[Federal Register Volume 81, Number 90 (Tuesday, May 10, 2016)]
[Notices]
[Pages 28873-28875]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-10980]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-5520-N]


Announcement of Requirements and Registration for ``A Bill You 
Can Understand'' Design and Innovation Challenge: Help Patients 
Understand Their Medical Bills and the Financial Aspect of Health

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice.

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SUMMARY: This notice announces a Challenge to engage those in the 
health care community working on these issues, as well as new players 
from other industries, such as human-centered design and digital 
technology, to help in redesigning the ``Medical Bill'' or the 
``Medical Billing Process.''

DATES: Submission Dates: May 9, 2016, 12:01 a.m., Eastern daylight time 
(e.d.t.) through August 10, 2016, 11:59 p.m., e.d.t.
    Judging Dates: August 20 through September 10, 2016.
    Winners Announced: September 25 through 28, 2016.

FOR FURTHER INFORMATION CONTACT: Ben Shannon, Communications Advisor, 
Office of the Assistant Secretary for Public Affairs, Department of 
Health and Human Services, 200 Independence Avenue SW., Washington, DC 
20201, phone (202) 205-2819, email [email protected].

SUPPLEMENTARY INFORMATION:

I. Background

    Patients in the United States often have difficulty understanding 
the medical billing process. Currently, there is no standard for 
consumer medical billing documents, and bills vary in content, 
presentation, and use of jargon. Consumers also receive bills from 
multiple sources and may not understand the rationale for each bill, or 
know that they will be receiving multiple bills for one episode of 
care.
    HHS recognizes that many health care organizations have been doing 
important work to address the complex problems that individuals face as 
they navigate the medical billing process. A national design and 
innovation challenge is a unique way to both support these ongoing 
efforts and catalyze innovation.

II. Provisions of the Notice

    The Challenge has two objectives:

[[Page 28874]]

     Objective 1: ``Redesigning the Medical Bill'': Improving 
the medical bill itself. That is, making it more readable and easier 
for the consumer to understand.
     Objective 2: ``Redesigning the Medical Billing Process'': 
Improving the overall medical billing process. Submissions could 
address any step in the consumer journey from the medical encounter to 
afterward (for example, providing information at discharge on the 
medical billing process, developing a consolidated bill, creating a 
unified billing portal, etc.).
    HHS intends for the challenge to produce conceptual solutions and 
frames that will help health systems and payers continue to make 
improvements in reducing the complexity of medical bills and improving 
the financial aspect of health from the patient's perspective. HHS 
anticipates health systems and payers will find ways to work with 
Challenge winners to evaluate their solutions for implementation and 
testing in the real world after the Challenge concludes.

A. Subject of the Challenge Competition

    ``A Bill You Can Understand'' design and innovation challenge will 
invite participants to design a medical bill that is easier to 
understand, as well as reinvent cost of care estimation and the medical 
billing journey with the goal of improving the patient financial 
experience. Participants will be asked to submit entries that improve 
both the design of the medical bill and patient experience of the 
medical billing process. Submissions will include the (1) design 
concept for the redesigned medical bill, (2) journey map or wireframe 
for the redesigned patient experience, (3) written explanation of 
submission, and (3) video explanation of submission. Specific criteria 
for the written and video explanations will be provided on the 
Challenge Web site. These may include but are not limited to explaining 
how the redesign will better empower patients to understand the 
financial information provided on their medical bill and take 
appropriate action and vision for an improved patient financial 
experience. The challenge is sponsored by AARP, administrated by 
Mad*Pow, an experience design agency, and organized in collaboration 
with HHS.

B. Eligibility Rules for Participating in the Competition

    The Challenge is open to any contestant, defined as (1) a business 
or non-profit entity or (2) an individual or team of no more than 5 
U.S. citizens or permanent residents of the United States who are 18 
years of age or older at the time of entry. All individual members of a 
team must meet the eligibility requirements.
    To be eligible to win a prize under this challenge, an individual 
or entity--
    (1) Shall have registered to participate in the competition under 
the rules issued by CMS;
    (2) Shall have complied with all the requirements under this 
Notice, the rules for participants referenced herein below, and the 
requirements set forth in 15 U.S.C. 3719;
    (3) In the case of a private entity, shall be incorporated in and 
maintain a primary place of business in the United States, and in the 
case of an individual, whether participating singly or in a group, 
shall be a citizen or permanent resident of the United States; and
    (4) May not be a Federal entity or Federal employee acting within 
the scope of their employment. Federal employees seeking to participate 
in this contest outside the scope of their employment should consult 
their ethics official prior to developing their submission.
    (5) May not be employees of CMS, judges of the Challenge, or any 
other party involved with the design, production, execution, or 
distribution of the Challenge or their immediate family (spouse, 
parents or step-parents, siblings and step-siblings, and children and 
step-children).
    (6) May not be the trustees, directors, shareholders, employees, 
clients (with respect to Mad*Pow only), contractors, agents, 
representatives and affiliates of AARP, Mad*Pow and any entity 
associated with the funding, administration, judging, or processing of 
the Challenge and the members of the immediate family which includes a 
person's spouse/domestic partner and the parents, siblings, children 
and grandchildren of the person and his or her spouse/domestic partner.
    (7) Federal grantees may not use Federal funds to develop COMPETES 
Act challenge applications unless consistent with the purpose of their 
grant award.
    (8) Federal contractors may not use Federal funds from a contract 
to develop COMPETES Act challenge applications or to fund efforts in 
support of a COMPETES Act challenge submission.
    An individual or entity shall not be deemed ineligible because the 
individual or entity used Federal facilities or consulted with Federal 
employees during a competition if the facilities and employees are made 
available to all individuals and entities participating in the 
competition on an equitable basis.
    By entering, each contestant agrees to:
    (a) Comply with, and be bound by, these official rules and the 
decisions of the Challenge and judges which are binding and final in 
all matters relating to this Challenge;
    (b) assume any and all risks and waive claims against the federal 
government and its related entities, except in the case of willful 
misconduct, for any injury, death, damage, or loss of property, 
revenue, or profits, whether direct, indirect, or consequential, 
arising from the contestant's participation in the Challenge, whether 
the injury, death, damage, or loss arises through negligence or 
otherwise. The contestant/submitter shall be liable for, and shall 
indemnify and hold harmless the government against, all actions or 
claims for any claim, demand, judgment, or other allegation arising 
from alleged violation of an individual's trademark, copyright, or 
other legally protected interest in challenge entries submitted to 
Mad*Pow. Provided, however, that contestants are not required to waive 
claims arising out of the unauthorized use or disclosure by AARP and/or 
Mad*Pow of the intellectual property, trade secrets, or confidential 
business information of the contestant.
    (c) Be responsible for obtaining their own liability insurance to 
cover claims by any third party for death, bodily injury, or property 
damage, or loss resulting from an activity carried out in connection 
with participation in the Challenge, and claims by the federal 
government for damage or loss to government property resulting from 
such an activity; and
    (d) Indemnify the federal government against third party claims for 
damages arising from or related to Challenge activities.
    Based on the subject matter of the Challenge, the type of work that 
it will possibly require, as well as an analysis of the likelihood of 
any claims for death, bodily injury, property damage, or loss 
potentially resulting from Challenge participation, no individual 
(whether competing singly or in a group) or entity participating in the 
Challenge is required to obtain liability insurance or demonstrate 
financial responsibility in order to participate in this Challenge.
    Contestants who are determined at any time to have violated the 
eligibility criteria will be disqualified from the Challenge.

C. Registration Process for Participants

    The entry period for the Challenge will begin as stated in the 
DATES section of this notice. Contestants can enter the Challenge by 
visiting the Challenge Web

[[Page 28875]]

site at http://www.abillyoucanunderstand.com, reviewing official 
challenge rules and guidelines, and registering a submission by 
submitting the Official Entry Form according to the instructions posted 
on the Challenge Web site. Each Submission entered into the Challenge 
must meet the ``Submission Requirements'' (any submission that, in the 
Challenge Judges' sole discretion, violates submission criteria will be 
disqualified). Once a submission is made, a team is prohibited from 
making any changes or alterations to the product described in its 
submission until the evaluation of the entries is completed.

D. Amount of the Prize

    Two winning contestants will be selected for the following prizes:
     Prize 1--$5000: Most Improved Medical Bill Design 
(Focusing on the design of the bill itself).
     Prize 2--$5000: Transformational Approach to Medical Cost 
Estimation and Billing Process (Focusing on what the patient sees and 
does throughout the process).

E. Payment of the Prize

    Prizes awarded under this competition will be paid by check and may 
be subject to federal income taxes. The prizes are donated by a private 
donor, AARP, Inc.

F. Basis Upon Which the Winners Will Be Selected

    The entries will be judged by HHS leadership with consideration of 
input from an advisory panel of individuals in compliance with the 
requirements of the COMPETES Act. Judges will be fair and impartial, 
may not have a personal or financial interest in, or be an employee, 
officer, director, or agent of, any entity that is a registered 
participant in the competition, and may not have a familial or 
financial relationship with an individual who is a registered 
contestant. Judges will be named after the Challenge begins. The 
judging panel will make decisions based on the following criteria:
    Criteria for Both Prizes 1 and 2:
     Contains all Necessary Data and Information.
     Usefulness and Understandability of Patient Facing 
Materials (Bill or Otherwise).
     Adherence to Plain Language Guidelines.
     Transparency of Data (Including How the Data is Translated 
and Explained).
     Uniqueness and Creativity of Solution.
    Additional Specific Criteria for Prize 1: Most Improved Medical 
Bill Design (Focusing on the design of the bill itself):
     Addresses Issues and Opportunities Associated with Bill 
Design.
     Incremental Innovation--Works with Existing Models 
(Workflow, Data, Technology, Patient Facing Materials).
    Additional Specific Criteria for Prize 2: Transformational Approach 
to Medical Cost Estimation and Billing Process (Focusing on what the 
patient sees and does throughout the process):
     Addresses Issues and Opportunities associated with Medical 
Cost Estimation and Billing Process.
     Alignment with Modern Consumer Expectations.
     Future Forward Innovation--Evolves Existing Models 
(Workflow, Data, Technology, Patient Facing Materials).
    The details of these criteria are provided on the Challenge Web 
site at http://www.abillyoucanunderstand.com.

G. Additional Information

    More information on the topic area can be found in the participant 
resource packet on the Challenge Web site at http://www.abillyoucanunderstand.com.

H. Regarding Copyright/Intellectual Property

    Each contestant, by submitting any design, irrevocably grants to 
HHS a royalty-free, irrevocable, perpetual, non-exclusive, transferable 
license to use, reproduce, modify, edit, adapt, publish, and display 
such design in whole or in part, on a worldwide basis, and to 
incorporate it into other works, in any form, media or technology now 
known or later developed, including for promotional, marketing, 
educational, training and other public health purposes consistent with 
HHS and/or CMS' mission and without further compensation to the 
contestant or any other person or entity. For clarity, each 
contestant's design and all rights, including intellectual property 
rights, title, and interest therein and thereto lie exclusively with 
each contestant. There is no agreement of sale, and no title, interest, 
or intellectual property rights or other ownership of the design are 
transferred per the official rules of the Challenge, except as 
explicitly stated here. HHS shall not be responsible for mediating 
disputes that arise relating to intellectual property ownership.
    Upon submission, contestants warrant that they are the sole author 
and owner of the Challenge Submission, and that the submission 
completely originates with the contestant, that it does not infringe 
upon any copyright or any other rights of any third party of which 
contestant(s) is aware, and is free of malware.
    The official rules of the Challenge are provided on the Challenge 
Web site at http://www.abillyoucanunderstand.com.

I. Compliance With Rules and Contacting Contest Winners

    Contest winners must comply with all terms and conditions of the 
official rules; winning is contingent upon fulfilling all requirements 
herein. The initial finalists will be notified by email, telephone, or 
mail after the date of the judging. Awards may be subject to federal 
income taxes, and HHS will comply with the Internal Revenue Service 
withholding and reporting requirements, where applicable.

J. Privacy

    If contestants choose to provide Mad*Pow or HHS with personal 
information by registering or filling out the submission form through 
the Challenge Web site, that information is used to respond to 
contestants in matters regarding their submission, announcements of 
entrants, finalists, and winners of the contest. Information is not 
collected for commercial marketing. Winners are permitted to cite that 
they won this Challenge.

K. General Conditions

    HHS reserves the right to cancel, suspend, and/or modify the 
Challenge, or any part of it, for any reason, at HHS' sole discretion.
    Participation in this contest constitutes contestants' full and 
unconditional agreement to abide by the official rules found at http://www.abillyoucanunderstand.com and www.Challenge.gov.

III. Collection of Information Requirements

    This document does not impose information collection requirements, 
that is, reporting, recordkeeping or third-party disclosure 
requirements. Consequently, there is no need for review by the Office 
of Management and Budget under the authority of the Paperwork Reduction 
Act of 1995 (44 U.S.C. 3501 et seq.).

    Dated: May 2, 2016.
Andrew M. Slavitt,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2016-10980 Filed 5-9-16; 8:45 am]
 BILLING CODE 4120-01-P