[Federal Register Volume 78, Number 36 (Friday, February 22, 2013)]
[Notices]
[Pages 12320-12322]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-04015]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10418, CMS-10028]


Agency Information Collection Activities: 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

[[Page 12321]]

automated collection techniques or other forms of information 
technology to minimize the information collection burden.
    1. Type of Information Collection Request: Revision of 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 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.
    The 60-day Federal Register notice published on December 4, 2012, 
(77 FR 71801) pertained to the 2012 MLR Annual Reporting Form and 
Instructions, and the comment period closed on February 4, 2013. We 
received a total of 4 public comments on 25 specific issues regarding 
the notice of the revised Medical Loss Ratio (MLR) PRA package. Most of 
the comments addressed clarifying the instructions or correcting 
typographical errors, the removal of calculated cells and the issuer's 
ability to copy and paste data onto the form, and the inclusion of a 
credibility indicator for small issuers so that small issuers would not 
need to fill out the complete MLR reporting form. We have taken into 
consideration all of the proposed suggestions and have made changes to 
the 2012 MLR Annual Reporting Form and Instructions.
    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.)
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: State Health 
Insurance Assistance Program (SHIP) Client Contact Form, Public and 
Media Activity Report Form, and Resource Report Form. Use: Section 
4360(f) of the Omnibus Budget Reconciliation Act (OBRA) 1990 requires 
the Secretary to provide a series of reports to the U.S. Congress on 
the performance of the program and its impact on beneficiaries and to 
obtain important informational feedback from beneficiaries. Further, in 
response to requirements of the Balanced Budget Act of 1997, CMS 
launched a comprehensive five-year campaign, the National Medicare 
Education Program (NMEP), to raise awareness among beneficiaries about 
their Medicare health plan options and help them assess the advantages 
and disadvantages each choice holds for them. The Medicare 
Modernization Act (MMA) of 2003 required State Health Insurance 
Assistance Programs (SHIPs) to be actively engaged in the 
implementation of the Medicare Prescription Drug Program (Part D). 
MIPPA legislation and Affordable Care Act legislation required SHIPs to 
provide enrollment assistance for the Limited Income Subsidy (LIS) and 
Medicare Savings Program (MSP). The goal is to ensure that 
beneficiaries are making an informed choice, regardless of whether they 
stay in Original Medicare or choose new options. CMS is responsible to 
Congress for demonstrating improvement over time in the level of 
awareness and understanding beneficiaries have about health plan 
options. The SHIPs are an integral component of this initiative. The 
information collected is used to fulfill the reporting requirements 
described in Section 4360(f) of OBRA 1990. CMS will utilize this data. 
The data will be accumulated and analyzed to measure SHIP performance 
in order to determine whether and to what extent the SHIPs have met the 
goals of improved CMS customer service to beneficiaries and better 
understanding by beneficiaries of their health insurance options. 
Further, the information will be used in the administration of the 
grants, to measure performance and appropriate use of the funds by the 
state grantees, to identify gaps in services and technical support 
needed by SHIPs, and to identify and share best practices. The overall 
burden of hours and expected number of respondents increase is based on 
projected future service growth and projected future increases in 
staffing to accommodate the increased demand to utilize the SHIP 
network to raise awareness about new CMS policies, outreach 
initiatives, or both. However, the instruments themselves have not 
changed. Form Number: CMS-10028 (OCN: 0938-0850); Frequency: 
Occasionally; Affected Public: State, Local, or Tribal Governments; 
Number of Respondents: 17,838; Total Annual Responses: 2,346,465. Total 
Annual Hours: 195,642. (For policy questions regarding this collection 
contact Gregory Price at 410-786-4041. 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, and phone number as well 
the 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 March 25, 2013.

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


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    Dated: February 15, 2013.
Martique Jones,
Deputy Director, Regulations Development Group, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2013-04015 Filed 2-21-13; 8:45 am]
BILLING CODE 4120-01-P