[Federal Register Volume 75, Number 5 (Friday, January 8, 2010)]
[Notices]
[Pages 1059-1060]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-31299]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10142, CMS-R-262, CMS-R-0282 and CMS-R-64]


Agency Information Collection Activities: Submission for OMB 
Review; 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), 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 2011 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 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. 
Refer to the supporting document attachment ``C'' for a list of 
changes. Form Number: CMS-10142 (OMB: 0938-0944); Frequency: 
Reporting--Yearly; Affected Public: Business or other for-profit and 
Not-for-profit institutions; Number of Respondents: 550; Total Annual 
Responses: 6,050; Total Annual Hours: 42,350. (For policy questions 
regarding this collection contact Diane Spitalnic at 410-786-5745. For 
all other issues call 410-786-1326.)
    2. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: CY 2011 Plan 
Benefit Package (PBP) Software and Formulary Submission; 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 PBP 
software, formulary file, and supporting documentation, as necessary. 
MA and PDP organizations use the PBP software to describe their 
organization's plan benefit packages, including information on 
premiums, cost sharing, authorization rules, and supplemental benefits. 
They also generate a formulary to describe their list of drugs, 
including information on prior authorization, step therapy, tiering, 
and quantity limits. Additionally, CMS uses the PBP and formulary 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 PBP 
and formulary 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. 
Refer to the supporting document ``Appendix B'' for a list of changes. 
Form Number: CMS-R-262 (OMB: 0938-0763); Frequency: 
Reporting--Yearly; Affected Public: Business or other for-profit and 
Not-for-profit institutions; Number of Respondents: 475; Total Annual 
Responses: 4988; Total Annual Hours: 12,113. (For policy questions 
regarding this collection contact Sara Walters at 410-786-3330. For all 
other issues call 410-786-1326.)
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare 
Advantage Appeals and Grievance Data Disclosure Requirements (42 CFR 
Sec.  422.111); Use: Medicare Advantage (MA) organizations must 
disclose information pertaining to the number of disputes, and their 
disposition in the aggregate, with the categories of grievances and 
appeals to any individual eligible to elect an MA organization who 
requests this information. Medicare demonstrations also are required to 
conform to MA appeals regulations and thus are included in the count of 
organizations affected by this requirement. MA organizations also are 
required by the statute and the MA regulation to provide aggregate 
grievance data to MA eligible beneficiaries upon request. MA eligible 
individuals will use this information to help them make informed 
decisions about their organization's performance in the area of appeals 
and grievances. Form Number: CMS-R-0282 (OMB: 0938-0778); 
Frequency: Reporting--Semi-annually and Yearly; Affected Public: 
Business or other for-profits and Not-for-profit institutions; Number 
of Respondents: 629; Total Annual Responses: 47,175; Total Annual 
Hours: 4,931.36. (For policy questions regarding this collection 
contact Stephanie Simons at 206-615-2420. For all other issues call 
410-786-1326.)
    4. Type of Information Collection Request: Extension of the 
currently approved collection; Title of Information Collection: 
Indirect Medical Education (IME) and Supporting Regulations at 42 CFR 
412.105; Direct Graduate Medical Education (GME) and Supporting 
Regulations at 42 CFR 413.75 through 413.83; Use: The information 
collected on interns and residents (IRs) is used by the Medicare Part A 
fiscal intermediaries (FI) and Part A Medicare Administrative 
Contractors (MAC) to verify the number of IRs used in the calculation 
of Medicare program payments for indirect medical education (IME) as 
well as direct graduate medical education (GME). The IR data collected 
from the hospitals is processed through computers at FIs/MACs to 
identify any duplicated time based upon the accumulated time of each 
individual that worked at one or more hospitals. The identification of 
duplicate IRs is necessary to ensure that no IR is counted more than 
once.
    The FIs/MACs use the information collected on IRs to help ensure 
that all

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program payments for IME and GME are based upon an accurate number of 
FTE-IRs, determined in accordance with Medicare regulations. The IR 
data submitted by the hospitals are used by the FIs/MACs during their 
audits of the providers' cost reports. The audit procedures help assure 
that the information reported was correct, and that IRs who should not 
have been reported by the hospitals (or portions of the IRs' time) are 
not included in the FTE count. The FIs/MACs also use reports of 
duplicate IRs to prevent improper payment for IME and GME. Form Number: 
CMS-R-64 (OMB: 0938-0456); Frequency: Reporting--Yearly; 
Affected Public: Business or other for-profit and Not-for-profit 
institutions; Number of Respondents: 1,190; Total Annual Responses: 
1,190; Total Annual Hours: 2,380. (For policy questions regarding this 
collection contact Milton Jacobson at 410-786-7553. For all other 
issues call 410-786-1326.)
    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 8, 2010.
    OMB, Office of Information and Regulatory Affairs. Attention: CMS 
Desk Officer. Fax Number: 202-395-6974. E-mail: [email protected].

    Dated: December 24, 2009.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations 
and Regulatory Affairs.
[FR Doc. E9-31299 Filed 1-7-10; 8:45 am]
BILLING CODE 4120-01-P