[Federal Register Volume 78, Number 228 (Tuesday, November 26, 2013)]
[Notices]
[Pages 70598-70599]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-28383]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for Review: Request for External Review (3206-NEW); 
Model Notice of Final Internal Adverse Benefit Determination and Case 
Intake Form

AGENCY: U.S. Office of Personnel Management.

ACTION: 30-Day Notice and request for comments.

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SUMMARY: National Healthcare Operations, U.S. Office of Personnel 
Management (OPM) offers the general public and other Federal agencies 
the opportunity to comment on a new information collection request 
(ICR), Office of Management and Budget (OMB) Control No. 3206-NEW, 
Request for External Review. The information collection comprises two 
forms: (1) Model Notice of Final Internal Adverse Benefit 
Determination, and (2) Case Intake Form. As required by the Paperwork 
Reduction Act of 1995, (Pub. L. 104-13, 44 U.S.C. chapter 35) as 
amended by the Clinger-Cohen Act (Pub. L. 104-106), OPM is soliciting

[[Page 70599]]

comments for this collection. The information collection was previously 
published in the Federal Register on August 2, 2013 at Volume 78 FR 
47016 allowing for a 60-day public comment period. Two comments were 
received for the information collection. The purpose of this notice is 
to allow an additional 30 days for public comments. The Office of 
Management and Budget is particularly interested in comments that:
    1. Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of OPM, including 
whether the information will have practical utility;
    2. Evaluate the accuracy of OPM's estimate of the burden of the 
proposed collection of information, including the validity of the 
methodology and assumptions used;
    3. Enhance the quality, utility, and clarity of the information to 
be collected; and
    4. Minimize the burden of the collection of information on those 
who are to respond, including through the use of appropriate automated, 
electronic, mechanical, or other technological collection techniques or 
other forms of information technology, e.g., permitting electronic 
submissions of responses.

DATES: Comments are encouraged and will be accepted until December 26, 
2013. This process is conducted in accordance with 5 CFR 1320.1.

ADDRESSES: Interested persons are invited to submit written comments on 
the proposed information collection to the Office of Information and 
Regulatory Affairs, Office of Management Budget, 725 17th Street NW., 
Washington, DC 20503, Attention: Desk Officer for the Office of 
Personnel Management or sent by email to [email protected] 
or faxed to (202) 395-6974.

FOR FURTHER INFORMATION CONTACT: A copy of this ICR, with applicable 
supporting documentation, may be obtained by contacting the Office of 
Information and Regulatory Affairs, Office of Management Budget, 725 
17th Street NW., Washington, DC 20503, Attention: Desk Officer for the 
Office of Personnel Management or sent via electronic mail to [email protected] or faxed to (202) 395-6974.

SUPPLEMENTARY INFORMATION: Section 1334 of the Patient Protection and 
Affordable Care Act, Public Law 111-148, as amended by the Health Care 
Education Reconciliation Act, Public Law 111-152 (together, 
``Affordable Care Act''), directed OPM to enter into contracts with 
health insurance issuers to offer coverage on Exchanges (also called 
``Health Insurance Marketplaces'') throughout the 50 States and the 
District of Columbia. OPM issued final regulations for the 
establishment of the Multi-State Plan (MSP) Program on March 11, 2013, 
78 FR 15560, which outlined an external review process that would be 
available to MSP enrollees.
    The regulations state that ``OPM will conduct external review of 
adverse benefit determinations using a process similar to OPM review of 
disputed claims under [the Federal Employees Health Benefits Program] . 
. . .'' 45 CFR 800.503(a). A necessary part of conducting external 
review of adverse benefit determinations is accepting requests for 
external review from MSP enrollees.
    In addition to requests for external review, OPM anticipates that 
MSP enrollees may contact it about inquiries or complaints regarding 
MSP options, which may have to be referred to other appropriate 
entities such as State insurance departments, State consumer assistance 
programs, and the U.S. Department of Health and Human Services.
    This notice announces that OPM is submitting to OMB a request for 
review and clearance of a new information collection, Request for 
External Review, comprising two forms: (1) Model Notice of Final 
Internal Adverse Benefit Determination, and (2) Case Intake Form. MSP 
issuers would use the Model Notice Of Final Internal Adverse Benefit 
Determination to provide written notice to enrollees about the result 
of any final internal adverse benefit determination, their external 
review rights, and how they may file a request for external review 
using one portion of the form. MSP enrollees, and their authorized 
representatives, would use the Case Intake Form to start or review a 
case regarding a request for external review about a denied claim, a 
complaint about an MSP issuer, or an inquiry for OPM.

Analysis

    Agency: National Healthcare Operations, Office of Personnel 
Management.
    Title: Request for External Review.
    OMB Number: 3206-NEW.
    Affected Public: Individuals or households; business or other for-
profit; not-for-profit institutions.

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                                                                        Model notice of final
                                                                      internal adverse benefit      Case intake
                                                                            determination              form
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Number of Respondents.............................................                       448,000             800
Estimated Time (Hours) Per Respondent.............................                          0.08               1
                                                                   ---------------------------------------------
    Total Burden Hours............................................                        37,400             800
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    U.S. Office of Personnel Management.
Katherine Archuleta,
Director.
[FR Doc. 2013-28383 Filed 11-25-13; 8:45 am]
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