collections must be received at the address below, 
no later than 5 p.m. on May 22, 2007.
    CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development--A, Attention: Melissa Musotto, 
Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: March 16, 2007.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E7-5297 Filed 3-22-07; 8:45 am]
BILLING CODE 4120-01-P