[Federal Register Volume 74, Number 6 (Friday, January 9, 2009)]
[Notices]
[Pages 902-903]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-52]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-R-262, CMS-10142 and CMS-R-137]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

AGENCY: Centers for Medicare & Medicaid Services.
    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), Department of Health and Human Services, 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 function; (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: Revision of a currently 
approved collection; Title of Information Collection: CY 2010 Plan 
Benefit Package (PBP) and Formulary Submission for Medicare Advantage 
(MA) Plans and Prescription Drug Plans (PDP) Use: Under the Medicare 
Modernization Act (MMA), Medicare Advantage (MA) and Prescription Drug 
Plan (PDP) organizations are required to submit plan benefit packages 
for all Medicare beneficiaries residing in their service area. The plan 
benefit package submission consists of the formulary file, Plan Benefit 
Package (PBP) software, and supporting documentation as necessary. MA 
and PDP organizations will generate a formulary to illustrate their 
list of drugs, including information on prior authorization, step 
therapy, tiering, and quantity limits. Additionally, the PBP software 
will be used to describe their organization's plan benefit packages, 
including information on premiums, cost sharing, authorization rules, 
and supplemental benefits. CMS uses the formulary and PBP data to 
review and approve the plan benefit packages proposed by each MA and 
PDP organization.
    CMS requires that MA and PDP organizations submit a completed 
formulary and PBP 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 CMS for review and 
approval. Based on operational changes and policy clarifications to the 
Medicare program and continued input and feedback by the industry, CMS 
has made the necessary changes to the plan benefit package submission. 
Form Number: CMS-R-262 (OMB 0938-0763); Frequency: Yearly; 
Affected Public: Business or other for-profits b. Not-for-profit 
institutions; Number of Respondents: 475; Total Annual Responses: 
4987.5; Total Annual Hours: 12112.5.
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of

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Information Collection: CY 2010 Bid Pricing Tool (BPT) for Medicare 
Advantage (MA) Plans and Prescription Drug Plans (PDP). Use: Under the 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 
(MMA), and implementing regulations at 42 CFR, Medicare Advantage 
organizations (MAO) and Prescription Drug Plans (PDP) are required to 
submit an actuarial pricing ``bid'' for each plan offered to Medicare 
beneficiaries for approval by CMS. MAOs and PDPs use the Bid Pricing 
Tool (BPT) software to develop their actuarial pricing bid. The 
information provided in the BPT is the basis for the plan's enrollee 
premiums and CMS payments for each contract year. The tool collects 
data such as medical expense development (from claims data and/or 
manual rating), administrative expenses, profit levels, and projected 
plan enrollment information. By statute, completed BPTs are due to CMS 
by the first Monday of June each year. CMS reviews and analyzes the 
information provided on the Bid Pricing Tool. Ultimately, CMS decides 
whether to approve the plan pricing (i.e., payment and premium) 
proposed by each organization. Form Number: CMS-10142 (OMB 
0938-0944); Frequency: Yearly; Affected Public: Business or other for-
profits b. Not-for-profit institutions; Number of Respondents: 550; 
Total Annual Responses: 6050; Total Annual Hours: 42,350.
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Internal Revenue 
Service (IRS)/Social Security Administration (SSA)/Centers for Medicare 
and Medicaid Services (CMS) Data Match and Supporting Regulations in 42 
CFR 411.20-491.206 Use: Medicare Secondary Payer (MSP) is essentially 
the same concept known in the private insurance industry as 
coordination of benefits; it refers to those situations where Medicare 
assumes a secondary payer role to certain types of private insurance 
for covered services provided to a Medicare beneficiary.
    Congress sought to reduce the losses to the Medicare program by 
requiring in 42 U.S.C. 1395y(b)(5) that the Internal Revenue Service 
(IRS), the Social Security Administration (SSA), and CMS perform an 
annual data match (the IRS/SSA/CMS Data Match, or ``Data Match'' for 
short). CMS uses the information obtained through Data Match to contact 
employers concerning possible application of the MSP provisions by 
requesting information about specifically identified employees (either 
a Medicare beneficiary or the working spouse of a Medicare 
beneficiary). This statutory data match and employer information 
collection activity enhances CMS's ability to identify both past and 
present MSP situations. Form Number: CMS-R-137 (OMB 0938-
0763); Frequency: Annually; Affected Public: Business or other for-
profit, not-for-profit institutions, farms, State, Local or Tribal 
Governments; Number of Respondents: 326,597; Total Annual Responses: 
326,597; Total Annual Hours: 1,900,795.
    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 by the OMB desk 
officer at the address below, no later than 5 p.m. on February 9, 2009: 
OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, New Executive Office Building, Room 10235, Washington, DC 
20503, Fax Number: (202) 395-6974.

    Dated: December 28, 2008.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E9-52 Filed 1-8-09; 8:45 am]
BILLING CODE 4120-01-P