[Federal Register Volume 77, Number 2 (Wednesday, January 4, 2012)]
[Notices]
[Pages 292-293]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-33750]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS-10142 and CMS-R-262]


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: 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 the Centers for 
Medicare & Medicaid Services (CMS).

[[Page 293]]

    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. CMS 
is requesting to continue its use of the BPT for the collection of 
information for CY2013 through CY2015. Form Number: CMS-10142 (OCN: 
0938-0944); Frequency: Yearly; Affected Public: Private Sector--
Business or other for-profits and not-for-profit institutions; Number 
of Respondents: 530; Total Annual Responses: 4,770; Total Annual Hours: 
143,100. (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: 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 Plan Benefit Package (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.
    CMS is requesting to continue its use of the PBP software and 
formulary submission for the collection of benefits and related 
information for CY 2013 through CY 2015. CMS estimates that 571 MA 
organizations and 64 PDP organizations will be required to submit the 
plan benefit package information in CY 2013. 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 (OCN: 
0938-0763); Frequency: Yearly; Affected Public: Private Sector--
Business or other for-profits and not-for-profit institutions; Number 
of Respondents: 635; Total Annual Responses: 6,015; Total Annual Hours: 
53,291. (For policy questions regarding this collection contact Kristy 
Holtje at (410) 786-2209. 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 
Email 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 3, 2012.

OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-6974, Email: [email protected].

    Dated: December 23, 2011.
Martique Jones,
Director, Regulations Development Group, Division-B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2011-33750 Filed 1-3-12; 8:45 am]
BILLING CODE 4120-01-P