[Federal Register Volume 76, Number 197 (Wednesday, October 12, 2011)]
[Notices]
[Pages 63302-63303]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-26344]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services

[Document Identifier CMS-10379]


Emergency Clearance: Public Information Collection Requirements 
Submitted to the Office of Management and Budget (OMB)

AGENCY: Center for Medicare and 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 and 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 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.
    We are, however, requesting an emergency review of the information 
collection referenced below. In compliance with the requirement of 
section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, we have 
submitted to the Office of Management and Budget (OMB) the following 
requirements for emergency review. We are requesting an emergency 
review because the collection of this information is needed before the 
expiration of the normal time limits under OMB's regulations at 5 CFR 
1320.13. This is necessary to ensure compliance with an initiative of 
the Administration. We cannot reasonably comply with the normal 
clearance procedures in that public harm is reasonably likely to result 
if normal clearance procedures are followed as stated in 5 CFR 
1320.13(a)(2)(i). The approval of this data collection process is 
essential to ensuring that consumers enrolled in individual and small 
group association products receive the consumer protections provided 
under Section 1003 of the Affordable Care Act. In absence of this 
change, a significant number of individual and small group rate 
increases for the 2012 plan year would not be subject to the review and 
public disclosure requirements of the rate review program and, instead, 
would be subject to rate increases that are largely unregulated.
    1. Type of Information Collection Request: Revision of a currently 
approved; Title of Information Collection: Rate Increase Disclosure and 
Review Reporting Requirements (45 CFR Part 154). Use: Under the Section 
1003 of the Affordable Care Act (Section 2794 of the Public Health 
Service Act), The Secretary, in conjunction with the States, is 
required to establish a process for the annual review, beginning with 
the 2010 plan year, of unreasonable increases in premiums for health 
insurance coverage. Section 2794 directs the Secretary to ensure the 
public disclosure of information of unreasonable rate increases and 
justification for those increases.
    On December 23, 2010, CMS published a proposed rate review 
regulation in the Federal Register for public comment (Rate Increase 
Disclosure and Review Rule, 75 FR 81004). CMS revised the proposed rule 
based on the public comments and published the final rate review 
regulation in the Federal Register on May 19, 2011. The final rule 
defines the unreasonable rate review process and issuer reporting and 
disclosure requirements (Rate Increase Disclosure and Review Rule, 76 
FR 29964). The regulation establishes the following reporting 
requirements:
     The Preliminary Justification: This data collection is 
required of all health insurance issuers for all rate increases that 
exceed the ``subject to review''' reporting threshold as defined in the 
rule. This information will be posted on an HHS Web site.
     Rate Review Final Determination: This data collection 
requires States with effective rate review programs and CMS to report 
their review findings and unreasonable rate increase determinations on 
all rate increases that are subject to review. This information will be 
posted on an HHS Web site.
     The Final Justification for An Unreasonable Rate Increase: 
This data collection is required of health insurance issuers that elect 
to implement a rate increase that is determined to be unreasonable 
based on State or CMS review. This information will be posted on the 
Health Insurance Issuer's Web site and on a CMS Web site.

1. Preliminary Justification

    The Preliminary Justification consists of three parts, Part I: Rate 
Increase Summary, Part II: Written Explanation of the Rate Increase, 
and Part III: Rate Filing Documentation. Issuers must complete Parts I 
and II for all rate increases that exceed the reporting threshold as 
defined in the rule. As described in the preamble of the rule, this 
information would be collected to provide consumers with basic 
information on all rate increases that are subject to review under the 
rate review program.
    Under the rule, ``subject to review'' rate increases would be 
reviewed by either States or CMS, depending on whether a State has an 
effective rate review program. Issuers would only be required to submit 
Part III of the Preliminary Justification when CMS is conducting the 
review of a rate increase that is ``subject to review.'' Accordingly, 
Part III requires health insurance issuers to provide detailed rate 
data that would be used for the purposes of conducting thorough 
actuarial reviews and for making determinations about whether rate 
increases are unreasonable.
    This Notice contains the following information about the 
Preliminary Justification:
     Preliminary Justification Issuer Instructions: health 
insurance issuer instructions for completing all three parts of the 
Preliminary Justification.
     Part I Worksheet: a standardized Excel worksheet that must 
be used to complete Part I of the Preliminary Justification.
     Sample internet display of the Rate Review Consumer 
Disclosure: Information provided in the Preliminary Justification would 
be posted on an HHS Web site. This sample display shows how the 
information contained in the Part I Worksheet would be displayed to 
consumers.

2. Rate Review Final Determination

    Under the rule, States and CMS would have to provide a Rate Review 
Final Determination at the close of their review of all ``subject to 
review'' rate increases. The Rate Review Final

[[Page 63303]]

Determination must provide the State's or CMS' determination on whether 
a rate increases is `unreasonable'. Section 154.301(a)(3) of the rule 
provides a list of actuarial review elements that must be taken into 
account as part of the rate review process. The Final Determination 
must provide a brief statement explaining how the review of elements 
set forth in Sec.  154.301(a)(3) caused the State or CMS to arrive at 
its determination that the rate is unreasonable.
    The Rate Review Final Determination will be entered into a data 
entry text box in the Rate Review Data Collection System. CMS is 
estimating that this statement would be approximately a paragraph in 
length. There is no specific form or set of instructions associated 
with this reporting requirement, apart from the reporting requirements 
provided in the rule. The information provided in the Rate Review Final 
Determination will be posted as part of the rate review consumer 
disclosure information on an HHS Web site.

3. Final Justification for An Unreasonable Rate Increase

    The rule states that if a health insurance issuer implements a rate 
increase determined by CMS or a State to be unreasonable, the health 
insurance issuer must provide a Final Justification for an Unreasonable 
Rate Increase. In the Final Justification, issuers would have to 
provide a short statement about why they are electing to implement an 
unreasonable rate increase. This statement would be entered into a data 
entry text box in the Rate Review Data Collection System and would not 
need to be more than a paragraph or two in length. There is no form or 
instructions associated with this statement apart from the requirements 
provided in the regulation.
    The Final Justification Statement will be posted on an HHS Web site 
in the same location as the Preliminary Justification and Rate Review 
Final Determination. Additionally, health insurance issuers 
implementing rate increases that were determined to be unreasonable, 
must post all of this information--the Preliminary Justification, the 
Rate Review Final Determination, and the Final Justification Statement 
on their Web sites for a period of 3 years.
    In addition to the aforementioned requirements, we have revised the 
information collection request as a result of an amendment to the 
regulation discussed in the final rule that published September 6, 2011 
(76 FR 54969). The amendment to the rate review final rule updated the 
applicability of the rate review requirements to include products that 
would be considered part of the individual or small group market had 
they not been sold through associations, including those that are 
consider to be large group products under State law or have been 
otherwise excluded from State's existing definitions for individual and 
small group products. This change will result in an increase in the 
total number of rate increases that are subject to the rate review 
reporting requirements. The amendment did not propose any changes to 
the information that issuers must submit for each rate increase. Thus, 
burden associated with each rate increase submission remains unchanged 
from the final rate review rule. Form Number: CMS-10379; (OCN: 0938-
1141) Frequency: Annually; Affected Public: Private Sector and States; 
Number of Respondents: 452; Number of Responses: 1,201; Total Annual 
Hours: 15,213. (For policy questions regarding this collection, contact 
Sally McCarty at (301) 492-4489. For all other issues call 410-786-
1326.)
    CMS is requesting OMB review and approval of this collection by 
October 31, 2011, with a 180-day approval period. Written comments and 
recommendations will be considered from the public if received by the 
individuals designated below by October 21, 2011.
    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.gov/PaperworkReductionActof1995/PRAL/list.asp 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.
    Interested persons are invited to send comments regarding the 
burden or any other aspect of these collections of information 
requirements. However, as noted above, comments on these information 
collection and recordkeeping requirements must be received via one of 
the following methods by October 21, 2011.
    1. Electronically. You may submit 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) 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, Room C4-26-05, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.
    3. By E-mail to OMB. OMB, Office of Information and Regulatory 
Affairs, Attention: CMS Desk Officer, E-mail: [email protected].

    Dated: October 6, 2011.
Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2011-26344 Filed 10-7-11; 11:15 am]
BILLING CODE 4120-01-P