[Federal Register Volume 77, Number 194 (Friday, October 5, 2012)]
[Notices]
[Pages 61001-61002]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-24647]


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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: Proposed Collection; 
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) 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.
    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).
    Title I of the MMA established a program to offer prescription drug 
benefits to Medicare enrollees through Prescription Drug Plans. MMA 
Title II revised several aspects of the Medicare+Choice program 
(renamed Medicare Advantage), including the payment methodology and the 
introduction of ``Regional'' MA plans. CMS payments to PDPs and MA 
plans will be on a market-based competitive approach.
    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 CY2014 through CY2016. 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: 555; Total Annual Responses: 4,995; Total Annual Hours: 
149,850. (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.
    After receiving OMB clearance in spring 2000, CMS implemented the 
PBP as part of the Contract Year (CY) 2001 Adjusted Community Rate 
Proposal (ACRP) process. In addition, information collected via the PBP 
and formulary has been used to support the marketing material review 
process, the National Medicare Education Program, and other program 
oversight and development activities. For instance, the PBP software 
automatically generates the standardized sentences for the Summary of 
Benefits (SB) by using the plan benefit package data entered into the 
PBP software by the organization's user. These standardized sentences 
are used by the MA organizations in their SB marketing materials and by 
CMS to generate plan benefits data for display in the Medicare & You 
handbook and on the www.medicare.gov Web site.
    CMS is requesting to continue its use of the PBP software and 
formulary submission for the collection of benefits and related 
information for CY 2014 through CY 2016. CMS estimates that 578 MA 
organizations and 63 PDP organizations will be required to submit the 
plan benefit package information in CY 2014. 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: 641; Total Annual Responses: 6,169; Total Annual Hours: 
56,708. (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/

[[Page 61002]]

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.
    In commenting on the proposed information collections please 
reference the document identifier or OMB control number. To be assured 
consideration, comments and recommendations must be submitted in one of 
the following ways by December 4, 2012:
    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.

    Dated: October 2, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-24647 Filed 10-4-12; 8:45 am]
BILLING CODE 4120-01-P