[Federal Register Volume 76, Number 239 (Tuesday, December 13, 2011)]
[Notices]
[Pages 77537-77538]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-31920]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-9996-N2]


Early Retiree Reinsurance Program

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice.

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SUMMARY: This notice announces that CMS, based on the projected 
availability of funding under the Early Retiree Reinsurance Program 
(ERRP), is exercising its authority under the ERRP regulations at 45 
CFR 149.45(a) to deny ERRP reimbursement requests, in their entirety, 
that include claims that are incurred after December 31, 2011. 
Therefore, plan sponsors must not include such claims in their Claim 
Lists and Summary Cost Data submitted in support of a reimbursement 
request. Should circumstances related to the availability of ERRP 
funding change, CMS may issue a new notice announcing approval of ERRP 
reimbursement request that include claims incurred after December 31, 
2011.

DATES: Effective Date: This notice is effective December 9, 2011.

FOR FURTHER INFORMATION CONTACT: David Mlawsky, (410) 786-6851.

SUPPLEMENTARY INFORMATION:

I. Background

    The Patient Protection and Affordable Care Act (Pub. L. 111-148, 
enacted on March 23, 2010) (the Affordable Care Act), included a 
provision that establishes the temporary Early Retiree Reinsurance 
Program (ERRP), which provides reimbursement to eligible sponsors of 
employment-based plans for a portion of the costs of providing health 
coverage to early retirees (and eligible spouses, surviving spouses, 
and dependents of such retirees). Section 1102(a)(1) of the Affordable 
Care Act required the Secretary to establish the program within 90 days 
of enactment of the law (by June 21, 2010). In the May 5, 2010 Federal 
Register (75 FR 24450), we published an interim final regulation with 
comment period, implementing the program as of June 1, 2010. Section 
1102(e) of the Affordable Care Act appropriates funding of $5 billion 
for the temporary program. The regulation at 45 CFR 149.45(a) states 
that based on the projected or actual availability of program funding, 
the Secretary may deny applications that otherwise meet the 
requirements of this part, and if an application is approved, may deny 
all or part of a sponsor's reimbursement request. Under that authority, 
in the April 5, 2011 Federal Register (76 FR 18766), the Secretary 
announced that CMS would stop accepting applications for ERRP as of May 
6, 2011.

II. Provisions of This Notice

    CMS is exercising our authority under 45 CFR 149.45(a) to deny 
certain reimbursement requests based on the available amount remaining 
of the $5 billion in appropriated program funding, and the rate at 
which it is being disbursed. We are now announcing that any Claim List 
submitted to ERRP in support of a reimbursement request, that includes 
one or more claims with an incurred date identified as January 1, 2012 
or after, will be rejected in its entirety. Therefore, to avoid such a 
consequence, a plan sponsor must not submit any Claim List or Summary 
Cost Data that includes any claim with an incurred date identified as 
January 1, 2012 or later.
    As specified in 45 CFR 149.325, a claim may be submitted to ERRP 
only after it has been incurred, and paid. Therefore, under this 
notice, and consistent with current policy, if a claim is incurred on 
or before December 31, 2011, but paid after December 31, 2011, the 
sponsor may submit the claim, but not until it has been paid. Existing 
guidance defining the date upon which various types of claims are 
considered

[[Page 77538]]

to have been incurred, and paid, for purposes of ERRP, are detailed at 
http://www.errp.gov, by clicking on Common Questions, and then clicking 
on Costs and Reimbursement.
    We note that our decision to deny reimbursement requests that 
include claims with incurred dates of January 1, 2012, or after, is 
based on the actual availability of remaining appropriated ERRP funds 
and the rate at which reimbursements have been disbursed, as opposed to 
the projected amounts of ERRP reimbursements that applicants listed in 
their ERRP applications. Should circumstances related to the 
availability of ERRP funding change, we may decide it is appropriate to 
approve reimbursement requests that include claims incurred after 
December 31, 2011. If this occurs, we will provide such notice in the 
Federal Register.

III. Collection of Information Requirements

    This document does not impose any new information collection and 
recordkeeping requirements. Consequently, it need not be reviewed by 
the Office of Management and Budget under the authority of the 
Paperwork Reduction Act of 1995. However, the information collection 
requirements associated with the ERRP are currently approved under OMB 
control number 0938-1087, with an expiration date of September 30, 
2014.

    Authority:  45 CFR 149.45(a).

    Dated: December 6, 2011.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2011-31920 Filed 12-9-11; 11:15 am]
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