[Federal Register Volume 81, Number 94 (Monday, May 16, 2016)]
[Notices]
[Pages 30308-30309]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-11499]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-838, CMS-10157 and 10469]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, Department of Health 
and Human Services.

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 (the PRA), federal agencies are require; 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 60 days for public 
comment on the proposed action. Interested persons are invited to send 
comments regarding our burden estimates 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.

DATES: Comments must be received by July 15, 2016.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number. To be assured consideration, comments and 
recommendations must be submitted in any one of the following ways:
    1. Electronically. You may send 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) that are 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.
    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:

Contents

    This notice sets out a summary of the use and burden associated 
with the following information collections. More detailed information 
can be found in each collection's supporting statement and associated 
materials (see ADDRESSES).

CMS-838 Medicare Credit Balance Reporting Requirements
CMS-10157 HIPPA Eligibility Tracking System
CMS-10469 Issuer Reporting Requirements for Selecting a Cost-Sharing 
Reductions Reconciliation Methodology

    Under the 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 requires federal agencies 
to publish a 60-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.
    1. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Medicare Credit 
Balance Reporting Requirements; Use: Quarterly credit balance reporting 
is needed to monitor and control the identification and timely 
collection of improper payments. Credit balances are mainly 
attributable to provider billing practices and cannot be eliminated by 
program functions; they will continue to occur. The OIG issued a 
Management Advisory Report (MAR) on their extended review of credit 
balances (See Attachment). They state that approximately 90 percent of 
credit balances result from providers: (1) Billing Medicare and a 
private insurer for the same service, (2) submitting duplicate billings 
for services in a manner which cannot be detected by system edits, and 
(3) billing for services not performed. The MAR recommends that CMS 
continue its plan of recovery by requiring hospitals to report Medicare 
credit balances to contractors on a quarterly basis. Form Number: CMS-
838 (OMB control number: 0938-0600); Frequency: Quarterly; Affected 
Public: Private sector (Business or other For-profits); Number of 
Respondents: 52,582; Total Annual Responses: 210,328; Total Annual 
Hours: 630,984. (For policy questions regarding this collection contact 
Anita Crosier at 410-786-0217).
    2. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: HIPPA Eligibility 
Tracking System; Use: Federal law requires that CMS take precautions to 
minimize the security risk to the federal information system. Federal 
Information Processing Standards Publication (FIPS PUB) 1( ) 1-2 
Paragraph 11.7--Security and Authentication states that: ``Agencies 
shall employ risk management techniques to determine the appropriate 
mix of security controls needed to protect specific data and systems. 
The selection of controls shall take into account procedures required 
under applicable laws and regulations.'' Accordingly, CMS requires that 
entities who wish to connect to the HETS application via the CMS 
Extranet and/or Internet are uniquely identified. CMS is required to 
verify the identity of the

[[Page 30309]]

person requesting the Protected Health Information (PHI) and the 
person's authority to have access to Medicare eligibility information. 
Furthermore, CMS requires that trading partners who wish to conduct 
eligibility transactions on a real-time basis with CMS provide certain 
assurances as a condition of receiving access to the Medicare 
eligibility information for the purpose of conducting real-time 270/271 
inquiry/response transactions. Form Number: CMS-10157 (OMB control 
number: 0938-0960); Frequency: Quarterly; Affected Public: Private 
sector (Business or other For-profits and Not-For-Profits); Number of 
Respondents: 2,000; Total Annual Responses: 2,000; Total Annual Hours: 
250. (For policy questions regarding this collection contact Rupinder 
Singh at 410-786-7484).
    3. Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Issuer Reporting 
Requirements for Selecting a Cost-Sharing Reductions Reconciliation 
Methodology; Use: Sections 1402 and 1412 of the Affordable Care Act 
provide for reductions in cost sharing on essential health benefits for 
low- and moderate-income enrollees in silver level qualified health 
plans (QHP) on individual market Exchanges. It also provides for 
reductions in cost sharing for Indians enrolled in QHPs at any metal 
level. These cost-sharing reductions will help eligible individuals and 
families afford the out-of-pocket spending associated with health care 
services provided through Exchange-based QHP coverage.
    The law directs QHP issuers to notify the Secretary of the 
Department of Health and Human Services (HHS) of cost-sharing 
reductions made under the statute for qualified individuals, and 
directs the Secretary to make periodic and timely payments to the QHP 
issuer equal to the value of those reductions. Further, the law permits 
advance payment of the cost-sharing reduction amounts to QHP issuers 
based upon amounts specified by the Secretary.
    Under established HHS regulations, QHP issuers will receive advance 
payments of the cost-sharing reductions throughout the year. Each 
issuer will then be subject to one of two reconciliation processes 
after the year to ensure that HHS reimbursed each issuer the correct 
advance cost-sharing amount. This information collection request 
establishes the data collection requirements for a QHP issuer to report 
to HHS which reconciliation reporting option the issuer will be subject 
to for a given benefit year. Form Number: CMS-10469 (OMB control 
number: 0938-1214); Frequency: Annually; Affected Public: Private 
sector (Businesses or other for-profits); Number of Respondents: 575; 
Total Annual Responses: 575; Total Annual Hours: 13,200. (For policy 
questions regarding this collection contact Pat Meisol at 410-786-
1917.)

    Dated: May 11, 2016.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2016-11499 Filed 5-13-16; 8:45 am]
 BILLING CODE 4120-01-P