[Federal Register Volume 77, Number 233 (Tuesday, December 4, 2012)]
[Notices]
[Pages 71801-71802]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-29243]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10418]


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: Revision of a currently approved 
collection; Title of Information Collection: Annual MLR and Rebate 
Calculation Report and MLR Rebate Notices; Use: Under Section 2718 of 
the Affordable Care Act and implementing regulation at 45 CFR part 158, 
a health insurance issuer (issuer) offering group or individual health 
insurance coverage must submit a report to the Secretary concerning the 
amount the issuer spends each year on claims, quality improvement 
expenses, non-claims costs, federal and state taxes and licensing and 
regulatory fees, and the amount of earned premium. An issuer must 
provide an annual rebate if the amount it spends on certain costs 
compared to its premium revenue (excluding federal and states taxes and 
licensing and regulatory fees) does not meet a certain ratio, referred 
to as the medical loss ratio (MLR). An interim final rule (IFR) 
implementing the MLR was published on December 1, 2010 (75 FR 74865) 
and modified by technical corrections on December 30, 2010 (75 FR 
82277), which added part 158 to Title 45 of the Code of Federal 
Regulations. The IFR was effective January 1, 2011. A final rule 
regarding selected provisions of the IFR was published on December 7, 
2011 (76 FR 76574, CMS-9998-FC) and an interim final rule regarding an 
issue not included in issuers' reporting obligations (disbursement of 
rebates by non-federal governmental plans) was also published December 
7, 2011 (76 FR 76596, CMS-9998-IFC2) Both rules published on December 
7, 2011 and

[[Page 71802]]

were effective January 1, 2012. Each issuer is required to submit 
annually MLR data, including information about any rebates it must 
provide, on a form prescribed by CMS, for each state in which the 
issuer conducts business. Each issuer is also required to provide a 
rebate notice to each policyholder that is owed a rebate and each 
subscriber of policyholders that are owed a rebate for any given MLR 
reporting year. Additionally, each issuer is required to maintain for a 
period of seven years all documents, records and other evidence that 
support the data included in each issuer's annual report to the 
Secretary.
    Based upon HHS' experience in the MLR data collection and 
evaluation process, HHS is updating its annual burden hour estimates to 
reflect the actual numbers of submissions, rebates and rebate notices. 
In addition, the notice requirement for issuers that do not owe rebates 
applied only to the 2011 reporting year, and does not apply to 2012 and 
subsequent MLR reporting years.
    We have simplified the format of the reporting form and the method 
by which issuers submit their data. For the 2012 MLR reporting year, 
when submitting data to CMS, issuers will have the option to use either 
a Microsoft Excel (.xls) or a Comma Separated Value (.csv) file format. 
This will allow issuers flexibility and reduce the burden in submitting 
the MLR report. The new method will no longer include pre-calculated 
fields which will reduce the burden as well as the possibility of 
error.
    The 2012 MLR Reporting Form and instructions also reflect changes 
for the 2012 reporting year and beyond that are set forth in the 
December 2011 Final Rule as to whether certain already reported 
expenditures such as ICD-10 conversion costs are taken into account in 
calculating an issuer's MLR.
    HHS has created and published a host of electronic training tools 
to assist issuers with the preparation and submission of MLR data forms 
and Rebate calculations. Consequently the agency is reducing its 
current burden hours from 354,570 to 311,302. Form Number: CMS-10418 
(OCN: 0938-1164); Frequency: Annual submission for each respondent; 
Affected Public: Private Sector, Business or other for-profits and not-
for-profit institutions; Number of Respondents: 502; Number of 
Responses: 3,085; Total Annual Hours: 311,302. (For policy questions 
regarding this collection, contact Carol Jimenez at (301) 492-4457. 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.
    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 February 4, 2013:
    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: November 29, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-29243 Filed 12-3-12; 8:45 am]
BILLING CODE 4120-01-P