[Federal Register Volume 81, Number 58 (Friday, March 25, 2016)]
[Notices]
[Pages 16184-16186]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-06830]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-855O, CMS-10438, CMS-10439 and CMS-10440]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is 
announcing an opportunity for the public to comment on CMS' intention 
to collect information from the public. Under the Paperwork Reduction 
Act of 1995 (PRA), federal agencies are required to publish notice in 
the Federal Register concerning each proposed collection of 
information, including each proposed extension or reinstatement of an 
existing collection of information, and to allow a second opportunity 
for public comment on the notice. Interested persons are invited to 
send comments regarding the 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

[[Page 16185]]

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.

DATES: Comments on the collection(s) of information must be received by 
the OMB desk officer by April 25, 2016.

ADDRESSES: When commenting on the proposed information collections, 
please reference the document identifier or OMB control number. To be 
assured consideration, comments and recommendations must be received by 
the OMB desk officer via one of the following transmissions: OMB, 
Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-5806, or Email: 
OIRA_[email protected].
    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, you may make 
your request using one of following:
    1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to [email protected].
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. The term ``collection of 
information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and 
includes agency requests or requirements that members of the public 
submit reports, keep records, or provide information to a third party. 
Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires 
federal agencies to publish a 30-day notice in the Federal Register 
concerning each proposed collection of information, including each 
proposed extension or reinstatement of an existing collection of 
information, before submitting the collection to OMB for approval. To 
comply with this requirement, CMS is publishing this notice that 
summarizes the following proposed collection(s) of information for 
public comment:
    1. Type of Information Collection Request: Revision of a currently 
approved information collection; Title of Information Collection: 
Medicare Registration Application; Use: The primary function of the 
CMS-855O is to gather information from a physician or other eligible 
professional to help CMS determine whether he or she meets certain 
qualifications to be enrolled in the Medicare program for the sole 
purpose of ordering or certifying certain Medicare items or services 
and/or prescribing Medicare Part D drugs for Medicare beneficiaries. 
The application allows a physician or other eligible professional to 
enroll in Medicare without being approved for billing privileges. The 
required information is submitted when the applicant requests 
enrollment in Medicare for the sole purpose of ordering and certifying 
certain Medicare items and services or for prescribing Medicare Part D 
drugs. The application is used by Medicare contractors to collect data 
to help ensure that the applicant has the necessary credentials to 
order and certify certain Medicare items and services or to prescribe 
Medicare Part D drugs. This includes ensuring that the physician is not 
excluded debarred from the Medicare program. Form Number: CMS-855O (OMB 
control number: 0938-1135); Frequency: Occasionally; Affected Public: 
Private Sector (Business or other for-profits), State, Local, or Tribal 
Governments; Number of Respondents: 448,000; Number of Responses: 
24,000; Total Annual Hours: 243,600. (For questions regarding this 
collection contact Kimberly McPhillips (410) 786-8438.)
    2. Type of Information Collection Request: Revision of a currently 
approved information collection; Title of Information Collection: Data 
Collection to Support Eligibility Determinations and Enrollment for 
Employers in the Small Business Health Options Program; Use: Section 
1311(b)(1)(B) of the Affordable Care Act directs that the SHOP assist 
qualified small employers in facilitating the enrollment of their 
employees in QHPs offered in the small group market. Section 
1311(c)(1)(F) of the Affordable Care Act directs HHS to establish 
criteria for certification of health plans as QHPs and plans to utilize 
a uniform enrollment form for qualified employers. Further, section 
1311(c)(5)(B) directs HHS to develop a Web site that assists employers 
in determining if they are eligible to participate in SHOP.
    This proposed information collection was previously published in 
the Federal Register on December 11, 2015 (80 FR 76994) and allowed 60 
days for public comment. No comments were received. Form Number: CMS-
10439 (OMB control number 0938-1194); Frequency: Annually; Affected 
Public: Private Sector; Number of Respondents: 6,000; Number of 
Responses: 6,000; Total Annual Hours: 12,000. (For questions regarding 
this collection contact Christelle Jang at (410) 786-8438.)
    3. Type of Information Collection Request: Revision of a currently 
approved information collection; Title of Information Collection: Data 
Collection to Support Eligibility Determinations and Enrollment for 
Employers in the Small Business Health Options Program; Use: Section 
1311(b)(1)(B) of the Affordable Care Act directs that the SHOP assist 
qualified small employers in facilitating the enrollment of their 
employees in QHPs offered in the small group market. Section 
1311(c)(1)(F) of the Affordable Care Act directs HHS to establish 
criteria for certification of health plans as QHPs and plans to utilize 
a uniform enrollment form for qualified employers. Further, section 
1311(c)(5)(B) directs HHS to develop a Web site that assists employers 
in determining if they are eligible to participate in SHOP.
    This proposed information collection was previously published in 
the Federal Register on December 11, 2015 (80 FR 76994) and allowed 60 
days for public comment. No comments were received. Form Number: CMS-
10439 (OMB Control Number 0938-1194); Frequency: Annually; Affected 
Public: Private Sector; Number of Respondents: 6,000; Number of 
Responses: 6,000; Total Annual Hours: 12,000. (For questions regarding 
this collection contact Christelle Jang at (410) 786-8438.)
    4. Type of Information Collection Request: Revision of a currently 
approved information collection; Title of Information Collection: Data 
Collection to Support Eligibility Determinations for Insurance 
Affordability Programs and Enrollment through Health Benefits 
Exchanges, Medicaid and Children's Health Insurance Program Agencies; 
Use: Section 1413 of the Affordable Care Act directs the Secretary of 
Health and Human Services to develop and provide to each State a 
single, streamlined form that may be used to apply for coverage through 
the Exchange and Insurance Affordability Programs, including Medicaid, 
the Children's Health Insurance Program (CHIP), and the Basic Health 
Program, as applicable. The application must be structured to maximize 
an applicant's ability to complete the form satisfactorily, taking into 
account the characteristics of individuals who qualify for the 
programs. A State may develop and use its own single streamlined 
application if

[[Page 16186]]

approved by the Secretary in accordance with section 1413 and if it 
meets the standards established by the Secretary.
    Section 155.405(a) of the Exchange Final Rule (77 FR 18310) 
provides more detail about the application that must be used by the 
Exchange to determine eligibility and to collect information necessary 
for enrollment. The regulations in Sec.  435.907 and Sec.  457.330 
establish the requirements for State Medicaid and CHIP agencies related 
to the use of the single streamlined application. CMS is designing the 
single streamlined application to be a dynamic electronic application 
that will tailor the amount of data required from an applicant based on 
the applicant's circumstances and responses to particular questions. 
The paper version of the application will not be able to be tailored in 
the same way but is being designed to collect only the data required to 
determine eligibility. Individuals will be able to submit an 
application electronically, through the mail, over the phone through a 
call center, or in person, per Sec.  155.405(c)(2) of the Exchange 
Final Rule, as well as through other commonly available electronic 
means as noted in Sec.  435.907(a) and Sec.  457.330 of the Medicaid 
Final Rule. The application may be submitted to an Exchange, Medicaid 
or CHIP agency. The electronic application process will vary depending 
on each applicant's circumstances, their experience with health 
insurance applications and online capabilities. The goal is to solicit 
sufficient information so that in most cases no further inquiry will be 
needed. Form Number: CMS-10440 (OMB control number: 0938-1191); 
Frequency: Annually; Affected Public: Individuals and Households; 
Number of Respondents: 7,200,000; Total Annual Responses: 7,200,000; 
Total Annual Hours: 2,410,767. (For policy questions regarding this 
collection contact Beth Liu at 301-492-4135.)

    Dated: March 22, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2016-06830 Filed 3-24-16; 8:45 am]
 BILLING CODE 4120-01-P